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Erbas Unverdi G, Ballikaya E, Cehreli ZC. Clinical comparison of silver diamine fluoride (SDF) or silver-modified atraumatic restorative technique (SMART) on hypomineralised permanent molars with initial carious lesions: 3-year results of a prospective, randomised trial. J Dent 2024; 147:105098. [PMID: 38797490 DOI: 10.1016/j.jdent.2024.105098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions. METHODS 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis. RESULTS The caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations. CONCLUSIONS During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss. CLINICAL SIGNIFICANCE Both SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants. CLINICALTRIALS REGISTRATION NUMBER NCT03862014.
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Affiliation(s)
- Gizem Erbas Unverdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey
| | - Elif Ballikaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey.
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Bardellini E, Amadori F, Rosselli L, Garo ML, Majorana A, Conti G. Molar Incisor Hypomineralization: Optimizing Treatment Protocols for Hypersensitivity: A Randomized Clinical Trial. Dent J (Basel) 2024; 12:186. [PMID: 38920887 PMCID: PMC11203314 DOI: 10.3390/dj12060186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/28/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
Dentin hypersensitivity (DH) is a common challenge in pediatric patients with molar incisor hypomineralization (MIH), stemming from enamel porosity or exposed dentin after enamel breakdown. This three-arm randomized controlled clinical trial aims to evaluate the effectiveness of three different desensitizing treatment protocols. The study was conducted on 39 children, aged 6-14 years old, with MIH and DH. Group A received casein phosphopeptide plus amorphous calcium phosphate fluoride (CPP-ACPF) mousse and sham light therapy, Group B received placebo mousse and photo-bio-modulation therapy (PMBT), and Group C received both CPP-ACPF mousse and PMBT. DH evaluation using a visual analogue scale was performed at multiple time points. Both CPP-ACPF mousse and PMBT individually demonstrated desensitizing effects on dental elements affected by MIH. While PMBT had a greater immediate effect, the combination of the two therapies proved most effective in reducing DH. The VAS scores were statistically lower in group C compared to groups A and B, both after the first session (p = 0.0001) and after 28 days (p = 0.0005). This study suggests promising avenues for managing DH in MIH patients, highlighting the potential of combined therapies, specifically CPP-ACPF mousse and PMBT, for enhanced clinical outcomes.
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Affiliation(s)
- Elena Bardellini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy; (F.A.); (L.R.); (A.M.)
| | - Francesca Amadori
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy; (F.A.); (L.R.); (A.M.)
| | - Laura Rosselli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy; (F.A.); (L.R.); (A.M.)
| | | | - Alessandra Majorana
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy; (F.A.); (L.R.); (A.M.)
| | - Giulio Conti
- Department of Medicine e Surgery, School of Dentistry, University of Insubria, Via Ravasi 2, 21100 Varese, Italy;
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Santos PS, Vitali FC, Fonseca-Souza G, Maia LC, Cardoso M, Feltrin-Souza J, Fraiz FC. Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: A systematic review and meta-analysis. J Dent 2024; 145:104981. [PMID: 38582436 DOI: 10.1016/j.jdent.2024.104981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH have greater likelihood of presenting DH/toothache than controls. DATA Studies evaluating DH/toothache in patients with MIH were included. Studies focusing on other enamel defects were excluded. SOURCES Eight databases, including grey literature, were searched in January 2024. STUDY SELECTION The methodological quality of studies was assessed using the Joanna Briggs Institute checklist for Cross-sectional studies. Proportion and association meta-analyses, subgrouped by diagnostic methods, were conducted. The certainty of evidence was assessed using GRADE approach. RESULTS Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses. Two studies fulfilled all items of the methodological quality checklist. The overall prevalence of DH/toothache among patients with MIH was 45 %. Prevalence rates of 30 %, 47 %, and 55 % were estimated based on proxy reports, self-reports, and air stimulation, respectively. The overall prevalence of DH/toothache per tooth was 22 %, ranging from 16 % to 29 % according to the diagnostic method. Patients with MIH demonstrated higher likelihood of presenting proxy reports of DH/toothache compared to those without MIH (OR: 1.51, 95 % CI [1.23-1.85], P < 0.01, I2: 0 %). The certainty of evidence was very low, mainly due to the low methodological quality of included studies and high inconsistency. CONCLUSIONS The global prevalence of DH/toothache was 22 %, per tooth, and 45 % per patient. Estimates vary according to diagnostic methods. Patients with MIH showed higher likelihood of presenting proxy reports of DH/toothache than controls. CLINICAL SIGNIFICANCE This systematic review contributes valuable information to the dental literature by assessing the prevalence and associated factors of DH/toothache in patients with MIH. The findings can guide future research, inform clinical practices and public policy makers, and ultimately improve the management of oral health of patients with MIH. REGISTRATION PROSPERO CRD42023432805.
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Affiliation(s)
- Pablo Silveira Santos
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil; Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Filipe Colombo Vitali
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Fabian Calixto Fraiz
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Kisacik S, Ozler CO, Olmez S. Molar incisor hypomineralization and oral health-related quality of life: a sample of 8-12-years-old children. Clin Oral Investig 2024; 28:105. [PMID: 38244077 PMCID: PMC10799822 DOI: 10.1007/s00784-024-05490-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES The study aimed to evaluate the impact of molar incisor hypomineralization (MIH) and tooth sensitivity on the oral health in terms of the quality of life (OHRQoL). In addition, the impact of tooth maturity on tooth sensitivity was evaluated in the study. MATERIALS AND METHODS Children aged 8-12 years with and without MIH participated in this descriptive cross-sectional study. They were chosen through the convenience sample technique. The Pediatric-Oral-Health-related-Quality-of-Life (POQL) scale was used to assess OHRQoL. The presence of the MIH and decayed, filled and missing teeth due to caries (using dmft/s, DMFT/S indexes) were recorded. The tooth sensitivity and dental maturity status were evaluated with the Shiff-Cold-Air-Sensitivity-Scale (SCASS) and Demirjian-method, respectively. Statistical analysis of the data was performed by Pearson Chi-Square Test and Mann-Whitney U test (p<0.05). RESULTS In this study, the participants were a total of 260 children, half were affected by the MIH. Their mean POQL scores were higher than those of the children without MIH with a statistically significantly difference in the total child scale score (p=0.014). Among the children with the MIH, child total QoL score was found to be higher in SCASS positive response group (p=0.011). The teeth with MIH (p<0.001) showed higher response to the stimulus. According to the dental age and dental maturity categories of the children with MIH, the total child scale score was found to be higher in the SCASS category (p=0.011), and the response status to the SCASS was statistically significant (p=0.042 and p=0.05, respectively). CONCLUSIONS Among the children with MIH, the OHRQoL was found to be negatively affected. The teeth with the MIH tend to reveal more tooth sensitivity than healthy teeth. Many conditions such as having MIH, and tooth sensitivity might have an impact on the OHRQoL. In addition, more sensitivity to the stimulus was observed in the teeth with lower tooth maturity status; the dental age and dental maturity might have effects on tooth sensitivity. CLINICAL RELEVANCE Considering the negative impacts due to MIH, the evaluation of OHRQoL is critical for dentists to employ a well-defined guide in their clinical decisions.
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Affiliation(s)
- Seyma Kisacik
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Altindag, Ankara, Turkey.
| | - Cansu Ozsin Ozler
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Altindag, Ankara, Turkey
| | - Seval Olmez
- Faculty of Dentistry, Department of Pediatric Dentistry, Hacettepe University, 06100, Altindag, Ankara, Turkey
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Sanfelice EB, Heck ADS, Bittencourt HR, Weber J, Burnett LH, Spohr AM. Short-term Results of the Masking Effect of an Infiltrant Resin on Mild Molar Incisor Hypomineralization Lesions in Anterior Teeth. Oper Dent 2024; 49:34-42. [PMID: 38180470 DOI: 10.2341/23-029-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 01/06/2024]
Abstract
This non-controlled clinical study evaluated the masking effect of an infiltrant resin on mild molar incisor hypomineralization (MIH) lesions. Thirty MIH-affected anterior teeth with creamy/ white opacities from 12 children aged 6-15 years received the application of an infiltrant resin (Icon- DMG). Standard photographs were taken before (T1), immediately after (T2), and 1 week after (T3) resin infiltration. Two calibrated examiners qualitatively analyzed the color match using the Fédération Dentaire Internationale (FDI) scale. The binomial distribution test analyzed the scores of the color match at T1 with T2 and T3, and McNemar's test analyzed the scores of the color match between T2 and T3 (α=0.05). There was a significant increase in color match between T1 and T2 (p=0.0005), between T1 and T3 (p=0.0005), and between T2 and T3 (p=0.0019). It was concluded that infiltrant resin was effective in improving the esthetic appearance of creamy/white opacities on MIH-affected anterior teeth.
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Affiliation(s)
- E B Sanfelice
- Eneida Beatriz Sanfelice, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ab da Silva Heck
- Amanda Baptista da Silva Heck, DDS, MS, Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - H R Bittencourt
- Hélio Radke Bittencourt, MS, PhD, Department of Statistics, Polytechnic School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Jbb Weber
- João Batista Blessmann Weber, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - L H Burnett
- Luiz Henrique Burnett Júnior, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A M Spohr
- *Ana Maria Spohr, DDS, MS, PhD, Department of Restorative DentistryPontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Butera A, Pascadopoli M, Pellegrini M, Trapani B, Gallo S, Radu M, Scribante A. Biomimetic hydroxyapatite paste for molar-incisor hypomineralization: A randomized clinical trial. Oral Dis 2023; 29:2789-2798. [PMID: 36135352 DOI: 10.1111/odi.14388] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/26/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this randomized clinical trial was to evaluate the desensitizing and remineralizing effect of a new zinc-hydroxyapatite-based paste in sites affected by molar-incisor hypomineralization (MIH), by assessing dental sensitivity, tooth wear, and periodontal indexes. MATERIALS AND METHODS Twenty-five patients with presence of 1 enamel demineralization of permanent molars and incisors in two different quadrants were recruited. After professional dental hygiene, a domiciliary hydroxyapatite-based paste was assigned and recommended to be applied on 2 MIH teeth in one random quadrant (test group), while the 2 contralateral MIH teeth did not undergo paste application (control group). The following primary outcomes were assessed: Plaque Control Record (PCR), Bleeding Index (BI), MIH Treatment Need Index (MIH-TNI), and Schiff Air Index (SAI). RESULTS No significant inter- and intragroup differences were found for PI and BI, except for both intragroup T0-T1. For MIH-TNI, significant intergroup differences were detectable in the test group after 9 months of treatment. For SAI values, no significant differences were found in the control group, while in the test group, significant lower values were found after 1 and 3 months since baseline, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Biomimetic zinc-hydroxyapatite showed a desensitizing effect when used to treat MIH.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Matteo Pellegrini
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Benedetto Trapani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Monica Radu
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Scribante
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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Maciel JLB, Geng Vivanco R, Pires-de-Souza FDCP. Remineralization, color stability and surface roughness of tooth enamel brushed with activated charcoal-based products. J ESTHET RESTOR DENT 2023; 35:1144-1151. [PMID: 37083113 DOI: 10.1111/jerd.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To evaluate the effect of activated charcoal-based (AC) products on color alteration, remineralizing potential and surface roughness of dental enamel. MATERIALS AND METHODS Bovine incisors were cut into 6 × 6 × 2 mm fragments. Initial color (EasyShade, Vita) and surface roughness (Surfcorder SE1700, Kosakalab) readings were performed. Fragments were separated into five groups (n = 17) according to the treatment: Control: Fluoride toothpaste (Colgate Total 12, Colgate); Charcoal + NaF: AC toothpaste (ACT) with sodium fluoride (Colgate Natural Extracts, Colgate); Charcoal + MFP + n-HA: ACT with sodium monofluorophosphate and nanohydroxyapatite (Black is White, Curaprox); Charcoal: Fluoride-free ACT (ProActive, Hinode); and Charcoal powder: AC powder. Simulated toothbrushing was performed and final color and surface roughness readings were obtained. Fragments were then polished, and initial microhardness (HMV-2, Shimatzu) readings were done. Samples were artificially demineralized and brushed again. Final microhardness readings were taken. Data were statistically analyzed. RESULTS Fluoride-free charcoal presented the lowest surface roughness alteration (p < 0.05). Charcoal powder had the lowest color change (p < 0.05) and negative values for whiteness index for dentistry alteration. All the groups presented values below whiteness acceptability threshold and negative relative microhardness values. Control showed the highest remineralizing potential (p < 0.05). CONCLUSIONS ACPs did not produce color alteration different from the fluoride toothpaste, except for Charcoal powder that caused less color change. ACPs caused surface roughness alteration similar to the fluoride toothpaste. ACT with fluoride and AC powder did not have remineralizing potential. CLINICAL SIGNIFICANCE Activated charcoal-based products (ACP) promise effective tooth whitening and quick results, without teeth damage. In addition, some ACPs contain fluoride in toothpaste composition and promise rehardening potential. However, ACPs are not as effective as other whitening agents and can alter the surface roughness of the enamel. Even if the ACPs contain fluoride or other remineralizing agents, they might be ineffective.
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Affiliation(s)
- João Lucas Borim Maciel
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Rocio Geng Vivanco
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
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Alzahrani AY, Alamoudi NMH, El Meligy OAES. Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review. Dent J (Basel) 2023; 11:157. [PMID: 37504223 PMCID: PMC10378579 DOI: 10.3390/dj11070157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is a significant health problem that can affect the child's quality of life by negatively affecting their esthetics and function. This review aimed to summarize the etiology and pathogenesis of MIH. It also aimed to summarize the recent studies on MIH in children and adolescents, focusing on diagnosis, prevention, and clinical management. An electronic search on the PubMed, Cochrane Database of Systematic Reviews, MEDLINE, MedlinePlus, WHO reports, and Google Scholar databases was performed. The volume of research on the etiology, presentation, and clinical management of MIH is still expanding. The creation and validation of indices for the diagnosis and management of MIH, as well as any potential genetic aspects appear to be the main areas of current research. Notably, MIH was linked to childhood illnesses, the use of antibiotics, and early childhood fever. Although many studies discuss the different options for managing MIH lesions, evidence-based studies that address the long-term outcomes of MIH are still lacking. Indeed, future clinical studies should be directed to evaluate the impact of each systemic etiological factor and its different types of management on normal amelogenesis. Regarding the diagnosis, future research should focus on the pre-eruption diagnosis and early approaches to prevent the post-eruption breakdown and caries. Regarding the treatment of MIH, future investigations should emphasize further improvements in adhesion and the use of new materials and techniques, such as digital dentistry.
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Affiliation(s)
- Ahmed Yahya Alzahrani
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
- Pediatric Dentistry, Taif Dental Centre, Ministry of Health, Taif 26511, Saudi Arabia
| | | | - Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
- Pediatric Dentistry & Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria 21521, Egypt
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Fossati AL, Sobral APT, Hermida Bruno MLL, Viarengo NO, Sertaje MRF, Santos EM, Gonçalves MLL, Ferrari RAM, Fernandes KPS, Horliana ACRT, Motta LJ, Bussadori SK. Photobiomodulation and glass ionomer sealant as complementary treatment for hypersensitivity in molar incisor hypomineralisation in children: protocol for a blinded randomised clinical trial. BMJ Open 2023; 13:e068102. [PMID: 37316315 DOI: 10.1136/bmjopen-2022-068102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Photobiomodulation has been widely used as a complementary treatment for dentin hypersensitivity, with reports of clinical success. However, the literature offers only one study, in which photobiomodulation was used for the treatment of sensitivity in molars with molar incisor hypomineralisation (MIH). The aim of the proposed study is to determine whether photobiomodulation enhances the results of treatment with glass ionomer sealant on molars with MIH that present sensitivity. METHODS AND ANALYSIS The study involves 50 patients from 6 to 12 years of age that will be randomly allocated in two groups. Group 1 (control group) (n=25): toothpaste with a concentration of fluoride ≤1000 ppm two times a day, glass ionomer sealant and sham low-level laser (LLL) and group 2 (n=25): toothpaste with a concentration of fluoride ≤1000 ppm two times a day, glass ionomer sealant and active LLL. The evaluations will involve MIH record, Simplified Oral Hygiene Index (OHI), Schiff Cold Air Sensitivity Scale (SCASS) and visual analogue scale (VAS) before the procedure. Immediately after the procedure, the hypersensitivity index (SCASS/VAS) will be registered. Records of OHI and SCASS/VAS will be registered after 48 hours as well as 1 month after the procedure. The persistence of the sealant will also be registered. It is expected that by the second consultation, a decrease in sensitivity will be observed due to the treatments received in the two groups. ETHICS AND DISSEMINATION This protocol has been approved by the local medical ethical committee (certificate: CEUCU 220516). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT05370417.
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Affiliation(s)
- Ana Laura Fossati
- Interinstitutional Doctorate, Universidad Católica del Uruguay, Montevideo, Uruguay
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
| | - Ana Paula Taboada Sobral
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos, Santos, Brazil
| | - María Laura Laura Hermida Bruno
- Interinstitutional Doctorate, Universidad Católica del Uruguay, Montevideo, Uruguay
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
| | - Natalia Osorio Viarengo
- Interinstitutional Doctorate, Universidad Católica del Uruguay, Montevideo, Uruguay
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
| | - María Roxana Ferreira Sertaje
- Interinstitutional Doctorate, Universidad Católica del Uruguay, Montevideo, Uruguay
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
| | - Elaine Marcilio Santos
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos, Santos, Brazil
| | | | | | | | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil
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Vicioni-Marques F, Carvalho MR, Raposo F, de Paula-Silva FWG, de Queiroz AM, Leal SC, Manton DJ, de Carvalho FK. Association of dental hypersensitivity and anxiety in children with molar-incisor hypomineralisation (MIH). Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00803-4. [PMID: 37199855 DOI: 10.1007/s40368-023-00803-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
AIM The objective of this study was to investigate whether dental hypersensitivity and dental fear were linked to the presence and severity of MIH. METHODS For this cross-sectional study, 1830 students between the ages of 6 and 12 years were recruited from four randomly selected schools. The Children's Fear Survey Schedule-Dental Subscale questionnaire was used to assess dental anxiety and fear. The children's self-reported dental hypersensitivity resulting from MIH was evaluated using the Wong-Baker Facial Scale and the Visual Analog Scale (VAS). RESULTS MIH was correlated with tooth hypersensitivity, particularly in severe cases. Dental fear was present in 17.4% of the children with MIH, but it was not associated with dental hypersensitivity, gender, or age. CONCLUSION No association was found between dental fear and dental hypersensitivity in children with MIH.
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Affiliation(s)
- F Vicioni-Marques
- Department of Pediatric Dentistry, University of São Paulo at School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - M R Carvalho
- Department of Pediatric Dentistry, University of São Paulo at School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - F Raposo
- Department of Pediatric Dentistry, University of Brasilia, Federal District, Brasilia, Brazil
| | - F W G de Paula-Silva
- Department of Pediatric Dentistry, University of São Paulo at School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - A M de Queiroz
- Department of Pediatric Dentistry, University of São Paulo at School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil
| | - S C Leal
- Department of Pediatric Dentistry, University of Brasilia, Federal District, Brasilia, Brazil
| | - D J Manton
- University of Groningen, UMCG, Centre for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - F K de Carvalho
- Department of Pediatric Dentistry, University of São Paulo at School of Dentistry of Ribeirao Preto, Ribeirao Preto, Brazil.
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11
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Yucesoy DT, Fong H, Hamann J, Hall E, Dogan S, Sarikaya M. Biomimetic Dentin Repair: Amelogenin-Derived Peptide Guides Occlusion and Peritubular Mineralization of Human Teeth. ACS Biomater Sci Eng 2023; 9:1486-1495. [PMID: 36854046 PMCID: PMC10015427 DOI: 10.1021/acsbiomaterials.2c01039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Exposure of dentin tubules due to loss of protective enamel (crown) and cementum (root) tissues as a result of erosion, mechanical wear, gingival recession, etc. has been the leading causes of dentin hypersensitivity. Despite being a widespread ailment, no permanent solution exists to address this oral condition. Current treatments are designed to alleviate the pain by either using desensitizers or blocking dentin tubules by deposition of minerals or solid precipitates, which often have short-lived effects. Reproducing an integrated mineral layer that occludes exposed dentin with concomitant peritubular mineralization is essential to reestablish the structural and mechanical integrity of the tooth with long-term durability. Here, we describe a biomimetic treatment that promotes dentin repair using a mineralization-directing peptide, sADP5, derived from amelogenin. The occlusion was achieved through a layer-by-layer peptide-guided remineralization process that forms an infiltrating mineral layer on dentin. The structure, composition, and nanomechanical properties of the remineralized dentin were analyzed by cross-sectional scanning electron microscopy imaging, energy dispersive X-ray spectroscopy, and nanomechanical testing. The elemental analysis provided calcium and phosphate compositions that are similar to those in hydroxyapatite. The measured average hardness and reduced elastic modulus values for the mineral layer were significantly higher than those of the demineralized and sound human dentin. The structural integration of the new mineral and underlying dentin was confirmed by thermal aging demonstrating no physical separation. These results suggest that a structurally robust and mechanically durable interface is formed between the interpenetrating mineral layer and underlying dentin that can withstand long-term mechanical and thermal stresses naturally experienced in the oral environment. The peptide-guided remineralization procedure described herein could provide a foundation for the development of highly effective oral care products leading to novel biomimetic treatments for a wide range of demineralization-related ailments and, in particular, offers a potent long-term solution for dentin hypersensitivity.
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Affiliation(s)
- Deniz T. Yucesoy
- Department
of Materials Science and Engineering, University
of Washington, Seattle, Washington 98195, United States
- Department
of Bioengineering, Izmir Institute of Technology, Urla, Izmir 35430, Turkey
- Phone: +90-232-750-6959.
| | - Hanson Fong
- Department
of Materials Science and Engineering, University
of Washington, Seattle, Washington 98195, United States
| | - John Hamann
- Department
of Materials Science and Engineering, University
of Washington, Seattle, Washington 98195, United States
| | - Eric Hall
- Department
of Materials Science and Engineering, University
of Washington, Seattle, Washington 98195, United States
| | - Sami Dogan
- Department
of Restorative Dentistry, University of
Washington, Seattle, Washington 98195, United States
| | - Mehmet Sarikaya
- Department
of Materials Science and Engineering, University
of Washington, Seattle, Washington 98195, United States
- Phone: +1-206-543-0724. Fax: +1-206-543-3100.
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12
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Enax J, Amaechi BT, Farah R, Liu JA, Schulze zur Wiesche E, Meyer F. Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review. Dent J (Basel) 2023; 11:dj11030080. [PMID: 36975577 PMCID: PMC10047667 DOI: 10.3390/dj11030080] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Rayane Farah
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Jungyi Alexis Liu
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Erik Schulze zur Wiesche
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
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13
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Sezer B, Tuğcu N, Calışkan C, Durmuş B, Kupets T, Bekiroğlu N, Kargül B, Bourgeois D. Effect of casein phosphopeptide amorphous calcium fluoride phosphate and calcium glycerophosphate on incisors with molar-incisor hypomineralization: A cross-over, randomized clinical trial. Biomed Mater Eng 2022; 33:325-335. [DOI: 10.3233/bme-211371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Within the scope of minimally invasive dentistry, the use of different biocompatible remineralization agents on incisors affected by molar-incisor hypomineralization (MIH) gains importance. OBJECTIVE: To evaluate the effect of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and calcium glycerophosphate (CaGP) in mineral density (MD) of white/creamy and yellow/brown demarcated opacities on incisors affected by MIH by means laser fluorescence (LF). METHODS: As a cross-over, randomized trial, twenty-two children with 167 incisors affected by MIH were recruited and randomly assigned to one of the two different agents and crossed over to other agents with two weeks washout in between. Incisors were examined by using LF at all before and after three months periods. RESULTS: The results of the paired t-tests for determining the period effect between the baseline findings showed significant difference in white/creamy and yellow/brown demarcated opacities of LF values for both groups (p < 0.05). The difference between both groups according to after categorization of 20% increasing in MD in the percent of change before and after application on LF values; was not found statistically significant in white/creamy (p = 0.970) and yellow/brown (p = 0.948) opacities. CONCLUSIONS: The primary outcome was CPP-ACFP and CaGP had a positive effect in decreasing hypomineralization on MIH-affected enamel for three months period.
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14
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Bekes K, Amend S, Priller J, Zamek C, Stamm T, Krämer N. Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up. Clin Oral Investig 2022; 26:1879-1888. [PMID: 34468888 PMCID: PMC8816787 DOI: 10.1007/s00784-021-04163-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/24/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 12 weeks after sealing using two different materials (composite and glass ionomer). Furthermore, the retention rates of both materials were analyzed. METHODS Thirty-nine children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Both teeth were sealed by two calibrated operators using a split-mouth design with either Clinpro Sealant in combination with Scotchbond Universal (C) or Ketac Universal (K), respectively. Clinical pain assessments (Schiff Score Air Sensitivity Scale [SCASS], Visual Analog Scale [VAS]) were made at baseline ("pre"), immediately after treatment ("post"), and after 1, 4, 8, and 12 weeks. Paired t tests were calculated in each group between baseline and all other time points. RESULTS Thirty-eight children with 76 molars completed all stages of the study. Regardless of the material used, the application of the sealant decreased hypersensitivity significantly immediately as well as throughout the 12-week recalls (all p values < 0.001). We found no statistically significant difference among both materials chosen in any of the time points evaluated. Furthermore, retention of both materials was comparable in both groups. CONCLUSIONS Both sealant materials were able to reduce hypersensitivity successfully immediately and throughout the 12-week follow-up. Furthermore, their performance was similar in terms of retention. CLINICAL RELEVANCE Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating hypersensitivity relief of MIH-affected molars using two sealing techniques.
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Affiliation(s)
- Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Stefanie Amend
- Department of Paediatric Dentistry, Medical Centre for Dentistry Section for Outcomes Research, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Julia Priller
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Claudia Zamek
- Private Practice, Graf-Adolf-Straße 24, 40212, Düsseldorf, Germany
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Norbert Krämer
- Department of Paediatric Dentistry, Medical Centre for Dentistry Section for Outcomes Research, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
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15
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Mendonça FL, Regnault FGDC, Di Leone CCL, Grizzo IC, Bisaia A, Fragelli C, Oliveira TM, Magalhães AC, Rios D. Sensitivity Treatments for Teeth with Molar Incisor Hypomineralization: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e27843. [PMID: 34989687 PMCID: PMC8778566 DOI: 10.2196/27843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/21/2022] Open
Abstract
Background The sensitivity of teeth with molar incisor hypomineralization (MIH) can affect children’s quality of life and is a challenging problem for dentists. Remineralizing agents such as sodium fluoride varnish seem to reduce the sensitivity of teeth with MIH, but long-term clinical trials with large samples are still needed for more evidence about its effectiveness as a desensitizing agent before its clinical recommendation. Objective This randomized clinical trial aims to compare three treatment interventions for teeth with MIH and hypersensitivity. Methods A total of 60 children aged 6-10 years presenting with at least one first permanent molar with sensitivity and no loss of enamel will be randomly assigned to three groups: the control group (sodium fluoride varnish; Duraphat, Colgate); experimental group I (4% titanium tetrafluoride varnish); and experimental group II (a coating resin containing surface prereacted glass-ionomer filler; PRG Barrier Coat, Shofu). The sodium fluoride varnish and 4% titanium tetrafluoride varnish will be applied once per week for 4 consecutive weeks and the PRG Barrier Coat resin will be applied in the first session and the application will be simulated the following 3 weeks to guarantee the blinding of the study. The primary outcome will be sensitivity level measured at different moments (before each material application, immediately after application or simulation, and 1, 2, 4, and 6 months after the last application/simulation) by one examiner using the Wong-Baker FACES Pain Rating Scale, the Schiff Cold Air Sensitivity Scale, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale. As secondary outcomes, parental satisfaction and child self-reported discomfort after the treatment will be measured with a questionnaire prepared by the researcher. The data will undergo statistical analysis and the significance level will be set at 5%. Results The project was funded in 2018, and enrollment was completed in November 2019. The recruitment of participants is currently underway and the first results are expected to be submitted for publication in 2022. Conclusions If found effective in reducing the patient’s sensitivity long term, these agents can be considered as a treatment choice, and the findings will contribute to the development of a treatment protocol for teeth with sensitivity due to MIH. Trial Registration Brazilian Registry of Clinical Trials Universal Trial Number U1111-1237-6720; https://tinyurl.com/mr4x82k9 International Registered Report Identifier (IRRID) DERR1-10.2196/27843
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Affiliation(s)
- Fernanda L Mendonça
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Camilla C L Di Leone
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Isabella C Grizzo
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Aliny Bisaia
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Camila Fragelli
- Morphology and Children's Clinic Department, Araraquara Dental School, São Paulo State University, Araraquara, Brazil
| | - Thais M Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Ana C Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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16
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Vicioni-Marques F, Paula-Silva FWGD, Carvalho MR, Queiroz AMD, Freitas OD, Duarte MPF, Manton DJ, Carvalho FKD. Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. J Appl Oral Sci 2022; 30:e20210538. [PMID: 35476115 PMCID: PMC9040738 DOI: 10.1590/1678-7757-2021-0538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia.
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17
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MOSQUIM V, ZABEU GS, FORATORI-JUNIOR GA, BORGES AB, RIOS D, MAGALHÃES AC, WANG L. S-PRG-based toothpastes compared to NaF toothpaste and NaF varnish on dentin permeability in vitro. J Appl Oral Sci 2022; 30:e20220082. [PMID: 35674543 PMCID: PMC9239301 DOI: 10.1590/1678-7757-2022-0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/20/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives To analyze the effect of 5 toothpastes containing different percentages of S-PRG fillers compared to NaF toothpaste and NaF varnish on the dentin hydraulic conductance (Lp). Methodology Dentin disks (1.0±0.2 mm thickness) were cut from third molars, and their Lp values were evaluated using Flodec. The specimens were allocated into 7 groups (n=8). The minimum (smear layer) and the maximum (after acid etching) Lp values were recorded. Lp was also assessed after treatment with either a 0wt.%, 1wt.%, 5wt.%, 20wt.%, or 30wt.% S-PRG toothpaste, a NaF toothpaste, or a NaF varnish. Toothpastes were applied by brushing for 15 s, allowing it to settle for 1 min, and rinsing with deionized water. The NaF varnish was applied for 4 min and was removed with a probe. Specimens were exposed to citric acid (6%, pH 2.1, 1 min) and their final Lp was recorded. The pH of all products was recorded (n=3) and specimens from each group were analyzed by Laser Scanning Confocal Microscopy (LSCM). Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (a=0.05). Results The highest Lp reduction was noticed for the 5wt.% S-PRG toothpaste, NaF toothpaste, and NaF varnish. However, the toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG were similar to all toothpastes but differed from the NaF varnish. After erosion, all groups retrieved their maximum Lp values, except for the NaF varnish. The LSCM evidenced deposits on the surface of specimens treated with 5%, 20%, and 30% S-PRG-based toothpastes and NaF toothpaste. Even more deposits were observed for the NaF varnish. After the erosive challenge, the deposits were diminished in all groups. Conclusion Toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG fillers behaved similarly to a conventional NaF toothpaste, even after an erosive challenge. The NaF varnish promoted better reduction of the Lp, but its effect was also diminished after erosion.
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18
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An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2022; 23:39-64. [PMID: 34110615 PMCID: PMC8927013 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
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Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig 2021; 26:2197-2205. [PMID: 34743243 PMCID: PMC8572062 DOI: 10.1007/s00784-021-04236-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
Objectives This study evaluated and compared the effect of silver diamine fluoride (SDF) and silver-modified atraumatic restorative treatment (SMART) sealants for the treatment of initial carious lesions of permanent molars affected by molar incisor hypomineralization (MIH). Methods One hundred and twelve hypomineralized permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF and SMART sealant groups (n = 56 teeth/group) in a split-mouth fashion. Hypersensitivity, formation of caries, and enamel breakdown were evaluated in both groups. Hypersensitivity was assessed by Schiff Cold Air Sensitivity Scale (SCASS), and clinical assessments of SMART sealants were performed according to modified USPHS criteria at 1, 6, and 12 months. The data were analyzed statistically using Fisher’s exact test, Kaplan–Meier analysis, Mann–Whitney U test, and Friedman test. Results Twenty-six hypomineralized molars with marked baseline hypersensitivity showed significantly lower SCASS scores at all evaluation periods (p < 0.001). There was no significant difference in hypersensitivity scores between the groups at the repeated applications of SDF at 1, 6, and 12 months. The cumulative survival rates of SMART sealants on occlusal and palatal surfaces were 88.7% and 58.8%, respectively. Conclusions In hypomineralized molars, both SDF and SMART sealants showed favorable short-term prevention against dental caries while providing effective desensitization. Marginal discoloration was the most common side effect of the SMART sealants as a result of SDF application. Clinical Significance Both SDF and SMART sealants showed similar short-term effectiveness as non-aerosol procedures in arresting enamel caries and reducing hypersensitivity in hypomineralized molars. Trial registration Clinical Trials Registration Number: NCT03862014.
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20
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Hypersensitivity in teeth affected by molar-incisor hypomineralization (MIH). Sci Rep 2021; 11:17922. [PMID: 34504122 PMCID: PMC8429747 DOI: 10.1038/s41598-021-95875-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/30/2021] [Indexed: 11/12/2022] Open
Abstract
Tooth hypersensitivity is a common symptom in patients with molar-incisor hypomineralization (MIH). Therefore, this clinical study aimed to assess potential associations between patient- and tooth-related variables and the intensity of hypersensitivity in MIH-affected permanent teeth compared to healthy controls. Fifty-seven MIH patients and 20 healthy adolescents with a total of 350 MIH-affected and 193 healthy teeth were included in this study. The intensity of hypersensitivity was measured after cold air stimulation using the Schiff Cold Air Sensitivity Scale (SCASS) by the dentist and visual analogue scale (VAS) by the patient. Tooth hypersensitivity was low in non-MIH teeth (97.9% of the group had zero SCASS and VAS values). In contrast, MIH-affected teeth with demarcated opacities and atypical restorations had moderate SCASS and VAS values, whereas teeth with enamel breakdown were mostly linked to severe hypersensitivity. The logistic regression model confirmed a significantly lower level of hypersensitivity in MIH patients aged ≥ 8 years (OR 0.06, 95% CI 0.01–0.50, p = 0.009) and higher levels in molar teeth (OR 5.49, 95% CI 1.42–21.27, p = 0.014) and teeth with enamel disintegration (OR 4.61, 95% CI 1.68–12.63, p = 0.003). These results indicate that MIH-related tooth hypersensitivity seems to be present in disintegrated molars immediately after tooth eruption.
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21
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Bekes K, Amend S, Priller J, Zamek C, Stamm T, Krämer N. Changes in oral health-related quality of life after treatment of hypersensitive molar incisor hypomineralization-affected molars with a sealing. Clin Oral Investig 2021; 25:6449-6454. [PMID: 33876317 PMCID: PMC8531117 DOI: 10.1007/s00784-021-03947-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
Objectives The aim of this study was to investigate the changes in oral health-related quality of life (OHRQoL) before and after treatment of hypersensitive molars affected by molar incisor hypomineralization (MIH) with a sealing. Methods Thirty-eight children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Two affected teeth were sealed by two calibrated operators using a split-mouth design: Clinpro Sealant in combination with Scotchbond Universal, and Ketac Universal (3M), respectively. OHRQoL was measured using the German version of the CPQ8–10 (CPQ-G8–10) at baseline, and after 1, 4, 8, and 12 weeks, respectively. Results The CPQ total score decreased significantly from a mean of 14.7 (±5.9) to 6.4 (±4.7) (p < 0.001) 1 week after treatment revealing improved OHRQoL. After 12 weeks, OHRQoL improved again proven by a decreased mean score of 2.7 (±3.2). Conclusions Sealing of hypersensitive MIH-affected molars revealed a significant improvement of OHRQoL immediately and throughout the 12-week follow-up. Clinical relevance Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating the effect of sealing on OHRQoL in affected patients.
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Affiliation(s)
- Katrin Bekes
- Department of Paediatric Dentistry, Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
| | - Stefanie Amend
- Department of Paediatric Dentistry, Medical Centre for Dentistry Section for Outcomes Research, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Julia Priller
- Department of Paediatric Dentistry, Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - Claudia Zamek
- Private Practice, Graf-Adolf-Straße 24, 40212, Düsseldorf, Germany
| | - Tanja Stamm
- Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Outcomes Research, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Norbert Krämer
- Department of Paediatric Dentistry, Medical University of Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
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Sobral APT, Santos EM, Aranha AC, Soares PV, Moriyama CM, Gonçalves MLL, Ribeiro RA, Motta LJ, Horliana ACRT, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. The control of pain due to dentin hypersensitivity in individuals with molar-incisor hypomineralisation: a protocol for a randomised controlled clinical trial. BMJ Open 2021; 11:e044653. [PMID: 33692185 PMCID: PMC7949385 DOI: 10.1136/bmjopen-2020-044653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dentin hypersensitivity (DH) is defined as high sensitivity of the vital dentin when exposed to thermal, chemical or tactile stimuli. Two mechanisms are required for the occurrence of DH: (1) the dentin must be exposed and (2) the dentinal tubules must be open and connected to the pulp. Molar-incisor hypomineralisation (MIH) is a qualitative abnormality of a genetic origin that affects tooth enamel and, in most cases, is accompanied by DH. The control of tooth sensitivity is fundamental to the successful treatment of MIH. The aim of the proposed randomised, controlled, clinical trial is to evaluate the effectiveness of different protocols for the control of DH in patients with teeth affected by MIH. METHODS AND ANALYSIS One hundred and forty patients who meet the inclusion criteria will be allocated to four groups. Group 1 will be the control group (placebo). In Group 2, sensitive teeth will be sealed with PermaSeal (Ultradent). In Group 3, sensitive teeth will receive low-level laser (LLL, AsGaAl) at a wavelength of 780 nm (Laser XT Therapy, DMC, São Carlos, Brazil). In Group 4, sensitive teeth will be treated with both LLL and PermaSeal (Ultradent). DH will be evaluated 15 min after the application of the treatments and the patients will be reevaluated 1 week, 1 month, 3 months and 6 months after the treatments. The primary outcome of this study is change in pain/sensitivity, when evaluated through a Visual Analogue Scale, to determine the effectiveness of the proposed treatments, as well as differences among the evaluation times for each proposed treatment. ETHICS AND DISSEMINATION This protocol has been ethically approved by the local medical ethical committee (protocol number: 4.020.261). Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT04407702.
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Affiliation(s)
- Ana Paula Taboada Sobral
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Elaine Marcilio Santos
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Pro-rectory for Academic Affairs, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Ana Cecilia Aranha
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo Vinícius Soares
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Marcela Leticia Leal Gonçalves
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | | | - Lara Jansiski Motta
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | | | | | | | - Sandra Kalil Bussadori
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
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Arslanagić A, Marković N, Bajrić E, Burnazović Ristić L. Demarcated Opacities as Predictors of Progression of the Molar Incisor Hypomineralisation: a Pilot Study. Acta Stomatol Croat 2021; 54:420-430. [PMID: 33642606 PMCID: PMC7871435 DOI: 10.15644/asc54/4/9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives Demarcated opacities (DO) on teeth affected by Molar Incisor Hypomineralisation (MIH) were observed to investigate if parameters of DO existence and the number of teeth affected could be used to predict the progression of disease. Material and methods In 2009, the MIH prevalence was 11.5% (n=51) among 446 subjects in Sarajevo, aged from 6 to 9 years. In subjects with MIH who gave consent for further participation (n=25), the teeth with DO were observed after a 12-month period. Results our sample included 29 permanent incisors and 14 first permanent molars with DO. The number of teeth with light opacities was significantly higher than the number of teeth with dark opacities. Opacities were more numerous on surfaces which were not exposed to masticatory pressure. The size of tooth surface affected by DO occurrence ranged from 1.33% to 56.56%. The number of affected teeth ranged from two to six. A strong positive correlation between MIH progression and dark colored opacities located on the occlusal/incisal surface of teeth was noted. Larger part of tooth surface was affected by hypomineralisation in the case of dark-colored opacities. The DO presence on incisors was more likely to be located on vestibular surfaces and on the first permanent molars on their occlusal surfaces. Conclusions The color of DO occurrence was the best predictor for MIH progression both independently and in combination with the number of affected teeth. Location of DO occurrence was a good independent predictor for MIH progression. It is important to collect information about color and location of DO presence.
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Affiliation(s)
- Amra Arslanagić
- University of Sarajevo, Faculty of Dentistry with Clinics, Department of Pedodontics and Preventive Dentistry, Sarajevo, Bosnia and Herzegovina
| | - Nina Marković
- University of Sarajevo, Faculty of Dentistry with Clinics, Department of Pedodontics and Preventive Dentistry, Sarajevo, Bosnia and Herzegovina
| | - Elmedin Bajrić
- University of Sarajevo, Faculty of Dentistry with Clinics, Department of Pedodontics and Preventive Dentistry, Sarajevo, Bosnia and Herzegovina
| | - Lejla Burnazović Ristić
- University of Sarajevo, Medical Faculty, Pharmacology Department, Sarajevo, Bosnia and Herzegovina
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Hypersensitivity in Molar Incisor Hypomineralization: Superficial Infiltration Treatment. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041823] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To date, there are no standardized protocols available in the literature for hypersensitivity treatment in molar incisor hypomineralization (MIH) patients. The aim of this study was to evaluate the efficacy of erosion–infiltration treatments with resin in children with a strong hypersensitivity and also to develop a minimally invasive diagnostic–therapeutic pathway for young MIH patients. Patients with clinical signs of MIH were enrolled according to international guidelines. A total of 42 patients (8–14 years old) with sensitivity of at least one molar and patients with post eruptive enamel fractures, but without dentin involvement or cavitated carious lesions were selected. A single superficial infiltration treatment with ICON (DMG, Germany) was performed with a modified etching technique. Sensitivity was tested with the Schiff Scale and Wong Baker Face Scale and was repeated at 12 months follow-up. All patients reported lower sensitivity values at the end of the treatment. Significant differences of sensitivity according to the Schiff scale were reported between T0 and all subsequent follow-ups, p < 0.05. The treatment of erosion infiltration with ICON resin is a minimally invasive preventive treatment that significantly improves the problem of hypersensitivity in permanent molars with MIH.
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Molar Incisor Hypomineralization (MIH) in a Child with Congenital Chronic Intestinal Pseudoobstruction (CIPO). Case Rep Dent 2021; 2020:8894657. [PMID: 33457023 PMCID: PMC7787807 DOI: 10.1155/2020/8894657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/26/2020] [Accepted: 12/10/2020] [Indexed: 11/18/2022] Open
Abstract
Molar incisor hypomineralization (MIH) is a qualitative enamel defect of systemic origin affecting 1-4 permanent first molars (PFMs) frequently in association with affected permanent incisors (PIs). The exact etiology of MIH is still unclear but considered to be multifactorial. This present case report to the best of our knowledge is the first case reported which acknowledges MIH in a patient with chronic intestinal pseudoobstruction (CIPO) with underlying neurological disease due to somatic mitochondrial disorder. It also elicits the availability of various contemporary treatment options and their proper selection and early intervention to manage the functional and aesthetic problems caused by enamel defects and to improve the quality of life in the patients.
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Bekes K, Mitulović G, Meißner N, Resch U, Gruber R. Saliva proteomic patterns in patients with molar incisor hypomineralization. Sci Rep 2020; 10:7560. [PMID: 32371984 PMCID: PMC7200701 DOI: 10.1038/s41598-020-64614-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/16/2020] [Indexed: 12/12/2022] Open
Abstract
Molar incisor hypomineralization (MIH) is an endemic pediatric disease with an unclear pathogenesis. Considering that saliva controls enamel remineralization and that MIH is associated with higher saliva flow rate, we hypothesized that the protein composition of saliva is linked to disease. To test this, we enrolled 5 children aged 6-14 years with MIH showing at least one hypersensitive molar and 5 caries-free children without hypomineralization. Saliva samples were subjected to proteomic analysis followed by protein classification in to biological pathways. Among 618 salivary proteins identified with high confidence, 88 proteins were identified exclusively in MIH patients and 16 proteins in healthy controls only. Biological pathway analysis classified these 88 patient-only proteins to neutrophil-mediated adaptive immunity, the activation of the classical pathway of complement activation, extracellular matrix degradation, heme scavenging as well as glutathione -and drug metabolism. The 16 controls-only proteins were associated with adaptive immunity related to platelet degranulation and the lysosome. This report suggests that the proteaneous composition of saliva is affected in MIH patients, reflecting a catabolic environment which is linked to inflammation.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Vienna, Austria.
| | - G Mitulović
- Proteomics Core Facility, Clinical Institute of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - U Resch
- Department of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - R Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Muniz RSC, Carvalho CN, Aranha ACC, Dias FMCS, Ferreira MC. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: Randomised clinical trial. Int J Paediatr Dent 2020; 30:323-333. [PMID: 31808584 DOI: 10.1111/ipd.12602] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/23/2019] [Accepted: 12/02/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a qualitative enamel defect. AIM To investigate the low-level laser therapy (LLLT) associated with fluoride varnish for the desensitisation of teeth with MIH. DESIGN A randomised clinical trial was conducted with 66 children, randomly allocated to the treatments: laser (L); fluoride varnish (FV); and laser + fluoride varnish (L + FV). The participants in the L group underwent two sessions of LLLT (48-hour interval). The FV group received four applications of varnish at one-week intervals. The L + FV underwent two sessions of LLLT and four applications of varnish. Prior to each session and one month after the onset of treatment, tooth sensitivity and its magnitude were evaluated. Intra- and inter-group comparisons were performed (α = 5%). RESULTS A significant reduction in the mean sensitivity score was found over time in all groups. After the final treatment, a significant difference was found between the L and L + FV groups (P = .011), with a lower score in the L + FV group (0.09), whereas no difference was found between the FV and L + FV groups (P = .095). CONCLUSIONS Fluoride varnish and the combination of treatments (L + FV) had greater desensitising action on teeth with MIH. Laser therapy demonstrated an immediate desensitising effect, whereas fluoride varnish had a late-onset effect.
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Affiliation(s)
| | - Ceci Nunes Carvalho
- School of Dentistry, Postgraduate Program in Dentistry, Ceuma University, São Luís, Brazil
| | - Ana Cecília Correa Aranha
- Department of Restorative Dentistry, School of Dentistry, São Paulo University, São Paulo, SP, Brazil
| | | | - Meire Coelho Ferreira
- School of Dentistry, Postgraduate Program in Dentistry, Ceuma University, São Luís, Brazil
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Gatón-Hernandéz P, Serrano CR, da Silva LAB, de Castañeda ER, da Silva RAB, Pucinelli CM, Manton D, Ustrell-Torrent JM, Nelson-Filho P. Minimally interventive restorative care of teeth with molar incisor hypomineralization and open apex-A 24-month longitudinal study. Int J Paediatr Dent 2020; 30:4-10. [PMID: 31593607 DOI: 10.1111/ipd.12581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/29/2019] [Accepted: 09/24/2019] [Indexed: 11/29/2022]
Abstract
AIM To assess the efficacy of treatment using a minimally invasive approach (selective removal of carious tissue, restoration and preventive strategies) in immature permanent molars with MIH. DESIGN A total of 281 patients, aged 6-8 years, with carious lesions (ICDAS 5-6), severe MIH, and incomplete root formation (one tooth/patient) were included. After clinical and radiographic examinations, selective carious tissue removal was performed, and the teeth received interim restoration for 6 months and were then restored with composite resin. Clinical and radiographic follow-up was undertaken, 6, 12, 18, and 24 months. A protocol of preventive oral care measures was established and repeated at each follow-up, including diet counselling, oral hygiene instruction, dental plaque control, and topical application of fluoride varnish containing CPP-ACP. All clinical procedures and evaluations were done by a single operator. RESULTS Clinical and radiographic success was observed 24 months after treatment in 96.8% of the cases. Failures were due to enamel fracture at restoration margins, resulting in pulpitis and absence of apex closure. CONCLUSION Selective removal of carious tissue, interim, and subsequently definitive restoration, combined with home and professional preventive measures, maintained marginal integrity of restorations in immature permanent molars with severe MIH, confirmed by pulp vitality and occurrence of apexogenesis.
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Affiliation(s)
| | | | | | | | | | | | - David Manton
- Growth and Development, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia.,School of Dentistry, University of Groningen, Groningen, Netherlands
| | | | - Paulo Nelson-Filho
- School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Elhennawy K, Krois J, Jost-Brinkmann PG, Schwendicke F. Outcome and comparator choice in molar incisor hypomineralisation (MIH) intervention studies: a systematic review and social network analysis. BMJ Open 2019; 9:e028352. [PMID: 31377700 PMCID: PMC6687020 DOI: 10.1136/bmjopen-2018-028352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Outcome and comparator choice strongly determine the validity and implementation of clinical trial results. We aimed to assess outcome and comparator choice in intervention studies on molar incisor hypomineralisation (MIH) using systematic review and social network analysis (SNA). DESIGN AND DATA SOURCES Medline, Embase, Cochrane Central, Google Scholar, opengrey.eu as well as DRKS.de and Clinicaltrials.gov were searched for MIH intervention studies. The search covered the period from 1980 to 2019. ELIGIBILITY CRITERIA Clinical single-arm/multiarm, controlled/uncontrolled studies reporting on the management of MIH were included. Reported outcomes and comparators were extracted and categorised. SNA was used to evaluate comparator choice and the resulting trial networks. DATA EXTRACTION Of the 7979 identified records, 100 were evaluated in full text and 35 studies (17 randomised controlled trials, 14 prospective and 4 retrospective cohort studies) were included. RESULTS In total, 2124 patients with a mean age of 11 years (min/max 6/70 years) were included. Outcomes fell in one of 11 different outcome categories: restoration success, aesthetic improvement, pain/hypersensitivity/discomfort, mineral gain, space management, anaesthesia effectiveness, preventive success, efficiency, quality of life, gingival and periodontal health and patient satisfaction. Comparators were mainly restorative interventions (17 studies), remineralisation (3), treatment of hypersensitivity (10), aesthetic interventions (5) and orthodontic interventions (3). Two highly clustered comparator networks emerged; many interventions were not robustly linked to these networks. CONCLUSIONS MIH intervention studies recorded both clinically centred and patient-centred outcomes. Core outcome set development should consider these and supplement them with outcomes on, for example, applicability. The high number of compared interventions tested in only few studies and our SNA results implicate that the current evidence may not be robust.
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Affiliation(s)
- Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Raposo F, de Carvalho Rodrigues AC, Lia ÉN, Leal SC. Prevalence of Hypersensitivity in Teeth Affected by Molar-Incisor Hypomineralization (MIH). Caries Res 2019; 53:424-430. [PMID: 30677762 DOI: 10.1159/000495848] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 11/28/2018] [Indexed: 11/19/2022] Open
Abstract
AIM This study aimed to investigate the prevalence of hypersensitivity in molar-incisor hypomineralization (MIH)-affected molars through a census carried out in 8-year-old schoolchildren. METHODS Examinations were conducted by a calibrated examiner, using the Nyvad criteria for caries diagnosis and a new criterion for MIH assessment. For hypersensitivity assessment, all MIH-affected molars were included. Nonaffected molars from the same child were used as controls. Air blast reaction was measured using the Visual Analogue Scale (VAS) and the Schiff Cold Air Sensitivity Scale (SCASS) scale, while tactile hypersensitivity was scored using VAS only. Statistical analysis was performed using the Kruskal-Wallis test followed by Dunn's multiple comparisons test for quantitative data. χ2 was used for the comparison of categorical data. RESULTS In total, 631 children were assessed, of whom 102 had MIH-affected molars (16.1%). Of these, 51.7 and 8.7% presented enamel and dentin carious lesions, respectively. Regarding the number of teeth, 239 molars were MIH affected (59.8%), with 188 (78.7%) being classified as mild (opacities only), 20 (8.4%) as moderate (posteruptive enamel breakdown), and 31 (13%) as severe (posteruptive breakdown involving dentin/atypical restorations). Hypersensitivity was recorded in only one control molar, while the prevalence of hypersensitivity in MIH-affected molars was 34.7%, being of low intensity and more prevalent in moderate (55%) and severe cases (51.6 %) than in mild cases (29.8%, p = 0.008). An association between hypersensitivity and the presence of mild and moderate cases was observed. Although the same association was observed for severe cases, it was not considered a reliable information as 90% of the MIH-affected molars with posteruptive breakdown involving dentin were affected by carious lesions. It is known that dental caries is a confounding factor for the presence of hypersensitivity. CONCLUSIONS Hypersensitivity was significantly higher in MIH-affected molars than in nonaffected molars, being associated with MIH teeth presenting opacities and posteruptive enamel breakdown.
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Affiliation(s)
- Fernanda Raposo
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil,
| | | | - Érica Negrini Lia
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - Soraya Coelho Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
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da Cunha Coelho ASE, Mata PCM, Lino CA, Macho VMP, Areias CMFGP, Norton APMAP, Augusto APCM. Dental hypomineralization treatment: A systematic review. J ESTHET RESTOR DENT 2018; 31:26-39. [PMID: 30284749 DOI: 10.1111/jerd.12420] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/08/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. OBJECTIVE To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. MATERIALS AND METHODS PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. RESULTS From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. CONCLUSIONS Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). CLINICAL SIGNIFICANCE Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.
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Affiliation(s)
- Ana Sofia Estima da Cunha Coelho
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,iCBR, Coimbra Institute of Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Carolina Alves Lino
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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