amelogenesis imperfectaに罹患した混合歯列を有する小児の口腔管理

Oral management of a child with mixed dentition affected by amelogenesis imperfecta.

• Ana Beatriz Silveira Moretti
• Vivien Thiemy Sakai
• Thais Marchini Oliveira
• Sandra Harumi Fujiwara
• Carlos Ferreira Santos
• Maria Aparecida Andrade Moreira Machado
• Salete Moura Bonifácio Silva

抄録

Amelogenesis Imperfecta（AI）は，乳歯と永久歯のエナメル質の沈着，石灰化，成熟に影響を及ぼす遺伝性の発達障害である．患者さんは通常、歯の知覚過敏をはじめ、咀嚼機能や審美性に問題を抱えています。さらに、歯の外観に対する不満がしばしば見られ、患者さんの社会生活に影響を与えます。乳歯列や混合歯列を有する小児の口腔リハビリテーションは，成長期や永久歯列の萌出終了までは決定的な治療ができないため，複雑である。この臨床報告では，AIに罹患した7歳の混合歯列の少女の口腔管理について述べている．本症例では，歯の摩耗と歯根吸収が顕著で，咬合垂直方向の寸法が減少し，開咬となり，永久歯の萌出順序にも変化がみられた．ほとんどの歯をレジン添加グラスアイオノマーセメントで修復しました。この方法により、患者の知覚過敏は著しく減少し、咀嚼機能と審美性が改善されました。また、心理的にも良い影響が見られました。

Amelogenesis Imperfecta (AI) is a hereditary developmental disorder affecting deposition, calcification or maturation of dental enamel in both the primary and permanent dentitions. Patients usually present tooth sensitivity as well as problems in chewing function and esthetics. In addition, dissatisfaction with the teeth appearance is often found, affecting the patient's social life. Oral rehabilitation of children with primary or mixed dentition is complex, since no definitive treatment can be done during periods of growth and until the end of eruption of the permanent dentition is accomplished. This clinical report describes the oral management of a 7-year-old girl with mixed dentition affected by AI. The patient showed accentuated teeth wear and root resorption, decreased occlusal vertical dimension, open bite and alteration in the sequence of eruption of permanent teeth. Most of the teeth were restored with resin modified glass ionomer cement. This approach markedly decreased the patient's dental hypersensitivity and improved functional chewing and esthetics. Positive psychological influence of the treatment on this patient was also observed.