Warfarin and dabigatran: Implications and dental management of anticoagulated patients Varfarina e dabigatrana: Implicações e conduta odontológica no Paciente anticoagulado

Abstract

Molar-incisor-hypomineralization is described as the presence of demarcated opacities varying in calor from creamy-whitish to yellow-brownish affecting first permanent molars often combined to permanent incisors also affected. When primary molars are affected, it is called Deciduous Molar hypomineralization. The hypomineralized enamel is fragile and might break predisposing to caries. The aim of the present paper was to review the literature about Molar-incisor-hypomineralization regarding its clinicai and microstructure features, prevalence, etiological factors and clinicai implications. A search on PubMed database was done focused in publications from 2001 on. That condition is relatively frequent worldwide with prevalence between 10 and 25% being reported in severa! countries. Perinatal problems, diseases and antibiotics intake in the first years of life have been reported as possible causative factors, although its etiology is still unclear. The presence of hypomineralization in primary molars has been considered an important predictor for the presence in permanent. Histologically, the enamel is highly porous, the prisms are disorganized and significant lower hardness values are observed in comparison to normal enamel. Restorative treatment of hypomineralized teeth is usually more complex because the enamel breakdown might be extensive resulting in atypical restorations. Hypomineralized teeth can frequently be difficult to anesthetize due to hypersensitivity. Based on present review it was possible to conclude that hypomineralization represents a challenge to the clinicai practice. Dental clinicians should be aware of ali the clinicai implications related to Molar-incisor- hypomineralization in order to provide appropriate preventive and restorative treatment to the patients.