Термин гипоплазия означает недостаточное развитие. Если речь идет о гипоплазии эмали, значит, развит недостаточно поверхностный слой зуба. Эмаль покрывает наружную часть зуба, защищая его от механических и химических повреждений, противостоит микроорганизмам, вызывающим развитие кариеса.
На зубы ребенка до появления на свет, непосредственно воздействуют многие патологические состояния: ранний и поздний токсикозы, грипп, ОРВИ, краснуха, токсоплазмоз. После рождения недоразвитость эмали обуславливается недоношенностью, родовыми травмами, энцефалопатией, врожденной аллергией, рахитом, проблемами с кальциевым обменом.
Практически в половине случаев у детей обнаруживают гипоплазию. Нередки случаи системной гипоплазии с поражением нескольких зубов. Уровень распространенности проблемы среди населения по статистике достигает 30-40%.
Патология может проявляться от легкой формы, при которой затронут лишь цвет эмали, отличающийся от нормы, до наиболее тяжелой – аплазии (бывает только врожденной) с открытыми участками зубной эмали и болевыми ощущениями из-за этого.
Проблема к тому же имеет эстетический аспект, воздействующий на психологическое состояние, особенно у девочек старшего возраста, обуславливая замкнутость характера и нежелание общаться.
Как бороться с гипоплазией эмали?
При наличии гипоплазии эмали посещение стоматолога обязательно, в противном случае можно потерять пораженный зуб или все зубы. Очаги гипоплазии предварительно измеряют и фиксируют в амбулаторной карте, чтобы контролировать результаты лечения.
При этой патологии по показаниям назначают комплексную реминерализующую терапию, базирующуюся на применении местно фосфорно-кальциевых препаратов, натуральных биологически активных веществ, витаминных составов, назначаемых по схемам курсами. Особенность терапии заключается в том, что проводят ее сами пациенты, а врач-стоматолог корректирует проводимые мероприятия и контролирует этапы лечения.
Больные должны понимать, что подобная терапия проводится длительно. При белых пятнах на зубах размером 4-5 мм лечение продолжается от 8 до 16 месяцев. У более 90% пациентов достигаются устойчивые результаты, устранить полностью очаги гипоплазии не удается лишь тем, кто не соблюдал основные лечебные правила.
Если поверхность зуба поражена бороздками и углублениями, гипоплазированный участок эмали ликвидируют наложением пломбы из пломбировочного материала, который соответствует эмали зубов по цвету, и обладает необходимой прилипаемостью.
Если режущий край зуба сильно истончен, на буграх моляров и премоляров отмечается аплазия, такие зубы покрывают искусственными коронками. Взрослым на клыки и резцы изготавливают пластмассовые фарфоровые или металлические коронки с облицовкой.
У детей ортопедическое лечение проводят после того, как зубочелюстная система окончательно сформировалась. Если зубы имеют обширные дефекты, изготавливают ортодонтические коронки, предназначенные для предохранения зуба от разрушения, а затем после 16 лет заменяют их постоянными протезами.
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