Fatores associados aos defeitos de desenvolvimento de esmalte em dente permanente: estudo de caso

Abstract

Enamel development defects are changes resulting from disturbances in the amelogenesis process, which may involve genetic, systemic, local or environmental factors. The factors that trigger enamel development defects are mainly related to injuries during the development of the tooth structure. In the primary dentition, the literature shows the existence of an association between the presence of enamel defects and some traumatic factors related to pregnancy and the occurrence of diseases, trauma or medication consumption in childhood, up to three years of age. In the permanent dentition, trauma to the primary dentition is associated with the presence of enamel defects, as well as the experience of caries in the primary dentition and the occurrence of systemic diseases in childhood. The objective of the present study was to present a clinical case and discuss the possible etiological factors related to the diagnosis of enamel development defects. A seven-year-old female patient sought care complaining of an unerupted tooth. Family history did not reveal changes of the same nature in close relatives. The medical history revealed respiratory difficulty, infection and poor development of the thymus gland at birth, resulting in orotracheal intubation in the first days of life. Imaging examinations revealed morphological changes in the crowns of tooth germs 11 and 21, in addition to agenesis of 35. The extraoral examination revealed mandibular retrognathism and the intraoral examination revealed changes in the crown of 11, the presence of opaque white spots on the deciduous molars and a deep bite. Initially, the diagnostic hypothesis was hypomature amelogenesis imperfecta. However, due to the clinical and imaging characteristics, the hypothesis was revised, discussing the possible associated etiological factors.