1
|
Taylor GD, Exley C, Innes N, Vernazza CR. Young people's and adults' views and experiences of decision-making to manage compromised first permanent molars: a qualitative study. Int J Paediatr Dent 2024. [PMID: 38803044 DOI: 10.1111/ipd.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/27/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Little information on young people's and adults' views and experiences on decision-making for managing compromised first permanent molars (cFPM) exists. AIM To establish young people's and adults' views and experiences of decision-making for managing cFPM. DESIGN Face-to-face (online) semi-structured interviews were undertaken using an iteratively designed topic guide. Participants aged 12-65 were purposively sampled with recruitment from different dental clinics (three primary care, an out-of-hours emergency and one dental hospital). Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS Three themes were generated from young people's interviews (n = 9): (i) influencing factors; (ii) long-term considerations; and (iii) shared decision-making. Three themes were generated from adults' interviews (n = 13): (i) influences that affect decisions; (ii) perceptions of the specialist's role; and (iii) importance of shared decision-making for children and young people. CONCLUSION Several factors influenced decision-making; for young people, professional opinions were important, and parental/peer influences less so. For adults, it was based on decisions on their prior experiences. Adults felt young people were abnormal if referred to a specialist. Young people wanted autonomy in decision-making to be respected; in reality, their views were rarely heard. There is potential to increase young people's involvement in shared decision-making for cFPM, which aligns with their aspirations.
Collapse
Affiliation(s)
- Greig D Taylor
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Nicola Innes
- School of Dentistry, Cardiff University, Cardiff, UK
| | - Christopher Robert Vernazza
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| |
Collapse
|
2
|
Hajdarević A, Čirgić E, Robertson A, Sabel N, Jälevik B. Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7-8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists. Eur Arch Paediatr Dent 2024; 25:93-103. [PMID: 38315353 PMCID: PMC10942915 DOI: 10.1007/s40368-023-00860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). METHODS An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. RESULTS A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. "When root furcation is under development of the second permanent molar on radiographs" was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. CONCLUSION Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.
Collapse
Affiliation(s)
- A Hajdarević
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Clinic of Pediatric Dentistry, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
| | - E Čirgić
- Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Robertson
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N Sabel
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Folktandvården Björkekärr, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - B Jälevik
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
3
|
Osborne R, Silva M, Taylor GD. Qualitative study exploring general dental practitioners' views of MIH and its management in the UK and Australia. Int J Paediatr Dent 2023. [PMID: 37969051 DOI: 10.1111/ipd.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 09/08/2023] [Accepted: 10/12/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Molar-incisor hypomineralisation (MIH) is a prevalent condition, and how it is managed varies greatly between professional groups. AIM To explore, and compare, the UK and Australian general dental practitioners' management of MIH in children. DESIGN Face-to-face (remote) semistructured interviews were undertaken, using country-specific topic guides. Participants were purposively sampled and recruited through national conferences and research networks (eviDent Foundation and Northern Dental Practice Based Research Network). Interviews (from each country) were audio-recorded, transcribed verbatim and independently analysed using thematic analysis. RESULTS Two major themes arose from the UK interviews: (i) decision-making complexities and understanding of treatment options and (ii) need for specialist input. The main Australian themes were (i) multidisciplinary approach to management supporting decision-making complexities and (ii) economic implications for care. Several difficulties, such as financial implications, multidisciplinary care and clinical decision-making, were identified as barriers to effectively managing MIH by GDPs in primary care. CONCLUSION There are similarities and differences in the knowledge and management of MIH amongst UK and Australian nonspecialists. The different healthcare systems played a significant role in shaping how GDPs manage MIH with barriers relating to affordability, multidisciplinary care and clinical decision-making.
Collapse
Affiliation(s)
- R Osborne
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - M Silva
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Evident Foundation, South Yarra, Victoria, Australia
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
4
|
Geduk N, Ozdemir M, Erbas Unverdi G, Ballikaya E, Cehreli ZC. Clinical and radiographic performance of preformed zirconia crowns and stainless-steel crowns in permanent first molars: 18-month results of a prospective, randomized trial. BMC Oral Health 2023; 23:828. [PMID: 37924021 PMCID: PMC10623757 DOI: 10.1186/s12903-023-03501-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 10/07/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The treatment of young permanent first molars with extensive carious tissue loss may often require restoration with preformed crowns. This study compared the clinical and radiographic performance of stainless-steel crowns (SSCs) and preformed zirconia crowns (ZCs). METHODS Forty-eight molar incisor hypomineralisation (MIH)- or caries-affected permanent molars in 20 healthy patients between 6-13-year-old were randomly divided into ZC and SSC groups (n = 24 teeth/group) in a split-mouth design. The oral hygiene levels of patients were assessed using Greene and Vermillion simplified oral hygiene index (OHI-S). Plaque accumulation and gingival health were evaluated using the Silness&Löe plaque index (PI) and Löe&Silness gingival index (GI), respectively. Clinical retention, marginal extension level, marginal adaptation of crowns and wear of the antagonist teeth were assessed at baseline, 1, 6, 12 and 18 months. The radiological assessments for evaluating the marginal adaptation of crowns and periapical pathology of crowned teeth were performed at 6 and 12 months. The data were analyzed using Kaplan-Meier analysis, Mann-Whitney U test, and two-way ANOVA. RESULTS A total of forty teeth in 17 children were evaluated for 18 months. ZCs had significantly lower gingival and plaque index values than teeth restored with SSCs during all evaluation periods (p < 0.05). Neither crown type resulted in clinically-detectable wear on opposing dentition or periapical pathology. One ZC was lost at 13 months, while all SSCs survived in function clinically. The cumulative survival rates of ZCs and SSCs were 95.2% and 100% respectively. CONCLUSIONS Both ZCs and SSCs showed high clinical retention rates in young permanent molars. ZCs had lower plaque accumulation and better gingival health than SSCs, which were consistently associated with mild gingival inflammation. CLINICAL TRIAL REGISTRATION NUMBER NCT05049694.
Collapse
Affiliation(s)
- Nazli Geduk
- Denturla Oral and Dental Health Polyclinic, Urla, 35430, Izmir, Turkey
| | - Merve Ozdemir
- Department of Pediatric Dentistry, Faculty of Dentistry, Lokman Hekim University, Sogutozu, Ankara, 06510, Turkey
| | - Gizem Erbas Unverdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, 06100, Turkey
| | - Elif Ballikaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, 06100, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, 06100, Turkey.
| |
Collapse
|
5
|
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.
Collapse
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.
| |
Collapse
|
6
|
AlKhalaf R, Neves ADA, Warburton F, Banerjee A, Hosey MT. Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital-based services. Int J Paediatr Dent 2022; 32:724-736. [PMID: 34967478 PMCID: PMC9540387 DOI: 10.1111/ipd.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are diverse opinions among dentists about managing compromised first permanent molars (cFPMs) in children and a perceived lack of guidance to help them evaluate prognosis. AIM To evaluate the current management of cFPM in children referred to a UK hospital centre and to report the severity of the affected teeth. DESIGN A service evaluation was undertaken, based on case records of medically fit children (6-11 years) referred to for the management of cFPMs. The presence of hypomineralisation, post-eruptive breakdown and the proposed care plans were recorded. Radiographic signs of severity were scored using the ICDAS index (intra/inter-rater kappa 0.96/0.82). RESULTS From 349 records screened over a 4-month period, 249 met the selection criteria. Almost 81% were planned to have extraction of at least one cFPM, whereas 19.3% were managed without extraction. More than half of the extraction cases (n = 105) had radiographic radiolucencies not exceeding the middle third of dentine in the worst-affected FPM. At the time of extraction, the mean age of the patients was 9.8 years (±0.9). GA was used in 196 (97.5%) cases, and 40.8% had not received previous treatment in any of their cFPMs. CONCLUSION Potentially restorable cFPMs in children is, most of the time, in a cohort of UK patients referred for tier 3 services, being managed by timed extractions under general anasethesia.
Collapse
Affiliation(s)
- Reem AlKhalaf
- Centre of OralClinical & Transitional ScienceFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
- Department of clinical dental sciencesCollege of DentistryPrincess Nourah Bint Abdul Rahman UniversityRiyadhSaudi Arabia
| | - Aline de Almeida Neves
- Clinical Lecturer in Paediatric DentistryCentre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
- Federal University of Rio de JaneiroRio de JaneiroBrazil
| | - Fiona Warburton
- Oral Clinical Research UnitFaculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonLondonUK
| | - Avijit Banerjee
- Restorative DentistryCentre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
| | - Marie Therese Hosey
- Centre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
| |
Collapse
|
7
|
Humphreys J, Morgan E, Clayton S, Jarad F, Harris R, Albadri S. Molar-incisor hypomineralisation combat: exploratory qualitative interviews with general dental practitioners in England regarding the management of children with molar-incisor hypomineralisation. Br Dent J 2022:10.1038/s41415-022-4254-2. [PMID: 35618918 PMCID: PMC9135101 DOI: 10.1038/s41415-022-4254-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/10/2021] [Indexed: 11/09/2022]
Abstract
Introduction Molar-incisor hypomineralisation (MIH) presents as a spectrum, with severe cases becoming increasingly complex to manage. This study aimed to investigate the perceptions and experience of general dental practitioners (GDPs) in England when managing children with MIH.Method Semi-structured telephone interviews with GDPs who regularly treat children took place in May 2020. A sample of four male and six female GDPs with 1-15 years of experience was achieved through purposively sampling interested parties following advertisement via professional groups. Thematic analysis using a realist and inductive approach was used in analysis.Results The overarching theme was of managing uncertainty, with four subthemes: setting the scene; fighting the tooth; working within the system; and self and interpersonal insight. Despite being knowledgeable, participants expressed varying levels of confidence in many aspects while managing children with MIH. There was a great deal of uncertainty surrounding 'doing the right thing' across the themes. Systemic barriers to managing children with MIH within the general dental service were identified.Conclusion The challenges of managing children with MIH was experienced as 'uncertainty'. Barriers within the general dental service made managing children with MIH difficult and participants relied on colleagues in secondary care to manage severe cases.
Collapse
Affiliation(s)
- Judith Humphreys
- Department of Paediatric Dentistry, University of Liverpool, UK.
| | - Emma Morgan
- Department of Paediatric Dentistry, University of Liverpool, UK
| | - Stephen Clayton
- Department of Public Health, Policy and Systems, University of Liverpool, UK
| | - Fadi Jarad
- Department of Restorative Dentistry, University of Liverpool, UK
| | - Rebecca Harris
- Department of Public Health, Policy and Systems, University of Liverpool, UK
| | - Sondos Albadri
- Department of Paediatric Dentistry, University of Liverpool, UK
| |
Collapse
|
8
|
Negrescu J, Kodra L, Ziada H, Al-Talib T, Abubakr NH. Molar Incisor Hypomineralization: Awareness among Postdoctoral Dental Residents: A Cross-Sectional Study. Dent J (Basel) 2022; 10:dj10040064. [PMID: 35448058 PMCID: PMC9025221 DOI: 10.3390/dj10040064] [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: 02/04/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 01/25/2023] Open
Abstract
Background: Molar incisor hypomineralization (MIH) is the presentation of an enamel defect, where incisors and one (or more) molars are affected. Identifying MIH is significant in restoring its visual defect and avoiding pain or other consequences of this condition. The present cross-sectional study aimed to evaluate the awareness, ability, and confidence in identifying MIH among postgraduate residents in the state of Nevada. Methods: This cross-sectional study was conducted among postdoctoral dental residents at the School of Dental Medicine, University of Nevada, Las Vegas. This cross-sectional study used images of cases of MIH and a survey to collect the data. The survey included demographics, educational background, and basic knowledge of MIH. Results: The response rate to the invitation to participate was 91%. The confidence in identifying MIH was 100%, 50%, and 33.3% for pediatric, orthodontic, and general practice residency (GPR). A total of 70% were aware of this anomaly from their predoctoral dental education and indicated the need for further related education. There was 33% confusion with fluorosis and 16.6% with amelogenesis imperfecta. A total of 66.6% of the participants indicated that they require further education relating to MIH. Conclusion: Within the limitations of the present investigation, MIH awareness among the investigated groups varied but was highest amongst the pediatric residents.
Collapse
Affiliation(s)
- Jana Negrescu
- DMD Students School of Dental Medicine, University of Nevada, Las Vegas, NV 89557, USA; (J.N.); (L.K.)
| | - Laurenc Kodra
- DMD Students School of Dental Medicine, University of Nevada, Las Vegas, NV 89557, USA; (J.N.); (L.K.)
| | - Hassan Ziada
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89557, USA; (H.Z.); (T.A.-T.)
| | - Tanya Al-Talib
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89557, USA; (H.Z.); (T.A.-T.)
| | - Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89557, USA
- Correspondence: ; Tel.: +1-702-774-2307
| |
Collapse
|
9
|
da Costa Rosa T, Pintor AVB, Magno MB, Marañón-Vásquez GA, Maia LC, Neves AA. Worldwide trends on molar incisor and deciduous molar hypomineralisation research: a bibliometric analysis over a 19-year period. Eur Arch Paediatr Dent 2022; 23:133-146. [PMID: 34674159 DOI: 10.1007/s40368-021-00676-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/12/2021] [Indexed: 12/16/2022]
Abstract
AIM To identify the worldwide trends in scientific evidence and gaps in knowledge regarding molar incisor hypomineralisation (MIH) and deciduous molar hypomineralisation/hypomineralised second primary molars (DMH/HSPM), exploring the contribution of authors and countries, possible etiological factors and proposed treatments, in order to guide future research in the area. METHODS Searches were conducted in MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, Embase and Google Scholar. Studies employing the terms MIH, DMH/HSPM and their linguistic variations were included. The following data were extracted: title, authors, year and journal of publication and first author's affiliation country. Studies were categorized according to topic, dentition, study design, etiological factors and types of treatments. Categories were analysed in relation to their distribution, co-occurrence, cross-correlation and/or autocorrelation. RESULTS Five hundred and three studies were included. The most published authors were Manton D (n = 47), de Souza JF (n = 22) and Ghanim A (n = 22) and four main collaboration clusters have been identified. Most of the studies were conducted on permanent dentition (MIH) (87.4%); with observational design (57.2%). The "European Archives of Paediatric Dentistry" was the most published journal (13.3%) and a significant increase in the number of publications was observed in the last decade. MIH was most studied in relation to prevalence/incidence, systemic factors involved in its aetiology and treatment with composite restorations, while a gap in knowledge was observed for extraction and sealants. Less studies were published on DMH/HSPM and most of them evaluated risk factors or prevalence/incidence. The gap of knowledge was observed in relation to treatments and patient's quality of life. CONCLUSIONS This bibliometric review provided a comprehensive overview of research in MIH and DMH/HSPM over the past 19 years. Within the limitations of the present study, the following conclusions can be drawn: global trends point to an increasing peak of scientific publication, especially in the last decade, while there is a shortage of clinical studies on treatments, mainly evaluating tooth extractions. Finally the multifactorial nature should be further explored, considering environmental and systemic factors together.
Collapse
Affiliation(s)
- T 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
| | - A V B Pintor
- 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
| | - M B Magno
- 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
| | - G A Marañón-Vásquez
- 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
| | - L C Maia
- 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
| | - A A Neves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil.
| |
Collapse
|
10
|
Somani C, Taylor GD, Garot E, Rouas P, Lygidakis NA, Wong FSL. An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2022; 23:39-64. [PMID: 34110615 PMCID: PMC8927013 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
Collapse
Affiliation(s)
- C Somani
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E Garot
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - P Rouas
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece
| | - F S L Wong
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
11
|
Donnell CC, Johnston MJ, Foley JI. The Six-Year-Old 'Adult'. Prim Dent J 2022; 10:74-82. [PMID: 35088635 DOI: 10.1177/20501684211065326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children are not miniature adults, yet when a child celebrates their sixth birthday, little do they know that, with the arrival of their first 'adult' tooth, they are about to gain their first real experience of being a 'grown-up'. The age of six is a key milestone in the mental, physical and emotional wellbeing of children, with most children in the UK having commenced primary school education by their fifth birthday. Six-year-olds are about to enter the most critical period in their dental development, the mixed-dentition phase, where their mouths are in a near continuous state of flux. This pivotal age in their dental development should not be undervalued; the dental decisions we make at this age means childhood lasts a lifetime. Caries is the most prevalent, preventable global disease, and with one in four children suffering from dental caries in the primary dentition by the time they start school, the foundations we lay down at the age of six translate into lifelong benefits for the permanent dentition. In this paper, the aim is to demonstrate that at the age of six we get a second chance to get things right. From caries risk factors and tailoring the five pillars of prevention by educating parents on the developing dentition, to reinforcing the importance of habit-breaking, developmental anomalies of enamel and early orthodontic intervention, this paper describes the importance of the age of six, never before so exclusively expressed in a dental sense.
Collapse
Affiliation(s)
- Christopher C Donnell
- Specialty Registrar in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Matthew J Johnston
- Dental Core Trainee, Oral and Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Jennifer I Foley
- Deputy Director / Honorary Consultant in Paediatric Dentistry Edinburgh Dental Institute; Senior Clinical Lecturer in Paediatric Dentistry, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
12
|
Agel M, Scambler S, Hosey MT. Parental Views on Minimally Invasive Dentistry versus General Anaesthesia Extractions of Children's Compromised First Permanent Molars: An Exploratory Qualitative Study. Prim Dent J 2022; 10:27-32. [PMID: 35088636 DOI: 10.1177/20501684211066230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The current standard of care for first permanent molars (FPMs) requiring extraction is removal of these teeth between the chronological ages of eight to ten years, as per UK guidelines.1 This often involves a general anaesthetic (GA) with surgical admission to hospital. This study explores parental views on minimally invasive (MI) techniques as an alternative to the UK current standard of care for extractions of FPMs deemed to require removal between the chronological ages of eight to ten years. METHODS A qualitative investigation, using semi-structured interviews was conducted with parents/carers of children attending a teaching hospital for extraction of compromised FPMs under GA. Thematic framework analysis was used to present the findings. The consolidated criteria for reporting qualitative research (COREQ) were used as a guide to ensure quality. RESULTS The main themes emerging were: participants' surprise at how poor the prognosis was for their child's FPMs; acceptance that care was beyond the scope of primary care; willingness by some to undergo GA again; requests for information about the guarantee of success of MI treatment; concerns about the residual black staining from silver diamine fluoride (SDF); and acceptance of extraction spaces because of potential future failure of MI. CONCLUSION This exploratory qualitative study has shown that, while extraction of compromised FPMs under GA is accepted by most parents/carers, there appears to be a growing acceptance of MI approaches to restore FPMs instead of extraction of these teeth.
Collapse
Affiliation(s)
- Mona Agel
- Specialty Registrar in Paediatric Dentistry, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Sasha Scambler
- Reader in Medical Sociology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Marie Therese Hosey
- Head of Paediatric Dentistry, Programme Coordinator MSc Paediatric Dentistry, Centre for Oral Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| |
Collapse
|
13
|
Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
Collapse
Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
14
|
Warrilow L, McDonald S. Management of Patients with Poor Prognosis First Permanent Molars Beyond 'Ideal' Timing. Prim Dent J 2021; 10:20-26. [PMID: 35088643 DOI: 10.1177/20501684211066237] [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] [Indexed: 06/14/2023]
Abstract
The management of compromised first permanent molars is a common clinical conundrum in paediatric dentistry. Extensive guidance exists which supports the timed extraction of severely affected molars presenting at 8-10 years to allow favourable eruption of unaffected second permanent molars. However, treatment planning becomes more of a challenge when this window of opportunity is missed. In these situations, we are left with a tooth of guarded long-term prognosis in a patient where access and cooperation can be challenging. Delays to routine care as a result of the COVID-19 pandemic are likely to make this a more common clinical presentation so this article aims to discuss management options for these patients.
Collapse
Affiliation(s)
- Laura Warrilow
- Speciality Registrar Paediatric Dentistry, Birmingham Community Healthcare Foundation Trust, UK
| | - Sheridan McDonald
- Consultant in Paediatric Dentistry, Birmingham Community Healthcare Foundation Trust, UK
| |
Collapse
|
15
|
Alkadhimi A, Cunningham SJ, Parekh S, Noar JH, Travess HC. Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists. J Orthod 2021; 49:7-16. [PMID: 34476998 DOI: 10.1177/14653125211041126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To obtain the views and opinions of specialist members of the British Orthodontic Society (BOS) and British Society of Paediatric Dentistry (BSPD) in relation to (1) the multidisciplinary management of patients affected by molar incisor hypomineralisation (MIH) and (2) the diagnosis and management of MIH-affected first permanent molars (FPMs) in four clinical scenarios, and compare the responses to those of an expert panel consensus. DESIGN A prospective cross-sectional study. SETTING Part 1: Eastman Dental Institute and part 2: online questionnaire. METHODS Four clinical scenarios showing patients with differing severities of MIH affected FPMs were considered by a panel of orthodontists and paediatric dentists to agree on the severity of MIH and management. A 21-item online questionnaire sent to both specialist groups, after pilot study. The questionnaire covered demographics, access to multidisciplinary clinics, clinicians' opinions on various management aspects, and questions relating to the management of the same 4 clinical scenarios. RESULTS The overall response was 21.9% (20% of the orthodontists and 45% of the paediatric dentists). Approximately half of the respondents from both groups felt that these patients should be managed through a multidisciplinary treatment type clinic (49.0% of the orthodontists and 47.2% of the paediatric dentists). Only 40.3% of the orthodontists and 35.0% of the paediatric dentists agreed completely with the panel consensus on all management options. When assessing overall agreement on all four FPMs for all scenarios, agreement was predicted by severity of MIH (P<0.001) and complexity of malocclusion (P<0.001) where more complex malocclusions and more severe MIH resulted in poorer agreement, but specialty was not a significant predictor (P=0.21). CONCLUSION The majority of the respondents from both groups, felt that managing patients with MIH affected FPMs is challenging. Approximately half of the orthodontists and the paediatric dentists, felt that MIH affected patients should be managed through a multidisciplinary type clinic. Managing more severe cases on multidisciplinary clinics is indicated, to incorporate specialist input into decision making.
Collapse
Affiliation(s)
- Aslam Alkadhimi
- Orthodontic Department, The Royal London Dental Hospital, London, UK
| | | | - Susan Parekh
- Department of Paediatric Dentistry, UCL Eastman Dental Institute, London, UK
| | - Joe H Noar
- Royal National ENT and Eastman Dental Hospitals, London, UK
| | - Helen C Travess
- Department of Orthodontics, OMFS and Restorative Dentistry, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK
| |
Collapse
|
16
|
Taylor GD, Carr K, Rogers HJ, Vernazza CR. A systematic review of the quality and scope of decision modelling studies in child oral health research. BMC Oral Health 2021; 21:318. [PMID: 34167525 PMCID: PMC8229274 DOI: 10.1186/s12903-021-01680-3] [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] [Received: 02/26/2021] [Accepted: 06/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background Decision analytic models are often used in economic evaluations to estimate long-term costs and effects of treatment which span beyond the time-frame of a clinical trial, therefore providing a better understanding of the long-term implications of decisions that conventional trial-based economic evaluations fail to provide. This is particularly relevant for considering oral health interventions in children as treatments may affect adult oral health. However, in the field of child oral health there has not been an evaluation of the quality and scope of decision analytical models which extend into adulthood. The aim of this review is to examine the scope and quality of decision modelling studies, with horizons extending into adulthood, within the field of child oral health. Methods The following databases were searched: NHS Economic Evaluation Database (CRD York), MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, the Cochrane Library and Econlit. Full economic evaluations, in the field of child oral health, published after 1997 which included a decision model with a horizon that extended beyond the age of 18 years old were included. Included studies were appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by calibrated reviewers.
Results Four hundred studies were identified, of which nine met the inclusion criteria. Of the nine, eight were cost-effectiveness models. The majority focussed on the prevention or management of dental caries. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 82% (median = 85%, range = 54–100%). Discounting of costs and performing an incremental analysis were noted as key methodological weaknesses. The mean percentage of applicable CHEERS criteria met by each study was 82% (median = 87%, range = 32–96%). Justifying the type of model, analytical methods used, and sources of funding were most commonly unreported. Conclusions There is a paucity of decision analytical models in the field of child oral health. Most of those that are available are of high methodological and reporting quality. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01680-3.
Collapse
Affiliation(s)
- Greig D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. .,Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - Katherine Carr
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Helen J Rogers
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Chris R Vernazza
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
17
|
Sumner O, Goldsmith R, Heath N, Taylor GD. The interaction and interference of preformed metal crowns on magnetic resonance imaging: a scoping review with a systematic methodology. Eur Arch Paediatr Dent 2021; 22:1023-1031. [PMID: 34115334 PMCID: PMC8629884 DOI: 10.1007/s40368-021-00644-z] [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] [Received: 03/10/2021] [Accepted: 05/31/2021] [Indexed: 11/05/2022]
Abstract
Purpose Preformed metal crowns are widely used to restore primary and permanent teeth. Children may require magnetic resonance imaging (MRI) for diagnosis and monitoring of diseases in the head and neck region. Metallic objects, in the field of view, may compromise the diagnostic value of an MRI. The impact on the diagnostic quality of an MRI in children who have had preformed metal crowns placed has not been assessed. The aim of this systematic review was to evaluate the impact that PFMCs have on MRI imaging quality and thus the overall diagnostic value. Methods Electronic searches of the following databases were completed: MEDLINE, EMBASE, Cochrane Library, Web of Science and Open Grey. Primary in vivo studies on children who had at least one preformed metal crown placed and required an MRI investigation were to be included. PRISMA guidelines were followed and screening/data extraction was carried out by two independent calibrated reviewers. Results A total of 7665 articles were identified. After removing duplicates, 7062 were identified for title and abstract screening. Thirty-four articles underwent full-text review, of which none met the inclusion criteria. Most common reasons for exclusion were not placing preformed metal crowns (n = 16) or in vitro studies (n = 12). Conclusion No in vivo studies were identified to establish the hypothetical impact preformed metal crowns would have on the diagnostic quality of an MRI in the head and neck region. Decision making needs to be guided on a case by case basis. Further high-quality clinical studies are required.
Collapse
Affiliation(s)
- O Sumner
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R Goldsmith
- Newcastle Upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - N Heath
- Newcastle Upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. .,Newcastle Upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK.
| |
Collapse
|
18
|
Humphreys J, Jarad F, Albadri S. Management of molar-incisor hypomineralisation by general dental practitioners - part two: treatment. Br Dent J 2021:10.1038/s41415-021-2842-1. [PMID: 33893397 DOI: 10.1038/s41415-021-2842-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022]
Abstract
Introduction Molar-incisor hypomineralisation (MIH) is a common occurrence in primary and secondary care settings. While severe cases may need specialist care, mild cases should be managed in primary care.Aims To assess how UK-based general dental practitioners (GDPs) plan treatment for children with MIH using two clinical vignettesDesign An electronic vignette survey was designed using clinical photographs and radiographs. Vignette one presented a child with mild MIH who was unhappy about the appearance of his teeth. Vignette two presented an anxious child with severe MIH, caries and sensitivity. Further questions relating to confidence in management of MIH and referral were included. Participants were UK-based GDPs who regularly treat children. The survey was distributed by email and across social media platforms. Data collection occurred between February and May 2019.Results Fifty-eight GDPs completed the survey. Around half of participants addressed the aesthetic concerns of the child in vignette one. The majority of participants demonstrated sound treatment planning in terms of preventive care and management of molars. More GDPs identified increased caries risk in vignette two.Conclusion These findings demonstrate most GDPs in this study were working as effective tier one and two providers when faced with management of children with MIH.
Collapse
Affiliation(s)
- Judith Humphreys
- University of Liverpool, Paediatric Dentistry, Pembroke Place, Liverpool, L3 5PS, UK.
| | - Fadi Jarad
- University of Liverpool, Restorative Dentistry, Liverpool, L3 5PS, UK
| | | |
Collapse
|
19
|
Uhlen MM, Tseveenjav B, Wuollet E, Furuholm J, Ansteinsson V, Mulic A, Valen H. Stainless-steel crowns in children: Norwegian and Finnish dentists' knowledge, practice and challenges. BMC Oral Health 2021; 21:190. [PMID: 33845821 PMCID: PMC8040753 DOI: 10.1186/s12903-021-01556-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists. METHODS The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists' perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents' background and their answers were evaluated. RESULTS Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type. CONCLUSION Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.
Collapse
Affiliation(s)
- M M Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway.
| | - B Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - E Wuollet
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - V Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| |
Collapse
|
20
|
Molar Incisor Hypomineralization (MIH) in a Child with Congenital Chronic Intestinal Pseudoobstruction (CIPO). Case Rep Dent 2021; 2020:8894657. [PMID: 33457023 PMCID: PMC7787807 DOI: 10.1155/2020/8894657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/26/2020] [Accepted: 12/10/2020] [Indexed: 11/18/2022] Open
Abstract
Molar incisor hypomineralization (MIH) is a qualitative enamel defect of systemic origin affecting 1-4 permanent first molars (PFMs) frequently in association with affected permanent incisors (PIs). The exact etiology of MIH is still unclear but considered to be multifactorial. This present case report to the best of our knowledge is the first case reported which acknowledges MIH in a patient with chronic intestinal pseudoobstruction (CIPO) with underlying neurological disease due to somatic mitochondrial disorder. It also elicits the availability of various contemporary treatment options and their proper selection and early intervention to manage the functional and aesthetic problems caused by enamel defects and to improve the quality of life in the patients.
Collapse
|
21
|
Humphreys J, Albadri S. Management of Molar Incisor Hypomineralisation (MIH): A 1-Year Retrospective Study in a Specialist Secondary Care Centre in the UK. CHILDREN-BASEL 2020; 7:children7120252. [PMID: 33255293 PMCID: PMC7761497 DOI: 10.3390/children7120252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/10/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022]
Abstract
(1) Background: Molar incisor hypomineralisation (MIH) is an enamel defect that affects an estimated 14.2% of children worldwide. Care takes place in primary and secondary care facilities. (2) Aim: To investigate how children with MIH are managed within a specialist centre in the north of England. (3) Method: A retrospective service evaluation within the paediatric dentistry department was registered with the clinical governance unit. Children who attended consultant-led new-patient clinics between 1 January and 31 December 2015 with a diagnosis of MIH were included. The data collected concerned the pre-referral treatment, the history and diagnoses and the treatments completed. (4) Results: Out of 397 records reviewed, 48 (12.1%) had MIH, where 81.3% and 18.8% of patients had severe and mild MIH, respectively. The majority of patients (n = 44 (91.7%)) were referred appropriately. Treatment was completed at the specialist centre for 44 (91.7%) patients. Twenty-five (52.1%) patients had an extraction of one or more first permanent molar teeth. Sixteen patients had the extractions at between 8 and 10 years old and 2 had the extractions later as part of an orthodontic plan. (5) Conclusion: Most children had severe MIH and were referred at an appropriate time to facilitate the consideration of loss of poor prognosis of first permanent molars (FPMs). Most children required specialist management of their MIH.
Collapse
|
22
|
Alkhalaf R, Neves ADA, Banerjee A, Hosey MT. Minimally invasive judgement calls: managing compromised first permanent molars in children. Br Dent J 2020; 229:459-465. [PMID: 33037366 DOI: 10.1038/s41415-020-2154-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022]
Abstract
This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.
Collapse
Affiliation(s)
- Reem Alkhalaf
- Centre of Oral, Clinical & Translational Science, Faculty of Dentistry, Oral and Craniofacial Research, King's College London, London, UK
| | - Aline de Almeida Neves
- Clinical Lecturer in Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK; Adjunct Professor in Paediatric Dentistry, Federal University of Rio de Janeiro, Brazil.
| | - Avijit Banerjee
- Professor of Cariology & Operative Dentistry, Honorary Consultant/Clinical Lead, Restorative Dentistry, Conservative & MI Dentistry/Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marie Therese Hosey
- Professor of Paediatric Dentistry, Honorary Consultant, Chair of Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| |
Collapse
|
23
|
Molar Incisor Hypomineralisation-To Extract or to Restore beyond the Optimal Age? CHILDREN-BASEL 2020; 7:children7080091. [PMID: 32781715 PMCID: PMC7464986 DOI: 10.3390/children7080091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
Abstract
The management of compromised first permanent molars (FPMs) in children presents a clinical challenge to the dental team. Hypomineralised FPMs in molar incisor hypomineralisation (MIH) conditions could undergo post-eruptive breakdown, making them susceptible to caries, leading to their subsequent loss. The planned extraction of compromised FPMs is a valid alternative to complex restorative treatment. However, establishing the presence or absence of third permanent molars, amongst other considerations, is crucial to reaching a successful outcome. Clinicians should understand the importance of an orthodontic examination around the age of 8 years old with regard to establishing a differential therapeutic decision about the ideal timing of MIH-affected FPMs’ extraction in children. The aim of this article is to highlight that, with an interdisciplinary approach, a good outcome can be achieved following the extraction of poorly prognosed FPMs. The most cost-effective way of addressing MIH-affected FPMs is extraction, followed by orthodontic space closure when indicated. This obviates the need for the repeated restorative replacement and saves perfectly healthy premolars from being extracted for space creation in orthodontic treatment in several clinical scenarios.
Collapse
|
24
|
Taylor GD, Vernazza CR, Abdulmohsen B. Success of endodontic management of compromised first permanent molars in children: A systematic review. Int J Paediatr Dent 2020; 30:370-380. [PMID: 31778237 DOI: 10.1111/ipd.12599] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Endodontic therapies may be required in the management of compromised first permanent molar teeth; their success in children, however, is unknown. AIM To determine the success of endodontic therapies used on first permanent molar teeth in children aged sixteen and under. DESIGN MEDLINE, Embase, Cochrane library, CENTRAL, Clinicaltrials.gov, and the ISRCTN registry as well as relevant paediatric, endodontic, and traumatology journal were searched using a detailed search strategy. References of included studies were hand-searched. A PICOS question was formulated: (P): children aged sixteen and under; (I): endodontic therapies (not pulp capping) on a first permanent molar tooth; (C): no treatment; (O): clinical success of endodontic therapy; and (S): all study types included. Bias was assessed using the Cochrane and Robins-I risk tools. Quality of evidence was assessed using the GRADE approach. Significant heterogeneity precluded meta-analysis. RESULTS 4172 studies were retrieved and eleven were included in the narrative review. Partial and coronal pulpotomies have high success rates in the short term and long term. Limited evidence is available for conventional pulpectomy or regenerative techniques. CONCLUSIONS Partial and coronal pulpotomies are successful endodontic therapies for use in a compromised child's first permanent molar.
Collapse
Affiliation(s)
- Greig D Taylor
- Centre for Oral Health Research, School of Dental Sciences, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher R Vernazza
- Centre for Oral Health Research, School of Dental Sciences, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Bana Abdulmohsen
- Centre for Oral Health Research, School of Dental Sciences, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
25
|
Wall A, Leith R. A questionnaire study on perception and clinical management of molar incisor hypomineralisation (MIH) by Irish dentists. Eur Arch Paediatr Dent 2020; 21:703-710. [PMID: 32185633 DOI: 10.1007/s40368-020-00519-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/04/2020] [Indexed: 01/28/2023]
Abstract
AIM Molar incisor hypomineralisation (MIH) is a significant global health problem frequently encountered by dentists. The aim of this questionnaire-based study was to gain a better understanding of how dentists in the Republic of Ireland perceive and manage MIH. In addition, to compare these findings with results of existing international studies. METHODS Following ethical approval, an online survey was created consisting of 16 questions based on previous surveys regarding perception and treatment of MIH. Photographs and information regarding three specific cases were also included. The questionnaire was distributed by email and the data were analysed using SPSS statistical software. RESULTS The total number of respondents was 230, of which 204 were general dentists. The majority of dentists (58%) reported that they observe MIH on a weekly basis. Those dentists exclusively in private practice and respondents aged 36 and older were less likely to note frequent MIH (p = 0.042). The vast majority of respondents felt either confident or very confident in diagnosing MIH (91%). Overall, 71% reported to feel comfortable managing MIH; however, those in private practice only (p = 0.023) and those aged 36 and older (p = 0.011) were less likely to report being comfortable managing MIH. The most commonly cited barrier to care was the child's behaviour, followed by difficulty in achieving local anaesthesia. Composite resin was the most commonly selected material used to restore teeth affected by MIH (84%). In the scenario on cavity design, the results showed a similar number of dentists selected the most conservative and the most aggressive preparation indicating a disparity among choices. CONCLUSIONS MIH is frequently encountered by Irish general dentists. The overall wide disparity of responses is in line with other studies, and further highlights the need for the development of strong treatment guidelines and continuing dental education to assist dentists in treatment planning for MIH.
Collapse
Affiliation(s)
- A Wall
- Paediatric Department, Dublin Dental Hospital, Lincoln Place, Dublin 2, Ireland.
| | - R Leith
- Paediatric Department, Dublin Dental Hospital, Lincoln Place, Dublin 2, Ireland
| |
Collapse
|
26
|
|
27
|
United Arab Emirates dentists' perceptions about the management of broken down first permanent molars and their enforced extraction in children: a questionnaire survey. Eur Arch Paediatr Dent 2019; 21:31-41. [PMID: 30887464 DOI: 10.1007/s40368-019-00434-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The broken down first permanent molar (BDFPM) is common in children. Enforced extractions of first permanent molars (EExFPMs) guidelines were published in the United Kingdom (UK) in 2014. We aimed to assess the knowledge and practice of dentists in the United Arab Emirates (UAE) of BDFPMs in children in light of the guidelines. METHODS A cross-sectional sample of UAE-based dentists treating children completed a self-administered questionnaire covering; knowledge and practice of the principle of EExFPMs; to whom dentists would refer in case of BDFPMs; knowledge of the ideal age for EExFPMs (8-10 years) and finally actual awareness of the EExFPMs guidelines. Chi-square tests (p < 0.05). RESULTS A total of 199 questionnaires were completed (total return rate was 66.33%). There was no agreement on how to deal with a scenario of BDFPMs. Over 85% majority believed in saving BDFPMs rather than extracting them but 89% would consult/refer to other specialists. Whilst 51% of the participants had never carried out EExFPMs in children, 69% were aware of the EExFPMs concept and 61% knew the ideal timing of a lower FPM extraction. More than 82% were unaware of the actual UK EExFPMs guidelines. Paediatric dentists would consider EExFPMs more than other groups (p = 0.007). CONCLUSION In the UAE dentist sample surveyed, there was a preference for preserving BDFPMs rather than extracting them in children, despite knowing when the ideal time for extraction was. Training background and specialty were influencing factors. There was a lack of awareness of the actual UK 2014 EExFPMs guidelines.
Collapse
|
28
|
Clarity needed on how to treat compromised first permanent molars. Br Dent J 2019. [DOI: 10.1038/s41415-019-0117-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|