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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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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.
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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
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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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Santos PS, Vitali FC, Fonseca-Souza G, Maia LC, Cardoso M, Feltrin-Souza J, Fraiz FC. Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: A systematic review and meta-analysis. J Dent 2024; 145:104981. [PMID: 38582436 DOI: 10.1016/j.jdent.2024.104981] [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: 02/27/2024] [Revised: 03/29/2024] [Accepted: 03/31/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES To determine the prevalence of dentin hypersensitivity (DH) and toothache in patients with Molar-Incisor Hypomineralization (MIH); and evaluate whether patients with MIH have greater likelihood of presenting DH/toothache than controls. DATA Studies evaluating DH/toothache in patients with MIH were included. Studies focusing on other enamel defects were excluded. SOURCES Eight databases, including grey literature, were searched in January 2024. STUDY SELECTION The methodological quality of studies was assessed using the Joanna Briggs Institute checklist for Cross-sectional studies. Proportion and association meta-analyses, subgrouped by diagnostic methods, were conducted. The certainty of evidence was assessed using GRADE approach. RESULTS Fifteen studies were included in the qualitative analysis and fourteen in the meta-analyses. Two studies fulfilled all items of the methodological quality checklist. The overall prevalence of DH/toothache among patients with MIH was 45 %. Prevalence rates of 30 %, 47 %, and 55 % were estimated based on proxy reports, self-reports, and air stimulation, respectively. The overall prevalence of DH/toothache per tooth was 22 %, ranging from 16 % to 29 % according to the diagnostic method. Patients with MIH demonstrated higher likelihood of presenting proxy reports of DH/toothache compared to those without MIH (OR: 1.51, 95 % CI [1.23-1.85], P < 0.01, I2: 0 %). The certainty of evidence was very low, mainly due to the low methodological quality of included studies and high inconsistency. CONCLUSIONS The global prevalence of DH/toothache was 22 %, per tooth, and 45 % per patient. Estimates vary according to diagnostic methods. Patients with MIH showed higher likelihood of presenting proxy reports of DH/toothache than controls. CLINICAL SIGNIFICANCE This systematic review contributes valuable information to the dental literature by assessing the prevalence and associated factors of DH/toothache in patients with MIH. The findings can guide future research, inform clinical practices and public policy makers, and ultimately improve the management of oral health of patients with MIH. REGISTRATION PROSPERO CRD42023432805.
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Affiliation(s)
- Pablo Silveira Santos
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil; Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Filipe Colombo Vitali
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - Fabian Calixto Fraiz
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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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.
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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
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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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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.
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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.
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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.
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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
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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.
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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
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Al-Nerabieah Z, AlKhouli M, Dashash M. Assessment of diagnostic accuracy and reliability of reveal fluorescence dental loupes in detecting molar incisor hypomineralization in children. Photodiagnosis Photodyn Ther 2024; 46:104033. [PMID: 38432500 DOI: 10.1016/j.pdpdt.2024.104033] [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: 12/11/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Molar-Incisor Hypomineralization (MIH) poses challenges to accurate diagnosis, impacting children's oral health. Traditional methods exhibit limitations, necessitating innovative approaches. This study aimed to evaluate the reliability and diagnostic accuracy Reveal Fluorescence Dental Loupes (RFDLs) for the detection of MIH METHODS: This cross-sectional study, adhering to STRAD guidelines, involved 38 healthy children (age 7-9) with MIH. Ethical approval and informed consent were obtained. Microscope images and Reveal loupes were employed for examinations. Validity was assessed against microscope results, and inter- and intra-examiner reliability were measured using ICC and Kappa coefficients. Sensitivity, specificity, and overall accuracy were calculated, with an AUC-ROC analysis for discriminatory ability. RESULTS Intra-examiner reliability scores were excellent (Examiner 1: ICC 0.92, Examiner 2: ICC 0.94). Inter-examiner reliability (Kappa 0.92) indicated almost perfect agreement. Reveal demonstrated high sensitivity (82.61 %) and specificity (92.59 %), with an overall accuracy of 88.70 %. AUC-ROC analysis supported its robust discriminatory ability (AUC: 0.871). CONCLUSIONS Reveal Fluorescence Dental Loupes emerged as a promising diagnostic tool for accurate MIH detection, particularly in outreach settings. The study highlights the transformative impact of accessible and reliable diagnostic tools on pediatric oral health outcomes. While acknowledging limitations and the absence of a gold standard, the findings contribute to advancing MIH diagnostic capabilities. Further research in diverse populations is warranted for comprehensive validation.
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Affiliation(s)
- Zuhair Al-Nerabieah
- Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria.
| | - Muaaz AlKhouli
- Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria
| | - Mayssoon Dashash
- Professor, Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria
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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.
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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
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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.
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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
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Altner S, Milutinovic I, Bekes K. Possible Etiological Factors for the Development of Molar Incisor Hypomineralization (MIH) in Austrian Children. Dent J (Basel) 2024; 12:44. [PMID: 38534268 DOI: 10.3390/dj12030044] [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: 08/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a developmental enamel defect that primarily affects the first permanent molars and sometimes the incisors. Its increasing prevalence worldwide has raised clinical concerns, yet its exact cause remains unknown. This study aimed to assess potential factors influencing MIH development by analyzing the medical history of children aged 6 to 12 years using a questionnaire. METHODS This study included 100 children aged 6-12 years diagnosed with MIH during dental examination, and 100 age-matched children in the non-MIH (healthy) group from the Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna. The parents of the participants completed a two-page questionnaire regarding possible etiological factors of MIH. RESULTS The data analysis involved 100 children with MIH (mean age 8.5; ±1.3; 52% female) and 100 children in the healthy group (mean age 9.2; ±1.3; 42% female). The optimized binary logistic regression analysis revealed a significant association between MIH development and cesarean-section delivery (OR = 3; CI = [1.5-6.2]) and sixth disease (roseola) (OR = 3.5; CI = [1.5-8.0]). CONCLUSIONS This study suggests that cesarean-section delivery and sixth disease (roseola) might increase the likelihood of MIH development in children.
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Affiliation(s)
- Sarra Altner
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
- Clinic of General, Special Care, and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Ivan Milutinovic
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Katrin Bekes
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
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Abreu de Moraes D, Negrini Lia É, Jácome LMT, de Azevedo Pedrosa Cunha C, de Freitas Velloso Monte L. Oral health in individuals with cystic fibrosis: A cross-sectional study. Heliyon 2024; 10:e25241. [PMID: 38356573 PMCID: PMC10865253 DOI: 10.1016/j.heliyon.2024.e25241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
Cystic Fibrosis (CF) is an autosomal recessive disease characterized by the production of thick and viscous mucus progressively affecting various organs and systems, with recurrent respiratory infections. The aim of this study was to learn about the oral health characteristics in CF patients. METHODOLOGY Data, such as sociodemographic, general and oral health, were collected from the medical records of CF patients aged 0 to 18 years old. The number of patients with tooth decay, prevalence of developmental defects of enamel (DDE), classification of dental occlusion, sialometry, salivary pH and oral microbial profile and respiratory secretions evaluations were recorded. RESULTS Most patients had pancreatic insufficiency (84.2%), malnutrition (60%), respiratory problems (75.4%) and genotyping of the F508del (66.7%). Regarding the medications used, 96.5% used vitamins and electrolyte replacement, 84,02% used pancreatic enzymes, 64.9% used dornase alfa and 47% were using antibiotics. The percentage of patients with tooth decay was 19.3%, 47% had DDE, low salivary flow and basic salivary pH. The most prevalent microorganisms found on tongue biofilm and respiratory secretions were SA and PA. There was a positive association between the presence of bacteria and fungi found on both the tongue and respiratory secretions. The presence of fungi on the tongue biofilm was significantly associated with the use of antibiotics. CONCLUSIONS These findings underscore the importance of dentists focusing on prevention and on the specific needs of the patient as well.
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Affiliation(s)
- Daniela Abreu de Moraes
- Centro Universitário do Distrito Federal, Quadra SEPS 704/904, Asa Sul, 70390-045 Brasília, DF, Brazil
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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.
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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.
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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.
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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
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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.
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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
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Geiken A, Banz L, Kock M, Schwendicke F, Graetz C. Does information about MIH on dental homepages in Germany offer high quality? A systematic search and analysis. Eur Arch Paediatr Dent 2024; 25:127-135. [PMID: 38300412 PMCID: PMC10942881 DOI: 10.1007/s40368-023-00857-4] [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: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The internet is increasingly used to seek health information. A dental condition of increasing concern and public interest is molar incisor hypomineralisation (MIH), why we evaluated the information quality of German dentists 'websites on the topic of MIH. METHODS A systematic search was performed by two independent investigators using three search engines. The information content of websites on MIH and technical, functional aspects, overall quality, and risk of bias were assessed using validated instruments (LIDA, DISCERN). Practice-related characteristics (practice type, specialization, setting, number and mean age of dentists) were recorded, and associations of these characteristics with websites' overall quality were explored using multivariable linear regression modelling. RESULTS 70 sites were included. 52% were multipractices in urban areas (49%). The most common age group was middle-aged individuals (41-50 years). The average number of dentists/practice was 2.5. The majority met more than 50% of the DISCERN and LIDA criteria (90%, 91%). The MIH definition was frequently used (67%), MIH symptoms were described (64%), and 58% mentioned therapies. The prevalence of MIH was mentioned less frequently (48%). MIH example photographs were rarely shown (14%). In multivariable analysis, most practice-related factors were not significant for overall site quality. Only chain practices had slightly higher quality in this regard (2.2; 95% CI of 0.3-4.1). CONCLUSIONS MIH is mentioned on a large proportion of dentists' websites. Overall technical, functional, and generic quality was high. Risk of bias is limited. While most websites provided a basic definition of MIH and its symptoms, important information for patients was missing.
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Affiliation(s)
- A Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - L Banz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - M Kock
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - F Schwendicke
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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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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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.
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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
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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.
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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
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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.
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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
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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.
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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 Paediatric Dentistry, Justus Liebig University, Giessen, Germany
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24
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Tenenbaum A, Borsa L, Lupi L, Germa A. Child oral health: A plea for interdisciplinarity. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:83-91. [PMID: 38040649 DOI: 10.3917/spub.hs1.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
A child’s oral health has major implications both for their general health and for their quality of life. Even before birth, the mother’s oral health can affect the development of the baby and pregnancy outcomes. From the very first months of life, feeding habits together with non-nutritive sucking ones, early transmission of pathogenic bacteria, and oral hygiene practices prefigure the child’s future health. The aim of this article is to provide a comprehensive overview of our current knowledge regarding the main oral health issues affecting children, namely dental caries, erosive tooth wear, developmental defects of enamel, maxillofacial growth anomalies, and traumatic dental injuries. Additionally, it aims to examine the oral health prevention and promotion programs that have been implemented in France over several decades. These prevention and promotion initiatives are not only part of a national program but are also being organized at a territorial level, although, unfortunately, they often remain limited to regional, departmental, or municipal scopes. It is essential for all those involved with children, whether they are health care professionals or not, to collaborate effectively to enhance both oral health and overall well-being. This requires fostering an interdisciplinary approach that involves various contributors working together in a complementary way.
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Affiliation(s)
- Annabelle Tenenbaum
- UFR d’Odontologie, Université Paris Cité
- Laboratoire Éducations et Promotion de la santé UR 3412, UFR Santé, Médecine, Biologie Humaine, Université Paris Sorbonne Paris Nord
- AP-HP, Groupe Hospitalier Pitié Salpêtrière, Service d’Odontologie, Département de santé publique orale, F-75651, Paris, France
| | - Leslie Borsa
- Université Côte d’Azur, Faculté de Chirurgie Dentaire-Odontologie Nice, France Département de Santé Publique
- Laboratoire Microbiologie orale, Immunothérapie et Santé (Micoralis), Université Côte d’Azur, Nice, France
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Laurence Lupi
- Université Côte d’Azur, Faculté de Chirurgie Dentaire-Odontologie Nice, France Département de Santé Publique
- Laboratoire Microbiologie orale, Immunothérapie et Santé (Micoralis), Université Côte d’Azur, Nice, France
- Pôle Odontologie, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Alice Germa
- UFR d’Odontologie, Université Paris Cité
- Université Paris Cité Centre de Recherche en Épidémiologie et Statistiques/CRESS, INSERM, INRA, Paris, France
- Service de médecine bucco-dentaire, APHP, hôpital Charles Foix, Ivry-sur-Seine, France
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25
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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.
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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
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Gil-Bona A, Karaaslan H, Depalle B, Sulyanto R, Bidlack FB. Proteomic Analyses Discern the Developmental Inclusion of Albumin in Pig Enamel: A New Model for Human Enamel Hypomineralization. Int J Mol Sci 2023; 24:15577. [PMID: 37958567 PMCID: PMC10650821 DOI: 10.3390/ijms242115577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
Excess albumin in enamel is a characteristic of the prevalent developmental dental defect known as chalky teeth or molar hypomineralization (MH). This study uses proteomic analyses of pig teeth to discern between developmental origin and post-eruptive contamination and to assess the similarity to hypomineralized human enamel. Here, the objective is to address the urgent need for an animal model to uncover the etiology of MH and to improve treatment. Porcine enamel is chalky and soft at eruption; yet, it hardens quickly to form a hard surface and then resembles human teeth with demarcated enamel opacities. Proteomic analyses of enamel from erupted teeth, serum, and saliva from pigs aged 4 (n = 3) and 8 weeks (n = 2) and human (n = 4) molars with demarcated enamel opacities show alpha-fetoprotein (AFP). AFP expression is limited to pre- and perinatal development and its presence in enamel indicates pre- or perinatal inclusion. In contrast, albumin is expressed after birth, indicating postnatal inclusion into enamel. Peptides were extracted from enamel and analyzed by nano-liquid chromatography-tandem mass spectrometry (nanoLC-MS/MS) after tryptic digestion. The mean total protein number was 337 in the enamel of all teeth with 13 different unique tryptic peptides of porcine AFP in all enamel samples but none in saliva samples. Similarities in the composition, micro-hardness, and microstructure underscore the usefulness of the porcine model to uncover the MH etiology, cellular mechanisms of albumin inclusion, and treatment for demarcated opacities.
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Affiliation(s)
- Ana Gil-Bona
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Hakan Karaaslan
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Baptiste Depalle
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Rosalyn Sulyanto
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
- Department of Dentistry, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Felicitas B. Bidlack
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
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27
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Felsch M, Meyer O, Schlickenrieder A, Engels P, Schönewolf J, Zöllner F, Heinrich-Weltzien R, Hesenius M, Hickel R, Gruhn V, Kühnisch J. Detection and localization of caries and hypomineralization on dental photographs with a vision transformer model. NPJ Digit Med 2023; 6:198. [PMID: 37880375 PMCID: PMC10600213 DOI: 10.1038/s41746-023-00944-2] [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: 03/06/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
Caries and molar-incisor hypomineralization (MIH) are among the most prevalent diseases worldwide and need to be reliably diagnosed. The use of dental photographs and artificial intelligence (AI) methods may potentially contribute to realizing accurate and automated diagnostic visual examinations in the future. Therefore, the present study aimed to develop an AI-based algorithm that can detect, classify and localize caries and MIH. This study included an image set of 18,179 anonymous photographs. Pixelwise image labeling was achieved by trained and calibrated annotators using the Computer Vision Annotation Tool (CVAT). All annotations were made according to standard methods and were independently checked by an experienced dentist. The entire image set was divided into training (N = 16,679), validation (N = 500) and test sets (N = 1000). The AI-based algorithm was trained and finetuned over 250 epochs by using image augmentation and adapting a vision transformer network (SegFormer-B5). Statistics included the determination of the intersection over union (IoU), average precision (AP) and accuracy (ACC). The overall diagnostic performance in terms of IoU, AP and ACC were 0.959, 0.977 and 0.978 for the finetuned model, respectively. The corresponding data for the most relevant caries classes of non-cavitations (0.630, 0.813 and 0.990) and dentin cavities (0.692, 0.830, and 0.997) were found to be high. MIH-related demarcated opacity (0.672, 0.827, and 0.993) and atypical restoration (0.829, 0.902, and 0.999) showed similar results. Here, we report that the model achieves excellent precision for pixelwise detection and localization of caries and MIH. Nevertheless, the model needs to be further improved and externally validated.
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Affiliation(s)
- Marco Felsch
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Ole Meyer
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
| | - Anne Schlickenrieder
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Paula Engels
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Jule Schönewolf
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Felicitas Zöllner
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Roswitha Heinrich-Weltzien
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital Jena, Jena, Germany
| | - Marc Hesenius
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Volker Gruhn
- Institute for Software Engineering, University of Duisburg-Essen, Essen, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Ludwig-Maximilians University of Munich, Munich, Germany.
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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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29
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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.
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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
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30
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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.
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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
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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.
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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
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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.
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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
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Boyer E, Monfort C, Lainé F, Gaudreau É, Tillaut H, Bonnaure-Mallet M, Cordier S, Meuric V, Chevrier C. Prenatal exposure to persistent organic pollutants and molar-incisor hypomineralization among 12-year-old children in the French mother-child cohort PELAGIE. ENVIRONMENTAL RESEARCH 2023; 231:116230. [PMID: 37236387 DOI: 10.1016/j.envres.2023.116230] [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: 01/17/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Exceptional episodes of exposure to high levels of persistent organic pollutants have already been associated with developmental defects of enamel among children, but knowledge is still scarce concerning the contribution of background levels of environmental contamination. METHODS Children of the French PELAGIE mother-child cohort were followed from birth, with collection of medical data and cord blood samples that were used to measure polychlorinated biphenyls (PCBs), organochlorine pesticides (OCs), and perfluorinated alkyl substances (PFASs). At 12 years of age, molar-incisor hypomineralization (MIH) and other enamel defects (EDs) were recorded for 498 children. Associations were studied using logistic regression models adjusted for potential prenatal confounders. RESULTS An increasing log-concentration of β-HCH was associated with a reduced risk of MIH and EDs (OR = 0.55; 95% CI, 0.32-0.95, and OR = 0.65; 95% CI, 0.43-0.98, respectively). Among girls, intermediate levels of p,p'-DDE were associated with a reduced risk of MIH. Among boys, we observed an increased risk of EDs in association with intermediate levels of PCB 138, PCB 153, PCB 187, and an increased risk of MIH with intermediate levels of PFOA and PFOS. CONCLUSIONS Two OCs were associated with a reduced risk of dental defects, whereas the associations between PCBs and PFASs and EDs or MIH were generally close to null or sex-specific, with an increased risk of dental defects in boys. These results suggest that POPs could impact amelogenesis. Replication of this study is required and the possible underlying mechanisms need to be explored.
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Affiliation(s)
- Emile Boyer
- INSERM, INRAE, Univ Rennes, CHU Rennes, Institut NUMECAN (Nutrition Metabolism and Cancer), F-35000, Rennes, France.
| | - Christine Monfort
- Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
| | | | - Éric Gaudreau
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec (INSPQ), Québec, Québec, Canada
| | - Hélène Tillaut
- Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
| | - Martine Bonnaure-Mallet
- INSERM, INRAE, Univ Rennes, CHU Rennes, Institut NUMECAN (Nutrition Metabolism and Cancer), F-35000, Rennes, France
| | - Sylvaine Cordier
- Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
| | - Vincent Meuric
- INSERM, INRAE, Univ Rennes, CHU Rennes, Institut NUMECAN (Nutrition Metabolism and Cancer), F-35000, Rennes, France
| | - Cécile Chevrier
- Univ Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-35000, Rennes, France
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Mazur M, Corridore D, Ndokaj A, Ardan R, Vozza I, Babajko S, Jedeon K. MIH and Dental Caries in Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:1795. [PMID: 37372913 DOI: 10.3390/healthcare11121795] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7-10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology.
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Affiliation(s)
- Marta Mazur
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Denise Corridore
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Artnora Ndokaj
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Roman Ardan
- Department of Economic Sciences, Koszalin University of Technology, 75-343 Koszalin, Poland
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Sylvie Babajko
- Laboratory of Biomedical Research in Odontology, Unité Propre de Recherche 2496, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Katia Jedeon
- Laboratory of Biomedical Research in Odontology, Unité Propre de Recherche 2496, Université Paris Cité, 1 rue Maurice Arnoux, 92120 Montrouge, France
- Department of Restorative Dentistry and Endodontics, Rothschild Hospital, 5 rue Santerre, 75012 Paris, France
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35
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Fernández-Bonet J. MIH should be a core component of every dental curriculum. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00810-5. [PMID: 37306867 DOI: 10.1007/s40368-023-00810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Affiliation(s)
- J Fernández-Bonet
- Department of Stomatology II, University of the Basque Country, Leioa, Spain.
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36
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Lakhani S, Noble F, Rodd H, Cobourne MT. Management of children with poor prognosis first permanent molars: an interdisciplinary approach is the key. Br Dent J 2023; 234:731-736. [PMID: 37237201 DOI: 10.1038/s41415-023-5816-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 05/28/2023]
Abstract
Although there have been continuous improvements in child oral health over recent decades, first permanent molars (FPMs) remain susceptible to early caries and can often be affected by hypomineralisation. We highlight current thinking in caries management and the restoration of hypomineralised FPMs, while also discussing enforced loss of these teeth within the context of interceptive extractions or extractions as part of orthodontic treatment. Compromised FPMs can negatively impact on quality of life for a child and present significant management challenges for the dental team. Although a high-quality evidence base is lacking for the different treatment options, early diagnosis and multidisciplinary treatment planning are key to achieving the best outcomes.
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Affiliation(s)
- Shrita Lakhani
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Fiona Noble
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Helen Rodd
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Martyn T Cobourne
- Centre for Craniofacial & Regenerative Biology, Department of Orthodontics, Faculty of Dental, Oral & Craniofacial Sciences, King´s College London, London, United Kingdom.
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37
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Hamza B, Karkoutly M, Papageorgiou SN, Bshara N. Molar-incisor hypomineralisation: Knowledge and perception of Syrian undergraduate and postgraduate dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:343-352. [PMID: 35543303 DOI: 10.1111/eje.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/18/2022] [Accepted: 04/02/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Dentists' knowledge and expertise, especially in their early career, are primarily shaped during undergraduate studies. This cross-sectional study aimed to assess the knowledge and perception of Syrian under- and postgraduate students regarding diagnosing and managing molar-incisor hypomineralisation (MIH)-affected teeth. MATERIALS AND METHODS Final-year dental students (FY-students), postgraduates in paediatric dentistry (PD-postgraduates) and postgraduates in other lines of specialty (OS-postgraduates) in all Syrian dental schools were invited to participate in an established web-based survey covering the knowledge and attitudes regarding the prevalence, aetiology, diagnosis and management of MIH. Data were analysed with descriptive statistics and Fisher's exact/chi-squared tests at 5%. RESULTS In total, 1142 post- and undergraduate students from six public and five private dental schools in Syria participated in this study (867 FY-students, 74 PD-postgraduates and 201 OS-postgraduates). PD-postgraduates were found to present statistically significantly better knowledge regarding MIH compared with the two other groups. Only 19% of FY-students and 54% of OS-postgraduates reported themselves familiar with MIH (compared with 97% of PD-postgraduates). Similarly, 18% of FY-students and 27% of OS-postgraduates were capable of diagnosing MIH (compared with 81% of PD-postgraduates). Stainless-steel crowns and direct composite fillings were chosen as most suitable for treating MIH-affected molars from all responders. CONCLUSIONS FY-students and even OS-postgraduates in Syria lack knowledge and confidence when confronted with MIH. The university curricula need to include more educational materials to equip the students with the necessary tools to manage MIH clinically.
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Affiliation(s)
- Blend Hamza
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Mawia Karkoutly
- Pediatric Dentistry Department, Dental College, Damascus University, Damascus, Syria
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nada Bshara
- Pediatric Dentistry Department, Dental College, Damascus University, Damascus, Syria
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38
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Rodd HD, Nazzal H, Bonifacio CC, Ruth CW, Crombie F, El Shahawy O, Folayan MO, Gambetta-Tessini K, Goyal A, Hasmun N, Issa AI, Jundi S, Manton DJ, Narasimhan S, Omar S, Parekh S, Popoola BO, Silva M, Taylor G, Naomi YQ. An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol. Dent J (Basel) 2023; 11:dj11050117. [PMID: 37232768 DOI: 10.3390/dj11050117] [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: 03/27/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental anomalies in different populations. METHODS Investigators were trained and calibrated for the assessment of MIH and dental anomalies and ethical approvals obtained in each participating country. The study aimed to recruit 584 children with MIH and 584 children without MIH. Patients aged 7-16 years who attend specialist clinics will be invited to participate. Children will undergo a clinical examination to determine the presence and severity of MIH, using an established index. The presence of any other anomalies, affecting tooth number, morphology, or position, will be documented. Panoramic radiographs will be assessed for dental anomalies and the presence of third permanent molars. Statistical analysis, using a chi squared test and regression analysis, will be performed to determine any differences in dental anomaly prevalence between the MIH and non-MIH group and to determine any association between dental anomalies and patient characteristics. CONCLUSION This large-scale study has the potential to improve understanding about MIH with benefits for patient management.
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Affiliation(s)
- Helen D Rodd
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield S10 2TA, UK
| | - Hani Nazzal
- Department Clinical Oral Health Sciences, College of Dental Medicine, Qatar University, Doha P.O. Box 2713, Qatar
- Hamad Dental Centre, Hamad, Medical Corporation, Doha P.O. Box 3050, Qatar
| | | | - Choe Wei Ruth
- National University Centre for Oral Health Singapore, Singapore 119085, Singapore
| | - Felicity Crombie
- Melbourne Dental School, University of Melbourne, Melbourne 3010, Australia
| | - Osama El Shahawy
- Pediatric Dentistry Department, Cairo University, Cairo 12613, Egypt
| | | | - Karla Gambetta-Tessini
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca 3460000, Maule, Chile
| | - Ashima Goyal
- Oral Health Sciences Centre, PGIMER, Chandigarh 160012, India
| | - Noren Hasmun
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin 9054, New Zealand
| | - Ahmad I Issa
- Ministry of National Guard Health Affairs, King Abdulaziz Hospital, Riyadh 36428, Al Ahsa, Saudi Arabia
| | - Suhad Jundi
- Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Ar-Ramtha P.O. Box 3030, Jordan
| | - David J Manton
- Academic Center for Dentistry (ACTA), Gustav Mahlerlaan, 3004 Amsterdam, The Netherlands
- University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | | | - Samah Omar
- Pediatric Dentistry Department, Loma Linda University School of Dentistry, Loma Linda, CA 92350, USA
| | - Susan Parekh
- UCL Eastman Dental Institute, London WC1E 6DG, UK
| | | | - Mihiri Silva
- Melbourne Dental School, University of Melbourne, Melbourne 3010, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia
| | - Greig Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE2 4AZ, UK
| | - Yang Qiyue Naomi
- Youth Preventive Services, Health Promotion Board, Singapore 179369, Singapore
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Zhang Y, Wang Y, Zhang Z, Wang Y, Jia J. Study on machine learning of molar incisor hypomineralization in an endemic fluorosis region in central China. Front Physiol 2023; 14:1088703. [PMID: 37008000 PMCID: PMC10050366 DOI: 10.3389/fphys.2023.1088703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/22/2023] [Indexed: 03/17/2023] Open
Abstract
Objectives: The aim of the present study was to develop a machine learning model to predict the risk of molar incisor hypomineralization (MIH) and to identify factors associated with MIH in an endemic fluorosis region in central China.Methods: A cross-sectional study was conducted with 1,568 schoolchildren from selected regions. The clinical examination included an investigation of MIH based on the European Academy of Paediatric Dentistry (EAPD) criteria. In this study, supervised machine learning (e.g., logistic regression) and correlation analysis (e.g., Spearman correlation analysis) were used for classification and prediction.Results: The overall prevalence of MIH was 13.7%. The nomograph showed that non-dental fluorosis (DF) had a considerable influence on the early occurrence of MIH and that this influence became weaker as DF severity increased. We examined the association between MIH and DF and found that DF had a protective correlation with MIH; the protective effect became stronger as DF severity increased. Furthermore, children with defective enamel were more likely to experience caries, and dental caries were positively correlated with MIH (OR = 1.843; 95% CI: 1.260–2.694). However, gender, oral hygiene, and exposure to poor-quality shallow underground water did not increase the likelihood of developing MIH.Conclusions: DF should be considered a protective factor within the multifactorial etiology of MIH.
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Affiliation(s)
- Yimeng Zhang
- Henan University School of Stomatology, Kaifeng, China
| | - Yu Wang
- The Key Laboratory of Clinical Resources Translation, Henan University, Kaifeng, China
| | - Zhaoxin Zhang
- Henan University School of Stomatology, Kaifeng, China
| | - Yuqi Wang
- Henan University School of Stomatology, Kaifeng, China
| | - Jie Jia
- Henan University School of Stomatology, Kaifeng, China
- The First Affiliated Hospital of Henan University, Kaifeng, China
- *Correspondence: Jie Jia,
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Enax J, Amaechi BT, Farah R, Liu JA, Schulze zur Wiesche E, Meyer F. Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review. Dent J (Basel) 2023; 11:dj11030080. [PMID: 36975577 PMCID: PMC10047667 DOI: 10.3390/dj11030080] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Rayane Farah
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Jungyi Alexis Liu
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Erik Schulze zur Wiesche
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
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Arrow P, Piggott S, Jamieson L, Brennan D, Tonmukayakul U, Kularatna S, Atkinson D, Nanda S. Dental enamel defects and dental caries of primary teeth among Indigenous children in Western Australia. Aust Dent J 2023; 68:35-41. [PMID: 36461644 PMCID: PMC10952132 DOI: 10.1111/adj.12948] [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] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Teeth affected with enamel defects (EDs) are at an increased risk of dental caries. In spite of improving oral health status overall in Australia, Indigenous Australians still experience higher rates of dental caries than non-Indigenous Australians. This study reports on the prevalence of EDs and dental caries experience among Indigenous children in the Kimberley region of Western Australia. METHODS Health status of all the primary teeth (ICDAS II criteria) and the presence of EDs on index teeth (modified Dental Defects of Enamel index; DDE) of young Indigenous children who participated in a 2-arm intervention trial was recorded. Generalized estimating equations were used to estimate the association between EDs and dental caries and effect estimates were presented as odds ratios and associated 95% confidence intervals. RESULTS Person-level prevalence, from 237 children (mean age 3.6 years, standard deviation 1.7) assessed for EDs, was 58% and tooth-level prevalence was 24%. Teeth affected with demarcated or diffuse defects were associated with a twofold higher odds of having caries experience, odds ratio (OR) 2.5, 95% confidence interval (CI) 1.7-3.7 and OR 2.7, 95% CI 1.7-4.0 respectively. CONCLUSIONS The presence of EDs among young Indigenous children was associated with a higher odds of caries experience among affected teeth.
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Affiliation(s)
- P Arrow
- Dental Health ServicesDepartment of HealthPerthWestern AustraliaAustralia
- Dental SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - S Piggott
- Dental Health ServicesDepartment of HealthPerthWestern AustraliaAustralia
| | - L Jamieson
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - D Brennan
- Australian Research Centre for Population Oral HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - U Tonmukayakul
- Institute for Health TransformationDeakin UniversityGeelongAustralia
| | - S Kularatna
- School of Public Health and Social WorkQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - D Atkinson
- Rural Clinical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - S Nanda
- Department of HealthPerthWestern AustraliaAustralia
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Enamel Phenotypes: Genetic and Environmental Determinants. Genes (Basel) 2023; 14:genes14030545. [PMID: 36980818 PMCID: PMC10048525 DOI: 10.3390/genes14030545] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Dental enamel is a specialized tissue that has adapted over millions of years of evolution to enhance the survival of a variety of species. In humans, enamel evolved to form the exterior protective layer for the crown of the exposed tooth crown. Its unique composition, structure, physical properties and attachment to the underlying dentin tissue allow it to be a resilient, although not self-repairing, tissue. The process of enamel formation, known as amelogenesis, involves epithelial-derived cells called ameloblasts that secrete a unique extracellular matrix that influences the structure of the mineralizing enamel crystallites. There are over 115 known genetic conditions affecting amelogenesis that are associated with enamel phenotypes characterized by either a reduction of enamel amount and or mineralization. Amelogenesis involves many processes that are sensitive to perturbation and can be altered by numerous environmental stressors. Genetics, epigenetics, and environment factors can influence enamel formation and play a role in resistance/risk for developmental defects and the complex disease, dental caries. Understanding why and how enamel is affected and the enamel phenotypes seen clinically support diagnostics, prognosis prediction, and the selection of treatment approaches that are appropriate for the specific tissue defects (e.g., deficient amount, decreased mineral, reduced insulation and hypersensitivity). The current level of knowledge regarding the heritable enamel defects is sufficient to develop a new classification system and consensus nosology that effectively communicate the mode of inheritance, molecular defect/pathway, and the functional aberration and resulting enamel phenotype.
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Swanson AK, Duqum IS, Heimisdóttir LH, Wright JT. Digital restorative workflows for developmental dental defects in young patients: A case series. J Am Dent Assoc 2023; 154:340-348. [PMID: 36641328 DOI: 10.1016/j.adaj.2022.11.014] [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: 06/18/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Digital technology is rapidly changing the provision of oral health care, although its adoption for the oral health care of young patients has lagged. The authors describe digitally supported treatment approaches for managing treatment of developmental dental defects in the early permanent dentition. CASE DESCRIPTION Four adolescent patients with amelogenesis imperfecta received transitional anterior restorations for esthetic and functional rehabilitation using a variety of digital workflows. Combinations of restoration type, materials, and fabrication methods were selected to meet the needs of each patient on the basis of their specific amelogenesis imperfecta phenotype and chief symptoms. These cases highlight the application of digital technology in pediatric and adolescent dentistry for managing the treatment of developmental dental defects. PRACTICAL IMPLICATIONS Digitally supported restorative approaches, as described in this report, offer broad applicability of materials and techniques directed at treating the complex restorative needs of young patients in the transitional and early permanent dentition.
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Grieshaber A, Waltimo T, Haschemi AA, Erb J, Steffen R, Bornstein MM, Kulik EM. Prevalence of and factors associated with molar-incisor hypomineralisation in schoolchildren in the canton of Basel-Landschaft, Switzerland. Clin Oral Investig 2023; 27:871-877. [PMID: 35881241 PMCID: PMC9889500 DOI: 10.1007/s00784-022-04648-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES As prevalence of molar-incisor hypomineralisation varies considerably in different countries and regions, the aim of this study was to obtain representative epidemiological data for schoolchildren living in the canton of Basel-Landschaft, Switzerland. MATERIAL AND METHODS A representative population of schoolchildren of three different age groups, i.e. 1st grade (mean age: 7.4 years), 6th grade (mean age: 12.6 years), and 9th grade (mean age: 15.7 years) visiting compulsory schools in the canton of Basel-Landschaft, Switzerland, was examined. The presence or absence of molar-incisor hypomineralisation at time of examination was recorded as well as potential influencing factors such as age group, gender, nationality, or the children's place of residence. RESULTS A total of 1252 schoolchildren could be included. On average, the prevalence of MIH in the study population was 14.8%. No statistically significant differences were found for nationality, gender, or place of residence. Although not statistically significant, children from the youngest age group had the highest while children from the oldest age group had the lowest MIH prevalence. CONCLUSION With a mean value of 14.8%, MIH prevalence among schoolchildren living in the canton of Basel-Landschaft, Switzerland, is comparable to mean values recorded globally. CLINICAL RELEVANCE This study represents the first study on MIH prevalence in Switzerland and also provides further evidence on potential influencing factors.
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Affiliation(s)
- Andreina Grieshaber
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Tuomas Waltimo
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Asin A. Haschemi
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Judith Erb
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Richard Steffen
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland ,Private Practice, 8570 Weinfelden, Switzerland
| | - Michael M. Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, 4058 Basel, Switzerland
| | - Eva M. Kulik
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland
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Né YGDS, Frazão DR, Lopes GDO, Fagundes NCF, Souza-Rodrigues RD, Paula-Silva FWG, Maia LC, Lima RR. Association between respiratory diseases and molar-incisor hypomineralization: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:990421. [PMID: 36590944 PMCID: PMC9800926 DOI: 10.3389/fmed.2022.990421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/24/2022] [Indexed: 12/23/2022] Open
Abstract
The molar-incisor permineralização (MIH) is a qualitative enamel developing abnormality involving the occlusal and/or incisal third of one or more molars or permanent incisors, caused by systemic factors. Several systemic disorders and environmental factors, such as respiratory diseases, have been reported as probable causes of MIH. Thus, this work aimed to evaluate whether respiratory diseases and MIH are associated. The searches were carried out in electronic databases, including PubMed, Scopus, Web of Science, the Cochrane Library, LILACS, OpenGrey, and Google Scholar. The acronym PECO was used, in which the P (population) was humans in permanent dentition stage; (E-exposure) molar-incisor hypomineralization; (C-comparison) reference population and (O - outcome) respiratory diseases. After the search retrieval, the duplicates were removed, and the articles were evaluated by title and abstract; then, the papers were read and thoroughly assessed. After selection, the risk of bias assessment was performed using the Newcastle-Ottawa Scale (NOS) for observational studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess the level of evidence. Three thousand six hundred and sixty six were found through the searches. After exclusion by duplicates, title, abstract, and full-reading, 13 articles remained. The articles included in this review evaluated the association of MIH with asthma, tonsilitis, pneumonia, and bronchitis. Most reports showed a low risk of bias. When exploring through GRADE, a very low level of evidence was found. We observed that the included studies showed that children with MIH had more respiratory diseases than the group that did not have MIH. Systematic review registration https://osf.io/un76d.
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Affiliation(s)
- Yago Gecy de Sousa Né
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Deborah Ribeiro Frazão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Géssica de Oliveira Lopes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Nathália Carolina Fernandes Fagundes
- School of Dentistry, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, 5528 Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Renata Duarte Souza-Rodrigues
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
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Estivals J, Fahd C, Baillet J, Rouas P, Manton DJ, Garot E. The prevalence and characteristics of and the association between MIH and HSPM in South-Western France. Int J Paediatr Dent 2022; 33:298-304. [PMID: 36511101 DOI: 10.1111/ipd.13040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/19/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) involve qualitative structural developmental anomalies of tooth enamel, affecting the first permanent molars (FPM) and the second primary molars, respectively. This developmental anomaly of systemic origin has important consequences for oral health. AIM To determine the prevalence of MIH and HSPM in south-western France and explore the distribution of hypomineralised lesions on permanent and primary molars. DESIGN Amongst 856 children (aged 7-9 years) in schools randomly selected by the Academy of Bordeaux (Ministry of Education), the FPM, permanent incisors and the second primary molars were examined by two examiners trained and calibrated for the diagnostic criteria for MIH and HSPM of the European Academy of Paediatric Dentistry. RESULTS Molar-incisor hypomineralisation was present in 160 children (18.7%) and HSPM in 81 children (9.5%); 4.9% had both HSPM and MIH (42 of 856). Hypomineralised lesions were present in 1-4 FPM in affected individuals (mean = 2.4) and were distributed in an asymmetrical manner with widely varying severity at the tooth and individual level. A child with HSPM was more likely to have MIH than a child without HSPM (95% CI OR = 6.0 [3.7-9.7]; p < .0001). CONCLUSION Molar-incisor hypomineralisation and HSPM have three main asymmetrical characteristics: tooth location, severity of hypomineralisation and number of teeth affected.
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Affiliation(s)
- Julia Estivals
- Université de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France.,CNRS, MCC, PACEA, UMR 5199, Université de Bordeaux, Pessac, France.,C.H.U de Bordeaux, Bordeaux, France
| | - Caroline Fahd
- Université de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
| | - Jeanne Baillet
- Université de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
| | - Patrick Rouas
- Université de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France.,CNRS, MCC, PACEA, UMR 5199, Université de Bordeaux, Pessac, France.,C.H.U de Bordeaux, Bordeaux, France
| | - David John Manton
- Centrum voor Tandheelkunde en Mondzorgkunde, Universitair Medisch Centrum Groningen, Groningen, The Netherlands
| | - Elsa Garot
- Université de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France.,CNRS, MCC, PACEA, UMR 5199, Université de Bordeaux, Pessac, France.,Centre de Compétence des Maladies Rares Orales et Dentaires, CCMR O-Rares, C.H.U. de Bordeaux, Bordeaux, France
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Amaechi BT, Farah R, Liu JA, Phillips TS, Perozo BI, Kataoka Y, Meyer F, Enax J. Remineralization of molar incisor hypomineralization (MIH) with a hydroxyapatite toothpaste: an in-situ study. BDJ Open 2022; 8:33. [PMID: 36496424 PMCID: PMC9741585 DOI: 10.1038/s41405-022-00126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
AIM This randomized, double-blind, crossover, in-situ study, compared the efficacy of toothpastes based on microcrystalline hydroxyapatite (HAP; fluoride-free) or fluoride, in remineralizing molar incisor hypomineralization (MIH). METHODS Two lesion-bearing enamel blocks were produced from each of thirty extracted permanent molars diagnosed with MIH. Sixty produced blocks were randomly assigned to two groups (30/group): 20% HAP or 1450 ppm fluoride toothpaste. Each group was subdivided into, etched (n = 20), with lesion surface treated with 32% phosphoric acid-etchant for 5 s, and unetched (n = 10). Blocks were cemented into intra-oral appliances (2 blocks/appliance) worn full-time by 15 subjects. Subjects used the toothpastes in a two-phase crossover manner, lasting 14 days per phase, after one-week washout period. Baseline and post-treatment mineral density (MD) was quantified using microcomputed tomography. RESULTS Overall, both groups showed statistically significant (paired t-test; p < 0.001) net-gain when MD was compared pre-treatment and post-treatment. HAP: pre-treatment (1.716 ± 0.315) and post-treatment (1.901 ± 0.354), Fluoride: pre-treatment (1.962 ± 0.363) and post-treatment (2.072 ± 0.353). Independent t-test demonstrated a practically significantly (≥10%) higher percentage remineralization with HAP toothpaste (26.02 ± 20.68) compared with fluoride toothpaste (14.64 ± 9.60). Higher percentage remineralization was observed in etched than unetched samples. CONCLUSION The tested toothpaste based on hydroxyapatite can remineralize MIH lesions. Pre-treating the tooth surface with acid-etchant enhanced remineralization.
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Affiliation(s)
- Bennett Tochukwu Amaechi
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Rayane Farah
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Jungyi Alexis Liu
- grid.267309.90000 0001 0629 5880Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Thais Santiago Phillips
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Betty Isabel Perozo
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Yuko Kataoka
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Karkoutly M, Hamza B, Al Batal S, Al Barazi A, Bshara N. Knowledge, perceptions, attitudes, and clinical experiences on molar incisor hypomineralization among Syrian pediatric dentists and general dental practitioners: a cross-sectional study. BMC Oral Health 2022; 22:561. [PMID: 36456977 PMCID: PMC9714236 DOI: 10.1186/s12903-022-02620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a widespread oral health problem. Dentists encounter several challenges regarding MIH management worldwide. The aim of this study was to evaluate and compare the knowledge, perceptions, attitudes, and clinical experiences on MIH among general dental practitioners and pediatric dentists in Syria. METHODS All general dental practitioners and pediatric dentists belonging to the Syrian Dental Syndicate of Damascus were invited to complete a cross-sectional structured questionnaire (n = 1936). The questionnaire consisted of four sections and required responses regarding demographic data, knowledge, perceptions, attitudes, and experiences on MIH. Data were analyzed with Pearson's chi-square test and multivariate regression models using SPSS Ver. 23.0. RESULTS The overall response rate was 36.31% (703/1936). Pediatric dentists were significantly more familiar with MIH (p < 0.001) and more confident when diagnosing it (p < 0.001). Most participants (43.95%) perceived an increase in MIH prevalence in Syria. Stainless steel crowns were the most favorable restorative material for molars with post-eruptive breakdown (51.38%). As for molars and incisors with opacities, composite resin was preferred with (41.82%), and (67.51%) respectively. General dental practitioners requested further training regarding MIH treatment (p < 0.001). CONCLUSIONS Pediatric dentists were equipped with further knowledge regarding MIH, and were more confident when diagnosing it. There is a need for additional training and education for general dental practitioners. Most respondents perceived an increase in the prevalence of MIH. There is a dearth of data regarding MIH prevalence in Syria. The materials of choice for restoring teeth with MIH were stainless steel crowns and composite resin.
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Affiliation(s)
- Mawia Karkoutly
- grid.8192.20000 0001 2353 3326Pediatric Dentistry Department, Dental College, Damascus University, Damascus, Syrian Arab Republic
| | - Blend Hamza
- grid.7400.30000 0004 1937 0650Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Sami Al Batal
- grid.8192.20000 0001 2353 3326Pediatric Dentistry Department, Dental College, Damascus University, Damascus, Syrian Arab Republic
| | - Amat Al Barazi
- grid.8192.20000 0001 2353 3326Dental College, Damascus University, Damascus, Syrian Arab Republic
| | - Nada Bshara
- grid.8192.20000 0001 2353 3326Pediatric Dentistry Department, Dental College, Damascus University, Damascus, Syrian Arab Republic
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Afshari E, Dehghan F, Vakili MA, Abbasi M. Prevalence of Molar-incisor hypomineralization in Iranian children – A systematic review and narrative synthesis. BDJ Open 2022; 8:15. [PMID: 35697687 PMCID: PMC9192646 DOI: 10.1038/s41405-022-00111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction Molar-incisor hypomineralization is a developmental defect of enamel with clinical features vary from demarcated opacities to severe tissue breakdown which calls for considerable preventive and interceptive measures. The aim of this article was to systematically review the literature on the prevalence of MIH in Iran and highlight the condition in Iranian children. Materials and Methods A systematic search of literature was conducted in Scopus, Pubmed, Ovid, Embase, Web of Science, and Google-Scholar as well as national Iranian database and digital archives of dental schools from the beginning of 2000 to the end of 2021 for published and unpublished studies. Data from cross-sectional, cohort, and case-control studies on prevalence of molar-incisor hypomineralization among 6–13-year-old children was gathered, using the following MeSH terms and keywords and their Persian equivalents: Prevalence, Hypomineralisation, Hypomineralization, MIH, “molar incisor”, “molar-incisor”, “cheese molars”, “Hypomineralised first permanent molars”, “Hypomineralized first permanent molars”, “developmental defects of enamel”, “enamel developmental defects”, Iran*. Methodological quality and the risk of bias of quantitative studies was assessed using a modified version of Newcastle-Ottawa Scale. Due to the considerable clinical and statistical heterogeneity of the included studies, pooling of data through meta-analysis was not possible. Therefore, a descriptive synthesis of data was performed. Results Fifteen cross-sectional studies with a total number of 12011 participants were included in the systematic review. The prevalence of MIH ranged from 5.1% to 25.6%. All of the included studies were at a moderate risk of bias (NOS of 4-6). The lowest prevalence of MIH was reported in Kerman (5.14%) and the highest in Tehran (25.6%). Substantial methodological, clinical and statistical heterogeneity was observed. Conclusion This is the first study to systematically review the available literature on MIH prevalence in Iran. However, the present review has some limitations such as limited number of included studies, large heterogeneity of the research, and moderate quality of included studies. Further high-quality research is warranted.
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Rodrigues JA, Olegario I, Assunção CM, Bönecker M. Future Perspectives in Pediatric Dentistry: Where are We Now and where are We Heading? Int J Clin Pediatr Dent 2022; 15:793-797. [PMID: 36866132 PMCID: PMC9973069 DOI: 10.5005/jp-journals-10005-2475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Oral diseases in children are still a major public health problem that can negatively impact parents and their children's quality of life. Even though oral diseases are largely preventable, initial signs of them can be detected in the 1st year of life, and its severity might increase with time if no preventive measures are taken. Based on this, we aim to discuss "where is pediatric dentistry now?" and "where is pediatric dentistry heading?" Early life oral health conditions are a good predictor of oral health status in adolescence, adulthood, and elderly people. A healthy childhood provides the foundation and opportunities for life; therefore, pediatric dentists have the unique opportunity to identify the presence of unhealthy habits in the 1st year of life and educate the parents and family members to change them for life. If all educational and preventive strategies fail or are not put into practice, the child might present oral health problems, such as dental caries, erosive tooth wear (ETW), hypomineralization, and malocclusion, that could have a great impact on other stages of life. At the moment, in pediatric dentistry, there are many alternatives to prevent and treat these oral health problems. However, if prevention fails, minimally invasive approaches, and new dental materials and technologies have been developed recently and will be important tools available in the near future in order to enhance children's oral health. How to cite this article Rodrigues JA, Olegario I, Assunção CM, et al. Future Perspectives in Pediatric Dentistry: Where are We Now and where are We Heading? Int J Clin Pediatr Dent 2022;15(6):793-797.
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Affiliation(s)
- Jonas A Rodrigues
- Pediatric Dentistry Division; Department of Surgery and Orthopedics, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Isabel Olegario
- Department of Public & Child Dental Health, School of Dental Science, Dublin Dental University Hospital, Trinity College, Dublin, Leinster, Ireland
| | - Cristiane M Assunção
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Bönecker
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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