DOI: 10.36347/sjds.2018.v05i05.001

Pages: 252-256

Developmental defects of enamel (DDE) are frequently observed in both pediatric and orthodontic dental practices. DDE consist mainly of hypoplasia, diffuse and demarcated opacities. Often, a combination of enamel defects may be recognized in the same child. Molar Incisor Hypomineralization (MIH) is a specific pattern of DDE in which there is hypomineralization of systemic origin usually affecting one to four permanent first molars and incisors. Patients may complain of one or more of the following: poor esthetics, thermal and mechanical sensitivity, attrition, secondary caries, tooth discoloration, malocclusion and periodontal problems. Early diagnosis of DDE is important for appropriate treatment planning and for prevention of future complications. An accurate diagnosis may improve the clinician’s dental care in many aspects: caries risk assessment, aesthetics, improved adhesion, retention, durability and debonding of orthodontic bands and brackets. Moreover; financial considerations, behavioral management, and medico-legal issues can be affected by early identification of DDE. The purpose of this article is to discuss those pre-treatment and treatment considerations that may affect: a) The management of the young patient diagnosed with demarcated opacities and b) Choice of adhesive material and technique used for bonding and debonding of orthodontic brackets in a patient affected by demarcated opacities.