Developmental Defects of Enamel in Permanent Dentition Associated with Childhood Septic Shock: A Case Report

Abstract

Introduction:
Developmental defects of enamel, such as hypoplasia and hypomineralization, pose diagnostic and therapeutic challenges in pediatric dentistry. Their simultaneous occurrence can compromise the structural integrity, function, and aesthetics of the permanent dentition. Severe systemic factors during early dental development may play a role in their etiology. Objective: To present a clinical case of concurrent enamel hypoplasia and hypomineralization in a pediatric patient, highlighting the impact of severe systemic medical history and the comprehensive clinical approach used. Case Description: An 11-year-old male patient with a history of septic shock during early childhood, which resulted in necrosis of the anterior third of the tongue and amputation of three toes on the left foot. Clinical examination revealed structural defects consistent with hypoplasia and demarcated opacities characteristic of hypomineralization in the upper and lower permanent first molars, central and lateral incisors, and lower permanent canines. Treatment included extraction of the lower first molars, placement of stainless-steel crowns on the upper first molars, a Nance space maintainer, and composite resin restorations on the incisors. Results: The treatment restored masticatory function, improved dental aesthetics, and helped prevent occlusal complications. Clinical follow-up showed good adaptation and satisfaction from both the patient and caregivers. Conclusion: The coexistence of enamel hypoplasia and hypomineralization in patients with severe systemic history requires early diagnosis and personalized planning. Timely intervention can significantly improve oral health and quality of life in pediatric patients.