Case series: clinical findings and oral rehabilitation of patients with amelogenesis imperfecta.
BACKGROUND
Children with amelogenesis imperfecta (AI) experience many oral difficulties including sensitivity and aesthetics. The methods of treating AI children are limited and therefore a program of care was evaluated in order to assess the clinical efficacy of providing preventive and restorative treatments.


METHODS
A non-randomised convenience sample of 12 patients with AI was evaluated. A comprehensive patient history was recorded, followed by a clinical and radiographic assessment of oral health. In 8/12 patients a hypoplastic form of AI was diagnosed, in 2/12 cases hypomaturation and in 2/12 cases hypocalcified form were noted. Chief complaints were mainly related to unsatisfactory aesthetics and dental sensitivity. In 8 patients there was active dental caries. Most of the patients had gingivitis and showed fair oral hygiene. The presence of non-enamel dental anomalies was recorded in 9 patients.


METHODS
All patients received meticulous preventive care. Initial treatment depended on AI type and oral health of the patient. During the transition period, both conventional and resin modified glassionomer cements, as well as composite resin materials, were used to restore posterior teeth. Direct composite resin restorations were used to improve the appearance of anterior teeth. In 4 patients a long-lasting interdisciplinary approach including orthodontics, metal-ceramic crowns and fixed partial dentures, and direct composite restorations was required.


RESULTS
Follow-up periods varied between 2-11 years. All children have been regularly recalled at 3 monthly intervals. Caries prevalence has remained low during the follow-up postoperative period and patients have reported satisfaction with the treatment they have received.


CONCLUSIONS
AI is associated with multiple non-enamel anomalies and requires a complex treatment. Treatment planning is related to the age of the patient, the type and severity of the disorder, and the oral health of the patient. Early diagnosis, preventive care and timely treatment are of foremost importance to improve oral health in children with AI.
Markovic
D
D
Dept. of Paediatric and Preventive Dentistry, Faculty of Dentistry, University of Belgrade, Dr Subotica 11, 1000 Belgrade, Serbia.
Petrovic
B
B
Peric
T
T
D000293:Adolescent; D000567:Amelogenesis Imperfecta / Q000145:classification / Q000175:diagnosis* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003188:Composite Resins / Q000737:chemistry; D003442:Crowns; D003731:Dental Caries / Q000628:therapy; D003743:Dental Enamel / Q000002:abnormalities; D003744:Dental Enamel Hypoplasia / Q000175:diagnosis / Q000534:rehabilitation; D003764:Dental Materials / Q000737:chemistry; D003793:Dental Restoration, Permanent / Q000379:methods; D003807:Dentin Sensitivity / Q000628:therapy; D003830:Denture, Partial, Fixed; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000628:therapy; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008297:Male; D016876:Metal Ceramic Alloys / Q000737:chemistry; D009911:Oral Hygiene Index; D009971:Orthodontics, Corrective; D010347:Patient Care Planning; D017060:Patient Satisfaction; D019279:Resin Cements / Q000737:chemistry; D016896:Treatment Outcome
D003188:Composite Resins; D003764:Dental Materials; D005899:Glass Ionomer Cements; D016876:Metal Ceramic Alloys; D019279:Resin Cements