Diagnostic confusion between dental caries and primary molar hypomineralization: Case report

Abstract

Introduction: Hypomineralization of the second primary molar (HSMP) is a qualitative defect of the enamel with alterations in translucency and opacity that is associated with severe dental caries lesions, mainly when there are demarcated opacities. The objective of this case report is to describe the diagnostic confusion between dental caries and HSMP in a 5-year-old pediatric patient. Case report: A 5-year-old female patient, partially collaborating, went to the dental clinic of the Universidad Científica del Sur (Lima, Peru) accompanied by her mother. During the intraoral clinical examination, dental caries lesions and the presence of dental plaque were observed. The mother stated that tooth 55 had received treatment several times, since the restorations did not remain in the mouth. Tooth 55 presented a caries lesion with extensive subgingival coronary destruction, and atypical characteristics of dental caries that led to the diagnosis of HSMP. Radiographic examinations were performed on teeth 55 and 75. Oral hygiene orientations, composite resin restorations, pulp therapy and steel crown were carried out. Tooth 55 presented pulpal necrosis, but due to the poor prognosis, extraction and placement of a distal shoe was indicated. Currently, the patient is in follow-up for the evaluation of the treatments performed. Conclusion: Confusion in the diagnosis of dental caries and HSMP can cause irreversible clinical consequences in affected teeth. HSMP increases the severity of caries lesions, affecting prognosis and leading to invasive treatments.