目的:除了磨牙切牙低矿化外,近年来,原发性牙列中牙釉质矿化不足的发生变得越来越重要。低矿化第二乳磨牙(HSPM)定义为影响一个至所有四个第二乳磨牙的全身起源的低矿化。几年前,引入了“维尔茨堡概念”,根据受影响牙齿的严重程度,提出了MIH发现的分级(MIH治疗需要指数)与适当的治疗计划相结合。最近,更新了这一概念,并增加了新的治疗方法.然而,目前,该概念仅针对恒牙的治疗计划。由于需要扩大其范围以涵盖主要牙齿,因此,HSPM,本文旨在发展维尔茨堡概念的第二个组成部分,治疗计划,对于原发性牙列的反应,近年来对该病的关注日益增加。尽管不同治疗方案的证据基础仍然薄弱,有必要为临床医生的日常实践提供指导.
方法:作者对文献进行了全面回顾,包括临床和实验室研究以及已发布的指南。
结果:HSPM维尔茨堡概念的治疗计划包含预防和再生方面,非侵入性干预措施,临时和永久修复技术,和提取。
结论:目的是为从业者提供实际指导,承认通过临床试验进一步验证的必要性。
OBJECTIVE: In addition to molar incisor hypomineralisation, the occurrence of enamel hypomineralisation in the primary dentition has become increasingly important in recent years. Hypomineralised second primary molar (HSPM) is defined as hypomineralisation of systemic origin affecting from one to all four second primary molars. Some years ago, the \"Würzburg concept\" was introduced, which proposed a grading of MIH findings (MIH treatment need index) in combination with an appropriate treatment plan depending on the severity of the affected tooth. Recently, this concept was updated and new treatment approaches have been added. However, currently, the concept solely addresses the treatment plan for permanent teeth. As there is a need to expand its scope to encompass primary teeth and, consequently, HSPM, this paper seeks to develop the second component of the Würzburg concept, the treatment plan, for the primary dentition in response to the increased focus on the disease in recent years. Although the evidence base for the different treatment options is still weak, there is a need for guidance for clinicians in their day-to-day practice.
METHODS: The authors conducted a comprehensive review of the literature, encompassing clinical and laboratory studies along with published guidelines.
RESULTS: The treatment plan of the HSPM Würzburg concept contains prophylactic and regenerative aspects, non-invasive interventions, temporary and permanent restorative techniques, and extraction.
CONCLUSIONS: The intention is to provide practical guidance to practitioners, acknowledging the necessity for further validation through clinical trials.