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Amend S, Stork S, Lücker S, Seipp A, Gärtner U, Frankenberger R, Krämer N. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dent Mater 2024; 40:1015-1024. [PMID: 38744567 DOI: 10.1016/j.dental.2024.05.010] [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: 12/25/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This in vitro pilot study aimed to evaluate whether different pre-treatments (demineralization, deproteinization, (chemo-)mechanical reduction of the surface layer) influence the penetration depth of a resin infiltrant into MIH-affected enamel compared to initial carious lesions. METHODS Thirty extracted human permanent molars with non-cavitated initial carious lesions (n = 5) or MIH (n = 25) were chosen and randomly assigned to six experimental groups: IC: initial caries; M: MIH; MN: MIH, 5.25% sodium hypochlorite; MM: MIH, microabrasion; MA: MIH, air abrasion; MAN: MIH, air abrasion and 5.25% sodium hypochlorite. A modified indirect dual fluorescence staining method was adopted to assess the penetration depth (PD) of the resin infiltrant and the lesion depth (LD) by confocal laser scanning microscopy (CLSM). Exemplarily, scanning electron microscopic (SEM) images were captured. The relationship between group assignment and penetration/lesion depth was estimated using a linear mixed model incorporating the tooth as random effect (two observations/tooth). The significance level was set at p < 0.05. RESULTS For MIH-affected molars, the mean PD (in µm; median, [minimum-maximum]) were M (178.2 [32.5-748.9]), MN (275.6 [105.3-1131.0]), MM (48.7 [0.0-334.4]), MA (287.7 [239.4-491.7]), and MAN (245.4 [76.1-313.5]). Despite the observed differences in PD between the groups, these could not be statistically verified (Bonferroni, p = 0.322). The percentage penetration was significantly higher for IC than for MIH groups (Bonferroni, p < 0.05). SIGNIFICANCE Compared to IC, resin infiltration into MIH-affected enamel ist more variable. Different pre-treatments influence the resin penetration into developmentally hypomineralized enamel to a fluctuating level.
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Affiliation(s)
- Stefanie Amend
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Stephan Stork
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Susanne Lücker
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Anika Seipp
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Ulrich Gärtner
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Marburg), Philipps-University Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany.
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
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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
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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.
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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
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Erbas Unverdi G, Ballikaya E, Cehreli ZC. Clinical comparison of silver diamine fluoride (SDF) or silver-modified atraumatic restorative technique (SMART) on hypomineralised permanent molars with initial carious lesions: 3-year results of a prospective, randomised trial. J Dent 2024; 147:105098. [PMID: 38797490 DOI: 10.1016/j.jdent.2024.105098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions. METHODS 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis. RESULTS The caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations. CONCLUSIONS During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss. CLINICAL SIGNIFICANCE Both SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants. CLINICALTRIALS REGISTRATION NUMBER NCT03862014.
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Affiliation(s)
- Gizem Erbas Unverdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey
| | - Elif Ballikaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye 06230, Ankara, Turkey.
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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.
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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.
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Schulz-Weidner N, Gruber M, Schraml EM, Wöstmann B, Krämer N, Schlenz MA. Improving the Communication of Dental Findings in Pediatric Dentistry by Using Intraoral Scans as a Visual Aid: A Randomized Clinical Trial. Dent J (Basel) 2024; 12:15. [PMID: 38248223 PMCID: PMC10814675 DOI: 10.3390/dj12010015] [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: 10/20/2023] [Revised: 12/12/2023] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
The aim of this first randomized clinical trial (RCT) was to determine whether intraoral scans (IOS) can be used as a visual aid to improve the communication of dental findings in pediatric dentistry. Therefore, 60 children (mean age 10.1 ± 3.3 years) and their accompanying parents/primary caregivers were examined between July 2022 and February 2023. Patients were randomly allocated to two groups: half of the participants were informed of the children's dental findings including treatment plans by verbal explanation alone (control group, n = 30), while the other half were informed using IOS (Trios 4, 3Shape) as a visual aid to support the verbal explanation (study group, n = 30). Both groups then completed a questionnaire regarding their children's diagnosis, treatment needs, planned therapy, and oral hygiene. Statistical analysis was performed using a t-test (p < 0.05). Overall, there was a significant difference between the two groups (p < 0.001) in terms of understanding the current oral situation of their children. While 85.5 ± 17.3% (mean ± standard deviation) of the answers were correct in the study group, only 57.2 ± 17.8% of the participants in the control group were capable of answering the questions correctly. In particular, the control group had difficulties answering the questions about treatment needs and therapy correctly. Within the limitations of this first pilot study, IOS can be clearly recommended as a visual aid to improve the communication of dental findings with PGs in pediatric dentistry.
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Affiliation(s)
- Nelly Schulz-Weidner
- Dental Clinic—Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany;
| | - Marina Gruber
- Dental Clinic—Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (M.G.); (B.W.)
| | - Eva May Schraml
- Department of Oral and Maxillofacial Surgery, Justus Liebig University, Klinikstrasse 33, 35392 Giessen, Germany;
| | - Bernd Wöstmann
- Dental Clinic—Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (M.G.); (B.W.)
| | - Norbert Krämer
- Dental Clinic—Department of Pediatric Dentistry, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany;
| | - Maximiliane Amelie Schlenz
- Dental Clinic—Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, 35392 Giessen, Germany; (M.G.); (B.W.)
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