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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).
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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
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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.
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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.
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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.
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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.
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McCarra C, Olegário IC, O'Connell AC, Leith R. Prevalence of hypomineralised second primary molars (HSPM): A systematic review and meta-analysis. Int J Paediatr Dent 2022; 32:367-382. [PMID: 34432910 DOI: 10.1111/ipd.12892] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/21/2021] [Accepted: 07/31/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the prevalence of HSPM worldwide on a child and a tooth level and investigate the influence of diagnostic criteria on the prevalence of HSPM. DESIGN A comprehensive literature search was performed through MEDLINE/PubMed, Scopus, and Web of Science databases. The grey literature was also screened as were the reference lists of included studies. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of HSPM. RESULTS The search strategy identified 1,988 articles, 487 were retrieved for full-text evaluation, and 37 studies were included in the meta-analysis (32 for child and 23 for tooth level prevalence), providing data from 26,805 individuals and 81,107 molars. The prevalence of HSPM was 6.8% (95% CI 4.98%-8.86%) on a child level and 4.08% on a tooth level (95% CI = 2.80%-5.59%). The diagnostic criteria used did not seem to influence the prevalence results (P > .05). The majority of the papers (75%) showed a low-to-moderate risk of bias. CONCLUSION There was a broad variation in the prevalence reported that may be attributed to differences in the study population. The present meta-analysis showed a HSPM prevalence worldwide of 6.8% on a child level and 4.1% on a tooth level.
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Affiliation(s)
- Charlotte McCarra
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Isabel Cristina Olegário
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Anne C O'Connell
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Rona Leith
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
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Lopes LB, Machado V, Mascarenhas P, Mendes JJ, Botelho J. The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Sci Rep 2021; 11:22405. [PMID: 34789780 PMCID: PMC8599453 DOI: 10.1038/s41598-021-01541-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/06/2021] [Indexed: 12/28/2022] Open
Abstract
Molar-Incisor Hypomineralization (MIH) is a qualitative defect of enamel of unknown etiology, affecting one or more permanent molars and may include incisors. This condition is a clinical challenge and its prevalence is still uncertain given the recent increase in research. Thus, we aimed to comprehensively estimate the overall prevalence of MIH and associated characteristics. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS and TRIP databases, until July 2021. Heterogeneity and publication bias were computed via I2 test statistics and Egger's significance test, respectively. Random-effects meta-analysis of prevalence were processed. We used the Strength of Recommendation Taxonomy [SORT] to grading the strength of evidence. Overall, 116 observational studies were included, with one study with moderate methodological quality and the remaining of high methodological quality. Subgroup analysis confirmed an influence of not using the 2003 MIH case definition (p = 0.0066). The pooled prevalence of MIH was 13.5% (95% CI 12.0-15.1, I2 = 98.0%). Affected incisors were seen in 36.6% (95% CI 30.0-43.7, I2 = 92.5%) of the cases. Lastly, the prevalence of hypomineralization of the second primary molars was observed in 3.6% of the MIH cases (95% CI 1.9-6.8, I2 = 96.3%). America was the continent with highest prevalence (15.3, 95% CI 12.8-18.3, p < 0.001, I2 = 96.3%) and Asia had the lowest prevalence (10.7, 95% CI 8.5-13.5, p < 0.001, I2 = 98.7%), however no continental differences were found. Sample size and year of publication were slight contributing factors to the heterogeneity in the analysis. Overall, these results were classified with a SORT A recommendation.
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Affiliation(s)
- Luísa Bandeira Lopes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - Paulo Mascarenhas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal.
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal.
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Sosa-Soto J, Padrón-Covarrubias AI, Márquez-Preciado R, Ruiz-Rodríguez S, Pozos-Guillén A, Pedroza-Uribe IM, Bayardo-González RA, Garrocho-Rangel A. Molar incisor hypomineralization (MIH): prevalence and degree of severity in a Mexican pediatric population living in an endemic fluorosis area. J Public Health Dent 2021; 82:3-10. [PMID: 33554368 DOI: 10.1111/jphd.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/17/2021] [Accepted: 01/22/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate the prevalence and severity of molar incisor hypomineralization (MIH) in 8 years old children living in an endemic fluorosis area. METHODS MIH prevalence rate was determined from a study sample comprising 613 participants. They were recruited from 11 urban public schools with similar socio-economic status. Oral evaluations were performed and diagnosed MIH teeth were classified under Ghanim et al.'s criteria. Statistical descriptive and comparative analyzes were carried out. RESULTS First permanent molars were the tooth group most affected, followed by the upper central incisors, lower central incisors, lower lateral incisors, and upper lateral incisors. There was no significant statistical difference by gender and by maxillary/mandible arches (P = 0.82 and 0.26, respectively). The frequency of MIH was more in molars compared to incisors (P < 0.02). CONCLUSIONS The MIH prevalence in this study was 12.4 percent. According to the MIH severity, degree 2 was the most frequently detected (76.4 percent).
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Affiliation(s)
- Joselyn Sosa-Soto
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
| | - Ana Isabel Padrón-Covarrubias
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
| | - Raúl Márquez-Preciado
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
| | - Socorro Ruiz-Rodríguez
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
| | - Amaury Pozos-Guillén
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico.,Basic Sciences Laboratory, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
| | | | | | - Arturo Garrocho-Rangel
- Paediatric Dentistry Postgraduate Program, Faculty of Dentistry, San Luis Potosi University, San Luis Potosi, Mexico
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Bezamat M, Souza JF, Silva FMF, Corrêa EG, Fatturi AL, Brancher JA, Carvalho FM, Cavallari T, Bertolazo L, Machado-Souza C, Koruyucu M, Bayram M, Racic A, Harrison BM, Sweat YY, Letra A, Studen-Pavlovich D, Seymen F, Amendt B, Werneck RI, Costa MC, Modesto A, Vieira AR. Gene-environment interaction in molar-incisor hypomineralization. PLoS One 2021; 16:e0241898. [PMID: 33406080 PMCID: PMC7787379 DOI: 10.1371/journal.pone.0241898] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/22/2020] [Indexed: 01/12/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is an enamel condition characterized by lesions ranging in color from white to brown which present rapid caries progression, and mainly affects permanent first molars and incisors. These enamel defects usually occur when there are disturbances during the mineralization or maturation stage of amelogenesis. Both genetic and environmental factors have been suggested to play roles in MIH’s development, but no conclusive risk factors have shown the source of the disease. During head and neck development, the interferon regulatory factor 6 (IRF6) gene is involved in the structure formation of the oral and maxillofacial regions, and the transforming growth factor alpha (TGFA) is an essential cell regulator, acting during proliferation, differentiation, migration and apoptosis. In this present study, it was hypothesized that these genes interact and contribute to predisposition of MIH. Environmental factors affecting children that were 3 years of age or older were also hypothesized to play a role in the disease etiology. Those factors included respiratory issues, malnutrition, food intolerance, infection of any sort and medication intake. A total of 1,065 salivary samples from four different cohorts were obtained, and DNA was extracted from each sample and genotyped for nine different single nucleotide polymorphisms. Association tests and logistic regression implemented in PLINK were used for analyses. A potential interaction between TGFA rs930655 with all markers tested in the cohort from Turkey was identified. These interactions were not identified in the remaining cohorts. Associations (p<0.05) between the use of medication after three years of age and MIH were also found, suggesting that conditions acquired at the age children start to socialize might contribute to the development of MIH.
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Affiliation(s)
- Mariana Bezamat
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Juliana F. Souza
- Department of Stomatology, Federal University of Paraná, Curitiba, State of Paraná, Brazil
| | - Fernanda M. F. Silva
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Emilly G. Corrêa
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Aluhe L. Fatturi
- Department of Stomatology, Federal University of Paraná, Curitiba, State of Paraná, Brazil
| | - João A. Brancher
- Graduate Program of Dentistry, Positivo University, Curitiba, State of Pará, Brazil
| | - Flávia M. Carvalho
- Department of Genetics, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tayla Cavallari
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Laís Bertolazo
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Cleber Machado-Souza
- Graduate Program of Applied Biotechnology to Child and Adolescent Health, Pequeno Príncipe College, Curitiba, State of Pará, Brazil
| | - Mine Koruyucu
- Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Merve Bayram
- Department of Pedodontics, Medipol Istanbul University, Istanbul, Turkey
| | - Andrea Racic
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Benjamin M. Harrison
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yan Y. Sweat
- Craniofacial Anomalies Research Center and Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Ariadne Letra
- Department of Diagnostic and Biomedical Sciences, and Center for Craniofacial Research, UTHealth School of Dentistry at Houston, Houston, Texas, United States of America
| | - Deborah Studen-Pavlovich
- Department of Pediatric Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Figen Seymen
- Department of Pedodontics, Istanbul University, Istanbul, Turkey
| | - Brad Amendt
- Craniofacial Anomalies Research Center and Department of Orthodontics, College of Dentistry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Renata I. Werneck
- Graduate Program of Dentistry, Pontifical Catholic University of Paraná, Curitiba, State of Paraná, Brazil
| | - Marcelo C. Costa
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Modesto
- Department of Pediatric Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Alexandre R. Vieira
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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Olmo-González B, Moreno-López R, Ribera-Uribe M. Dental management strategies for Molar Incisor Hypomineralization. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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