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Sluka B, Held U, Wegehaupt F, Neuhaus KW, Attin T, Sahrmann P. Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data. BMC Oral Health 2024; 24:127. [PMID: 38273324 PMCID: PMC10809700 DOI: 10.1186/s12903-023-03637-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 11/08/2023] [Indexed: 01/27/2024] Open
Abstract
Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.
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Affiliation(s)
| | - Ulrike Held
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zürich, Switzerland
| | - Florian Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Klaus W Neuhaus
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Philipp Sahrmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.
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Awwad A, Hamad R, Schiffner U, Splieth CH, Schmoeckel J. Effect of Prevalence and Severity of Molar-Incisor Hypomineralization on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis. Acta Stomatol Croat 2023; 57:381-394. [PMID: 38283314 PMCID: PMC10812914 DOI: 10.15644/asc57/4/8] [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: 09/19/2023] [Accepted: 11/16/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives The aim of this systematic review and meta-analysis is to assess the association between the MIH presence as well as the severity and OHRQoL in children. Material and methods Relevant studies were identified in PubMed, Embase, Cochrane and Google Scholar. Studies involving MIH and OHRQoL in children were included. A methodological quality assessment of included studies was performed using the Newcastle-Ottawa Scale (NOS) and its adapted version for cross-sectional studies. Random effects models were used to estimate summary effect measures for the association between MIH presence (presence vs. absence) as well as severity (moderate/severe MIH vs. no MIH) and OHRQoL using generic inverse variance meta-analyses. Tests for heterogeneity, publication bias and sensitivity of results were also performed. Results Out of 1696 identified publications 11 studies reporting on 5,017 children were included in the meta-analysis assessing the impact of MIH presence. There was no statistically significant association between the presence of MIH and lower OHRQoL in affected children (OR = 1.72, 95% CI = 0.99-2.98). Concerning MIH severity and its impact on OHRQoL, a sum of 6 studies were included in the meta-analysis involving a total of 2,595 children. There was a significant association between moderate/severe MIH and lower OHRQoL in affected children (OR = 3.43, 95% CI = 1.69-6.98). Conclusion Moderate/Severe MIH has a significant and clinically relevant negative impact on OHRQoL, and it should therefore be addressed adequately. Future research should also consider the impact of a uniform MIH diagnosis and precise severity criteria.
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Affiliation(s)
- Abdelrahman Awwad
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Rakan Hamad
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Ulrich Schiffner
- Center for Dental and Oral Medicine, Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian H Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
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Romo Pérez C, Lobo Cortés L, Morales Rojas MJ, Martín López ALS, Ramírez Vera KG. [Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 10:e130. [PMID: 38390611 PMCID: PMC10880695 DOI: 10.21142/2523-2754-1004-2022-130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/24/2022] [Indexed: 02/24/2024] Open
Abstract
Introduction Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems. Objective to evaluate the effect of MIH on oral health-related quality of life in children and adolescents. Materials and methods A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality. Results Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life. Conclusions The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.
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Affiliation(s)
- Camilo Romo Pérez
- Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS), Universidad del Magdalena. Santa Marta, Colombia. , Universidad del Magdalena Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS) Universidad del Magdalena Santa Marta Colombia
| | - Luis Lobo Cortés
- Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS), Universidad del Magdalena. Santa Marta, Colombia. , Universidad del Magdalena Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS) Universidad del Magdalena Santa Marta Colombia
| | - María José Morales Rojas
- Programa de Odontología, Universidad del Magdalena. Santa Marta, Colombia. Universidad del Magdalena Programa de Odontología Universidad del Magdalena Santa Marta Colombia
| | - Alma Luz San Martín López
- Facultad de Odontología, Universidad Veracruzana, Poza Rica, México. , Universidad Veracruzana Facultad de Odontología Universidad Veracruzana Poza Rica Mexico
| | - Karem Guadalupe Ramírez Vera
- Facultad de Odontología, Universidad Veracruzana, Poza Rica, México. , Universidad Veracruzana Facultad de Odontología Universidad Veracruzana Poza Rica Mexico
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Reissenberger T, Ebel M, Klode C, Hirsch C, Bekes K. Hypomineralized Teeth and Their Impact on Oral-Health-Related Quality of Life in Primary School Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10409. [PMID: 36012043 PMCID: PMC9408049 DOI: 10.3390/ijerph191610409] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Molar-incisor hypomineralization (MIH) has a strong negative effect on oral-health-related quality of life (OHRQoL). Malformed teeth can be hypersensitive, and the discoloration might affect children's appearances, reducing their well-being. The purpose of the study was to investigate how hypomineralized incisors and molars differ in children's perceived OHRQoL. MATERIALS AND METHODS 252 children aged 7-10 years old were included and subdivided into three equal groups (n = 84). Group A included children with asymptomatic molars and affected incisors. Group B included children presenting only affected molars. Group C was the control group, with children showing no MIH. All participants were asked to complete the German version of the Child Perceptions Questionnaire (CPQ-G8-10) to measure OHRQoL. RESULTS Participants in the posterior group showed a median total CPQ of 13.4 (±1.7), which was significantly higher than scores in the anterior and control group, which showed a median total CPQ of 8.4 (±1.4) and 4.2 (±0.7), respectively. Children in the posterior group suffered more from oral symptoms and functional limitations, whereas the anterior group dealt more with social and emotional well-being problems. CONCLUSIONS The position of the MIH-affected teeth causes different influences on perceived OHRQoL.
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Affiliation(s)
- Tim Reissenberger
- Independent Researcher, Odenthaler Straße 132, 51465 Bergisch Gladbach, Germany
| | - Markus Ebel
- Independent Researcher, Odenthaler Straße 132, 51465 Bergisch Gladbach, Germany
| | - Christian Klode
- Forum für Gesundheitswirtschaft Gemeinnützige GmbH, Am Wall 142, 28195 Bremen, Germany
| | - Christian Hirsch
- School of Dentistry, Department of Paediatric Dentistry, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
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Factors Involved in the Perception of Enamel Dyschromic Lesions-A Questionnaire-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020900. [PMID: 35055723 PMCID: PMC8775837 DOI: 10.3390/ijerph19020900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/24/2022]
Abstract
Dyschromic lesions (DLs) of tooth enamel are common disorders, with multiple etiologies and various clinical forms, that raise public health concerns. This study aimed to determine the factors that influence the perception of DLs and to assess the perceived need for dental treatment in various clinical cases. A paper-based questionnaire with attached images of frontal teeth exhibiting different DLs was distributed to patients, dental students, and dentists. A total of 383 volunteers participated in this study, and their answers were statistically described and analyzed. This study found that in cases with multiple, well-demarcated areas of opacities associated with diffuse opacities on neighboring teeth, most respondents noticed and reported only the most severe lesions, disregarding the minor ones. The contrast of the lesion with the color of the substrate influenced the overall perception and a significant correlation between these two variables was found. However, the color of the DLs did not significantly impact the overall perception of the lesions. A higher overall perception of DLs was significantly correlated with a favorable opinion regarding the need for treatment. Furthermore, gender and medical background were significantly associated with the overall perception of DLs.
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Lopes LB, Machado V, Mascarenhas P, Mendes JJ, Botelho J. The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Sci Rep 2021; 11:22405. [PMID: 34789780 PMCID: PMC8599453 DOI: 10.1038/s41598-021-01541-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/06/2021] [Indexed: 12/28/2022] Open
Abstract
Molar-Incisor Hypomineralization (MIH) is a qualitative defect of enamel of unknown etiology, affecting one or more permanent molars and may include incisors. This condition is a clinical challenge and its prevalence is still uncertain given the recent increase in research. Thus, we aimed to comprehensively estimate the overall prevalence of MIH and associated characteristics. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS and TRIP databases, until July 2021. Heterogeneity and publication bias were computed via I2 test statistics and Egger's significance test, respectively. Random-effects meta-analysis of prevalence were processed. We used the Strength of Recommendation Taxonomy [SORT] to grading the strength of evidence. Overall, 116 observational studies were included, with one study with moderate methodological quality and the remaining of high methodological quality. Subgroup analysis confirmed an influence of not using the 2003 MIH case definition (p = 0.0066). The pooled prevalence of MIH was 13.5% (95% CI 12.0-15.1, I2 = 98.0%). Affected incisors were seen in 36.6% (95% CI 30.0-43.7, I2 = 92.5%) of the cases. Lastly, the prevalence of hypomineralization of the second primary molars was observed in 3.6% of the MIH cases (95% CI 1.9-6.8, I2 = 96.3%). America was the continent with highest prevalence (15.3, 95% CI 12.8-18.3, p < 0.001, I2 = 96.3%) and Asia had the lowest prevalence (10.7, 95% CI 8.5-13.5, p < 0.001, I2 = 98.7%), however no continental differences were found. Sample size and year of publication were slight contributing factors to the heterogeneity in the analysis. Overall, these results were classified with a SORT A recommendation.
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Affiliation(s)
- Luísa Bandeira Lopes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - Paulo Mascarenhas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal.
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal.
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