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Pousette Lundgren G, Dahllöf G. Advances in clinical diagnosis and management of amelogenesis imperfecta in children and adolescents. J Dent 2024; 147:105149. [PMID: 38909645 DOI: 10.1016/j.jdent.2024.105149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVE To summarize studies published between 2017 and 2023 examining the clinical diagnosis and restorative management of amelogenesis imperfecta (AI) in children and adolescents. DATA The review incorporated publications on clinical diagnosis, patient-reported outcomes, clinical trials, cohort studies, and case reports that included individuals below 19 years of age with non-syndromic AI. SOURCES A literature search was conducted across electronic databases, PubMed, Web of Science, and CINAHL, including papers published between 2017 and 2023. The search yielded 335 unique results, of which 38 were eligible for inclusion. RESULTS New evidence on the genetic background of AI makes it now advisable to recommend genetic testing to supplement a clinical AI diagnosis. The discussions of the dental profession and the public on social media do not always incorporate recent scientific evidence. Interview studies are finding that the impact of AI on quality of life is more severe than previously appreciated. New evidence suggests that single-tooth ceramic crowns should be the first choice of treatment. Due to incomplete reporting, case reports have been of limited value. CONCLUSION In young patients with AI symptoms of pain and hypersensitivity decreased, and aesthetics were improved following all types of restorative therapy. Resin composite restorations were mainly performed in cases with hypoplastic AI and mild symptoms. Single tooth ceramic crown restorations have a high success rate in all types of AI and can be used in young individuals with AI. CLINICAL SIGNIFICANCE Prosthetic rehabilitation in adolescents with severe AI is cost effective, improves esthetics, reduces tooth sensitivity, and improves oral health-related quality of life.
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Affiliation(s)
- Gunilla Pousette Lundgren
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, POB 4064 SE-141 04 Huddinge, Sweden
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, POB 4064 SE-141 04 Huddinge, Sweden; Center for Oral Health Services and Research, Mid-Norway, TkMidt, Professor Brochs gt. 2 7030 Trondheim, Norway.
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Shields S, Chen T, Crombie F, Manton DJ, Silva M. The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review. Healthcare (Basel) 2024; 12:370. [PMID: 38338255 PMCID: PMC10855782 DOI: 10.3390/healthcare12030370] [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: 01/04/2024] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children's oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA.
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Affiliation(s)
- Stephanie Shields
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Inflammatory Origins, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Royal Children’s Hospital Melbourne, Melbourne, VIC 3052, Australia
| | - Tong Chen
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia;
| | - Felicity Crombie
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
| | - David J. Manton
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Centrum voor Tandheelkunde en Mondzorgkunde, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Mihiri Silva
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia; (S.S.); (D.J.M.)
- Inflammatory Origins, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Royal Children’s Hospital Melbourne, Melbourne, VIC 3052, Australia
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Geiken A, Banz L, Kock M, Schwendicke F, Graetz C. Does information about MIH on dental homepages in Germany offer high quality? A systematic search and analysis. Eur Arch Paediatr Dent 2024; 25:127-135. [PMID: 38300412 PMCID: PMC10942881 DOI: 10.1007/s40368-023-00857-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE The internet is increasingly used to seek health information. A dental condition of increasing concern and public interest is molar incisor hypomineralisation (MIH), why we evaluated the information quality of German dentists 'websites on the topic of MIH. METHODS A systematic search was performed by two independent investigators using three search engines. The information content of websites on MIH and technical, functional aspects, overall quality, and risk of bias were assessed using validated instruments (LIDA, DISCERN). Practice-related characteristics (practice type, specialization, setting, number and mean age of dentists) were recorded, and associations of these characteristics with websites' overall quality were explored using multivariable linear regression modelling. RESULTS 70 sites were included. 52% were multipractices in urban areas (49%). The most common age group was middle-aged individuals (41-50 years). The average number of dentists/practice was 2.5. The majority met more than 50% of the DISCERN and LIDA criteria (90%, 91%). The MIH definition was frequently used (67%), MIH symptoms were described (64%), and 58% mentioned therapies. The prevalence of MIH was mentioned less frequently (48%). MIH example photographs were rarely shown (14%). In multivariable analysis, most practice-related factors were not significant for overall site quality. Only chain practices had slightly higher quality in this regard (2.2; 95% CI of 0.3-4.1). CONCLUSIONS MIH is mentioned on a large proportion of dentists' websites. Overall technical, functional, and generic quality was high. Risk of bias is limited. While most websites provided a basic definition of MIH and its symptoms, important information for patients was missing.
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Affiliation(s)
- A Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - L Banz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - M Kock
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - F Schwendicke
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Sekundo C, Jung M, Muscholl C, Frese C. Oral health-related quality of life and survival analysis after preventive and restorative treatment of molar-incisor hypomineralisation. Sci Rep 2024; 14:777. [PMID: 38191504 PMCID: PMC10774292 DOI: 10.1038/s41598-024-51223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Abstract
The aim of this study was to assess the impact of molar-incisor hypomineralisation (MIH) on oral health-related quality of life (OHRQoL) in children and adolescents, including information on restorative care, tooth sensitivity, as well as sociodemographic factors. Thirty-five patients aged between 7 and 17 years underwent a comprehensive oral examination. Severity of MIH was graded using the MIH Treatment Need Index (MIH-TNI), OHRQoL using the Child Oral Health Impact Profile (COHIP-19). Clinical quality of restorations was assessed according to modified FDI-criteria, tooth sensitivity using the Schiff Cold Air Sensitivity Scale (SCASS). The mean age was 11.3 ± 3.0 years, 34% were female. On average, 6.9 ± 2.8 teeth were affected, 62,9% had hypersensitive teeth (SCASS ≥ 1). Eighty-nine percent of patients had received restorative care, with a mean of 3.3 ± 2.1 teeth restored, most often with composite, followed by fissure sealing. Nine percent of restorations failed by the FDI-criteria. Mean estimated survival times for success were 4.9 years (95% CI 3.5; 6.2) and 5.6 years (95% CI 5.0; 6.3) for fissure sealants and composite restorations, respectively. The mean COHIP-19 score was 64.3 ± 8.2 (max. possible score = 76). A higher severity of MIH-TNI correlated significantly with impaired OHRQoL (rs = - 0.38, p = 0.013). However, this was not mirrored in multiple regression analysis. Despite the high rate of restorative treatment with an acceptable failure rate, OHRQoL is reduced in children with MIH. Many teeth affected by MIH remain sensitive. Further studies are needed to assess the benefits of different restorative options.
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Affiliation(s)
- Caroline Sekundo
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Marina Jung
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Clara Muscholl
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Cornelia Frese
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Bekes K, Steffen R, Krämer N. Update of the molar incisor hypomineralization: Würzburg concept. Eur Arch Paediatr Dent 2023; 24:807-813. [PMID: 37856065 PMCID: PMC10657291 DOI: 10.1007/s40368-023-00848-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index-the MIH Treatment Need Index (MIH-TNI)-and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice. METHODS The authors reviewed the available literature, including clinical and laboratory studies and published guidelines. RESULTS The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction. CONCLUSIONS This is intended to help guide the practitioner and will need to be further validated by clinical trials.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Paediatric Dentistry, Justus Liebig University, Giessen, Germany
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