Developmental defects of enamel in first permanent molars associated with use of asthma drugs in preschool aged children: A retrospective case-control study

Assessment of the developmental defects of the enamel in children and adolescents with sickle cell disease: A comparative study

BACKGROUND

Sickle cell disease (SCD) is the most important hemoglobinopathy in terms of frequency and social impact and can affect the stomatognathic system.

AIM

To assess and compare the developmental defects of the enamel (DDE) in children and adolescents with and without SCD.

DESIGN

This was a cross-sectional, analytical, and comparative study of 210 children and adolescents aged 5-18 years, who visited the Hematology and Hemotherapy Hospital of Pernambuco.

RESULTS

Developmental defects of the enamel were observed in 55.2% of the SCD patients and 35.2% of the non-SCD patients (healthy group; p < .05). In the SCD group, DDE were more common in females than in males (69.1% vs. 40.0%; p < .05). The incidence of DDE in the permanent teeth was higher in the upper arch than in the lower arch (SCD group, 13.1% vs. 4.6%; healthy group, 8.9% vs. 3.6%; p < .05).

CONCLUSION

Compared with the healthy group, the SCD patients were almost twice as likely to develop DDE, mostly affecting females and the permanent teeth. These findings suggest that individuals with SCD need early dental care to avoid future oral problems.

Association between asthma and enamel defects in primary and young permanent teeth - A systematic review

Childhood respiratory diseases, such as asthma, are important public health problems worldwide and could be associated with tooth enamel defects. This study aimed to verify the relationship between asthma and enamel defects in teeth, to answer the following question: "Could asthma in children be significantly associated with enamel defects in deciduous dentition and young permanent teeth?." PUBMED-MEDLINE, EMBASE, LILACS, and COCHRANE databases were systematically searched and assessed articles (2000-2021) were cautiously scored according to a predetermined criterion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were considered. Twenty-two articles were critically appraised and used as a basis for conclusions. The relationship between asthma and enamel defects was confirmed in the majority of appraised papers, one with a high level of evidence, nine with a moderate level, and four with a low level. Out of the eight manuscripts investigating the influence of asthma medication on enamel defects, only three (one with high, one moderate, and another with a low level of evidence) suggested an association. It can be concluded that asthma is closely connected with enamel defects in young permanent teeth. However, as most of the papers appraised were of cross-sectional or case-control design, further well-designed clinical investigations with a prospective design are welcome to reinforce our findings.

Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

BACKGROUND

Developmental Defects of Enamel (DDE) is a pathology of the teeth that can greatly alter the quality of life of patients (hypersensitivity, esthetic issues, loss of function, etc.). The acquired DDE may occur as a result of a wide range of acquired etiological factors and his prevalence of this pathology may reach up to 89.9%. The main objective of this research was to identify and analyze, in current literature, the factors related to acquired DDE, in order to propose a general theory about the mechanisms involved.

METHODS

The search of the primary literature was conducted until [December 31, 2021]. Our search strategy uses the Pubmed/MEDLINE database and was structured around 3 terms ["Development," "Defect," and "Enamel"]. To be included, references had to be primary studies, written in English. Exclusion criteria were reviews, in vitro, animal, genetic or archeology studies, and studies focused on clinical management of DDE. One hundred and twenty three articles were included in this scoping review: 4 Randomized clinical trials, 1 letter, 5 cases reports, 2 fundamentals studies, and 111 observational studies (33 Cross-sectional studies, 68 Cohort study and 10 Case-control study). The quality of evidence was assessed using the PEDro scale for clinical trials, the Newcastle-Ottawa scale for observational studies, and a published tool to assess the quality of case reports and case series.

RESULTS

A scoping review of the literature identified 114 factors potentially involved in acquired DDE. The most frequently encountered pathologies are those causing a disorder of calcium homeostasis or a perturbation of the ARNT pathway in mother or child. The link between the ARNT pathway and metabolism deficiency in uncertain and needs to be defined. Also, the implication of this mechanism in tissue impairment is still unclear and needs to be explored.

CONCLUSIONS

By identifying and grouping the risk factors cited in the literature, this taxonomy and the hypotheses related to the mechanism allow health practitioners to adopt behaviors that limit the risk of developing aDDE and to set up a prevention of dental pathology. In addition, by reviewing the current literature, this work provides guidance for basic research, clinical studies, and literature searches.

Prenatal, perinatal and postnatal events associated with hypomineralized second primary molar: a systematic review with meta-analysis

OBJECTIVE

The etiology of hypomineralized second primary molar (HSPM) appears to be multifactorial but remains uncertain. Thus, the objective was to systematically review studies that investigated adverse health conditions in the prenatal, perinatal and postnatal periods associated with HSPM.

MATERIAL AND METHODS

The search was carried out in five databases and in gray literature. The risk of bias of observational studies was analyzed according to the Newcastle-Ottawa scale.

RESULTS

A total of 1878 studies were identified. Fourteen were eligible, and seven were included in the meta-analysis. Maternal smoking (OR = 2.88; 95%CI: 1.62-5.15) and presence of maternal hypertension (OR = 2.91; 95%CI: 1.35-6.28) were significantly associated with higher odds of HSPM. In the perinatal period, factors associated with HSPM were low birth weight (OR = 1.50; 95%CI: 1.15-1.96), prematurity (OR = 1.93; 95%CI: 1.37-2.71), delivery complications (OR = 2.42; 95%CI: 1.52-3.83) and need for an incubator (OR = 1.65; 95%CI: 1.01-2.70). Not breastfeeding (OR = 1.26; 95%CI: 1.01-1.58), use of antibiotics by the child (OR = 1.24; 95%CI: 1.04-1.48), fever (OR = 1.37; 95%CI: 1.10-1.72) and asthma (OR = 1.91; 95%CI: 1.16-3.13) were the postnatal factors associated with HSPM.

CONCLUSION

Maternal smoking, maternal hypertension, low birth weight, prematurity, delivery complications, need for incubation, not breastfeeding, antibiotic use, fever and childhood asthma were associated with HSPM. Well-designed prospective cohort studies are needed. Clinical relevance Understanding the etiological factors can be guiding aspects for individual clinical approaches, as well as guiding the design of preventive interventions for HSPM.

Root canal instrumentation efficacy of non-fused and fused primary molar roots: a micro-computed tomography study

PURPOSE

Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc^® Blue and MTwo^®) with manual stainless-steel instrumentation in primary molars using micro-CT analysis.

METHODS

Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three divergent roots were divided randomly (n = 15) according to instrument type (K file, MTwo®, and Reciproc® Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded.

RESULTS

No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p < 0.001) roots. The root segment had a significant effect on IA (p < 0.001) and the highest mean IA was observed in the apical third. Manual instrumentation had fewer procedural complications compared with rotary systems.

CONCLUSION

No differences were determined in the cleaning and shaping effectiveness of all systems in non-fused teeth. Uninstrumented areas (> 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation.

Biomechanical preparation in primary molars using manual and three NiTi instruments: a cone-beam-computed tomographic in vitro study

PURPOSE

To evaluate nickel-titanium rotary systems, ProTaper Universal (PTU), ProTaper Next (PTN), self-adjusting file (SAF), and stainless steel hand K files in deciduous root canals in longitudinal and horizontal sections by three-dimensional reconstruction. Whether there was any difference in shaping ability, transportation, dentine removal, untouched canal surface area, and preparation time among the different groups when used in primary root canals.

METHODS

Shaping and cleaning of canals in primary molars were done using the four systems, and CBCT and specialized software were used for scanning, image processing, three-dimensional reconstruction, and analysis of pre-operative and post-operative to evaluate the groups for their shaping properties, transportation, amount of dentine removal, untouched canal surface area, and preparation time in primary root canals.

RESULTS

None of the groups reported stripping of canals or instrument failure. SAF demonstrated less removal of dentine as compared to other groups. Hand K files presented with high untouched canal surface area, while it was least with SAF. In addition, rotary files provided faster preparation than hand files, and among the rotary systems, PTN took least time for cleaning and shaping of canals. All the groups were similar in transportation at cervical and apical third.

CONCLUSION

Under the conditions of this study, SAF seemed to result in more conservative and meticulous removal of dentine. This is desirable to preserve the integrity of thin-walled primary root canals. SAF also showed less untouched canal areas suggesting better contact with the primary canal walls. The rotary file groups required less clinical time which is important in paediatric treatments.