Tooth extraction as a therapeutic alternative in molars with severe hypomineralization. Longitudinal follow-up of a case.

Abstract

Incisor-Molar Hypomineralization (HMI) has a worldwide prevalence of 2.9% to 44%. Pain and tooth sensitivity are considered the main reason for consultation in affected patients, and that is why timely diagnosis and effective intervention provides significant improvements in the patient's quality of life. Case presentation: A 8-year-old male patient presented to the Pediatric Dentistry and Orthodontics Service of the Centro Médico Docente La Trinidad with pain and hypersensitivity. Clinical and radiographic evaluation revealed destruction of most of the enamel and dentin in the upper and lower first permanent molars, with atypical restorations present. The diagnosis was severe HMI with irreversible pulpitis. Class II Division 1 malocclusion with deep bite was also diagnosed. Under intravenous sedation, extraction of the first permanent molars was performed, achieving mesialization of the second permanent molars with complete space closure and correct inclination, showing optimal evolution. Orthodontic treatment with Class II mechanics was started once second permanent molars erupted. Conclusion: In the reported case, timely extractions of the first permanent molars with severe HMI were performed, achieving space closure with optimal mesialization of the second permanent molars.