Webinar "Hypomineralised enamel (MIH) - coming to a child near you" - Dr. David Manton скачать в хорошем качестве

Webinar "Hypomineralised enamel (MIH) - coming to a child near you" - Dr. David Manton

http://www.gceurope.com/products/prev... Identify the presence of molar incisor hypomineralisation (MIH) at an early stage and to be able to create an effective treatment plan. Molar incisor hypomineralisation (MIH) is a quite important feature that affects children has a long-term effect on teeth of adults as well. In this webinar, Dr. David Manton takes you through the simple detection and diagnosis, and offers information that will guide through the dental treatment options and treatment plan. Enamel hypoplasia is a quantitative defect of the enamel. If ameloblasts are affected in an early stage, the enamel is reduced in thickness, but of normal quality. The performance of hypomineralised enamel is quite different from hypoplastic enamel, so it is important to know and recognize these differences. With linear hypoplasia, all the teeth affected in that time tend to be affected. Individual hypoplastic teeth rather occur due to infection or trauma of the preceding deciduous tooth. For molar hypomineralisation or molar incisor hypomineralisation, the defect is distinctly different from hypoplasia. It is an area of enamel with in most cases normal thickness, but there is a marked difference in the amount of mineral in that enamel. It does not have that distinct pattern through all of the teeth developing at that time. The more severe the molars are, the more likely the incisors are affected. The distinct lesion is a demarcated opacity, distinct from diffuse opacity such as in fluorosis. Lesions of teeth are small or extensive, white to yellow/brown and post-eruptive breakdown is common. The specific cause of MIH is currently unknown. Clinical issues concern the increased caries susceptibility, but also difficulty to bond and poor restoration outcome. Treatment is often difficult because complete pain reduction with local anaesthesia is often not achieved. Sometimes the most effective treatment we can do that is satisfying on the short term is to stabilize the teeth and to reduce their sensitivity. Low-viscosity glass ionomers as well as high viscosity glass ionomers are often used in surface protection, such as Fuji II, Fuji IX, Fuji Triage and EQUIA. Remineralising agents might reduce sensitivity and lab studies also suggest that they increase the mineral content of the teeth. Differential diagnoses are fluorosis, white spot lesions, amelogenesis and gross caries. Gross caries is probably the hardest differential diagnosis and GC Tri Plaque ID Gel can be used for the caries risk assessment, which, especially in young children, is a rapid tool that is more practical than saliva testing. Children with high caries risk has worse outcome with respect to MIH affected teeth. With respect to minimal intervention dentistry, laboratory studies confirm that remineralisation can occur when CPP-ACP or CPP-ACFP is applied, such as GC Tooth Mousse and MI Paste Plus. When the teeth are covered with a low-viscosity glass ionomer cement, the pores in the enamel are filled and sensitivity is reduced. More extensive restorative procedures in children are done with composite or stainless steel crowns. A better bond strength could be obtained by using sodium hypochloride after the etching procedure. In some severe cases, minimal intervention dentistry is not indicated anymore and depending on the treatment plan, extraction can be considered. Extraction of the first molar tends to give the best outcome when the furcation of the second molar becomes apparent. Consultation of a specialist, such as a paediatric dentist or an orthodontist is recommended in complex cases.