2016, Number 3
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Rev Cubana Estomatol 2016; 53 (3)
Extrinsic dark-pigmentation of the tooth enamel in pediatric dentistry
Menezes CCBC, Perez RSMM, Formiga AL, de Oliveira GR, Botti RSMT, Baffi DM
Language: Portugués
References: 18
Page:
PDF size: 136.62 Kb.
ABSTRACT
Dark enamel pigments are due to extrinsic staining and associated with aesthetic
problems. The objective is to present two cases of children with black extrinsic
pigmentation in the tooth enamel, with emphasis on the type of treatment and
monitoring. This is a 5-year-old patient of who constantly used ferrous sulfate to treat
anemia by iron deficiency, and another 12-year-old patient with type 1 diabetes and
dermatomyositis. In the first case, we observed the presence of black extrinsic
pigments in the primary teeth and the first permanent molars, especially in the lingual
and vestibular part in the cervical region and middle third, together with incipient
caries lesions on the occlusal surfaces of molars and active white spots on the first
permanent molars. In the second case, there were strange black pigmentation in the
cervical region of the smooth surfaces of the primary and permanent teeth. In the first
case, the treatment performed was to remove black pigments and polishing the teeth
by means of professional prophylaxis and using an abrasive toothpaste containing
micro-granules of pumice. There was an improvement in the clinical aspect from the
second session and the treatment ended at the fifth session. For the second case, we
observed difficulty to remove the pigmented spots in the cervical region, together with
the risk of bleeding gums. When the child needed prophylactic antibiotics, we opted for
the daily control of the biofilm and it was not removed by professional cleaning,
because the patient did not complain about the aesthetic impact. As conclusions, the
extrinsic black pigments can be easily observed in children, and despite its aesthetic
effect, it does damage oral health. It should be noted that it is unclear how their
presence on the tooth surface reduces susceptibility to caries or tooth decay. In
addition, the choice of treatment should always be based on the relation risk-benefit
for the patient.
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