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Tarazona-Valero V, Almerich-Silla JM, Iranzo-Cortés JE, Ortolá-Siscar JC, Almerich-Torres T. Knowledge and perception regarding molar incisor hypomineralisation among dental students and dental hygienist students in Spain: a cross-sectional study. BMC Oral Health 2024; 24:300. [PMID: 38431602 PMCID: PMC10909293 DOI: 10.1186/s12903-024-04074-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/26/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Molar incisor hypomineralisation (MIH) has a high prevalence in the Spanish pediatric population and is a precursor of carious lesions in teeth in which it is present. Although this pathology is included in the curricula of the Degree in Dentistry and the Training Cycle in Oral Hygiene in our country, the contents currently taught seem to be insufficient in relation to the level of knowledge that we have today about this condition. METHODS A digital questionnaire of 18 questions was sent to a sample of 448 students attending the 4th and 5th year of the Degree in Dentistry and 2nd year of the Training Cycle in Oral Hygiene from different universities and vocational training centers in the Valencian Community. Descriptive and multivariate statistical analysis of the data was subsequently performed. RESULTS Of the 290 questionnaires that were obtained, 53.8% were from students attending the 2nd year of a training course in oral hygiene and 46.2% were from students pursuing a degree in dentistry. Most of the respondents had heard about MIH (75.2%), mainly through master classes. However, most students had difficulties distinguishing MIH lesions from other lesions (58.3%). The degree of knowledge about MIH was greater among dental students in all the aspects evaluated: prevalence, diagnosis, prevention, and treatment. Of all the students, 83.8% were interested in increasing their training on MIH, especially in the areas of diagnosis and treatment. CONCLUSION The results of the present study justify the need to expand the content on MIH, both theoretical and practical, in the educational curricula of the Degree in Dentistry and Integrated Vocational Training Centers in Spain.
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Affiliation(s)
- Vallivana Tarazona-Valero
- Departament d'Estomatologia, Facultat de Medicina i Odontologia, Universitat de València, Gascó Oliag, 1, Valencia, 46010, Spain
| | - José Manuel Almerich-Silla
- Departament d'Estomatologia, Facultat de Medicina i Odontologia, Universitat de València, Gascó Oliag, 1, Valencia, 46010, Spain.
| | - José Enrique Iranzo-Cortés
- Departament d'Estomatologia, Facultat de Medicina i Odontologia, Universitat de València, Gascó Oliag, 1, Valencia, 46010, Spain
| | - José Carmelo Ortolá-Siscar
- Departament d'Estomatologia, Facultat de Medicina i Odontologia, Universitat de València, Gascó Oliag, 1, Valencia, 46010, Spain
| | - Teresa Almerich-Torres
- Departament d'Estomatologia, Facultat de Medicina i Odontologia, Universitat de València, Gascó Oliag, 1, Valencia, 46010, Spain
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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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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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Seremidi K, Amend S, Krämer N, Gizani S. A cross-sectional survey on knowledge and attitudes of Greek dentists regarding molar incisor hypomineralisation diagnosis and treatment. BMC Oral Health 2022; 22:498. [PMID: 36384488 PMCID: PMC9670472 DOI: 10.1186/s12903-022-02525-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Molar Incisor Hypomineralisation (MIH) remains a challenge for clinicians underlining the gap in the literature regarding the condition. The study aimed to record knowledge and attitudes of Greek dentists regarding diagnosis and treatment of MIH and correlate findings with non-dental characteristics. Methods It is a cross-sectional study based on a questionnaire consisting of 37 multiple-choice questions. Data regarding diagnosis, aetiopathogenesis, and clinical management of MIH were collected from active members of three Greek Dental Associations. Chi-square and student’s t-test were used to correlate responses with practitioners’ characteristics and odds ratios calculated to evaluate differences on treatment of MIH-affected teeth (p < 0.05). Results From the 360 participants (response rate = 94%), 185 were general dental practitioners (GDPs) and 175 dental specialists (59 paediatric dentists (PDs), 38 orthodontists and 78 of other specialties).MIH was commonly encountered as a clinical problem, with GDPs reporting genetics and fluoride intake as common aetiological factors at significantly higher percentages as compared to PDs (p < 0.05). Permanent molars and incisors (44%) were the teeth most commonly affected, with yellow/brown demarcated opacities (68%) the most common clinical feature with PDs reporting them in a significantly higher percentage (p < 0.05). Dentists with specialisation, dentists that treat > 10 children per week and children with MIH-affected teeth had a 2–5.5 times greater probability to report difficulty achieving sufficient anaesthesia and hypersensitivity problems (p < 0.001). Agreement between GDPs’ and dental specialists’ views was found on less invasive treatment of anterior lesions. Non-PDs reported bulk-fill restorations and onlays as the ideal treatment of severely-affected posterior teeth, as compared to PDs that preferred preformed metal crowns (p < 0.05). Multivariate logistic regression analysis revealed that the age of the clinician, years of experience and number of children treated per week were the factors significantly associated with the decision for the treatment of only severely-affected posterior MIH teeth. Conclusions Most participants had encountered MIH-affected teeth in their clinical practice and were able to recognize main aetiological factors and clinical findings related to the condition. Nevertheless, their knowledge regarding treatment is limited. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02525-3.
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Yehia AM, Abdelaziz AM, Badran A. "Knowledge, clinical experience, and perceived need for training regarding molar-incisor hypomineralization among a group of Egyptian dental students: a cross-sectional study". BMC Oral Health 2022; 22:323. [PMID: 35918670 PMCID: PMC9344654 DOI: 10.1186/s12903-022-02356-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molar-Incisor Hypomineralization (MIH) is a common oral health condition that can lead to difficulties and complications for both dental professionals and patients. It also has a negative impact on the oral health-related quality of life. The present study aimed to assess the knowledge, clinical experience, and perceived need for training of a group of Egyptian dental students regarding MIH. METHODS Paper-based survey administration method was used to collect the responses of dental students regarding their knowledge, clinical experience, and perceived need for training about MIH. The survey consisted of two sections of questions regarding clinical features, etiological factors, prevalence, materials used in treating these teeth, factors affecting the choice of restorative materials, and their preferences regarding clinical training of MIH. Descriptive statistics was used for the data analysis by using SPSS® Statistics Version 26. RESULTS About two-thirds of the respondents were familiar with MIH (69.2%). The vast majority of students (87.8%) had difficulty distinguishing MIH as a developmental defect that differs from other tooth conditions (p < 0.001); most commonly enamel hypoplasia. The most common defects seen by the respondents were yellow/brown opacities (59.1%). Nearly half of the students (45.2%) choose composite resin as the material of choice for the treatment of MIH-affected teeth with aesthetics being the most common factor affecting the selection of restorative material. Almost all students expressed their needs for further clinical training on MIH, especially on treatment aspects. CONCLUSIONS Most students are familiar with MIH theoretically. However, there is an urgent need to include clinical training on MIH diagnosis in the practical sessions of pediatric dentistry courses.
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Affiliation(s)
| | | | - Amira Badran
- Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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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.
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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
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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.
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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
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Liu Y, He M. A survey on knowledge and attitudes towards molar-incisor hypomineralization among undergraduate and postgraduate students at the School of Stomatology, Wuhan University. BMC Oral Health 2022; 22:19. [PMID: 35081946 PMCID: PMC8793152 DOI: 10.1186/s12903-022-02055-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a developmental dental disease, and its clinical management challenges dentists. This study aimed to investigate the knowledge about MIH and the attitudes towards learning more about MIH among undergraduate and postgraduate students attending the School of Stomatology, Wuhan University. METHODS This survey was based on a questionnaire modified based on previous studies. The questionnaire was sent to 540 undergraduate and postgraduate students from the School of Stomatology, Wuhan University. The questions covered their clinical experience, perceptions, clinical management, and preferences for further training. Data were analysed with the Chi-square test. RESULTS We collected 368 questionnaires (response rate: 68%). Among them, 89% (328/368) were eligible for analysis. Most respondents (80%) had heard of MIH, primarily from classroom teaching. However, only 40% of the students had observed the disease clinically, and a relatively low proportion of students were familiar with the aetiology, prevalence, differential diagnosis, and treatment of MIH. Most respondents were highly enthusiastic and had great expectations about further systematic teaching about MIH. CONCLUSION Most students in this study had heard of MIH, but few were familiar with the principles of its differential diagnosis. Systematic teaching about MIH is warranted.
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Affiliation(s)
- Yanchen Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.,Department of Paediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Miao He
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China. .,Department of Paediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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Knowledge, attitudes, and beliefs regarding molar incisor hypomineralisation amongst Swiss dental students. BMC Oral Health 2021; 21:548. [PMID: 34702223 PMCID: PMC8549230 DOI: 10.1186/s12903-021-01911-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background Knowledge obtained at the undergraduate level regarding molar incisor hypomineralisation (MIH) has an impact on future practice of dentists and paediatric dentists. This cross-sectional study aimed to assess final-year dental students’ knowledge, attitudes and beliefs towards MIH in all Swiss universities. Methods A previously utilised survey (in both English and German) was distributed among final-year dental students in all Swiss dental schools (Basel, Bern, Geneva and Zurich). It probed students’ knowledge, attitudes and beliefs regarding the diagnosis, prevalence, aetiology, and management of MIH, and was structured in two parts: knowledge/perception and clinical application. The students’ responses were analysed statistically with descriptive statistics. Results 113 out of 133 final-year Swiss dental students took part in the study (85%). Nearly all students were familiar with MIH (99%), but only 12% of them felt confident when diagnosing MIH clinically. Direct composite fillings (66%), indirect restorations (28%) and preformed stainless-steel crowns (26%) were chosen as most suitable treatment options for MIH-affected teeth. Conclusion Final-year Swiss dental students are well informed about MIH. However, they report low level of confidence when clinically confronted with MIH-affected teeth regarding its diagnosis and treatment. Swiss Universities curricula should be revisited accordingly.
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Bekes K, Melichar K, Stamm T, Elhennawy K. Dental Students' Knowledge, Attitudes and Beliefs Regarding Molar Incisor Hypomineralization (MIH): A Survey in Vienna, Austria. J Multidiscip Healthc 2021; 14:2881-2889. [PMID: 34675536 PMCID: PMC8520889 DOI: 10.2147/jmdh.s326846] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/31/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Molar incisor hypomineralization (MIH) is a frequently encountered dental condition worldwide. The aim of this study was to evaluate the knowledge of Austrian dental students about MIH. Methods A validated paper-based survey was distributed among 100 final year dental students at the Medical University of Vienna to assess their knowledge, perception and believes regarding MIH. One hundred dental students at the University Dental Clinic of Vienna were included in the study. At the time of the survey, they were in their 11th or 12th semester (final year). Information about the knowledge on diagnosis and prevalence, and attitudes and beliefs around etiology and management was collected. Results All students replied, 94 questionnaires could be included in the analysis (50% female). 98% of the students were familiar with MIH and 86% were aware with the clinical features of MIH. Only 13% reported clinical ability to identify MIH. Regarding the etiology of MIH, most of the students (69%) named "genetic factors" as the most frequent etiological factor. Conclusion Dental students showed great interest in the topic of MIH, as the majority of all respondents were in favor of deepening their knowledge regarding this topic. The students should be offered opportunities to do this both during and after their studies.
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Affiliation(s)
- Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Kaya Melichar
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Section for Outcomes Research, Vienna, Austria
| | - Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
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