1
|
Gil-Bona A, Karaaslan H, Depalle B, Sulyanto R, Bidlack FB. Proteomic Analyses Discern the Developmental Inclusion of Albumin in Pig Enamel: A New Model for Human Enamel Hypomineralization. Int J Mol Sci 2023; 24:15577. [PMID: 37958567 PMCID: PMC10650821 DOI: 10.3390/ijms242115577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
Excess albumin in enamel is a characteristic of the prevalent developmental dental defect known as chalky teeth or molar hypomineralization (MH). This study uses proteomic analyses of pig teeth to discern between developmental origin and post-eruptive contamination and to assess the similarity to hypomineralized human enamel. Here, the objective is to address the urgent need for an animal model to uncover the etiology of MH and to improve treatment. Porcine enamel is chalky and soft at eruption; yet, it hardens quickly to form a hard surface and then resembles human teeth with demarcated enamel opacities. Proteomic analyses of enamel from erupted teeth, serum, and saliva from pigs aged 4 (n = 3) and 8 weeks (n = 2) and human (n = 4) molars with demarcated enamel opacities show alpha-fetoprotein (AFP). AFP expression is limited to pre- and perinatal development and its presence in enamel indicates pre- or perinatal inclusion. In contrast, albumin is expressed after birth, indicating postnatal inclusion into enamel. Peptides were extracted from enamel and analyzed by nano-liquid chromatography-tandem mass spectrometry (nanoLC-MS/MS) after tryptic digestion. The mean total protein number was 337 in the enamel of all teeth with 13 different unique tryptic peptides of porcine AFP in all enamel samples but none in saliva samples. Similarities in the composition, micro-hardness, and microstructure underscore the usefulness of the porcine model to uncover the MH etiology, cellular mechanisms of albumin inclusion, and treatment for demarcated opacities.
Collapse
Affiliation(s)
- Ana Gil-Bona
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Hakan Karaaslan
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Baptiste Depalle
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| | - Rosalyn Sulyanto
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
- Department of Dentistry, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Felicitas B. Bidlack
- The Forsyth Institute, 245 First Street, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
| |
Collapse
|
2
|
Gevert MV, Soares R, Wambier LM, Ribeiro AE, Avais LS, de Souza JF, Chibinski ACR. How is the quality of the available evidence on molar-incisor hypomineralization treatment? An overview of systematic reviews. Clin Oral Investig 2022; 26:5989-6002. [PMID: 35790597 DOI: 10.1007/s00784-022-04612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This overview analyzed the quality of the systematic reviews (SRs) available on treatments for molar-incisor hypomineralization (MIH). MATERIAL AND METHODS Six electronic databases were searched (PubMed/MEDLINE, Scopus, Web of Science, LILACS, Brazilian Bibliography of Dentistry and Cochrane Library) until March 2022. Two reviewers independently performed the selection, the quality assessment (Assessment of Multiple Systematic Reviews 2 - AMSTAR-2), and the risk of bias assessment of the SR (Risk of Bias in Systematic Reviews - ROBIS). RESULTS Two hundred nine records were retrieved; after removing duplicates and applying the inclusion/exclusion criteria, 5 SRs remained. Three SRs were rated as showing critically low methodological quality and high risk of bias, and two were rated as moderate methodological quality and low risk of bias. The identified treatments that may be suitable for MIH were classified as (1) non-invasive - casein incorporated into toothpaste and sugar-free chewing gum, toothpaste containing arginine, 0.4% stannous fluoride gel; fluoride varnish; (2) micro-invasive - resin sealants for pits and fissures, microabrasion, dental whitening, resin infiltration; (3) invasive - ART restorations, indirect restorations (metal, composite, or ceramic); and (4) mixed intervention - stainless steel crowns. CONCLUSION Despite the considerable number of published papers included in this set of systematic reviews, the evidence supporting the effectiveness of treatments for treating MIH is limited due to the methodological quality and risk of bias of the systematic reviews, as well as the quality of the primary studies (PROSPERO: CRD42020144831). CLINICAL RELEVANCE Different treatments have been purposed for MIH treatment, but there is still not enough scientific evidence of good quality for the establishment of a definitive clinical protocol for the treatment of MIH.
Collapse
Affiliation(s)
- Mayara Vitorino Gevert
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil
| | - Renata Soares
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil
| | - Letícia Maira Wambier
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil
| | - Ana Elisa Ribeiro
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil
| | - Letícia Simeoni Avais
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil
| | | | - Ana Cláudia Rodrigues Chibinski
- Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil.
| |
Collapse
|
3
|
Özgür B, Kargın ST, Ölmez MS. Clinical evaluation of giomer- and resin-based fissure sealants on permanent molars affected by molar-incisor hypomineralization: a randomized clinical trial. BMC Oral Health 2022; 22:275. [PMID: 35790955 PMCID: PMC9258125 DOI: 10.1186/s12903-022-02298-9] [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: 08/08/2021] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molar-incisor hypomineralization (MIH) is a common condition among children that significantly increases the risk of caries. The objective of this research was to evaluate the clinical success of giomer- and conventional resin-based sealants applied on first permanent molars (FPMs) affected by MIH. METHODS One-hundred FPMs with MIH which were indicated for non-invasive fissure sealant were selected in 39 children, aged 6-12 years. Using a split mouth design, the FPMs were randomized into two groups; Group 1. Resin sealant (etch-and-rinse + Conceal F) and Group 2. Giomer sealant (self-etch primer + BeautiSealant). Clinical evaluation was performed using the modified United States Public Health Service (USPHS) criteria at 1, 3, 6 and 12 months. The Log-rank, Fisher's exact test and Kaplan-Meier analysis were used for statistical analysis. RESULTS At 12 months, the retention rates in Group 1 and Group 2 were 68% and %8, respectively (p = 0.000). The cumulative survival rates of conventional resin sealants were significantly higher than giomer sealants for all follow-up visits (p < 0.05). In Groups 1 and 2, the distribution of unsuccessful sealants on mandibular vs maxillary FPMs were 32.1% vs 31.8% (p = 0.612) and 91.7% vs 92.3% (p = 0.664), respectively. Although the success rate was higher for teeth with white opacities or lesions with less extension in Group 1, no significant difference was found. The average survival time was found as 10.46 ± 3.21 months in Group 1 and 4.02 ± 4.43 months in Group 2. CONCLUSIONS The conventional resin-based sealants yielded a better clinical performance over the 12-month evaluation period than the giomer sealants which were applied with self-etch primer. The high failure rate observed in giomer sealants could be explained by the possible deficiency in the etching capacity of self-etch primer on MIH-affected teeth. Trial registration ClinicalTrials.gov, NCT04929782. Registered 10 June 2021-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04929782 .
Collapse
Affiliation(s)
- Beste Özgür
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, 06100, Altındag, Ankara, Turkey.
| | - Seren Tuğçe Kargın
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, 06100, Altındag, Ankara, Turkey
| | - Merih Seval Ölmez
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, 06100, Altındag, Ankara, Turkey
| |
Collapse
|
4
|
Caries-Preventive Effect and Retention of Glass-Ionomer and Resin-Based Sealants: A Randomized Clinical Comparative Evaluation. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7205692. [PMID: 35769675 PMCID: PMC9236800 DOI: 10.1155/2022/7205692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/21/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
Background. Deep fissures are highly unprotected from the development of caries. Resin-based materials and glass-ionomer cements for sealing fissures are useful in caries control through physical barrier formation, which prohibits metabolic exchange between fissure microorganisms. Retention is one of the most critical properties of fissure sealants. This in vivo study is aimed at comparing and evaluating the clinical efficacy of resin and glass ionomer-based fissure sealants on first permanent molars with follow-ups at 6-, 12-, and 18-month intervals. Methods. A randomized split-mouth design clinical study was conducted after obtaining the ethical committee approval. A total of 50 patients, aged between 7 and 12 years, were randomized and enrolled in the study to perform a total of 200 sealant placements on all four caries-free and hypoplasia-free first permanent molars having deep fissures, which are susceptible to caries, were included in this study. The four permanent molars were divided into the following four groups: group A (control), B (Grandioseal, Voco, Germany), C (Smartseal & Loc, Detax Gmbh & Co, Germany), and D (Fuji triage capsule, GC, Belgium). The sealed molars were clinically evaluated at intervals of 6, 12, and 18 months to assess sealant retention, surface roughness, marginal coloration, and caries status through visual evaluation of the sealant by two evaluators. Results. Concerning retention, there were statistically significant differences between the sealants in terms of the survival of partial and fully retained sealants as well as in the survival of caries-free teeth. Two resin-based (Smartseal & Loc) and glass-ionomer cement (Fuji triage) sealants showed significantly similar performances in permanent molars for up to 18 months. In terms of retention, one of the resin-based (Grandioseal) sealants performed better as compared to the others and showed better caries prevention in deep fissures. Conclusion. It is concluded that both the sealants had comparable retention and caries-preventive effects in 7 to 12-year-old children and can be considered as suitable sealants for a period of at least 18 months in moderate caries risk patients.
Collapse
|
5
|
Jiménez-Díaz J, Curtze-Scotts G, Barahona-Fuentes G. Retention rate of resin sealants in dental enamel with structural alterations: a systematic review. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.01.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resin sealants have been used preventively and therapeutically in tooth enamel. The latter can present different conditions in its structure. In this sense, adhesive retention in enamel has ample evidence of its effectiveness, but not in enamel with structural alterations. In this way, it is relevant to know the adhesive retention of these materials and how they behave over time in enamel with variations in its composition. To determine the retention rate of resin sealants in tooth enamel with structural alterations. The study is part of a systematic review following the PRISMA protocol. Articles published between 2010 and 2020 on the retentive behavior of resin sealants in dental with structural alterations were examined. The electronic search was carried out in Web of Science, Scopus, PubMed and Medline. Those articles that used resin sealants in dental enamel with structural alterations were incorporated in clinical trials. Results: Eight articles were found. These were stratified according to the application surface; (i) carious surface, (ii) surface with fluorosis and (iii) surface with hypomineralization of the molar incisor. It was evidenced that the retention rate of resin sealants on decayed enamel is 80% on average, in enamel with dental fluorosis 67.5% and enamel with hypomineralization of the molar incisor 72% 2 years after their application. The retentive behavior of resin sealants on enamel with structural alterations is adequate for the three application surfaces. However, further studies are required regarding dental fluorosis and molar incisor hypomineralization. The most significant evidence on the retention rate was found on various surfaces.
Collapse
Affiliation(s)
| | | | - Guillermo Barahona-Fuentes
- Grupo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Universidad de Las Américas, sede Viña del Mar, Chile
| |
Collapse
|
6
|
Singh SK, Goyal A, Gauba K, Bhandari S, Kaur S. Full coverage crowns for rehabilitation of MIH affected molars: 24 month randomized clinical trial. Eur Arch Paediatr Dent 2022; 23:147-158. [PMID: 34398412 DOI: 10.1007/s40368-021-00657-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Teeth affected with severe molar incisor hypomineralization (MIH) require extensive restorations, which do not last for a long time and often require treatment in the form of onlays or full coverage restorations. AIM To evaluate and compare the clinical performance of zirconia, lithium disilicate, and cast metal crowns as full-coverage restorations on MIH-affected first permanent molars (FPMs). METHODS 60 MIH affected FPMs requiring full-coverage crowns were identified in children aged 8-15 years and were randomly allocated to the three treatment groups according to the type of full coverage restoration received using block randomization technique. After an adequate removal of the MIH defect and restoration with composite resin, the tooth preparation was done followed by fabrication of crown and its cementation using resin cement. The intergroup comparison was done on the basis of USPHS criteria, gingival, plaque scores, patient and parents acceptance through a visual analog scale to decipher their clinical performance at 6, 12, 24 months. RESULTS After 24 months, the crowns showed similar clinical success in terms of the criterias used to compare their clinical performance. The retention, marginal adaptation, relief from hypersensitivity, proximal contact, gingival health with no statistically significant difference among the three groups. CONCLUSION Based on the observations, Lithium disilicate, Zirconia and full cast metal crowns showed similar clinical success in rehabilitation of First permanent molars with severe MIH over 24 months of evaluation. The clinical success is not influenced by the material of the restoration. However, prospective studies with a longer follow-up are required to reach a more definitive conclusion.
Collapse
Affiliation(s)
- S K Singh
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - A Goyal
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gauba
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Bhandari
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Kaur
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
7
|
Lee YL, Li KC, Yiu CKY, Boyd DH, Ekambaram M. Evaluation of developmentally hypomineralised enamel after surface pretreatment with Papacarie Duo gel and different etching modes: an in vitro SEM and AFM study. Eur Arch Paediatr Dent 2022; 23:117-131. [PMID: 34586616 DOI: 10.1007/s40368-021-00671-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed at investigating the surface morphology and nanotopography of normal enamel (NE) and developmentally hypomineralised enamel (HE) when subjected to various pretreatment protocols under scanning electron microscopy (SEM) and atomic force microscopy (AFM). METHODS Sixteen NE, 16 creamy/white (CW) HE and 16 yellow/brown (YB) HE specimens sectioned from extracted hypomineralised first permanent molars (FPMs) were included in this study. They were randomly distributed into 12 experimental groups (n = 4). Each group involved the following: (1) deproteinisation with Papacarie Duo® gel or no deproteinisation, and (2) the use of Scotchbond™ Universal Adhesive (Scotchbond) in self-etch (SE) mode or 37% phosphoric acid etchant. Subsequently, the surface morphology and nanotopography of pretreated enamel specimens were evaluated under SEM and AFM, respectively. RESULTS SEM observation showed that deproteinisation with Papacarie Duo® gel before phosphoric acid etching led to favourable etching patterns. This was consistent across all groups irrespective of the type of enamel specimen and the severity of hypomineralisation. In contrast, AFM results identified three factors that influenced surface parameters: (1) type of enamel specimen, (2) severity of hypomineralisation and (3) etching mode. YB HE recorded higher surface roughness values than CW HE and NE when subjected to the same pretreatment protocol. Deproteinisation and the application of Scotchbond in SE mode led to minimal topographic changes; however, acid etching was associated with an increase in surface roughness. CONCLUSION Deproteinisation with Papacarie Duo® gel followed by acid etching contributed to improved etching patterns on HE.
Collapse
Affiliation(s)
- Y-L Lee
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - K C Li
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - C K Y Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (SAR), People's Republic of China
| | - D H Boyd
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - M Ekambaram
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| |
Collapse
|
8
|
Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
Collapse
Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| |
Collapse
|
9
|
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: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [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
|
10
|
Olgen IC, Sonmez H, Bezgin T. Effects of different remineralization agents on MIH defects: a randomized clinical study. Clin Oral Investig 2021; 26:3227-3238. [PMID: 34821978 DOI: 10.1007/s00784-021-04305-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to present a comparative evaluation of the long-term efficacy of fluoride varnish and pastes containing CPP-ACP and CPP-ACP with fluoride (CPP-ACFP) in the remineralization of creamy-white and yellow-brown defects in permanent first molars with MIH. MATERIALS AND METHODS The study included 120 teeth with yellow-brown or creamy-white defects in 67 children (37 girls, 30 boys) aged 6-9 years (mean, 7.2) who were newly diagnosed with MIH with no substance loss or caries or prior restorative treatment. The patients were randomly divided into the experiment groups; control (oral hygiene motivation only), fluoride varnish, and pastes containing CPP-ACP and CPP-ACPF, and followed up for 24 months. The evaluations were made based on the ICDAS criteria and the measurements which were performed using the laser fluorescence method (DIAGNOdent, KaVo, Biberach, Germany) in the follow-ups. RESULTS The research was completed with 49 patients (23 females, 26 males; mean age, 7.7) and 90 teeth. All remineralization agents increased remineralization rates in both creamy-white and yellow-brown colored defects without presenting any statistically significant difference at the end of the follow-up period (p > 0.05). However, the effects of fluoride varnishes were late to observe when compared to pastes containing CPP-ACP and CPP-ACPF. CONCLUSIONS Pastes containing calcium and phosphate may be recommended for the longer-term preservation of teeth with yellow-brown defects which showed a post-eruptive breakdown in a shorter time. CLINICAL RELEVANCE There is a lack of studies investigating MIH treatments in which lesion appearance was recorded. This study evaluated creamy-white and yellow-brown MIH defects separately and reported long-term results of different remineralization agents.
Collapse
Affiliation(s)
- Irem Can Olgen
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hayriye Sonmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Tugba Bezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey.
| |
Collapse
|
11
|
Bekes K, Amend S, Priller J, Zamek C, Stamm T, Krämer N. Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up. Clin Oral Investig 2021; 26:1879-1888. [PMID: 34468888 PMCID: PMC8816787 DOI: 10.1007/s00784-021-04163-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/24/2021] [Indexed: 12/20/2022]
Abstract
Objectives The aim of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 12 weeks after sealing using two different materials (composite and glass ionomer). Furthermore, the retention rates of both materials were analyzed. Methods Thirty-nine children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Both teeth were sealed by two calibrated operators using a split-mouth design with either Clinpro Sealant in combination with Scotchbond Universal (C) or Ketac Universal (K), respectively. Clinical pain assessments (Schiff Score Air Sensitivity Scale [SCASS], Visual Analog Scale [VAS]) were made at baseline (“pre”), immediately after treatment (“post”), and after 1, 4, 8, and 12 weeks. Paired t tests were calculated in each group between baseline and all other time points. Results Thirty-eight children with 76 molars completed all stages of the study. Regardless of the material used, the application of the sealant decreased hypersensitivity significantly immediately as well as throughout the 12-week recalls (all p values < 0.001). We found no statistically significant difference among both materials chosen in any of the time points evaluated. Furthermore, retention of both materials was comparable in both groups. Conclusions Both sealant materials were able to reduce hypersensitivity successfully immediately and throughout the 12-week follow-up. Furthermore, their performance was similar in terms of retention. Clinical relevance Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating hypersensitivity relief of MIH-affected molars using two sealing techniques.
Collapse
Affiliation(s)
- Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
| | - Stefanie Amend
- Department of Paediatric Dentistry, Medical Centre for Dentistry Section for Outcomes Research, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Julia Priller
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
| | - Claudia Zamek
- Private Practice, Graf-Adolf-Straße 24, 40212, Düsseldorf, Germany
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Norbert Krämer
- Department of Paediatric Dentistry, Medical Centre for Dentistry Section for Outcomes Research, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| |
Collapse
|
12
|
Schraverus MS, Olegário IC, Bonifácio CC, González APR, Pedroza M, Hesse D. Glass Ionomer Sealants Can Prevent Dental Caries but Cannot Prevent Posteruptive Breakdown on Molars Affected by Molar Incisor Hypomineralization: One-Year Results of a Randomized Clinical Trial. Caries Res 2021; 55:301-309. [PMID: 34107492 DOI: 10.1159/000516266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
To evaluate the preventive effect of glass ionomer cement (GIC) against dental caries and posteruptive breakdown (PEB) on molars affected by molar incisor hypomineralization (MIH). In this randomized clinical trial, 77 children aged 5-9 years with at least 1 MIH-affected molar and without PEB or dentin caries lesions (n = 228) were included and randomly allocated to one of the following groups: (1) MIH-affected molars that remained unsealed and (2) MIH-affected molars that received GIC sealants. Dental caries and PEB were clinically evaluated after 6 and 12 months. Associations between dental caries and PEB with independent variables were evaluated using logistic regression analysis (p < 0.05). The MIH-affected molars allocated to the GIC sealant group were less likely to develop dental caries compared to those allocated to the unsealed group (OR = 0.23; 95% CI 0.06-0.95). Conversely, application of a GIC sealant was not associated with prevention of PEB (p = 0.313). Furthermore, MIH-affected molars presenting yellow-brown opacities were almost 5 times more likely to develop dental caries (p = 0.013) and PEB (p = 0.001) compared to those presenting white-creamy opacities. We can conclude that GIC sealants can prevent dental caries on MIH-affected molars; however, the same protective effect was not observed for PEB.
Collapse
Affiliation(s)
- Milou S Schraverus
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Isabel C Olegário
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Clarissa C Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ana Paola R González
- Programme of Specialization in Paediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Guadalajara, Mexico
| | - Murisi Pedroza
- Programme of Specialization in Paediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Guadalajara, Mexico
| | - Daniela Hesse
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| |
Collapse
|
13
|
Sobral APT, Santos EM, Aranha AC, Soares PV, Moriyama CM, Gonçalves MLL, Ribeiro RA, Motta LJ, Horliana ACRT, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. The control of pain due to dentin hypersensitivity in individuals with molar-incisor hypomineralisation: a protocol for a randomised controlled clinical trial. BMJ Open 2021; 11:e044653. [PMID: 33692185 PMCID: PMC7949385 DOI: 10.1136/bmjopen-2020-044653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dentin hypersensitivity (DH) is defined as high sensitivity of the vital dentin when exposed to thermal, chemical or tactile stimuli. Two mechanisms are required for the occurrence of DH: (1) the dentin must be exposed and (2) the dentinal tubules must be open and connected to the pulp. Molar-incisor hypomineralisation (MIH) is a qualitative abnormality of a genetic origin that affects tooth enamel and, in most cases, is accompanied by DH. The control of tooth sensitivity is fundamental to the successful treatment of MIH. The aim of the proposed randomised, controlled, clinical trial is to evaluate the effectiveness of different protocols for the control of DH in patients with teeth affected by MIH. METHODS AND ANALYSIS One hundred and forty patients who meet the inclusion criteria will be allocated to four groups. Group 1 will be the control group (placebo). In Group 2, sensitive teeth will be sealed with PermaSeal (Ultradent). In Group 3, sensitive teeth will receive low-level laser (LLL, AsGaAl) at a wavelength of 780 nm (Laser XT Therapy, DMC, São Carlos, Brazil). In Group 4, sensitive teeth will be treated with both LLL and PermaSeal (Ultradent). DH will be evaluated 15 min after the application of the treatments and the patients will be reevaluated 1 week, 1 month, 3 months and 6 months after the treatments. The primary outcome of this study is change in pain/sensitivity, when evaluated through a Visual Analogue Scale, to determine the effectiveness of the proposed treatments, as well as differences among the evaluation times for each proposed treatment. ETHICS AND DISSEMINATION This protocol has been ethically approved by the local medical ethical committee (protocol number: 4.020.261). Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT04407702.
Collapse
Affiliation(s)
- Ana Paula Taboada Sobral
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | - Elaine Marcilio Santos
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Pro-rectory for Academic Affairs, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Ana Cecilia Aranha
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo Vinícius Soares
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Marcela Leticia Leal Gonçalves
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | | | - Lara Jansiski Motta
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| | | | | | | | - Sandra Kalil Bussadori
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, São Paulo, SP, Brazil
| |
Collapse
|
14
|
Olmo-González B, Moreno-López R, Ribera-Uribe M. Dental management strategies for Molar Incisor Hypomineralization. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
15
|
Elhennawy K, Krois J, Jost-Brinkmann PG, Schwendicke F. Outcome and comparator choice in molar incisor hypomineralisation (MIH) intervention studies: a systematic review and social network analysis. BMJ Open 2019; 9:e028352. [PMID: 31377700 PMCID: PMC6687020 DOI: 10.1136/bmjopen-2018-028352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Outcome and comparator choice strongly determine the validity and implementation of clinical trial results. We aimed to assess outcome and comparator choice in intervention studies on molar incisor hypomineralisation (MIH) using systematic review and social network analysis (SNA). DESIGN AND DATA SOURCES Medline, Embase, Cochrane Central, Google Scholar, opengrey.eu as well as DRKS.de and Clinicaltrials.gov were searched for MIH intervention studies. The search covered the period from 1980 to 2019. ELIGIBILITY CRITERIA Clinical single-arm/multiarm, controlled/uncontrolled studies reporting on the management of MIH were included. Reported outcomes and comparators were extracted and categorised. SNA was used to evaluate comparator choice and the resulting trial networks. DATA EXTRACTION Of the 7979 identified records, 100 were evaluated in full text and 35 studies (17 randomised controlled trials, 14 prospective and 4 retrospective cohort studies) were included. RESULTS In total, 2124 patients with a mean age of 11 years (min/max 6/70 years) were included. Outcomes fell in one of 11 different outcome categories: restoration success, aesthetic improvement, pain/hypersensitivity/discomfort, mineral gain, space management, anaesthesia effectiveness, preventive success, efficiency, quality of life, gingival and periodontal health and patient satisfaction. Comparators were mainly restorative interventions (17 studies), remineralisation (3), treatment of hypersensitivity (10), aesthetic interventions (5) and orthodontic interventions (3). Two highly clustered comparator networks emerged; many interventions were not robustly linked to these networks. CONCLUSIONS MIH intervention studies recorded both clinically centred and patient-centred outcomes. Core outcome set development should consider these and supplement them with outcomes on, for example, applicability. The high number of compared interventions tested in only few studies and our SNA results implicate that the current evidence may not be robust.
Collapse
Affiliation(s)
- Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
16
|
da Cunha Coelho ASE, Mata PCM, Lino CA, Macho VMP, Areias CMFGP, Norton APMAP, Augusto APCM. Dental hypomineralization treatment: A systematic review. J ESTHET RESTOR DENT 2018; 31:26-39. [PMID: 30284749 DOI: 10.1111/jerd.12420] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/08/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. OBJECTIVE To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. MATERIALS AND METHODS PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. RESULTS From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. CONCLUSIONS Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). CLINICAL SIGNIFICANCE Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.
Collapse
Affiliation(s)
- Ana Sofia Estima da Cunha Coelho
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,iCBR, Coimbra Institute of Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Carolina Alves Lino
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | | | | | | |
Collapse
|