1
|
Lopes-Fatturi A, Fonseca-Souza G, Wambier LM, Brancher JA, Küchler EC, Feltrin-Souza J. Genetic polymorphisms associated with developmental defects of enamel: A systematic review. Int J Paediatr Dent 2024. [PMID: 38949474 DOI: 10.1111/ipd.13233] [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: 12/06/2023] [Revised: 05/20/2024] [Accepted: 06/15/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Polymorphisms in genes related to enamel formation and mineralization may increase the risk of developmental defects of enamel (DDE). AIM To evaluate the existing literature on genetic polymorphisms associated with DDE. DESIGN This systematic review was registered in the PROSPERO (CRD42018115270). The literature search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and in the gray literature. Observational studies assessing the association between DDE and genetic polymorphism were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. RESULTS One thousand one hundred and forty-six articles were identified, and 28 met the inclusion criteria. Five studies presented a low risk of bias. Ninety-two genes related to enamel development, craniofacial patterning morphogenesis, immune response, and hormone transcription/reception were included. Molar-incisor hypomineralization (MIH) and/or hypomineralization of primary second molars (HPSM) were associated with 80 polymorphisms of genes responsible for enamel development, immune response, morphogenesis, and xenobiotic detoxication. A significant association was found between the different clinical manifestations of dental fluorosis (DF) with nine polymorphisms of genes responsible for enamel development, craniofacial development, hormonal transcription/reception, and oxidative stress. Hypoplasia was associated with polymorphisms located in intronic regions. CONCLUSION MIH, HPSM, DF, and hypoplasia reported as having a complex etiology are significantly associated with genetic polymorphisms of several genes.
Collapse
|
2
|
Franco MMP, Ribeiro CCC, Ladeira LLC, Thomaz EBAF, Alves CMC. Pre- and perinatal exposures associated with molar incisor hypomineralization: Birth cohort, Brazil. Oral Dis 2023. [PMID: 37884359 DOI: 10.1111/odi.14783] [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: 08/27/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE To analyze prenatal and perinatal stressors associated with molar incisor hypomineralization (MIH) in adolescents. METHODS Prospective cohort study collected prenatal (socioeconomic status, maternal age, number of prenatal visits, smoking, obesity during pregnancy, abortion history, gestational hypertension) and perinatal stressors (type of delivery, gestational age, birth weight, intensive care unit-ICU at birth). The outcome was MIH at 18-19 years follow-up (n = 590). MIH was defined according to the Ghanim criteria - Model I. We performed a sensitivity analysis, including opacities demarcated in index tooth, incisive or molars, Model II. Through structural equation modeling, we analyzed direct and mediating pathways between multiple stressors with outcomes. RESULTS MIH was observed in 15.25% (n = 90), and opacities demarcated in any index tooth were observed in 22.8% of adolescents (n = 135). In Model I, no stressor explained MIH significantly, although we watched high standardized coefficients (SC) for low birth weight (SC = 0.223, p = 0.147), lower gestational age (SC = 0.351; p = 0.254), and ICU admission (SC = 0.447, p = 0.254). In Model II, advanced maternal age (SC = 0.148; p < 0.05) and not undergoing prenatal care (SC = 0.384, p < 0.03) explained opacities demarcated in incisors or molars. CONCLUSION Advanced maternal age and not undergoing prenatal care were associated with MIH lesion-like in incisors or molars.
Collapse
Affiliation(s)
- Marcela M P Franco
- Postgraduate Program in Dentistry, Federal University of Maranhão, Maranhão, São Luís, Brazil
| | - Cecilia C C Ribeiro
- Postgraduate Program in Dentistry, Federal University of Maranhão, Maranhão, São Luís, Brazil
| | - Lorena L C Ladeira
- Postgraduate Program in Dentistry, Federal University of Maranhão, Maranhão, São Luís, Brazil
| | | | | |
Collapse
|
3
|
Şen Yavuz B, Sezer B, Kaya R, Tuğcu N, Kargül B. Is there an association between molar incisor hypomineralization and developmental dental anomalies? A case-control study. BMC Oral Health 2023; 23:776. [PMID: 37865729 PMCID: PMC10590512 DOI: 10.1186/s12903-023-03540-8] [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: 08/03/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies. METHODS Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies. RESULTS No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively). CONCLUSIONS While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.
Collapse
Affiliation(s)
- Betül Şen Yavuz
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye
| | - Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
| | | | | | - Betül Kargül
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye
| |
Collapse
|
4
|
Georgina-Pérez L, Ribas-Pérez D, Dehesa-Santos A, Mendoza-Mendoza A. Relationship between the TGFBR1 Gene and Molar Incisor Hypomineralization. J Pers Med 2023; 13:jpm13050777. [PMID: 37240947 DOI: 10.3390/jpm13050777] [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: 03/18/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Molar Incisor Hypomineralization Syndrome (MIH) is a problem of increasing incidence that represents a new challenge in the dental treatment of many of the children we see in our dental offices. Understanding the etiology of this syndrome (still unknown) will help us to prevent the appearance of this process. Lately a certain genetic relationship has been suggested in the syndrome. The aim of the present study was to explore the relationship between activation of the TGFBR1 gene and the development of MIH, as recent studies suggest that there may be an association in this regard. MATERIALS AND METHODS The study sample consisted of 50 children between 6-17 years of age with MIH, each with at least one parent and a sibling with or without MIH, and a group control of 100 children without MIH. The condition of the permanent molars and incisors was evaluated and recorded based on the criteria of Mathu-Muju and Wright. Saliva samples were collected after washing and rinsing of the oral cavity. Genotyping was performed with the saliva samples for the selection of a target polymorphism of the studied gene (TGFBR1). RESULTS The mean age was 9.7 years (SD 2.36). Of the 50 children with MIH, 56% were boys and 44% girls. The degree of MIH was predominantly severe (58%), with moderate and mild involvement in 22% and 20% of the cases, respectively, according to the classification of Mathu-Muju. The allelic frequencies were seen to behave as expected. The logistic regression analysis aimed to relate each polymorphism to the presence or absence of the factors. These results were inconclusive, with no evidence suggesting an alteration of the TGFBR1 gene to be related to the appearance of MIH. CONCLUSIONS Within the limitations posed by a study of these characteristics, it can be affirmed that no relationship has been found between the TGFBR1 gene and the appearance of molar incisor hypomineralization.
Collapse
Affiliation(s)
| | - David Ribas-Pérez
- Department of Stomatology, Universidad de Sevilla, 41080 Seville, Spain
| | - Alexandra Dehesa-Santos
- Department of Clinical Dental Specialities, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | |
Collapse
|
5
|
Elzein R, Abdel-Sater F, Mehawej C, Jalkh N, Ayoub F, Chouery E. Identification by whole-exome sequencing of new single-nucleotide polymorphisms associated with molar-incisor hypomineralisation among the Lebanese population. Eur Arch Paediatr Dent 2022; 23:919-928. [PMID: 35986881 DOI: 10.1007/s40368-022-00738-2] [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: 02/20/2022] [Accepted: 07/21/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Molar-incisor hypomineralization (MIH) is a developmental qualitative enamel defect, causing a worldwide challenging dental problem. The etiology of this defect remains unclear. Here we identify by whole-exome sequencing (WES) new single-nucleotide polymorphisms (SNPs) in genes expressed during enamel mineralization and in those modulating prenatal, natal and postnatal risk factors among the Lebanese MIH children: immune system and xenobiotic detoxification. DESIGN Dental examination for MIH was performed based on the MIH index for diagnostic criteria. Saliva samples were collected from 37 non-related, MIH-diagnosed subjects for DNA extraction. WES was performed on the Illumina HiSeq2000 platform. The χ2 test and Fisher's exact test were used to determine relationship between SNPs frequencies and MIH. OR and its 95% CI were used to report the strength of association. The significance threshold was set at 0.05. RESULTS Among the Lebanese population, 37 SNPs presented a significant association with MIH in the following genes: AMTN, MMP-20, STIM1, STIM2, ORAI1, SLC34A2, SLC34A3, VDR, PVALB, HSP90B1, TRPM7, SLC24A4, CA6, SLC4A2, TNFRSF11A, IL10RB, ARNT, ESR1 and CYP1B1. CONCLUSION This is the first WES study conducted in patients with MIH. Yet, interactions between polymorphisms in different gene categories are to be investigated for a better assessment of MIH susceptibility.
Collapse
Affiliation(s)
- R Elzein
- Department of Pediatric Dentistry and Public Dental Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon. .,Medical Genetics Unit, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
| | - F Abdel-Sater
- Laboratory of Cancer Biology and Cellular Immunology, Department of Biological Sciences, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - C Mehawej
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - N Jalkh
- Medical Genetics Unit, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - F Ayoub
- Department of Forensic Odontology, Human Identification and Anthropology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - E Chouery
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| |
Collapse
|
6
|
Garot E, Rouas P, Somani C, Taylor GD, Wong F, Lygidakis NA. An update of the aetiological factors involved in molar incisor hypomineralisation (MIH): a systematic review and meta-analysis. Eur Arch Paediatr Dent 2022; 23:23-38. [PMID: 34164793 DOI: 10.1007/s40368-021-00646-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/02/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the aetiological factors associated with molar incisor hypomineralisation (MIH). To this day, the aetiology remains unknown. Determining risk factors would allow risk assessment and enhance early diagnosis of MIH in young patients. The aim was to assess, evaluate and summarise the relationship between MIH and reported aetiological hypotheses. METHODS Electronic database searches of MEDLINE, EMBASE, EBSCO, LILACS and Cochrane Library were conducted. Authors conformed to PRISMA guidelines. Studies were screened, data extracted, assessment of risk of bias and calibration was completed by two independent reviewers. Meta-analyses with heterogeneity calculations were performed. RESULTS Of the potential 8949 studies, 64 studies were included in the qualitative analysis whilst 45 were included in the quantitative analysis. Prenatal factors: results are inconclusive as only unspecified maternal illnesses appear to be linked to MIH. Perinatal factors: prematurity (OR 1.45; 95% CI 1.24-1.70; p = 0.0002) and caesarean delivery (OR 1.45; 95% CI 1.09, 1.93; p < 0.00001) are associated with an increased risk of developing MIH. Birth complications are also highlighted. These three factors can lead to hypoxia, and children with perinatal hypoxia are more likely to develop MIH (OR 2.76; 95% CI 2.09-3.64; p < 0.0001). Postnatal factors: measles, urinary tract infection, otitis media, gastric disorders, bronchitis, kidney diseases, pneumonia and asthma are associated with MIH. Fever and antibiotic use, which may be considered as consequences of childhood illnesses, are also associated with MIH. Genetic factors: an increasing number of studies highlight the genetic and epigenetic influences in the development of MIH. CONCLUSION Several systemic and genetic and/or epigenetic factors acting synergistically or additively are associated with MIH, revealing a multifactorial aetiology model. Peri- and postnatal aetiological factors are more likely to increase the odds of causing MIH than prenatal factors.
Collapse
Affiliation(s)
- E Garot
- Université de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France. .,CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France. .,Université de Bordeaux, PACEA, UMR 5199, Pessac, France.
| | - P Rouas
- Université de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France.,CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France.,Université de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - F Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece
| |
Collapse
|
7
|
Bussaneli DG, Vieira AR, Santos-Pinto L, Restrepo M. Molar-incisor hypomineralisation: an updated view for aetiology 20 years later. Eur Arch Paediatr Dent 2022; 23:193-198. [PMID: 34392496 DOI: 10.1007/s40368-021-00659-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The term Molar-Incisor Hypomineralisation (MIH) was introduced in 2001 by Weerheijm, Jälevik and Alaluusua, and describes a defect of systemic origin that affects one to four first permanent molars, often associated with permanent incisors. In the past 20 years, this definition dictated the work regarding MIH prevalence, associated risk factors, association with dental caries, impact on quality of life, and therapeutic options. PURPOSE In this report, we offer an updated and comprehensive view of MIH centred on the patient and the tooth. CONCLUSION MIH today is globally recognized as a potential public health problem and it is not a defect of purely systemic origin but rather a condition with complex aetiology that in some instances may be the result of gene-environmental interactions.
Collapse
Affiliation(s)
- D G Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - A R Vieira
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - L Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - M Restrepo
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia.
| |
Collapse
|
8
|
Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 86] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
Collapse
Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
9
|
Sezer B, Çarıkçıoğlu B, Kargül B. Dental age and tooth development in children with molar-incisor hypomineralization: A case-control study. Arch Oral Biol 2021; 134:105325. [PMID: 34871891 DOI: 10.1016/j.archoralbio.2021.105325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of the study was to determine the dental age for the evaluation of tooth development in children with molar-incisor hypomineralization (MIH) by using the Willems method, Cameriere-European formula, and London Atlas. DESIGN Panoramic radiographs of 308 children between the ages of 6-13 diagnosed with MIH and the same number of sex- and age-matched children without MIH were evaluated by two different examiners using the Willems method, Cameriere-European formula, and London Atlas. The mean difference between chronological age and dental age in both groups was calculated for each sex and age. The mean absolute error was used to determine the accuracies of the Willems method, Cameriere-European formula, and London Atlas. RESULTS There was a statistically significant difference found only in Willems method in dental age estimation between the groups with and without MIH (P = 0.001). In the evaluation performed with Cameriere-European formula and London Atlas, which are more accurate methods for dental age estimation in both groups, no statistically significant difference was found in dental age estimation between the two groups (P = 0.322, P = 0.290, respectively). There was a statistically significant intense linear correlation for three methods in both groups (P < 0.001). CONCLUSIONS MIH, which is a developmental enamel defect, does not affect dental age and tooth development since there was no significant difference between groups with and without MIH according to the evaluations made with accurate dental age estimation methods.
Collapse
Affiliation(s)
- Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Burak Çarıkçıoğlu
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Betül Kargül
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey.
| |
Collapse
|
10
|
Pang L, Wang K, Tao Y, Zhi Q, Zhang J, Lin H. A New Model for Caries Risk Prediction in Teenagers Using a Machine Learning Algorithm Based on Environmental and Genetic Factors. Front Genet 2021; 12:636867. [PMID: 33777105 PMCID: PMC7990890 DOI: 10.3389/fgene.2021.636867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/19/2021] [Indexed: 11/16/2022] Open
Abstract
Dental caries is a multifactorial disease that can be caused by interactions between genetic and environmental risk factors. Despite the availability of caries risk assessment tools, caries risk prediction models incorporating new factors, such as human genetic markers, have not yet been reported. The aim of this study was to construct a new model for caries risk prediction in teenagers, based on environmental and genetic factors, using a machine learning algorithm. We performed a prospective longitudinal study of 1,055 teenagers (710 teenagers for cohort 1 and 345 teenagers for cohort 2) aged 13 years, of whom 953 (633 teenagers for cohort 1 and 320 teenagers for cohort 2) were followed for 21 months. All participants completed an oral health questionnaire, an oral examination, biological (salivary and cariostate) tests, and single nucleotide polymorphism sequencing analysis. We constructed a caries risk prediction model based on these data using a random forest with an AUC of 0.78 in cohort 1 (training cohort). We further verified the discrimination and calibration abilities of this caries risk prediction model using cohort 2. The AUC of the caries risk prediction model in cohort 2 (testing cohort) was 0.73, indicating high discrimination ability. Risk stratification revealed that our caries risk prediction model could accurately identify individuals at high and very high caries risk but underestimated risks for individuals at low and very low caries risk. Thus, our caries risk prediction model has the potential for use as a powerful community-level tool to identify individuals at high caries risk.
Collapse
Affiliation(s)
- Liangyue Pang
- Guangdong Provincial Key Laboratory of Stomatology, Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Ketian Wang
- Guangdong Provincial Key Laboratory of Stomatology, Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Ye Tao
- Guangdong Provincial Key Laboratory of Stomatology, Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Qinghui Zhi
- Guangdong Provincial Key Laboratory of Stomatology, Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Jianming Zhang
- Foshan Stomatology Hospital, School of Stomatology and Medicine, Foshan University, Foshan, China
| | - Huancai Lin
- Guangdong Provincial Key Laboratory of Stomatology, Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
11
|
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.
Collapse
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:
| |
Collapse
|
12
|
Molar Incisor Hypomineralisation-To Extract or to Restore beyond the Optimal Age? CHILDREN-BASEL 2020; 7:children7080091. [PMID: 32781715 PMCID: PMC7464986 DOI: 10.3390/children7080091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
Abstract
The management of compromised first permanent molars (FPMs) in children presents a clinical challenge to the dental team. Hypomineralised FPMs in molar incisor hypomineralisation (MIH) conditions could undergo post-eruptive breakdown, making them susceptible to caries, leading to their subsequent loss. The planned extraction of compromised FPMs is a valid alternative to complex restorative treatment. However, establishing the presence or absence of third permanent molars, amongst other considerations, is crucial to reaching a successful outcome. Clinicians should understand the importance of an orthodontic examination around the age of 8 years old with regard to establishing a differential therapeutic decision about the ideal timing of MIH-affected FPMs’ extraction in children. The aim of this article is to highlight that, with an interdisciplinary approach, a good outcome can be achieved following the extraction of poorly prognosed FPMs. The most cost-effective way of addressing MIH-affected FPMs is extraction, followed by orthodontic space closure when indicated. This obviates the need for the repeated restorative replacement and saves perfectly healthy premolars from being extracted for space creation in orthodontic treatment in several clinical scenarios.
Collapse
|