1
|
Carvalho MR, Molena KF, Regalo SCH, Gonçalves LMN, de Paula-Silva FWG, Vicioni-Marques F, de Vasconcelos PB, de Carvalho FK, de Queiroz AM. Analysis of the stomatognathic system functions and mastication muscles in children affected by molar hypomineralization (MH): a cross-sectional study. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00925-3. [PMID: 38969936 DOI: 10.1007/s40368-024-00925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE To analyze the functions of the stomatognathic system in children with or without molar-incisor hypomineralization (MIH). METHODS For this cross-sectional study, 72 children aged 6-12 years were recruited and divided in two groups: with MIH (G1) and without MIH (G2). T-SCAN was used to verify the distribution of occlusal contacts, gnathodynamometer to measure maximum molar bite force, and Iowa Oral Pressure Instrument (IOPI) to assess the strength of facial expression muscles. The t test and paired t test (p ≤ 0.05) were used for statistical comparisons. RESULTS The molars affected by MIH exhibited lower distribution of occlusal forces (p < 0.001) and lower maximum molar bite force (p < 0.05) compared to the molars in the control group. However, there was no difference between the MIH-affected sides compared to the unaffected side, nor between the molars affected by MIH and their antagonists (p > 0.05). There were no differences in the forces of the facial expression muscles between the groups. CONCLUSIONS These findings suggest that MIH significantly impacts occlusal force distribution and bite force, but not facial expression musculature.
Collapse
Affiliation(s)
- M R Carvalho
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| | - K F Molena
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| | - S C H Regalo
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
- National Institute for Translational Medicine (INCT-TM), Ribeirão Preto, Brazil
| | - L M N Gonçalves
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| | - F W G de Paula-Silva
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| | - F Vicioni-Marques
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| | - P B de Vasconcelos
- National Institute for Translational Medicine (INCT-TM), Ribeirão Preto, Brazil
| | - F K de Carvalho
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil.
| | - A M de Queiroz
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. Do Café, Ribeirao Preto, São Paulo, Brazil
| |
Collapse
|
2
|
Gevert MV, Wambier LM, Ito LY, Feltrin de Souza J, Chibinski ACR. Which are the clinical consequences of Molar Incisor hypomineralization (MIH) in children and adolescents? Systematic review and meta-analysis. Clin Oral Investig 2024; 28:415. [PMID: 38967818 DOI: 10.1007/s00784-024-05800-5] [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: 03/11/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE This systematic review was conducted to address the following research question: "What are the clinical consequences (outcome) of Molar Incisor Hypomineralization (MIH) (exposure) in children and adolescents (population/patient)?". MATERIAL AND METHODS After defining the strategy, a search was performed in different databases (MEDLINE via Pubmed, Cochrane Library, BBO, LILACS, Scopus, Web of Science, Embase) and Grey literature in August 2023. Cross-sectional observational studies that identified clinical consequences of MIH (dental caries, post-eruptive structural loss, atypical restorations, hypersensitivity and tooth extraction) were included. The risk of bias was assessed following the Joanna Briggs Institute protocol for cross-sectional studies. Meta-analyses were conducted for each outcome, taking into account the number of patients and teeth. The effect measure considered was the prevalence; random-effects model was adopted. Heterogeneity was assessed using I2 statistics and prediction intervals (PI). RESULTS A total of 903 studies were identified; 41 were selected for qualitative analysis and 38 for quantitative analysis. Twenty eight studies were classified as presenting uncertain risk of bias, 11 as low risk and 3 as high risk of bias. The prevalence levels, ranked from highest to lowest and considering the tooth and patient units, respectively, were: caries lesions (0.252 - 95% CI 0.158-0.375; 0.512 - 95% CI 0.385-0.639); hypersensitivity (0.286 - 95% CI 0.190-0.407; 0.417 - 95% CI 0.197-0.674), post-eruptive fracture (0.125 - 95% CI 0.099-0.158; 0.257 - 95% CI 0.145-0.412); atypical restorations (0.048 - 95% CI 0.030-0.077; 0.167 - 95% CI 0.096 - 0.274); tooth extraction (0.012 - 95% CI 0.007-0.019; 0.090 - 95% CI 0.019 - 0.331). All meta-analyses resulted in heterogeneity greater than 85%, with the exception of the outcome "tooth extraction" according to the tooth unit (I2 = 57.83). This heterogeneity may be attributed to factors such as differences in the location where the study was realized, the socioeconomic conditions of the studied population, the asymmetric nature of MIH, and patient age. CONCLUSION The most common consequences of MIH are caries lesions, hypersensitivity, and post-eruptive breakdown. (PROSPERO:CRD42020201410).
Collapse
Affiliation(s)
- Mayara Vitorino Gevert
- Departament of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Letícia Maira Wambier
- Departament of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Larissa Yumi Ito
- Departament of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | |
Collapse
|
3
|
Neumayr J, Frenkel E, Schwarzmaier J, Ammar N, Kessler A, Schwendicke F, Kühnisch J, Dujic H. External validation of an artificial intelligence-based method for the detection and classification of molar incisor hypomineralisation in dental photographs. J Dent 2024; 148:105228. [PMID: 38972447 DOI: 10.1016/j.jdent.2024.105228] [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: 05/27/2024] [Revised: 06/29/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024] Open
Abstract
OBJECTIVES This ex vivo diagnostic study aimed to externally validate an open-access artificial intelligence (AI)-based model for the detection, classification, localisation and segmentation of enamel/molar incisor hypomineralisation (EH/MIH). METHODS An independent sample of web images showing teeth with (n = 277) and without (n = 178) EH/MIH was evaluated by a workgroup of dentists whose consensus served as the reference standard. Then, an AI-based model was used for the detection of EH/MIH, followed by automated classification and segmentation of the findings (test method). The accuracy (ACC), sensitivity (SE), specificity (SP) and area under the curve (AUC) were determined. Furthermore, the correctness of EH/MIH lesion localisation and segmentation was evaluated. RESULTS An overall ACC of 94.3 % was achieved for image-based detection of EH/MIH. Cross-classification of the AI-based class prediction and the reference standard resulted in an agreement of 89.2 % for all diagnostic decisions (n = 594), with an ACC between 91.4 % and 97.8 %. The corresponding SE and SP values ranged from 81.7 % to 92.8 % and 91.9 % to 98.7 %, respectively. The AUC varied between 0.894 and 0.945. Image size had only a limited impact on diagnostic performance. The AI-based model correctly predicted EH/MIH localisation in 97.3 % of cases. For the detected lesions, segmentation was fully correct in 63.4 % of all cases and partially correct in 33.9 %. CONCLUSIONS This study documented the promising diagnostic performance of an open-access AI tool in the detection and classification of EH/MIH in external images. CLINICAL SIGNIFICANCE Externally validated AI-based diagnostic methods could facilitate the detection of EH/MIH lesions in dental photographs.
Collapse
Affiliation(s)
- Julia Neumayr
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| | - Elisabeth Frenkel
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| | - Julia Schwarzmaier
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| | - Nour Ammar
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| | - Andreas Kessler
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany; Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany.
| | - Helena Dujic
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, Klinikum der Ludwig-Maximilians-Universität München, Klinik für Zahnerhaltung und Parodontologie, LMU, Goethestraße 70, Munich 80336, Germany
| |
Collapse
|
4
|
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.
Collapse
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;
| |
Collapse
|
5
|
Brejawi M, Venkiteswaran A, Sabri BM. Further discussions are needed regarding the currently used criteria for MIH diagnosis. Eur Arch Paediatr Dent 2024; 25:451-452. [PMID: 38407733 DOI: 10.1007/s40368-024-00873-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/27/2024]
Affiliation(s)
- M Brejawi
- Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia.
- Faculty of Dentistry, City University Ajman, Ajman, United Arab Emirates.
| | - A Venkiteswaran
- Lecturer of Paediatric Dentistry, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - B Md Sabri
- Lecturer and Head of Center of Population Oral Health and Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| |
Collapse
|
6
|
Wanderley Lacerda RH, Filgueiras VM, Guedes Mendonça AC, Vieira AR. Molar-incisor hypomineralization in a cohort of individuals born with cleft lip and palate. Orthod Craniofac Res 2024; 27 Suppl 1:21-26. [PMID: 37643023 DOI: 10.1111/ocr.12708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE This study aimed to investigate the frequency of molar-incisor hypomineralization (MIH) in individuals born with cleft lip and or cleft palate. SETTINGS AND SAMPLE Three hundred eighty-six individuals born with cleft lip and/or palate before orthodontic treatment. METHODS All the individuals were submitted to a clinical examination and intraoral standardized photos. The registration of MIH was taken by two orthodontists and analysed in association with the cleft type and laterality. The Kruskal-Wallis test and the regression test were used to compare the frequency of molars and incisors affected according to cleft type and laterality, sex and age. RESULTS We found a frequency of 67.87% of MIH in the studied sample. The frequency varied from 25% (in individuals born with cleft palate) to 77% in individuals born with bilateral cleft lip and palate). The number of affected molars was statistically different depending on cleft type and laterality (P < .001- Kruskal-Wallis test). Differences were found between individuals born with unilateral cleft lip and palate and unilateral cleft lip and alveolus (P = .03), and with isolated cleft palate (P = .03), and between individuals born with bilateral cleft lip and palate and born with unilateral cleft lip and alveolus (P = .01), and cleft palate (P = .01). Sex (P = .21) and age (P = .36) had no influence on the frequency of MIH. A positive correlation was found between the number of molars affected and incisors affected (P < .001). CONCLUSION Individuals born with cleft lip and palate have a higher frequency of MIH, and the complexity of cleft type was associated with the number of affected molars.
Collapse
Affiliation(s)
| | - Vitor Marques Filgueiras
- Cleft Lip and Palate Center, University Hospital of Paraiba, Federal University of Paraiba, Paraíba, Brazil
| | | | - Alexandre Rezende Vieira
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
7
|
Bekes K, Steffen R, Krämer N. Hypomineralised second primary molars: the Würzburg concept. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00913-7. [PMID: 38805129 DOI: 10.1007/s40368-024-00913-7] [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: 03/16/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE In addition to molar incisor hypomineralisation, the occurrence of enamel hypomineralisation in the primary dentition has become increasingly important in recent years. Hypomineralised second primary molar (HSPM) is defined as hypomineralisation of systemic origin affecting from one to all four second primary molars. Some years ago, the "Würzburg concept" was introduced, which proposed a grading of MIH findings (MIH treatment need index) in combination with an appropriate treatment plan depending on the severity of the affected tooth. Recently, this concept was updated and new treatment approaches have been added. However, currently, the concept solely addresses the treatment plan for permanent teeth. As there is a need to expand its scope to encompass primary teeth and, consequently, HSPM, this paper seeks to develop the second component of the Würzburg concept, the treatment plan, for the primary dentition in response to the increased focus on the disease in recent years. Although the evidence base for the different treatment options is still weak, there is a need for guidance for clinicians in their day-to-day practice. METHODS The authors conducted a comprehensive review of the literature, encompassing clinical and laboratory studies along with published guidelines. RESULTS The treatment plan of the HSPM Würzburg concept contains prophylactic and regenerative aspects, non-invasive interventions, temporary and permanent restorative techniques, and extraction. CONCLUSIONS The intention is to provide practical guidance to practitioners, acknowledging the necessity for further validation through clinical trials.
Collapse
Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Pediatric Dentistry, Justus Liebig University, Giessen, Germany
| |
Collapse
|
8
|
Taylor GD, Exley C, Innes N, Vernazza CR. Young people's and adults' views and experiences of decision-making to manage compromised first permanent molars: a qualitative study. Int J Paediatr Dent 2024. [PMID: 38803044 DOI: 10.1111/ipd.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/27/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Little information on young people's and adults' views and experiences on decision-making for managing compromised first permanent molars (cFPM) exists. AIM To establish young people's and adults' views and experiences of decision-making for managing cFPM. DESIGN Face-to-face (online) semi-structured interviews were undertaken using an iteratively designed topic guide. Participants aged 12-65 were purposively sampled with recruitment from different dental clinics (three primary care, an out-of-hours emergency and one dental hospital). Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS Three themes were generated from young people's interviews (n = 9): (i) influencing factors; (ii) long-term considerations; and (iii) shared decision-making. Three themes were generated from adults' interviews (n = 13): (i) influences that affect decisions; (ii) perceptions of the specialist's role; and (iii) importance of shared decision-making for children and young people. CONCLUSION Several factors influenced decision-making; for young people, professional opinions were important, and parental/peer influences less so. For adults, it was based on decisions on their prior experiences. Adults felt young people were abnormal if referred to a specialist. Young people wanted autonomy in decision-making to be respected; in reality, their views were rarely heard. There is potential to increase young people's involvement in shared decision-making for cFPM, which aligns with their aspirations.
Collapse
Affiliation(s)
- Greig D Taylor
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Nicola Innes
- School of Dentistry, Cardiff University, Cardiff, UK
| | - Christopher Robert Vernazza
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| |
Collapse
|
9
|
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] [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.
Collapse
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.
| |
Collapse
|
10
|
da Costa Rosa T, Cavalcanti YW, de Castro Costa M, de Almeida Neves A. Cost-effectiveness of restorative treatments for permanent molars with severe molar incisor hypomineralization: perspectives for the Brazilian public health system. Clin Oral Investig 2024; 28:301. [PMID: 38710794 DOI: 10.1007/s00784-024-05652-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: 09/18/2023] [Accepted: 04/03/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES To undertake a cost-effectiveness analysis of restorative treatments for a first permanent molar with severe molar incisor hypomineralization from the perspective of the Brazilian public system. MATERIALS AND METHODS Two models were constructed: a one-year decision tree and a ten-year Markov model, each based on a hypothetical cohort of one thousand individuals through Monte Carlo simulation. Eight restorative strategies were evaluated: high viscosity glass ionomer cement (HVGIC); encapsulated GIC; etch and rinse adhesive + composite; self-etch adhesive + composite; preformed stainless steel crown; HVGIC + etch and rinse adhesive + composite; HVGIC + self-etch adhesive + composite, and encapsulated GIC + etch and rinse adhesive + composite. Effectiveness data were sourced from the literature. Micro-costing was applied using 2022 USD market averages with a 5% variation. Incremental cost-effectiveness ratio (ICER), net monetary benefit (%NMB), and the budgetary impact were obtained. RESULTS Cost-effective treatments included HVGIC (%NMB = 0%/ 0%), encapsulated GIC (%NMB = 19.4%/ 19.7%), and encapsulated GIC + etch and rinse adhesive + composite (%NMB = 23.4%/ 24.5%) at 1 year and 10 years, respectively. The benefit gain of encapsulated GIC + etch and rinse adhesive + composite in relation to encapsulated GIC was small when compared to the cost increase at 1 year (gain of 3.28% and increase of USD 24.26) and 10 years (gain of 4% and increase of USD 15.54). CONCLUSION Within the horizon and perspective analyzed, the most cost-effective treatment was encapsulated GIC restoration. CLINICAL RELEVANCE This study can provide information for decision-making.
Collapse
Affiliation(s)
- Thamirys da Costa Rosa
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil
| | - Yuri Wanderley Cavalcanti
- Department of Clinical and Social Dentistry, School of Dentistry, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Marcelo de Castro Costa
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil.
| |
Collapse
|
11
|
Aykanat B, Elbay M. Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A randomized clinical trial. Int J Paediatr Dent 2024; 34:219-228. [PMID: 37688333 DOI: 10.1111/ipd.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/06/2023] [Accepted: 08/07/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low-level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied. AIM To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH. DESIGN This prospective, parallel-arm control, randomized, triple-blind clinical trial included children aged 7-12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p < .05). The chi-squared test was used to determine the effect of PBMT on categorical outcomes. RESULTS The no-pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate-to-high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p = .235, p = .143). CONCLUSIONS Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH.
Collapse
Affiliation(s)
- Berkehan Aykanat
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Mesut Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| |
Collapse
|
12
|
Papanikolaou F, Hesse D, Manton DJ, Bruers JJ, Garot E, Bonifácio CC. Knowledge and management of molar-incisor hypomineralisation amongst dentists in The Netherlands. Int J Paediatr Dent 2024. [PMID: 38659160 DOI: 10.1111/ipd.13197] [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] [Received: 12/19/2023] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a frequently encountered dental condition in the clinical setting, and correct diagnosis can influence management outcomes. AIM To assess the knowledge of and attitudes towards the management of MIH amongst dentists in the Netherlands. DESIGN The study was conducted as a cross-sectional web survey. The questionnaire used included questions regarding respondent characteristics, awareness, knowledge and management of MIH and was distributed through the Royal Dutch Association for Dentistry (KNMT) to a random sample of 900 dentists. Variables were analysed using descriptive statistics, and differences between distinct groups of dentists were tested using the chi-squared test. RESULTS Respondents consisted of 76.6% general dental practitioners, 9.1% paediatric dentists and 14.3% differentiated (specialist) dentists, with a 25.6% overall response rate. The majority knew the term MIH and its clinical characteristics, and could distinguish MIH from other enamel defects. Regarding aetiological factors, 76.6% reported a genetic component. In an asymptomatic case, 47.3% reported non-invasive treatments. In a mild symptomatic case, treatments from non-invasive to invasive were reported (p < .05). In a severe symptomatic case, the majority reported invasive treatments. Two-thirds of respondents were interested in further clinical training about MIH. CONCLUSIONS Most respondents knew the term MIH and its clinical characteristics and would like further clinical training about MIH.
Collapse
Affiliation(s)
- Foteini Papanikolaou
- Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniela Hesse
- Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David J Manton
- Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Cariology, Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Josef J Bruers
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Royal Dutch Dental Association (KNMT), Utrecht, The Netherlands
| | | | - Clarissa Calil Bonifácio
- Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
13
|
Marcianes M, Garcia-Camba P, Albaladejo A, Varela Morales M. Potential Association of Molar-Incisor Hypomineralization (MIH) with Dental Agenesis and Infraoccluded Deciduous Molars: Is MIH Related to Dental Anomaly Pattern (DAP)? An Observational Cross-Sectional Study. J Clin Med 2024; 13:2445. [PMID: 38673718 PMCID: PMC11051123 DOI: 10.3390/jcm13082445] [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: 02/20/2024] [Revised: 03/14/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8-14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis.
Collapse
Affiliation(s)
- Maria Marcianes
- Unit of Orthodontist, University Hospital Fundación Jiménez Diaz, 28040 Madrid, Spain (M.V.M.)
| | - Pablo Garcia-Camba
- Unit of Orthodontist, University Hospital Fundación Jiménez Diaz, 28040 Madrid, Spain (M.V.M.)
| | - Alberto Albaladejo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | | |
Collapse
|
14
|
Disha V, Zaimi M, Petrela E, Aliaj F. An Investigation into the Prevalence of Enamel Hypoplasia in an Urban Area Based on the Types and Affected Teeth. CHILDREN (BASEL, SWITZERLAND) 2024; 11:474. [PMID: 38671691 PMCID: PMC11049504 DOI: 10.3390/children11040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
Enamel hypoplasia (EH) is a qualitative defect, and it can have a significant impact on oral health. The aim of this study was to evaluate the prevalence of enamel hypoplasia in urban area in Albania. METHODOLOGY In total, 234 children of both sexes aged 8-12 years old were randomly selected in five schools in Tirana, Albania. They underwent an intra-oral examination. Diagnostic criteria were in accordance with a European meeting on MIH held in Athens, 2003, and the FDI. Medical history was retrieved using questionnaires, and data obtained from clinical examination were recorded. RESULTS The prevalence of enamel hypoplasia was 12.8%. The most commonly occurring enamel hypoplasia was the mild type (58.62%). The mandibular first molar showed the highest prevalence of enamel hypoplasia (19.5%), and the maxillary canines and premolars were the least affected (2.3%). In this study, medical story did not have a significant effect on enamel hypoplasia. CONCLUSIONS The prevalence of enamel hypoplasia remains high at 12.8%. Interestingly, the features of enamel hypoplasia were consistent across both sexes, with no correlation found between them. The predominant occurrence of mild enamel hypoplasia underscores the importance of implementing oral hygiene strategies in schools to mitigate its progression.
Collapse
Affiliation(s)
- Valbona Disha
- Department of Dentistry, Faculty of Medical Science, Albanian University, 1001 Tirana, Albania;
| | - Marin Zaimi
- Department of General and Visceral Surgery, Ulm University Hospital, 89075 Ulm, Germany
| | - Elizana Petrela
- Faculty of Medicine, Head of Statistic Service, UHC “Mother Teresa”, University of Medicine Tirana, 1001 Tirana, Albania
| | | |
Collapse
|
15
|
Brejawi M, Venkiteswaran A, Ergieg SMO, Md Sabri BA. Caries experience in children with molar-incisor hypomineralisation in Fujairah, United Arab Emirates and its association with hypomineralised teeth number. Eur Arch Paediatr Dent 2024; 25:211-216. [PMID: 38411884 DOI: 10.1007/s40368-024-00867-w] [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: 07/26/2023] [Accepted: 01/15/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) has been found associated with an increase in dental caries. Studies utilising the recent MIH diagnosis and calibration criteria recommended by the EAPD in 2021 are very scarce. Additionally, the available data in literature about the relationship between the hypomineralised teeth number (HTN) and caries come from only one study. PURPOSE To assess the relationship between MIH and caries experience among children in the city of Fujairah, UAE, utilising the recent criteria recommended by the European Academy of Paediatric Dentistry (EAPD) in 2021, and to assess the relationship between the number of teeth affected with MIH, and dental caries. METHODS One hundred and sixty-two children were included in this cross-sectional study, aged 7-9 years old. Children were examined for MIH according to Ghanim et al. (Eur Arch Paediatr Dent 16:235-246, 2015. 10.1007/s40368-015-0178-8) criteria and Ghanim et al. (Eur Arch Paediatr Dent 18:225-242. 10.1007/s40368-017-0293-92017) training manual. Caries experience was assessed with decayed, missing, filled (dmft, DMFT) scoring system. RESULTS dmft mean was 6.56 (SD ± 3.78) and DMFT mean was 0.91 (SD ± 1.23). Children with MIH had significantly higher dmft (p = 0.003) scores. Children with higher HTN had significantly higher dmft (p = 0.008) scores. CONCLUSION Children in Fujairah have extremely high caries scores. Children with MIH have more decayed, missing and filled teeth. Hypomineralised teeth number was positively associated with caries experience.
Collapse
Affiliation(s)
- M Brejawi
- Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
- Department of Pediatric Dentistry, City University Ajman, Ajman, UAE
| | - A Venkiteswaran
- Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia
| | - S M O Ergieg
- Faculty of Dentistry, Ajman University, Ajman, UAE
| | - B A Md Sabri
- Center of Population Oral Health and Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia.
| |
Collapse
|
16
|
Winkler JR, Dixon BL, Singh I, Soto R, Qiu Y, Zhang Y, Porucznik CA, Stanford JB. Prenatal exposure to environmental toxins and comprehensive dental findings in a population cohort of children. BMC Oral Health 2024; 24:326. [PMID: 38468230 DOI: 10.1186/s12903-023-03786-2] [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: 10/05/2022] [Accepted: 12/15/2023] [Indexed: 03/13/2024] Open
Abstract
Environmental toxins are known to have many impacts on growth and development in humans, starting in utero. Alterations in amelogenesis, caused by chemical and physical trauma that occur during the antenatal, perinatal and postnatal time periods, may result in developmental defects in deciduous and permanent tooth enamel, as demonstrated in animal studies. These defects can be clinically visible and result in a variety of morphological and functional problems in the dentition. Since enamel does not remodel after formation, it may serve as a permanent record of insults during organ development.Our primary purpose was to investigate any possible relationship between intrauterine exposure to endocrine disrupting chemicals (phenols and phthalates) and developmental defects in enamel in children, while also accounting for fluoride exposure. Our secondary purpose was to report descriptively on findings from comprehensive dental examinations performed on 356 children that were drawn from the general paediatric population. A cohort of children from the Utah Children's Project (N = 356) that had full medical exams, comprehensive medical and family histories and available biospecimens were given extraoral and intraoral examinations. They also completed an oral health questionnaire. Standardized intraoral photographs were taken of the teeth and viewed by standardised examiners and the dental observations were recorded for a full inventory of findings, including: tooth morphology, caries, restorations, colorations, attrition, erosion, fractures and hypomineralization. Perinatal maternal urine samples were assessed for the concentration of fluoride, phenols and phthalates, including bisphenol A (BPA).Pairwise statistical analyses were done to correlate the dental findings with one another and with the presence of environment chemicals found in the urine samples. Hypomineralization was the most common finding (96% of children; 37% of deciduous teeth, 42% of permanent teeth), consistent with molar incisor hypomineralization (MIH) described in other human populations. No consistent correlations were seen between dental findings and the presence of phenols and phthalates in prenatal urine, but the number of samples available for the assessment was limited (n = 35).In conclusion, we found a high proportion of dental hypomineralization in a population based paediatric cohort, but did not find an association with prenatal exposure to phenols and phthalates.
Collapse
Affiliation(s)
- James R Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Barbara L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Ishita Singh
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ray Soto
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Yuqing Qiu
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yue Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.
| |
Collapse
|
17
|
Afzal SH, Skaare AB, Wigen TI, Brusevold IJ. Molar-Incisor Hypomineralisation: Severity, caries and hypersensitivity. J Dent 2024; 142:104881. [PMID: 38331377 DOI: 10.1016/j.jdent.2024.104881] [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: 11/19/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES To investigate distribution of affected teeth and severity of molar-incisor hypomineralisation (MIH) in 8-9-year-old children. A second aim was to study association between severity of MIH and hypersensitivity, caries, and affection of incisors and second primary molars (SPM). METHODS A total of 3013 children in one age cohort participated in a cross-sectional study, of which 851 children were diagnosed with MIH. A majority of these children were re-examined and MIH diagnosis based on the European Academy of Paediatric Dentistry criteria was confirmed in 538 children. The re-examinations were undertaken at the local clinics by one calibrated dentist. Data were tested with bivariate logistic regression analysis. Results were reported using frequencies, proportions, odds ratios (OR) and confidence intervals (CI). RESULTS Almost half of the children with MIH (46.8 %) had at least one severely affected molar. Incisors were affected in 51.9 % of children with MIH, and the prevalence was higher in children with severe affection (57.4 %, p < 0.01). Among children with MIH, second primary molars were affected in 29.6 %, hypersensitivity in at least one first permanent molar was reported by 25.8 and 30.8 % had caries extending to dentine. Children classified with severe MIH were more likely to suffer from hypersensitivity (OR 5.62, 95 % CI 3.61-8.74) and dentine caries (OR 10.32, 95 % CI 6.46-16.50) than children with mild MIH. CONCLUSION Prevalence of hypomineralised incisors and SPM were high in the studied children with MIH. Children with severe MIH had higher probability of incisor affection, dentin caries and hypersensitivity. CLINICAL SIGNIFICANCE This study highlights the importance of understanding the association between MIH, caries and hypersensitivity, especially in children with severe MIH. These children need extensive and individualized care in the dental services to prevent caries and pain.
Collapse
Affiliation(s)
- Sadaf Haque Afzal
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, PO-Box 1109, Oslo 0317, Norway.
| | - Anne Berit Skaare
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, PO-Box 1109, Oslo 0317, Norway
| | - Tove Irene Wigen
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, PO-Box 1109, Oslo 0317, Norway
| | - Ingvild Johnsen Brusevold
- Department of Paediatric Dentistry, Behavioural Science and Forensic Dentistry, Institute of Clinical Dentistry, University of Oslo, PO-Box 1109, Oslo 0317, Norway
| |
Collapse
|
18
|
Santos PB. Why orthodontists need to know about molar incisor hypomineralization. Am J Orthod Dentofacial Orthop 2024; 165:256-261. [PMID: 38149955 DOI: 10.1016/j.ajodo.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/28/2023]
Abstract
Molar incisor hypomineralization (MIH) is a systemic developmental qualitative defect of the enamel that affects 1-4 first permanent molars with or without incisor involvement. Enamel hypomineralization is identified visually as a demarcated opacity with a clear border with varying extensions and can be white, yellow, or brown. This opacity is characterized by a reduced quality of enamel that is of normal thickness but not fully mineralized. It is very common for the affected teeth to present with posteruptive breakdown, making them susceptible to caries, leading to their subsequent loss. Thus, MIH is a significant dental problem with clinical, economic, and psychosocial implications. The planned extraction of compromised teeth is a valid alternative to complex restorative treatment. Orthodontists' involvement is essential in developing effective treatment strategies for children affected by MIH, contributing to their oral health and well-being.
Collapse
Affiliation(s)
- Patrícia Bittencourt Santos
- Department of Orthodontics and Pediatric Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| |
Collapse
|
19
|
Vieira LDS, Mandetta ARH, Bortoletto CC, Sobral APT, Motta LJ, Mesquita Ferrari RA, Duran CCG, Horliana ACRT, Fernandes KPS, Bussadori SK. A minimal interventive protocol using antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization: A case report. JOURNAL OF BIOPHOTONICS 2024; 17:e202300414. [PMID: 38163676 DOI: 10.1002/jbio.202300414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/17/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Molar incisor hypomineralization (MIH) is a qualitative developmental defect of enamel that occurs during the mineralization phase. Patients with MIH have increased risk of caries, hypersensitivity, and restoration failures. The present case report describes the treatment of a 10-year-old patient exhibiting two teeth with atypical carious lesions. A minimal interventive protocol was instituted combining antimicrobial photodynamic therapy and the selective chemical-mechanical removal of the carious tissue using the product Papacárie Duo®. This protocol is promising for the decontamination and control of hypersensitivity in teeth with MIH.
Collapse
Affiliation(s)
- Letícia Diniz Santos Vieira
- Undergraduate Program in Dentistry, UNICEPLAC University, Brasília, DF, Brazil
- Postgraduation Program in Biophotonic Medicine, Universidade Nove de Julho - UNINOVE, São Paulo, SP, Brazil
| | | | | | - Ana Paula Taboada Sobral
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos - UNIMES, Santos, SP, Brazil
| | - Lara Jansiski Motta
- Postgraduation Program in Biophotonic Medicine, Universidade Nove de Julho - UNINOVE, São Paulo, SP, Brazil
| | | | | | | | | | - Sandra Kalil Bussadori
- Postgraduation Program in Biophotonic Medicine, Universidade Nove de Julho - UNINOVE, São Paulo, SP, Brazil
| |
Collapse
|
20
|
Al-Nerabieah Z, AlKhouli M, Dashash M. Parental satisfaction and acceptance of silver diamine fluoride treatment for molar incisor hypomineralisation in pediatric dentistry: a cross-sectional study. Sci Rep 2024; 14:4544. [PMID: 38402306 PMCID: PMC10894263 DOI: 10.1038/s41598-024-55456-0] [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: 10/27/2023] [Accepted: 02/23/2024] [Indexed: 02/26/2024] Open
Abstract
The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6-9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH.
Collapse
Affiliation(s)
- Zuhair Al-Nerabieah
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Muaaz AlKhouli
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Mayssoon Dashash
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria
| |
Collapse
|
21
|
Al-Nerabieah Z, AlKhouli M, Dashash M. Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial. F1000Res 2024; 12:1052. [PMID: 38778809 PMCID: PMC11109571 DOI: 10.12688/f1000research.136653.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 05/25/2024] Open
Abstract
Background This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and Casein Phosphopeptide-Amorphous Calcium Phosphate fluoride Varnish (CPP-ACPFV) in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or CPP-ACPFV treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and CPP-ACPFV ( P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups ( P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with CPP-ACPFV. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and CPP-ACPFV as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration ISRCTN54243749 (13/01/2022).
Collapse
Affiliation(s)
- Zuhair Al-Nerabieah
- Pediatric Dentistry, Damascus University, Damascus, Damascus Governorate, Syria
| | - Muaaz AlKhouli
- Pediatric Dentistry, Damascus University, Damascus, Damascus Governorate, Syria
| | - Mayssoon Dashash
- Pediatric Dentistry, Damascus University, Damascus, Damascus Governorate, Syria
| |
Collapse
|
22
|
Ortega-Luengo S, Feijóo-Garcia G, Miegimolle-Herrero M, Gallardo-López NE, Caleya-Zambrano AM. Prevalence and clinical presentation of molar incisor hypomineralisation among a population of children in the community of Madrid. BMC Oral Health 2024; 24:229. [PMID: 38350956 PMCID: PMC10863200 DOI: 10.1186/s12903-024-04003-4] [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: 05/09/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE The main objective of this study was to estimate the prevalence of molar incisor hypomineralisation (MIH), an alteration of tooth enamel with an estimated worldwide prevalence rate of 14%, among children using primary care services in the Community of Madrid, Spain. MATERIALS AND METHODS This was a descriptive, cross-sectional and multicentre study. After calibrating all researchers and following the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD), children aged between 8 and 16 years who were users of the dental services at 8 primary oral health units of the Madrid Health Service (SERMAS) were included. The children underwent a dental examination, and the parents were asked to complete a questionnaire. RESULTS The prevalence of MIH was 28.63% (CI: 24.61-32.65%). The age cohorts most affected by MIH were 8 years (21.4%) and 11 years (20.7%). The presence of MIH was greater among girls (85; 60.71%) than among boys (55; 39.28%). The mean number of affected teeth per patient was 4.46 ± 2.8. The most frequently affected molar was the upper right first molar (74.3%), and the upper left central incisor was the most affected incisor (37.85%). Opacities were the defects most frequently recorded (63.57%). CONCLUSIONS The prevalence of MIH in this study is the highest of all relevant studies conducted in Spain.
Collapse
Affiliation(s)
| | - Gonzalo Feijóo-Garcia
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, 28040, Spain
| | | | - Nuria E Gallardo-López
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, 28040, Spain
| | - Antonia M Caleya-Zambrano
- Madrid Health Service (SERMAS), Madrid, Spain.
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, 28040, Spain.
| |
Collapse
|
23
|
Shields S, Chen T, Crombie F, Manton DJ, Silva M. The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review. Healthcare (Basel) 2024; 12:370. [PMID: 38338255 PMCID: PMC10855782 DOI: 10.3390/healthcare12030370] [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: 01/04/2024] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children's oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA.
Collapse
Affiliation(s)
- Stephanie Shields
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Inflammatory Origins, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Royal Children’s Hospital Melbourne, Melbourne, VIC 3052, Australia
| | - Tong Chen
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
| | - Felicity Crombie
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
| | - David J. Manton
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Centrum voor Tandheelkunde en Mondzorgkunde, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Mihiri Silva
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Inflammatory Origins, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Royal Children’s Hospital Melbourne, Melbourne, VIC 3052, Australia
| |
Collapse
|
24
|
Alghawe S, Raslan N. Management of permanent incisors affected by Molar-Incisor-Hypomineralisation (MIH) using resin infiltration: a pilot study. Eur Arch Paediatr Dent 2024; 25:105-116. [PMID: 38285169 DOI: 10.1007/s40368-024-00861-2] [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: 12/13/2022] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To compare the aesthetic improvement of Molar-Incisor-Hypomineralisation (MIH) opacities treated by applying Icon-Etch for three cycles with the opacities treated by Icon-Etch for once, in the course of resin infiltration technique. METHODS Thirty incisors were sorted based on the colour of the opacities and then distributed according to the number of Icon-Etch cycles using a randomisation table into the groups: (1) White/Creamy one cycle, (2) White/Creamy three cycles, (3) Yellow/Brown one cycle, (4) Yellow/Brown three cycles. The primary outcomes of applying the resin infiltration to the opacities were compared amongst groups according to the parents' satisfaction, the amount of coverage, and the colour matching with the surrounding sound enamel. The stability of the results after 3 months was evaluated using a spectrophotometer. RESULTS The colour of the opacity pre-treatment affected the outcomes significantly (p < 0.05), compared according to the method of application (p > 0.05) in terms of parents' satisfaction. Whilst the multiple applications for Icon-Etch cycles showed more coverage amount in White/Creamy opacities than the application ones (p < 0.05); in colour matching, there was no statistically significant difference between the two methods (p > 0.05). For yellow/brown opacities, some negative results occurred with the single Icon-Etch cycle. CONCLUSION In MIH opacities, it is possible to rely on the resin infiltration as a minimally invasive method to achieve acceptable results, especially with multiple Icon-Etch cycles applications in the white/creamy opacities. The colour stability has not been affected by either the colour of the opacity or the number of cycles.
Collapse
Affiliation(s)
- S Alghawe
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria.
| | - N Raslan
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria
| |
Collapse
|
25
|
Hajdarević A, Čirgić E, Robertson A, Sabel N, Jälevik B. Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7-8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists. Eur Arch Paediatr Dent 2024; 25:93-103. [PMID: 38315353 PMCID: PMC10942915 DOI: 10.1007/s40368-023-00860-9] [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: 12/29/2022] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). METHODS An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. RESULTS A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. "When root furcation is under development of the second permanent molar on radiographs" was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. CONCLUSION Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.
Collapse
Affiliation(s)
- A Hajdarević
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Clinic of Pediatric Dentistry, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
| | - E Čirgić
- Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Robertson
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N Sabel
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Folktandvården Björkekärr, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - B Jälevik
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
26
|
Restrepo M, Rojas-Gualdrón DF, de Farias AL, Escobar A, Vélez LF, Bussaneli DG, Santos-Pinto L. Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:154-160. [PMID: 37379461 DOI: 10.1111/eje.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/18/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.
Collapse
Affiliation(s)
- Manuel Restrepo
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | | | - Aline Leite de Farias
- School of Dentistry, CES University, Medellín, Colombia
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - Alfonso Escobar
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | - Luís Fernando Vélez
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | - Diego Girotto Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - Lourdes Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| |
Collapse
|
27
|
Milona M, Ciechanowicz A, Węsierska K, Gońda-Domin M, Zawiślak A, Jarząbek A, Sobalska-Kwapis M, Jarczak J, Gruszka R, Strapagiel D, Janiszewska-Olszowska J, Grocholewicz K. Association of Three Genetic Loci with Molar Incisor Hypomineralization in Polish Children. J Clin Med 2024; 13:857. [PMID: 38337551 PMCID: PMC10856562 DOI: 10.3390/jcm13030857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a qualitative, demarcated enamel defect of hypomineralization affecting one to four first permanent molars, often with incisor involvement. Its etiology is complex. However, evidence suggests the influence of genetic factors, potentially including the single nucleotide polymorphisms (SNPs) rs2889956, rs4811117 and rs13058467, which were previously linked to MIH in a genome-wide association study of German children. The aim was to replicate analyses of possible associations between the SNPs and molar incisor hypomineralization in Polish children. METHODS The final study group consisted of 778 children aged 126-168 months old. Saliva samples were taken, and genomic DNA was extracted and genotyped using beadchip microarrays. RESULTS Among the 778 subjects, there were 68 (8.7%) subjects with MIH and 710 (91.3%) subjects without MIH. There were no significant differences in distributions in age, sex, or the frequency of caries in permanent dentition between the MIH and non-MIH groups. The rs2889956, rs4811117, and rs13058467 genotype distributions in the studied group conformed to the expected Hardy-Weinberg equilibria, and there were no significant differences in the distributions of their alleles or genotypes between the MIH and non-MIH groups. CONCLUSION Our replication study did not confirm highly significant associations between the single nucleotide polymorphisms rs2889956, rs4811117, and rs13058467 with molar incisor hypomineralization in Polish children.
Collapse
Affiliation(s)
- Marta Milona
- Department of Hygiene and Epidemiology, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Andrzej Ciechanowicz
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
| | | | | | - Alicja Zawiślak
- Department of Interdisciplinary Dentistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (A.Z.); (J.J.-O.); (K.G.)
| | - Anna Jarząbek
- Laboratory of Paediatric Dentistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Marta Sobalska-Kwapis
- Biobank Lab, Department of Oncobiology and Epigenetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland; (M.S.-K.); (D.S.)
| | - Justyna Jarczak
- Regenerative Medicine Laboratory, Medical University of Warsaw, 02-097 Warszawa, Poland;
| | - Renata Gruszka
- Department of Molecular Biotechnology and Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland;
| | - Dominik Strapagiel
- Biobank Lab, Department of Oncobiology and Epigenetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-237 Lodz, Poland; (M.S.-K.); (D.S.)
| | - Joanna Janiszewska-Olszowska
- Department of Interdisciplinary Dentistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (A.Z.); (J.J.-O.); (K.G.)
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (A.Z.); (J.J.-O.); (K.G.)
| |
Collapse
|
28
|
Sluka B, Held U, Wegehaupt F, Neuhaus KW, Attin T, Sahrmann P. Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data. BMC Oral Health 2024; 24:127. [PMID: 38273324 PMCID: PMC10809700 DOI: 10.1186/s12903-023-03637-0] [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: 02/21/2023] [Accepted: 11/08/2023] [Indexed: 01/27/2024] Open
Abstract
Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.
Collapse
Affiliation(s)
| | - Ulrike Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland
| | - Florian Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Klaus W Neuhaus
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Philipp Sahrmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.
| |
Collapse
|
29
|
Børsting T, Fagerhaug TN, Schuller A, van Dommelen P, Stafne SN, Mørkved S, Stunes AK, Gustafsson MK, Syversen U, Sun YQ, Skeie MS. The association between serum vitamin D status and dental caries or molar incisor hypomineralisation in 7-9-year-old Norwegian children: a cross-sectional study. BMC Public Health 2024; 24:246. [PMID: 38254062 PMCID: PMC10802019 DOI: 10.1186/s12889-024-17745-1] [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: 03/29/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Research focusing on the association between serum vitamin D and oral health outcomes in children, such as dental caries and molar incisor hypomineralisation (MIH), shows inconsistent results. Previous studies have predominantly investigated dental caries and MIH as dichotomized outcomes, which limits the information on their distribution. In addition, the methods used for analysing serum vitamin D have varied. The present study aimed to investigate potential associations between serum vitamin D status measured by Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS) and the prevalence, as well as the number of teeth, affected by dental caries or MIH among 7-9-year-old Norwegian children. METHODS The study had a cross-sectional design and included 101 children aged 7-9 years. Serum 25-hydroxyvitamin D (25(OH)D) was measured and included as continuous (per 25 nmol/l) and categorised (insufficient (< 50 nmol/l) and sufficient (≥50 nmol/l)) exposure variables. Adjusted negative binomial hurdle models were used to investigate the potential associations between serum vitamin D and the oral health outcomes (dental caries and MIH) adjusted for sex, age, body mass index, season of blood draw, and mother's educational level. RESULTS Of the 101 children in the total sample, 27% had insufficient vitamin D levels (< 50 nmol/l). The descriptive analysis indicated that the children with insufficient vitamin D levels had a higher prevalence (33.3%) and a higher number of teeth affected by dental caries (mean (SD) = 0.7 (1.4)), compared to children with sufficient levels of vitamin D (21.6% and mean (SD) = 0.4 (0.8), respectively). The same holds for MIH, with a higher prevalence (38.5%) and a higher number of teeth affected (mean (SD) = 1.2 (2.3)), compared to children with sufficient levels of vitamin D (30.1% and mean (SD) = 0.8 (1.6), respectively). However, in the adjusted hurdle model analysis, neither the prevalence or number of teeth affected by caries or MIH showed statistically significant associations with having insufficient or lower vitamin D levels. CONCLUSIONS Vitamin D status was not significantly associated with the prevalence and number of teeth affected by caries and MIH among the participating children. Large prospective studies with multiple serum vitamin D measurements and oral examinations throughout childhood are warranted to elucidate the relationship.
Collapse
Affiliation(s)
- Torunn Børsting
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway.
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Tone Natland Fagerhaug
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Annemarie Schuller
- Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Paula van Dommelen
- Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Service, Trondheim University Hospital (St. Olavs Hospital), Trondheim, Norway
| | - Siv Mørkved
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Service, Trondheim University Hospital (St. Olavs Hospital), Trondheim, Norway
| | - Astrid Kamilla Stunes
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Medical Clinic, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway
| | - Miriam K Gustafsson
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Regional Education Center (RegUt), Helse Midt-Norge, Trondheim, Norway
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, Trondheim University Hospital (St. Olavs Hospital), Trondheim, Norway
| | - Yi-Qian Sun
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marit S Skeie
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| |
Collapse
|
30
|
Chun YHP, Tan C, Villanueva O, Colley ME, Quintanilla TJ, Basiouny MS, Hartel CA, Critchfield CS, Bach SBH, Fajardo RJ, Pham CD. Overexpression of ameloblastin in secretory ameloblasts results in demarcated, hypomineralized opacities in enamel. Front Physiol 2024; 14:1233391. [PMID: 38274050 PMCID: PMC10808694 DOI: 10.3389/fphys.2023.1233391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/01/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction: Developmental defects of the enamel manifest before tooth eruption and include amelogenesis imperfecta, a rare disease of underlying gene mutations, and molar-incisor hypomineralization (MIH), a prevalent disease in children originating from environmental and epigenetic factors. MIH enamel presents as the abnormal enamel marked by loss of translucency, demarcation between the healthy and affected enamel, and reduced mineral content. The pathophysiology of opaque, demarcated enamel lesions is not understood; however, the retention of enamel proteins in the matrix has been suggested. Ameloblastin (Ambn) is an enamel protein of the secreted calcium-binding phosphoproteins (SCPPs) critical for enamel formation. When the Ambn gene is mutated or deleted, teeth are affected by hypoplastic amelogenesis imperfecta. Methods: In this study, enamel formation in mice was analyzed when transgenic Ambn was overexpressed from the amelogenin promoter encoding full-length Ambn. Ambn was under- and overexpressed at six increasing concentrations in separate mouse lines. Results: Mice overexpressing Ambn displayed opaque enamel at low concentrations and demarcated lesions at high concentrations. The severity of enamel lesions increased starting from the inner enamel close to the dentino-enamel junction (DEJ) to span the entire width of the enamel layer in demarcated areas. Associated with the opaque enamel were 17-kDa Ambn cleavage products, a prolonged secretory stage, and a thin basement membrane in the maturation stage. Ambn accumulations found in the innermost enamel close to the DEJ and the mineralization front correlated with reduced mineral content. Demarcated enamel lesions were associated with Ambn species of 17 kDa and higher, prolonged secretory and transition stages, a thin basement membrane, and shortened maturation stages. Hypomineralized opacities were delineated against the surrounding mineralized enamel and adjacent to ameloblasts detached from the enamel surface. Inefficient Ambn cleavage, loss of contact between ameloblasts, and the altered basement membrane curtailed the endocytic activity; thus, enamel proteins remained unresorbed in the matrix. Ameloblasts have the ability to distinguish between Ambn concentration and Ambn cleavage products through finely tuned feedback mechanisms. The under- or overexpression of Ambn in murine secretory ameloblasts results in either hypoplastic amelogenesis imperfecta or hypomineralization with opaque or sharply demarcated boundaries of lesions, similar to MIH.
Collapse
Affiliation(s)
- Yong-Hee Patricia Chun
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Cell Systems and Anatomy, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Molecular Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Chunyan Tan
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Omar Villanueva
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Madeline E. Colley
- Department of Chemistry, University of Texas San Antonio, San Antonio, TX, United States
- Department of Biochemistry, Vanderbilt University, Nashville, TN, United States
- Mass Spectrometry Research Center, Vanderbilt University, Nashville, TN, United States
| | - Travis J. Quintanilla
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mohamed S. Basiouny
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Caldonia A. Hartel
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Cameron S. Critchfield
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Stephan B. H. Bach
- Department of Chemistry, University of Texas San Antonio, San Antonio, TX, United States
| | - Roberto J. Fajardo
- Department of Clinical and Applied Science Education, School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX, United States
| | - Cong-Dat Pham
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
31
|
Tarhuni H, Benghasheer HF, Naser Y, Arheiam A. Molar incisor hypomineralisation: A survey of awareness and management strategies among Libyan dentists in Benghazi. Int J Paediatr Dent 2024. [PMID: 38200629 DOI: 10.1111/ipd.13156] [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] [Received: 03/24/2023] [Revised: 12/07/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Molar incisor hypomineralisation (MIH) is a developmental enamel defect in the first permanent molars and frequently in the incisors. It poses a unique challenge to the dental practitioner because of its nature, clinical presentations and treatment strategies. AIM This study assessed the perception of Libyan dentists in Benghazi regarding MIH and its management. DESIGN Paper-based, self-administered questionnaires were distributed to dentists in Benghazi, Libya. The questionnaires investigated the awareness of MIH, knowledge of MIH aetiology, clinical challenges of MIH treatment and choices of restorative management. Descriptive statistics, chi-squared test and binary logistic regression analysis were performed at a significance level of ≤.05. RESULTS A total of 389 questionnaires were completed and analysed, giving an overall response rate of 76% (389/511). Most participants were female (85%, 332), with an average of 6.05 (SD = 6.24) years of experience. The majority of participants (67%) recognised MIH in their practice. Statistically significant differences in the awareness of MIH and its prevalence were observed according to the type of practice (p ≤ .001) and experience of dentists (p ≤ .001). Dentists working in public dental practice were less familiar with MIH and less likely to report it. Likewise, novice dentists were less aware of MIH than more experienced colleagues. The most reported aetiological factor in MIH was genetics by 60.2% of respondents, followed by environmental contamination (47.6%) and fluorides (42.9%). Most participants (92.3%) considered MIH a clinical problem. Aesthetics and diagnosis were the most reported challenging aspects (59.4% and 44.2%, respectively). The most commonly selected restorative options were high-fluoride glass ionomer cement (43.2%) and preformed metal crowns (41.6%). CONCLUSION The majority of participants reported awareness of the existence of MIH condition. Nevertheless, variations in estimating MIH prevalence and its proper treatment, as well as factors influencing its treatment and diagnosis, were recorded. It is recommended that the current dental curriculum is reviewed, and scientific evidence providing dental practitioners with updated information on the diagnosis and clinical management of MIH should be circulated.
Collapse
Affiliation(s)
- Hala Tarhuni
- Faculty of Dentistry, Community and Preventive Dentistry Department, University of Benghazi, Benghazi, Libya
| | - Hala Fathalla Benghasheer
- Faculty of Dentistry, Community and Preventive Dentistry Department, University of Benghazi, Benghazi, Libya
| | - Yasmin Naser
- Faculty of Dentistry, Community and Preventive Dentistry Department, University of Benghazi, Benghazi, Libya
| | - Arheiam Arheiam
- Faculty of Dentistry, Community and Preventive Dentistry Department, University of Benghazi, Benghazi, Libya
| |
Collapse
|
32
|
Humphreys J, Graham A, Rodd HD, Albadri S, Parekh S, Somani C, Hosey MT, Taylor GD. Molar incisor hypomineralisation: Teaching and assessment across the undergraduate dental curricula in the UK. Int J Paediatr Dent 2024. [PMID: 38195821 DOI: 10.1111/ipd.13158] [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] [Received: 10/11/2023] [Revised: 12/14/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND No consensus exists on how molar incisor hypomineralisation (MIH) should be covered by the undergraduate dental curricula. AIM To assess the current teaching and assessment of MIH in the UK. DESIGN A piloted questionnaire regarding the teaching and assessment of MIH was disseminated to paediatric, restorative and orthodontic teaching leads in each UK dental school (n = 16). Data were analysed using descriptive statistics, chi-squared and Kruskal-Wallis tests. RESULTS Response rates from paediatric, restorative and orthodontic teams were 75% (n = 12), 44% (n = 7) and 54% (n = 8), respectively. Prevention of caries, preformed metal crowns, anterior resin composites and vital bleaching were taught significantly more by paediatric teams (p = .006). Quality of life and resin infiltration were absent from restorative teaching. Orthodontic teaching focussed on the timing of first permanent molar extractions. Paediatric teams were mainly responsible for assessment. Risk factors, differential diagnoses for MIH and defining clinical features were more likely to be assessed by paediatric teams than by others (p = .006). All specialities reported that students were prepared to manage MIH. CONCLUSION Molar incisor hypomineralisation is primarily taught and assessed by paediatric teams. No evidence of multidisciplinary or transitional teaching/assessment existed between specialities. Developing robust guidance regarding MIH learning in the UK undergraduate curricula may help improve consistency.
Collapse
Affiliation(s)
- Judith Humphreys
- School of Dentistry, Liverpool University Dental Hospital, Liverpool, UK
| | - Anna Graham
- Guys and St Thomas' NHS Hospital Trust, London, UK
| | - Helen D Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sondos Albadri
- School of Dentistry, Liverpool University Dental Hospital, Liverpool, UK
| | - Susan Parekh
- Eastman Dental Institute, University College London Hospital, London, UK
| | - Cheryl Somani
- Eastman Dental Institute, University College London Hospital, London, UK
| | - Marie Therese Hosey
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Greig D Taylor
- School of Dental Sciences, Newcastle University, Newcastle, UK
| |
Collapse
|
33
|
Gómez-Clavel JF, Sánchez-Cruz FY, Santillán-Carlos XP, Nieto-Sánchez MP, Vidal-Gutiérrez X, Pineda ÁEGA. Knowledge, experience, and perception of molar incisor hypomineralisation among dentists in the metropolitan area of Mexico City: a cross-sectional study. BMC Oral Health 2023; 23:1018. [PMID: 38114978 PMCID: PMC10729561 DOI: 10.1186/s12903-023-03754-w] [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: 06/29/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is the most common developmental abnormality observed in teeth. Being a relatively new condition, its treatment can present a challenge for the dentist. There is currently no study available that has evaluated the knowledge of Mexican dental personnel. This study aimed to evaluate the knowledge, experience, and perceptions of dental surgeons regarding the detection, assessment, and treatment of MIH in the metropolitan area of Mexico City. METHODS A cross-sectional study was designed. Dentists from Mexico City and its metropolitan area were invited through social networks to answer a questionnaire of 30 questions related to MIH. Participants were classified into general practice dentists, paediatric dentists, and other speciality dentists. Pearson's chi-square test was used for data analysis. RESULTS The questionnaire was answered by 391 dentists. A total of 86% (338 out of 391) of them identified MIH lesions, while 84% of them reported having observed MIH lesions in their practice. The most frequently observed lesions were yellow-brown opacities which accounted for 47% of the lesions, 46% were white opacities, while only 7% were observed as post-eruptive fractures in the enamel as part of the manifestations of MIH. The most frequently reported problem in the management of teeth with MIH was insufficient training for treating children with MIH. A total of 84% of dentists stated that they would like more information on the treatment of MIH lesions. CONCLUSIONS Most of the surveyed dentists recognised MIH and reported having observed MIH lesions in their practice. Most of the dentists indicated that the main problem for the management of the MIH is the lack of training.
Collapse
Affiliation(s)
- José Francisco Gómez-Clavel
- Laboratory of Research in Education and Dentistry, Faculty of Higher Studies Iztacala (FES), National Autonomous University of Mexico, (UNAM), Mexico City, Mexico.
- Laboratorio de Investigación en Educación y Odontología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de los Barrios 1, Los Reyes Iztacala, Tlalnepantla, 54090, México.
| | - Fernando Yair Sánchez-Cruz
- Laboratory of Research in Education and Dentistry, Faculty of Higher Studies Iztacala (FES), National Autonomous University of Mexico, (UNAM), Mexico City, Mexico
| | - Ximena Paola Santillán-Carlos
- Laboratory of Research in Education and Dentistry, Faculty of Higher Studies Iztacala (FES), National Autonomous University of Mexico, (UNAM), Mexico City, Mexico
| | - Martha Patricia Nieto-Sánchez
- Specialization in Pediatric Stomatology, Faculty of Higher Studies Iztacala (FES), National Autonomous University of Mexico, (UNAM), Mexico City, Mexico
| | | | - Álvaro Edgar González-Aragón Pineda
- Laboratory of Public Health Research, Iztacala, Faculty of Higher Studies (FES), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| |
Collapse
|
34
|
Mandetta ARH, Bortoletto CC, Sobral APT, Gonçalves MLL, Motta LJ, Horliana ACRT, Ferrari RAM, Prates RA, Deana AM, Cordeiro RDCL, Pinto LAMDS, Fernandes KPS, Bussadori SK. Evaluation of antimicrobial photodynamic therapy and minimal intervention associated with deproteinisation in permanent teeth with molar incisor hypomineralisation: study protocol for a clinical, controlled, blinded trial. BMJ Open 2023; 13:e076226. [PMID: 38101830 PMCID: PMC10729058 DOI: 10.1136/bmjopen-2023-076226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel development that occurs in the mineralisation phase. MIH affects one or more permanent molars and, occasionally, permanent incisors. The aim of the proposed study is to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) on permanent teeth with MIH through decontamination and sensitivity control. METHODS AND ANALYSIS Patients from 8 to 12 years of age with permanent molars will be randomly allocated to three groups. Group 1: selective chemical-mechanical removal of carious dentinal tissue around the walls of the cavity with Papacárie Duo and a curette followed by the application of aPDT and deproteinisation with Papacárie Duo; group 2: selective removal of carious dentinal tissue around the walls of the cavity with a curette, followed by the application of aPDT and deproteinisation with a 5% sodium hypochlorite solution; group 3: selective removal of carious dentinal tissue using a curette. The selected teeth must have a carious lesion in the dentin and posteruptive enamel breakdown on one or more surfaces with an indication for clinical restorative treatment. The teeth will subsequently be restored using a mixed technique with resin-modified glass ionomer cement and bulk-fill composite resin. The data will be submitted to descriptive statistical analysis. Associations with age and sex will be tested using either the χ2 test or Fisher's exact test. Pearson's correlation coefficients will be calculated to determine the strength of correlations between variables. Comparisons of the microbiological results (colony-forming units) will be performed using analysis of variance and the Kruskal-Wallis test. Kaplan-Meier survival analysis will be performed to assess the performance of the restorations. ETHICS AND DISSEMINATION This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 61027522.0.0000.5511/approval date: 23 August 2022). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT05443035.
Collapse
Affiliation(s)
- Amanda Rafaelly Honório Mandetta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | | | - Ana Paula Taboada Sobral
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos, Santos, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Marcela Letícia Leal Gonçalves
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos, Santos, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | | | - Raquel Agnelli Mesquita Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Renato Araujo Prates
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Alessandro Melo Deana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Rita de Cássia Loiola Cordeiro
- Research of Department of Pediatric Dentistry, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Araraquara, Araraquara, SP, Brazil
| | | | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
| |
Collapse
|
35
|
Bekes K, Steffen R, Krämer N. Update of the molar incisor hypomineralization: Würzburg concept. Eur Arch Paediatr Dent 2023; 24:807-813. [PMID: 37856065 PMCID: PMC10657291 DOI: 10.1007/s40368-023-00848-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index-the MIH Treatment Need Index (MIH-TNI)-and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice. METHODS The authors reviewed the available literature, including clinical and laboratory studies and published guidelines. RESULTS The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction. CONCLUSIONS This is intended to help guide the practitioner and will need to be further validated by clinical trials.
Collapse
Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Paediatric Dentistry, Justus Liebig University, Giessen, Germany
| |
Collapse
|
36
|
Rizzardi KF, Rizzardi RF, Crescente CL, Tognetti VM, de Sousa ET, Parisotto TM. Relationship between cariogenic bacteria and molar incisor hypomineralization in Brazilian schoolchildren. Transl Pediatr 2023; 12:2001-2009. [PMID: 38130579 PMCID: PMC10730958 DOI: 10.21037/tp-23-48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/22/2023] [Indexed: 12/23/2023] Open
Abstract
Background Teeth with defects in their structure, such as the ones affected by molar-incisor hypomineralization (MIH), are more susceptible to carious lesions. Caries is a complex and multifactorial disease highly prevalent in childhood. The present research evaluated the relationship between the stages of MIH and cariogenic bacteria in children. Methods After examining 566 schoolchildren, four groups of 10 children each were formed: healthy (G1), mild MIH (G2 and G3), and severe MIH + caries (G4). Dental biofilm was assessed to quantify Streptococcus mutans (SM) and Lactobacillus spp. (LB) using real-time polymerase chain reaction (RT-PCR). Results LB counting in biofilm samples of healthy children (G1) and those with mild MIH characterized by white opacities (G2) were not significantly different. The same happened when the ones with yellow opacities (G3) were compared with severe MIH + caries (G4) (P>0.05). The post hoc Tukey test proved that G4 had greater levels of SM and LB when compared with G2 (P<0.05); however, the control group did not diverge from the others considering SM (P>0.05). Increased LB enhanced the severity of MIH [rate ratio (RR): 7.706; P=0.035]. Conclusions LB was influenced by different degrees of MIH and the presence of caries and could guide clinical decisions and patients' recommendations to prevent carious lesions in MIH children.
Collapse
Affiliation(s)
- Karina Ferreira Rizzardi
- Laboratory of Clinical and Molecular Microbiology, University São Francisco, Bragança Paulista, São Paulo, Brazil
| | - Rodrigo Ferreira Rizzardi
- Laboratory of Clinical and Molecular Microbiology, University São Francisco, Bragança Paulista, São Paulo, Brazil
| | - Camila Lopes Crescente
- Laboratory of Clinical and Molecular Microbiology, University São Francisco, Bragança Paulista, São Paulo, Brazil
| | - Valdineia Maria Tognetti
- Laboratory of Clinical and Molecular Microbiology, University São Francisco, Bragança Paulista, São Paulo, Brazil
| | - Emerson Tavares de Sousa
- Department of Preventative and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA, USA
| | - Thaís Manzano Parisotto
- Laboratory of Clinical and Molecular Microbiology, University São Francisco, Bragança Paulista, São Paulo, Brazil
| |
Collapse
|
37
|
Inchingolo AM, Inchingolo AD, Viapiano F, Ciocia AM, Ferrara I, Netti A, Dipalma G, Palermo A, Inchingolo F. Treatment Approaches to Molar Incisor Hypomineralization: A Systematic Review. J Clin Med 2023; 12:7194. [PMID: 38002806 PMCID: PMC10671994 DOI: 10.3390/jcm12227194] [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: 10/11/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
AIM This systematic review aimed to comprehensively evaluate the available literature on treating molar incisor hypomineralization (MIH) or enamel hypomineralization published between 2013 and 2023, focusing on identifying relevant studies and their characteristics. MATERIALS AND METHODS The search process encompassed reputable academic databases, including PubMed, Scopus, Cochrane Library, and Web of Science, using a precise keyword strategy ("((molar incisor hypomineralization) OR (enamel hypomineralization)) AND (treatment)"). A total of 637 articles were initially retrieved, followed by a strict selection process adhering to PRISMA guidelines. The inclusion criteria encompassed Randomized Control Trials (RCTs), case series with more than five clinical cases (CSs), studies involving human participants, availability as free full-text or accessible with university credentials, and English-language publications. Exclusion criteria included systematic or literature reviews, editorials, single-case reports, studies conducted in vitro, those involving animals, paid articles, and non-English-language publications. RESULTS The search yielded 864 articles, of which 23 met the stringent inclusion criteria after a meticulous selection process. These studies will serve as the basis for a comprehensive analysis of MIH treatment approaches. The systematic review ensures the quality and relevance of the chosen studies for a detailed assessment of MIH treatment strategies. CONCLUSIONS This systematic review will provide valuable insights into the characteristics of selected studies, patient profiles, and available treatment options for molar incisor hypomineralization, contributing to a better understanding of this dental condition's management.
Collapse
Affiliation(s)
- Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| |
Collapse
|
38
|
Osborne R, Silva M, Taylor GD. Qualitative study exploring general dental practitioners' views of MIH and its management in the UK and Australia. Int J Paediatr Dent 2023. [PMID: 37969051 DOI: 10.1111/ipd.13135] [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] [Received: 10/26/2022] [Revised: 09/08/2023] [Accepted: 10/12/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a prevalent condition, and how it is managed varies greatly between professional groups. AIM To explore, and compare, the UK and Australian general dental practitioners' management of MIH in children. DESIGN Face-to-face (remote) semistructured interviews were undertaken, using country-specific topic guides. Participants were purposively sampled and recruited through national conferences and research networks (eviDent Foundation and Northern Dental Practice Based Research Network). Interviews (from each country) were audio-recorded, transcribed verbatim and independently analysed using thematic analysis. RESULTS Two major themes arose from the UK interviews: (i) decision-making complexities and understanding of treatment options and (ii) need for specialist input. The main Australian themes were (i) multidisciplinary approach to management supporting decision-making complexities and (ii) economic implications for care. Several difficulties, such as financial implications, multidisciplinary care and clinical decision-making, were identified as barriers to effectively managing MIH by GDPs in primary care. CONCLUSION There are similarities and differences in the knowledge and management of MIH amongst UK and Australian nonspecialists. The different healthcare systems played a significant role in shaping how GDPs manage MIH with barriers relating to affordability, multidisciplinary care and clinical decision-making.
Collapse
Affiliation(s)
- R Osborne
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - M Silva
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Evident Foundation, South Yarra, Victoria, Australia
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
39
|
Gunay A. Knowledge and Attitudes of a Group of Dental Students in Turkey About Molar Incisor Hypomineralization. Med Sci Monit 2023; 29:e941824. [PMID: 37859334 PMCID: PMC10595039 DOI: 10.12659/msm.941824] [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: 07/18/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the knowledge and attitudes of 4th- and 5th-year students of Dicle University Faculty of Dentistry (Diyarbakır) about molar incisor hypomineralization (MIH). MATERIAL AND METHODS The questionnaires previously used in other countries were modified and the questionnaire forms consisting of 23 questions were distributed to the students online. The results of the analysis are presented as frequencies. The significance level was set as P<0.05. RESULTS A total of 111 4th-year students (51%) and 107 5th-year students (49%) participated in our study. A statistically significant difference was found between the 4th-year students (68.5%) and the 5th-year students (98.1%) in terms of having heard of the term MIH before (P<0.001). While most students reported knowing the clinical features of MIH, only 26.1% were confident in their diagnosis. A statistically significant difference was found between the 4th- and 5th-year students who thought that MIH was a clinical problem, in the distribution of those who had problems both in terms of aesthetics, and in providing adequate restoration (P=0.012). CONCLUSIONS Although most of the students were theoretically familiar with MIH, they were not confident in their diagnosis and found it difficult to differentiate MIH from other dental anomalies. However, the awareness of 5th-year dental students was better than that of the 4th-year students.
Collapse
|
40
|
Harz D, Catalán Gamonal B, Matute García S, Jeremias F, Martin J, Fresno MC. Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren. Eur Arch Paediatr Dent 2023; 24:577-584. [PMID: 37432610 DOI: 10.1007/s40368-023-00820-3] [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: 07/22/2022] [Accepted: 06/24/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. METHODS A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. RESULTS A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). CONCLUSIONS The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. IMPLICATIONS Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9, and with low SES.
Collapse
Affiliation(s)
- D Harz
- Dental School, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - F Jeremias
- Graduate Program in Dental Science Araraquara School of Dentistry, UNESP Univ Estadual Paulista São Paulo, Araraquara, São Paulo, Brazil
| | - J Martin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago, Chile
| | - M C Fresno
- Faculty of Dentistry, University of Chile, Santiago, Chile.
| |
Collapse
|
41
|
Cardoso-Silva L, Vicioni-Marques F, de Paula-Silva FWG, de Freitas BN, Nelson-Filho P, Tirapelli C, de Carvalho FK. Comparison between intraoral scanning and direct visual analysis for the assessment of developmental defects of enamel. J Dent 2023; 137:104677. [PMID: 37604397 DOI: 10.1016/j.jdent.2023.104677] [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: 03/24/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE To compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE). METHODS Thirty-nine extracted permanent human teeth with DDE were selected by an experienced examiner and digitised using IOS. The scanning was recorded using the OBS Studio software parallel to the IOS software to obtain a coloured high-definition MP4 file of the process. Two other experienced, blinded, and calibrated examiners randomly analysed the same teeth through DVA and IOS. A third examiner resolved any disagreements between the two examiners. Descriptive statistics were used to analyse the frequencies of the scores. Cohen's kappa test was used to determine whether the DVA scores were different from those assigned using IOS. Spearman's test was used to verify non-random examiner errors. The Chi-square test was used to compare score frequencies. Statistical significance was set at p <0.05. RESULTS Scores indicating more severe and extended DDE (p <0.05) were more frequently assigned with IOS than with DVA (IOS: 25.64%, 25.64%, 38.46%, and 35.90% between one-third to two-third of the lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 10.26%, 7.69%, 15.38%, and 10.26% for the respective aforementioned tooth surfaces). Contrarily, 'no visible enamel defect' was significantly less assigned for IOS than for DVA (IOS: 15.38%, 43.59%, 35.90%, 15.38%, and 17.95% for buccal, lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 38.46%, 66.67%, 56.41%, 51.28%, and 43.59% for the respective aforementioned tooth surfaces). Kappa agreement ranged from fair to moderate when comparing DVA and IOS; the correlation between both methods was positive, indicating that the examiners assigned the scores properly and the differences arose from employing different methods. CONCLUSION The assessment of DDE differed depending on the method used. IOS scores indicated more severe and extended DDE than DVA scores. Clinical investigation is the next step in validating the use of IOS for DDE diagnosis. CLINICAL SIGNIFICANCE This study showed that DDE can be assessed differently using IOS. It is clinically relevant as it directly affects the determination of the severity of the defect and dental treatment planning.
Collapse
Affiliation(s)
- Lana Cardoso-Silva
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | - Fernanda Vicioni-Marques
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | | | - Bruna Neves de Freitas
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Ribeirão Preto, São Paulo 14040-904, Brazil
| | - Paulo Nelson-Filho
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | - Camila Tirapelli
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Ribeirão Preto, São Paulo 14040-904, Brazil.
| | - Fabrício Kitazono de Carvalho
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| |
Collapse
|
42
|
Haidar M, Raslan N. Comparative study of articaine 4% versus lidocaine 2% in the local anesthesia of permanent mandibular first molars affected by MIH: a randomized controlled trial. Eur Arch Paediatr Dent 2023; 24:621-630. [PMID: 37526883 DOI: 10.1007/s40368-023-00827-w] [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: 12/29/2022] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE The current study compares articaine 4% with lidocaine 2% in terms of injection pain and effectiveness of anesthesia when treating permanent mandibular first molars (PMFMs) affected by molar incisor hypomineralization (MIH). In addition to comparing the complications of local anesthesia for both solutions. METHODS The sample included 20 children. Each child was randomly assigned to either articaine 4% or lidocaine 2% in their first session with the other solution being used at the subsequent session. Injection pain and the effectiveness of anesthesia were assessed using the Wong-Baker Faces® Pain Rating Scale and the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Parents were asked to report any complications of local anesthesia. The Wilcoxon-matched pairs signed-rank test was used to analyze the data. RESULTS Patients experienced greater pain when receiving articaine 4% injections according to both scales, differences were statistically significant when using the Wong-Baker Faces® Pain Rating scale (p < 0.05). Whereas, the FLACC scale did not show such differences (P > 0.05). Although there were no significant differences between the two solutions regarding the effectiveness of local anesthesia according to both scales (P > 0.05), articaine 4% was clinically found to be more effective than lidocaine 2%. No complications of local anesthesia were reported. CONCLUSIONS Articaine 4% injection was more painful than lidocaine 2%. However, both solutions were effective in anesthetizing PMFMs affected by MIH and without anesthetic complications in the studied sample. TRIAL REGISTRATION Clinical trial, NCT05200884, ( https://clinicaltrials.gov/ct2/show/NCT05200884 ).
Collapse
Affiliation(s)
- M Haidar
- Department of Pediatric Dentistry, Faculty of Dentistry, Tishreen University, Lattakia, Syria.
| | - N Raslan
- Department of Pediatric Dentistry, Faculty of Dentistry, Tishreen University, Lattakia, Syria
| |
Collapse
|
43
|
Houari S, DeRocher K, Thuy TT, Coradin T, Srot V, van Aken PA, Lecoq H, Sauvage T, Balan E, Aufort J, Calemme M, Roubier N, Bosco J, Jedeon K, Berdal A, Joester D, Babajko S. Multi-scale characterization of Developmental Defects of Enamel and their clinical significance for diagnosis and treatment. Acta Biomater 2023; 169:155-167. [PMID: 37574156 DOI: 10.1016/j.actbio.2023.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
Developmental Defects of Enamel (DDE) such as Dental Fluorosis (DF) and Molar Incisor Hypomineralization (MIH) are a major public health problem. Their clinical aspects are extremely variable, challenging their early and specific diagnosis and hindering progresses in restorative treatments. Here, a combination of macro-, micro- and nano-scale structural and chemical methods, including, among others, Atom Probe Tomography recently applied on tooth enamel, were used to study and compare MIH, DF and healthy teeth from 89 patients. Globally, we show that DF is characterized by an homogenous loss of mineral content and crystallinity mainly disrupting outside layer of enamel, whereas MIH is associated with localized defects in the depth of enamel where crystalline mineral particles are embedded in an organic phase. Only minor differences in elemental composition of the mineral phase could be detected at the nanoscale such as increased F and Fe content in both severe DDE. We demonstrate that an improved digital color measurement of clinical relevance can discriminate between DF and MIH lesions, both in mild and severe forms. Such discriminating ability was discussed in the light of enamel composition and structure, especially its microstructure, organics presence and metal content (Fe, Zn). Our results offer additional insights on DDE characterization and pathogenesis, highlight the potentiality of colorimetric measurements in their clinical diagnosis and provide leads to improve the performance of minimally invasive restorative strategies. STATEMENT OF SIGNIFICANCE: Developmental Defects of Enamel (DDE) are associated to caries and tooth loose affecting billions of people worldwide. Their precise characterization for adapted minimally invasive care with optimized materials is highly expected. Here In this study, first we propose the use of color parameters measured by a spectrophotometer as a means of differential clinical diagnosis. Second, we have used state-of-the-art techniques to systematically characterize the structure, chemical composition and mechanical optical properties of dental enamel teeth affected by two major DDE, Dental Fluorosis (DF) or Molar Incisor Hypomineralization (MIH). We evidence specific enamel structural and optical features for DF and MIH while chemical modifications of the mineral nanocrystals were mostly correlated with lesion severity. Our results pave the way of the concept of personalized dentistry. In the light of our results, we propose a new means of clinical diagnosis for an adapted and improved restoration protocol for these patients.
Collapse
Affiliation(s)
- Sophia Houari
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Unité de Formation et de Recherche d'Odontologie, Université Paris Cité, APHP, Service d'Odontologie - Hôpital La pitié-Salpetrière, Paris, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France.
| | - Karen DeRocher
- Department of Materials Science and Engineering, Northwestern University, IL, USA
| | - Tran Thu Thuy
- Faculty of Odonto-stomatology, HochiMinh University of Medicine and Pharmacology, HôchiMinh Ville, Viet Nam
| | - Thibaud Coradin
- Laboratoire de Chimie de la Matière Condensée, Sorbonne Université, CNRS, Paris, France
| | - Vesna Srot
- Stuttgart Center for Electron Microscopy, Max Planck Institute for Solid State Research, Stuttgart, Germany
| | - Peter A van Aken
- Stuttgart Center for Electron Microscopy, Max Planck Institute for Solid State Research, Stuttgart, Germany
| | - Hélène Lecoq
- CNRS UPR3079, Université d'Orléans, Conditions Extrêmes et Matériaux: Haute Température et Irradiation, Orléans, France
| | - Thierry Sauvage
- CNRS UPR3079, Université d'Orléans, Conditions Extrêmes et Matériaux: Haute Température et Irradiation, Orléans, France
| | - Etienne Balan
- Sorbonne Université, CNRS, Institut de Recherche pour le Developpement, Museum National d'Histoire Naturelle, Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Paris, France
| | - Julie Aufort
- Sorbonne Université, CNRS, Institut de Recherche pour le Developpement, Museum National d'Histoire Naturelle, Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Paris, France
| | | | - Nicolas Roubier
- Laboratoire de Mécanique Paris-Saclay, CNRS, Centrale-Supélec, Université Paris-Saclay, Châtenay-Malabry, France
| | - Julia Bosco
- Unité de Formation et de Recherche d'Odontologie, Université Paris Cité, APHP, Service d'Odontologie - Hôpital La pitié-Salpetrière, Paris, France
| | - Katia Jedeon
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France
| | - Ariane Berdal
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France
| | - Derk Joester
- Department of Materials Science and Engineering, Northwestern University, IL, USA
| | - Sylvie Babajko
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France; UR2496, Biomedical research in Odontology, Université Paris Cité, Montrouge, France
| |
Collapse
|
44
|
Ciocan B, Săndulescu M, Luca R. Real-World Evidence on the Prevalence of Molar Incisor Hypomineralization in School Children from Bucharest, Romania. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1563. [PMID: 37761524 PMCID: PMC10529811 DOI: 10.3390/children10091563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/02/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Molar incisor hypomineralization (MIH) is an understudied and underrecognized clinical entity occurring in children. We performed a cross-sectional study to determine the real-world prevalence of MIH among school children undergoing routine dental checkups at one primary and middle school in Bucharest, Romania. Our study cohort consisted of 266 children with evaluable data, of which 143 (53.8%) were males, with a median age of 10 years old (interquartile range: 8-11 years). In this study cohort, we have identified a prevalence of 14.3% (n = 38 cases) of MIH. Among patients diagnosed with MIH, hypomineralizations were present in 47.4% of children on the maxillary first molar, 92.1% on the mandibular first molar, 94.7% on the maxillary incisor, 36.8% on the mandibular incisor, and 5.3% on the deciduous second molar. We identified the maxillary incisor and the mandibular first molar as the most important examined sites significantly associated with the presence of MIH (p < 0.0001 each), highlighting the importance of paying focused attention to these sites during routine dental care in children. In order to establish the diagnosis of MIH, findings of hypomineralization should be present on at least one permanent first molar, according to the case definition currently in use; this definition does not include findings on the incisors. Thus, our finding that hypomineralization of the maxillary incisors is significantly associated with MIH is particularly important. While incisor hypomineralization is not diagnostic of MIH, based on our results, we conclude that it should raise the suspicion of MIH and lead to an attentive examination of the permanent molars in order to establish timely diagnosis.
Collapse
Affiliation(s)
- Beatrice Ciocan
- Doctoral School, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania
| | - Mihai Săndulescu
- Department of Implant-Prosthetic Therapy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania
| | - Rodica Luca
- Department of Pedodontics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 17-23 Calea Plevnei, 010221 Bucharest, Romania
| |
Collapse
|
45
|
Garot E, Lopez Onaindia D, Couture C, Morales JI, Cebrià A, Oms X, Manton DJ, Lozano M. Insights into molar-incisor hypomineralisation in past populations: A call to anthropologists. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 42:18-26. [PMID: 37523814 DOI: 10.1016/j.ijpp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/27/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Molar incisor hypomineralisation (MIH) is a developmental defect of enamel affecting the first permanent molars and often the incisors and affecting approximately 13% of the current population worldwide. Here, we aim to highlight potential differential diagnoses of MIH in archaeological collections (taphonomic discoloration, amelogenesis imperfecta, fluorosis, rachitic teeth, etc.). METHODS Causative factors of dental discolourations are identified through a literature review. RESULTS In an archaeological context, the sediments contained in the burial soil can lead to tooth discoloration. Taphonomic staining of the dentition may have a similar appearance to enamel hypomineralisation, and thus is a confounding factor that has the potential to cause miscalculation of the true prevalence of MIH within archaeological collections. Some rare medieval cases are reported in the modern literature but without microanalysis, misdiagnosis is possible. The aetiological factors of MIH are unknown but probably follow the multifactorial model involving systemic medical and genetic factors. CONCLUSIONS Systematic detection and diagnosis of MIH during anthropological studies is therefore of great interest. SIGNIFICANCE The hypotheses that only contemporary agents are causative factors of MIH could be refuted by the discovery of individuals living before medication or pollutants. The identification of MIH in a group of individuals also provides information regarding the health status of a population and reflects stress occurring during the period of mineralisation of the first permanent molars after secretion of the enamel matrix. LIMITATIONS Taphonomic alterations of archaeological remains prevent MIH diagnosis. SUGGESTIONS FOR FUTURE RESEARCH MIH diagnosis can be difficult in archaeological series and further non-destructive methods (microtomography, elemental analyses, etc.) are required.
Collapse
Affiliation(s)
- Elsa Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France; Univ. Bordeaux, CNRS, MCC, PACEA, UMR 5199, Pessac F-33600, France; Centre de Compétence des Maladies Rares Orales et Dentaires, CCMR O-Rares, C.H.U. de Bordeaux, Bordeaux, France.
| | | | | | - Juan Ignacio Morales
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Zona Educacional 4, Campus Sescelades URV (Edifici W3), Tarragona 43007, Spain; Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Avinguda de Catalunya 35, Tarragona 43002, Spain
| | - Artur Cebrià
- Department Història i Arqueologia, Seminari d'Estudis i Recerques Prehistòriques (SERP). Facultat de Geografia i Història, Universitat de Barcelona, C/ Montalegre 6-8, 08001 Barcelona, Spain
| | - Xavier Oms
- Department Història i Arqueologia, Seminari d'Estudis i Recerques Prehistòriques (SERP). Facultat de Geografia i Història, Universitat de Barcelona, C/ Montalegre 6-8, 08001 Barcelona, Spain
| | - David John Manton
- University of Groningen, University Medical Centre Groningen (UMCG), Cariology and Paediatric Dentistry, Centre for Dentistry and Oral Hygiene, the Netherlands; Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, the Netherlands
| | - Marina Lozano
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Zona Educacional 4, Campus Sescelades URV (Edifici W3), Tarragona 43007, Spain; Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Avinguda de Catalunya 35, Tarragona 43002, Spain
| |
Collapse
|
46
|
Santos PB, Pinto ETF. Letter to the Editor. Oper Dent 2023; 48:599-600. [PMID: 37721113 DOI: 10.2341/1559-2863-48-5-599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
- Patricia Bittencourt Santos
- assistant professor Department of Orthodontics and Pediatric Dentistry, Federal University of Rio Grande do Norte, Natal,
| | - Emmily Tamiris Farias Pinto
- MSc, graduate student Department of Orthodontics and Pediatric Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| |
Collapse
|
47
|
Marcianes M, García-Camba P, Albaladejo A, Varela Morales M. Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both Developmental Defects of Dental Enamel. J Clin Med 2023; 12:5533. [PMID: 37685598 PMCID: PMC10488015 DOI: 10.3390/jcm12175533] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/19/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6-43.6%), and specificity of 88.7% (95% CI = 84.5-93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications.
Collapse
Affiliation(s)
- María Marcianes
- Unit of Orthodontics, University Hospital Fundación Jiménez Diaz, 28040 Madrid, Spain
| | - Pablo García-Camba
- Unit of Orthodontics, University Hospital Fundación Jiménez Diaz, 28040 Madrid, Spain
| | - Alberto Albaladejo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | | |
Collapse
|
48
|
Hakmi A, Dashash M. Direct or indirect composite for restoring permanent first molars affected by Molar Incisor Hypomineralisation (MIH): a randomized clinical controlled trial. BDJ Open 2023; 9:37. [PMID: 37573344 PMCID: PMC10423268 DOI: 10.1038/s41405-023-00165-5] [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: 04/24/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 08/14/2023] Open
Abstract
AIM This study was undertaken to compare direct composite resin restorations (DCRR) and indirect composite resin restorations (ICRR) for treating permanent first molars affected by MIH in terms of clinical performance. MATERIALS AND METHODS This was a controlled, randomized, clinical split-mouth study. The studied sample consisted of 40 asymptomatic first permanent hypomineralised mandibular molars in 20 children aged between 7-11 years, these cases were divided randomly into two groups: Group 1 (experimental): 20 first permanent mandibular molars were restored with ICRR, and Group 2 (control): 20 first permanent mandibular molars that were restored with DCRR. The cavity was prepared using a diamond bur on a high-speed handpiece, and the prepared cavity was wiped with cotton moistened with sodium hypochlorite. The composite was applied directly with a total-etch bonding system. In the ICRR group, an impression for the prepared cavity was taken using a silicon-based material, and the restoration was adhesive with self-adhesive resin cement. The child's satisfaction with each of the two application techniques was assessed through the scale FACES. Restorations were evaluated during follow-up periods (3, 6, and 12 months) according to Modified USHPH criteria. RESULTS The clinical success rate was 90% in the ICRR group versus 85% in the DCRR group after 12 months of follow-up without statistically significant differences (P = 0.218). Children were significantly more satisfied (P = 0.0351) with ICRR than DCRR. CONCLUSIONS Both DCRR and ICRR can be considered effective restorations with acceptable clinical performance in the restoration of hypomineralised first permanent molars with an advantage of ICRR in terms of child acceptance of the restoration application technique.
Collapse
Affiliation(s)
- Abdulrhman Hakmi
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Damascus, Syria.
| | - Mayssoon Dashash
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Damascus, Syria
| |
Collapse
|
49
|
Lamloum D, Arghittu A, Ferrara P, Castiglia P, Dettori M, Gaeta M, Odone A, Campus G. A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist. Healthcare (Basel) 2023; 11:1895. [PMID: 37444729 DOI: 10.3390/healthcare11131895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future.
Collapse
Affiliation(s)
- Demetrio Lamloum
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20126 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Guglielmo Campus
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai 600077, India
| |
Collapse
|
50
|
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.
Collapse
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
| |
Collapse
|