Need for treatment of enamel hypoplasia of the first permanent molars in children

Relevance. Hypoplasia is one of the most common developmental enamel defects, which forming before tooth eruption. The presence of enamel hypoplasia in a child is a predictor of high caries risk. Especially often, the hypoplastic first permanent molars are affected by caries. Children with enamel hypoplasia require comprehensive treatment and follow-up care by a pediatric dentist.

Purpose. Study of the dynamics of maturation and the risk of caries in the first permanent molars in children with systemic hypoplasia of the enamel.

Materials and methods. In order to study the maturation dynamics and assess the risk of caries, 161 children aged 6-12 years were examined. The main group consisted of 131 children with a diagnosis of systemic enamel hypoplasia; the control group consisted of 30 children free of diagnosis of systemic enamel hypoplasia. A survey was conducted for all the examined with the identification of complaints, an examination of the oral cavity with an assessment of the state of hard tissues of the teeth, the dynamics of the processes of maturation of the enamel of the first permanent molars from the moment of teething in the oral cavity and for 1 year using the electrometric method were studied quarterly.  

Results. Children with hypoplasia of the enamel experience discomfort, pain, aesthetic dissatisfaction, therefore, the quality of life in this group of children is markedly reduced. In 75% of cases, the spotted form of systemic hypoplasia was observed in the examined children. The predominant localization of hypoplastic spots and defects is the tubercles and vestibular surfaces of the first permanent molars (84% of the examined). Hypoplastic molars erupt with incomplete mineralization; the final maturation of enamel in the area of hypoplastic sites by the end of the study did not occur. Moreover, in 90.38% of hypoplastic molars, the development of a carious process was noted.

Conclusions. Children with hypoplasia of the enamel are patients who need comprehensive dental treatment in connection with a number of problems that arise: aesthetic dissatisfaction and behavioral complexes, pain, high risk of caries and post-orally damaged teeth, especially the first permanent molars.

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