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Cardoso-Silva L, Vicioni-Marques F, de Paula-Silva FWG, de Freitas BN, Nelson-Filho P, Tirapelli C, de Carvalho FK. Comparison between intraoral scanning and direct visual analysis for the assessment of developmental defects of enamel. J Dent 2023; 137:104677. [PMID: 37604397 DOI: 10.1016/j.jdent.2023.104677] [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: 03/24/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE To compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE). METHODS Thirty-nine extracted permanent human teeth with DDE were selected by an experienced examiner and digitised using IOS. The scanning was recorded using the OBS Studio software parallel to the IOS software to obtain a coloured high-definition MP4 file of the process. Two other experienced, blinded, and calibrated examiners randomly analysed the same teeth through DVA and IOS. A third examiner resolved any disagreements between the two examiners. Descriptive statistics were used to analyse the frequencies of the scores. Cohen's kappa test was used to determine whether the DVA scores were different from those assigned using IOS. Spearman's test was used to verify non-random examiner errors. The Chi-square test was used to compare score frequencies. Statistical significance was set at p <0.05. RESULTS Scores indicating more severe and extended DDE (p <0.05) were more frequently assigned with IOS than with DVA (IOS: 25.64%, 25.64%, 38.46%, and 35.90% between one-third to two-third of the lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 10.26%, 7.69%, 15.38%, and 10.26% for the respective aforementioned tooth surfaces). Contrarily, 'no visible enamel defect' was significantly less assigned for IOS than for DVA (IOS: 15.38%, 43.59%, 35.90%, 15.38%, and 17.95% for buccal, lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 38.46%, 66.67%, 56.41%, 51.28%, and 43.59% for the respective aforementioned tooth surfaces). Kappa agreement ranged from fair to moderate when comparing DVA and IOS; the correlation between both methods was positive, indicating that the examiners assigned the scores properly and the differences arose from employing different methods. CONCLUSION The assessment of DDE differed depending on the method used. IOS scores indicated more severe and extended DDE than DVA scores. Clinical investigation is the next step in validating the use of IOS for DDE diagnosis. CLINICAL SIGNIFICANCE This study showed that DDE can be assessed differently using IOS. It is clinically relevant as it directly affects the determination of the severity of the defect and dental treatment planning.
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Affiliation(s)
- Lana Cardoso-Silva
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | - Fernanda Vicioni-Marques
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | | | - Bruna Neves de Freitas
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Ribeirão Preto, São Paulo 14040-904, Brazil
| | - Paulo Nelson-Filho
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
| | - Camila Tirapelli
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Ribeirão Preto, São Paulo 14040-904, Brazil.
| | - Fabrício Kitazono de Carvalho
- University of São Paulo, School of Dentistry of Ribeirão Preto, Department of Pediatric Dentistry, Ribeirão Preto, SP 14040-904, Brazil
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Olczak-Kowalczyk D, Krämer N, Gozdowski D, Turska-Szybka A. Developmental enamel defects and their relationship with caries in adolescents aged 18 years. Sci Rep 2023; 13:4932. [PMID: 36973358 PMCID: PMC10042880 DOI: 10.1038/s41598-023-31717-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Randomly selected 1,611 individuals aged 18 years formed a nationally representative sample from all provinces of Poland. Developmental defects of the enamel (DDE) and caries were assessed using the modified DDE index, molar incisor hypomineralisation (MIH) Treatment Need Index (MIH-TNI), FDI and WHO criteria by 22 trained and calibrated dentists. T-test was used for comparing group means. A simple and multiple logistic regression tests were used to assess the relationship between DDE and caries severity expressed as DMFT (p < 0.05). The prevalence of DDE was 13.7%. Demarcated opacities (DEO) were the most frequent (9.65%); 4% had diffuse opacities (DIO) and 1.5% had hypoplasia. MIH was diagnosed in 0.6% patients. The prevalence of caries was 93.2%, with mean DMFT of 6.50 ± 4.22. The DMFT value was 7.52 ± 4.77 in the group of patients with demarcated opacities (DEO); 7.85 ± 4.74 with diffuse opacities (DIO) and 7.56 ± 4.57 with enamel hypoplasia, respectively. There was a significant relationship between caries severity and DDE (p < 0.001), DEO (p = 0.001) and DIO (p = 0.038), and between DDE and DMFT index (p < 0.001). The results obtained in the study proved the significant relationship between DDE and DMFT in 18-year-olds, the assessment of which was the aim of the study.
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Affiliation(s)
- Dorota Olczak-Kowalczyk
- Department of Paediatric Dentistry, Medical University of Warsaw, Binieckiego 6 St, 02-097, Warsaw, Poland
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - Dariusz Gozdowski
- Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Science, Nowoursynowska 166, 02-787, Warsaw, Poland
| | - Anna Turska-Szybka
- Department of Paediatric Dentistry, Medical University of Warsaw, Binieckiego 6 St, 02-097, Warsaw, Poland.
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Molar-Incisor Hypomineralization: Prevalence Comparative Study in 6 Years of Interval. ScientificWorldJournal 2022; 2022:4743252. [DOI: 10.1155/2022/4743252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to evaluate the prevalence evolution rate of MIH (molar-incisor hypomineralization) after a 6-year period in Araraquara/SP, Brazil. This population-based study evaluated MIH in 545 schoolchildren (6–12 years of age) and other associated alterations, dental caries and dental fluorosis (DF). A semistructured questionnaire was sent to the schoolchildren’s parents/guardians with the purpose of identifying the socioeconomic profile. Associations between MIH and the clinical characteristics were analyzed by the Poisson analysis of regression with robust variance, estimating the RPc (crude prevalence ratio) with CI 95%. The level of significance of 5% was adopted. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n = 78), and at this time, an increase of 2% was observed, in comparison with the data of the first prevalence study conducted in 2010 (12.3%). The mild degree compromise was the most prevalent diagnosis in the affected teeth (82.0%). Among children with MIH, the mean number of affected teeth was 2.78. Of the total number of children with MIH, 32.0% presented alterations in both first permanent molars and permanent incisors. There is no significant association between MIH and dental caries experience on permanent dentition (PRc = 1.141; CI 95% 0.709–1.835) or on primary dentition (PRc = 1.132; CI 95% 0.749–1.709). Children with MIH presented significantly less prevalence of dental fluorosis (PRc = 0.505; CI 95% 0.268–0.950). There is no association between MIH and monthly Brazilian minimal wage income (PRc = 1.130; CI 95% 0.655–1.949). It was concluded that the number of MIH cases had increased, revealing a greater need for defining the etiological factors and establishing a correct diagnosis to make it possible to institute early intervention.
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Amarante BC, Arima LY, Pinheiro E, Carvalho P, Michel-Crosato E, Bönecker M. Diagnosis training and calibration for epidemiological studies on primary and permanent teeth with hypomineralization. Eur Arch Paediatr Dent 2022; 23:169-177. [PMID: 34990003 DOI: 10.1007/s40368-021-00686-3] [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: 12/01/2020] [Accepted: 12/13/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE The objective of this study was to assess the impact on diagnostic accuracy and Kappa values improvement during the three-phase training and calibration process for MIH/HSPM. METHODS Thirty dentists were calibrated as examiners for diagnosis of Molar Incisor Hypomineralization (MIH) using Ghanim's index. The whole process was divided into three phases. Phase 1: three meetings with the dentists for the first diagnosis training and calibration (sessions 1a and 1b); phase 2: for a period of 1 month, the dentists started practicing MIH/HSPM diagnosis in the Basic Health Units and an online follow-up group was created to discuss cases and resolve doubts; phase 3: two meetings with the dentists for the second calibration (sessions 2a and 2b). A webpage with educational material was prepared as support during the whole process to improve the dentists' skills in diagnosing MIH/HSPM. The examiners' responses were compared to a gold standard and the Kappa value was obtained. RESULTS The average clinical criteria kappa value of the examiners was 0.76 ± 0.19 for the first calibration and 0.93 ± 0.07 (p < 0.05) for the second calibration. For the eruption criteria, the average kappa value was 0.89 ± 0.14 for the first calibration and 0.98 ± 0.08 for the second calibration. Extension criteria had an average kappa value of 0.59 ± 0.15 during the first calibration and 0.75 ± 0.14 during the second calibration. CONCLUSION This study demonstrated that the methodology used was an effective tool for improving the diagnostic accuracy of MIH/HSPM.
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Affiliation(s)
- Bruna Cordeiro Amarante
- Department of Orthodontics and Pediatric Dentistry, Dental School, University of São Paulo (USP), São Paulo, Brazil.
| | - Letícia Yumi Arima
- Department of Orthodontics and Pediatric Dentistry, Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Emanuella Pinheiro
- Department of Orthodontics and Pediatric Dentistry, Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Patricia Carvalho
- Department of Orthodontics and Pediatric Dentistry, Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Edgard Michel-Crosato
- Department of Public Health, Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Marcelo Bönecker
- Department of Orthodontics and Pediatric Dentistry, Dental School, University of São Paulo (USP), São Paulo, Brazil
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Humphreys J, Jarad F, Albadri S. Management of molar-incisor hypomineralisation by general dental practitioners - part one: diagnosis. Br Dent J 2021:10.1038/s41415-021-2735-3. [PMID: 33762697 DOI: 10.1038/s41415-021-2735-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022]
Abstract
Introduction Molar-incisor hypomineralisation (MIH) affects one in six children in the UK. For the majority of patients who have mild MIH, this should be managed in primary care.Aims To assess UK-based general dental practitioners' (GDPs) ability to diagnose MIH when presented with multiple clinical vignettes.Design An electronic vignette survey was designed with use of clinical photographs - six cases had MIH and/or hypomineralised second primary molars (HSPMs) (seven possible diagnoses). Four control cases showing caries, fluorosis, amelogenesis imperfecta and dentinogenesis imperfecta were also included. Participants were UK-based GDPs. The survey was distributed by email and across social media platforms. Data collection occurred between February and May 2019.Results Seventy-six GDPs completed the survey; 68.4% (n = 52) of participants were female and 83% (n = 63) of participants graduated after the year 2000. The number of accurate diagnoses for each case were as follows - mild MIH (molars/incisors) 65.79%; mild MIH (molars only) 3.95%; HSPM and MIH (HSPM result) 0%; HSPM and MIH (MIH result) 50%; severe MIH (post-eruptive breakdown) 63.16%; severe MIH (caries) 31.58%; HSPM 3.95%.Conclusion GDPs are able to accurately diagnose MIH best when both incisors and molars are affected and caries is not present.
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Affiliation(s)
- Judith Humphreys
- University of Liverpool, Paediatric Dentistry, Pembroke Place, Liverpool, L3 5PS, UK.
| | - Fadi Jarad
- University of Liverpool, Restorative Dentistry, Liverpool, L3 5PS, UK
| | - Sondos Albadri
- University of Liverpool, Paediatric Dentistry, Pembroke Place, Liverpool, L3 5PS, UK
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Kevrekidou A, Kosma I, Kotsanos I, Arapostathis KN, Kotsanos N. Enamel opacities in all other than Molar Incisor Hypomineralisation index teeth of adolescents. Int J Paediatr Dent 2021; 31:270-277. [PMID: 33002247 DOI: 10.1111/ipd.12735] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/28/2020] [Accepted: 09/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND There are scarce data on the hypomineralisation of other permanent teeth (HOPT) than the index teeth of Molar Incisor Hypomineralisation (MIH). AIM To report on the prevalence and surface pattern of HOPT and seek associations with MIH. DESIGN Representative samples of urban Greek 14-year-olds were examined in classroom with a dental mirror. Their enamel defects were recorded using EAPD criteria for MIH. Descriptive statistics and correlation tests for HOPT vs previously reported MIH findings in the same samples were applied. RESULTS HOPT prevalence in 1156 consented adolescents was 22.9%. 148 (16.2%) of 912 no-MIH children had HOPT; 117 (48.1%) of the 244 MIH children had HOPT too (OR 3.0, 95% CI 2.4-3.6). There were more HOPT teeth per child in the MIH vs no-MIH children (P < .001). HOPT tooth frequency was as follows: second molar 33.7%, canine 25.7%, first premolar 23.6%, and second premolar 17.0%. Enamel breakdown was seen in 5.3% HOPT children. Vestibular to intraoral surface defect ratio differed between jaws (maxilla 187/88, mandible 149/17, P < .05). CONCLUSIONS Hypomineralisation defects in the MIH non-index teeth collectively had comparable prevalence and tooth surface patterns to MIH, but much lower severity. MIH was predictor for HOPT.
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Affiliation(s)
- Aikaterini Kevrekidou
- Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ismini Kosma
- Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kotsanos
- School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Kotsanos
- Department of Paediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Structural and chemical enamel characteristics of hypomineralised second primary molars. Eur Arch Paediatr Dent 2020; 22:361-366. [DOI: 10.1007/s40368-020-00557-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/19/2020] [Indexed: 01/23/2023]
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Vlachou C, Arhakis A, Kotsanos N. Distribution and morphology of enamel hypomineralisation defects in second primary molars. Eur Arch Paediatr Dent 2020; 22:241-246. [DOI: 10.1007/s40368-020-00543-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/02/2020] [Indexed: 12/01/2022]
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Abstract
Oral diseases are pathologic conditions that affect oral and maxillofacial tissues. Dental caries and periodontal diseases are the most common forms of oral diseases, but there are a wide variety of diseases that can occur in oral and maxillofacial tissues. These oral diseases range from metabolic, inflammatory, infectious, neoplastic, autoimmune, developmental, to idiopathic origin. Numerous oral conditions have overlapping clinical signs and symptoms, which make the diagnosis and management challenging for the dentist. However, a comprehensive understanding of clinical behavior will help in differentiating the various oral diseases and will provide a logical pathway to formulating a diagnosis.
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