Eficácia da terapia fotodinâmica antimicrobiana no controle da hipersensibilidade em dentes com Hipomineralização Molar Incisivo (HMI): estudo clínico, controlado, randomizado

Abstract

Molar incisor hypomineralization (IMH) is a qualitative defect in enamel development, which occurs in the mineralization phase. It affects one or more permanent first molars and is often associated with permanent incisors. Patients with MIH are at increased risk of caries, hypersensitivity and restoration failures. The objective of this study was to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in teeth with MIH, with the aim of promoting hypersensitivity control, using minimally invasive procedures. Patients aged 7 to 11 years old diagnosed with MIH, enrolled in the UNINOVE children's clinic, were selected. The selected teeth had carious lesions in dentin, with post-eruptive fractures on a single or multiple surfaces and indicated for restorative clinical treatment. The selected teeth were randomized into three groups. Papacárie + aPDT Group: selective chemo-mechanical removal of the caries lesion with Papacárie and antimicrobial photodynamic therapy; aPDT group: selective removal of carious tissue with dentin curette and antimicrobial photodynamic therapy; Control Group: selective removal of decayed tissue with a dentin curette. For antimicrobial photodynamic therapy, the light source used was a laser device emitting red light at λ = 660 nm with the following parameters: 100 mW, 6J per point, 60 seconds, 3571mW/cm2 and 214J/cm2. Subsequently, the teeth were restored using the mixed technique with resin-modified glass ionomer cement and bulkfill composite resin. The results presented are preliminary, with a sample power of 0.683. Data analysis involved descriptive statistics and ANOVA and Kruskal-Wallis analysis, which showed no statistically significant difference between the groups. Antimicrobial Photodynamic Therapy is a promising treatment for controlling hypersensitivity in molars with MIH and dentin carious lesions that will receive restorative treatment. Severe hypersensitivity seems to be related to a greater number of affected surfaces, and may be difficult to control with a worse pulp prognosis.