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Amend S, Stork S, Lücker S, Seipp A, Gärtner U, Frankenberger R, Krämer N. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dent Mater 2024; 40:1015-1024. [PMID: 38744567 DOI: 10.1016/j.dental.2024.05.010] [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: 12/25/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES This in vitro pilot study aimed to evaluate whether different pre-treatments (demineralization, deproteinization, (chemo-)mechanical reduction of the surface layer) influence the penetration depth of a resin infiltrant into MIH-affected enamel compared to initial carious lesions. METHODS Thirty extracted human permanent molars with non-cavitated initial carious lesions (n = 5) or MIH (n = 25) were chosen and randomly assigned to six experimental groups: IC: initial caries; M: MIH; MN: MIH, 5.25% sodium hypochlorite; MM: MIH, microabrasion; MA: MIH, air abrasion; MAN: MIH, air abrasion and 5.25% sodium hypochlorite. A modified indirect dual fluorescence staining method was adopted to assess the penetration depth (PD) of the resin infiltrant and the lesion depth (LD) by confocal laser scanning microscopy (CLSM). Exemplarily, scanning electron microscopic (SEM) images were captured. The relationship between group assignment and penetration/lesion depth was estimated using a linear mixed model incorporating the tooth as random effect (two observations/tooth). The significance level was set at p < 0.05. RESULTS For MIH-affected molars, the mean PD (in µm; median, [minimum-maximum]) were M (178.2 [32.5-748.9]), MN (275.6 [105.3-1131.0]), MM (48.7 [0.0-334.4]), MA (287.7 [239.4-491.7]), and MAN (245.4 [76.1-313.5]). Despite the observed differences in PD between the groups, these could not be statistically verified (Bonferroni, p = 0.322). The percentage penetration was significantly higher for IC than for MIH groups (Bonferroni, p < 0.05). SIGNIFICANCE Compared to IC, resin infiltration into MIH-affected enamel ist more variable. Different pre-treatments influence the resin penetration into developmentally hypomineralized enamel to a fluctuating level.
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Affiliation(s)
- Stefanie Amend
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Stephan Stork
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Susanne Lücker
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
| | - Anika Seipp
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Ulrich Gärtner
- Institute of Anatomy and Cell Biology, Justus-Liebig-University Giessen, Aulweg 123, 35392 Giessen, Germany.
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Marburg), Philipps-University Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany.
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg (Campus Giessen), Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany.
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Rexhaj F, Sabel N, Robertson A, Lundgren T. Proteomic profiling of human dental enamel affected by molar incisor hypomineralisation of different clinical severity grades: an in vitro study. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00911-9. [PMID: 38842758 DOI: 10.1007/s40368-024-00911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/13/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE The aim of this study was to explore the potential to profile and distinguish varying clinical severity grades of MIH, compared to normal enamel, using proteomics. METHODS Liquid chromatography-mass spectrometry analyses were conducted on enamel samples of extracted teeth, from 11 children and adolescents, spanning an age range of 6-18 years. Enamel powder samples were collected from extracted, third molars (n = 3) and first permanent molars diagnosed with MIH (n = 8). The MIH tooth samples were categorized into subgroups based on clinical severity grade. The data were statistically analyzed using ANOVA and Welch's t test. RESULTS Teeth affected by MIH exhibited a diverse array of proteins, each with different functions related to dental enamel, distinguishing them from their normal enamel counterparts. The application of microdissection combined with LC-MS techniques has revealed the potential to discern unique proteomic profiles among MIH-affected teeth, characterized by varying clinical severity grades. Both analyzed MIH groups displayed consistent trends in the presentation of biological processes, including underabundance of proteins primarily associated with cell organization and biogenesis. Furthermore, proteins linked to cell death were overabundant in both MIH groups. CONCLUSION Proteomics enabled the detection and differentiation of various proteins across different clinical severity grades of MIH.
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Affiliation(s)
- F Rexhaj
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, P. O. Box 450, 40530, Göteborg, Sweden.
| | - N Sabel
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, P. O. Box 450, 40530, Göteborg, Sweden
| | - A Robertson
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, P. O. Box 450, 40530, Göteborg, Sweden
| | - T Lundgren
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, P. O. Box 450, 40530, Göteborg, Sweden
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Tynior W, Świętek A, Hudy D, Ilczuk-Rypuła D, Strzelczyk JK. Molecular Detection of HPV, EBV, HSV-1, HCMV, and H. pylori Pathogens: An Evaluation among Polish Children with Molar Incisor Hypomineralization (MIH). Pathogens 2024; 13:345. [PMID: 38668300 PMCID: PMC11054144 DOI: 10.3390/pathogens13040345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
Molar incisor hypomineralization (MIH) is a congenital disorder of the enamel tissue, characterized by a quantitative deficiency. In childhood, infections such as EBV, HSV-1, HCMV, or H. pylori may occur and cause various diseases. This study aimed to investigate the prevalence of HPV, EBV, HSV-1, HCMV, and H. pylori infections in two groups of children: children with molar incisor hypomineralization (MIH) and a control group, using molecular methods. The study group included 47 children aged between 6-13 years who had been diagnosed with MIH. The control group consisted of 42 children. The study found that, in the MIH group, the prevalence of HPV-16 was 6.38%, HPV-18 was 4.26%, EBV was 31.91%, HSV-1 was 4.26%, HCMV was 4.26%, and H. pylori was 12.77%. There were no significant differences in the prevalence of any of tested pathogens between the study and the control group (p > 0.05). However, the study found a higher prevalence of EBV infection in children who had smallpox/pneumonia by the age of 3 years. Ten children were found to have at least two pathogens present. Moreover, both groups had a high prevalence and activity of EBV. These findings provide new insights into the carriage of pathogens among children with MIH, providing new information for parents, scientists, and healthcare professionals.
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Affiliation(s)
- Wojciech Tynior
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Agata Świętek
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
- Silesia LabMed Research and Implementation Centre, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Dorota Hudy
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Danuta Ilczuk-Rypuła
- Department of Pediatric Dentistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 2 Traugutta Sq, 41-800 Zabrze, Poland
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
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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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Alghawe S, Raslan N. Management of permanent incisors affected by Molar-Incisor-Hypomineralisation (MIH) using resin infiltration: a pilot study. Eur Arch Paediatr Dent 2024; 25:105-116. [PMID: 38285169 DOI: 10.1007/s40368-024-00861-2] [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: 12/13/2022] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To compare the aesthetic improvement of Molar-Incisor-Hypomineralisation (MIH) opacities treated by applying Icon-Etch for three cycles with the opacities treated by Icon-Etch for once, in the course of resin infiltration technique. METHODS Thirty incisors were sorted based on the colour of the opacities and then distributed according to the number of Icon-Etch cycles using a randomisation table into the groups: (1) White/Creamy one cycle, (2) White/Creamy three cycles, (3) Yellow/Brown one cycle, (4) Yellow/Brown three cycles. The primary outcomes of applying the resin infiltration to the opacities were compared amongst groups according to the parents' satisfaction, the amount of coverage, and the colour matching with the surrounding sound enamel. The stability of the results after 3 months was evaluated using a spectrophotometer. RESULTS The colour of the opacity pre-treatment affected the outcomes significantly (p < 0.05), compared according to the method of application (p > 0.05) in terms of parents' satisfaction. Whilst the multiple applications for Icon-Etch cycles showed more coverage amount in White/Creamy opacities than the application ones (p < 0.05); in colour matching, there was no statistically significant difference between the two methods (p > 0.05). For yellow/brown opacities, some negative results occurred with the single Icon-Etch cycle. CONCLUSION In MIH opacities, it is possible to rely on the resin infiltration as a minimally invasive method to achieve acceptable results, especially with multiple Icon-Etch cycles applications in the white/creamy opacities. The colour stability has not been affected by either the colour of the opacity or the number of cycles.
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Affiliation(s)
- S Alghawe
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria.
| | - N Raslan
- Department of Paediatric Dentistry, Tishreen University, Lattakia, Syria
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Chun YHP, Tan C, Villanueva O, Colley ME, Quintanilla TJ, Basiouny MS, Hartel CA, Critchfield CS, Bach SBH, Fajardo RJ, Pham CD. Overexpression of ameloblastin in secretory ameloblasts results in demarcated, hypomineralized opacities in enamel. Front Physiol 2024; 14:1233391. [PMID: 38274050 PMCID: PMC10808694 DOI: 10.3389/fphys.2023.1233391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/01/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction: Developmental defects of the enamel manifest before tooth eruption and include amelogenesis imperfecta, a rare disease of underlying gene mutations, and molar-incisor hypomineralization (MIH), a prevalent disease in children originating from environmental and epigenetic factors. MIH enamel presents as the abnormal enamel marked by loss of translucency, demarcation between the healthy and affected enamel, and reduced mineral content. The pathophysiology of opaque, demarcated enamel lesions is not understood; however, the retention of enamel proteins in the matrix has been suggested. Ameloblastin (Ambn) is an enamel protein of the secreted calcium-binding phosphoproteins (SCPPs) critical for enamel formation. When the Ambn gene is mutated or deleted, teeth are affected by hypoplastic amelogenesis imperfecta. Methods: In this study, enamel formation in mice was analyzed when transgenic Ambn was overexpressed from the amelogenin promoter encoding full-length Ambn. Ambn was under- and overexpressed at six increasing concentrations in separate mouse lines. Results: Mice overexpressing Ambn displayed opaque enamel at low concentrations and demarcated lesions at high concentrations. The severity of enamel lesions increased starting from the inner enamel close to the dentino-enamel junction (DEJ) to span the entire width of the enamel layer in demarcated areas. Associated with the opaque enamel were 17-kDa Ambn cleavage products, a prolonged secretory stage, and a thin basement membrane in the maturation stage. Ambn accumulations found in the innermost enamel close to the DEJ and the mineralization front correlated with reduced mineral content. Demarcated enamel lesions were associated with Ambn species of 17 kDa and higher, prolonged secretory and transition stages, a thin basement membrane, and shortened maturation stages. Hypomineralized opacities were delineated against the surrounding mineralized enamel and adjacent to ameloblasts detached from the enamel surface. Inefficient Ambn cleavage, loss of contact between ameloblasts, and the altered basement membrane curtailed the endocytic activity; thus, enamel proteins remained unresorbed in the matrix. Ameloblasts have the ability to distinguish between Ambn concentration and Ambn cleavage products through finely tuned feedback mechanisms. The under- or overexpression of Ambn in murine secretory ameloblasts results in either hypoplastic amelogenesis imperfecta or hypomineralization with opaque or sharply demarcated boundaries of lesions, similar to MIH.
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Affiliation(s)
- Yong-Hee Patricia Chun
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Cell Systems and Anatomy, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Molecular Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Chunyan Tan
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Omar Villanueva
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Madeline E. Colley
- Department of Chemistry, University of Texas San Antonio, San Antonio, TX, United States
- Department of Biochemistry, Vanderbilt University, Nashville, TN, United States
- Mass Spectrometry Research Center, Vanderbilt University, Nashville, TN, United States
| | - Travis J. Quintanilla
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mohamed S. Basiouny
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Caldonia A. Hartel
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Cameron S. Critchfield
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Stephan B. H. Bach
- Department of Chemistry, University of Texas San Antonio, San Antonio, TX, United States
| | - Roberto J. Fajardo
- Department of Clinical and Applied Science Education, School of Osteopathic Medicine, University of the Incarnate Word, San Antonio, TX, United States
| | - Cong-Dat Pham
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States
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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.
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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
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Houari S, DeRocher K, Thuy TT, Coradin T, Srot V, van Aken PA, Lecoq H, Sauvage T, Balan E, Aufort J, Calemme M, Roubier N, Bosco J, Jedeon K, Berdal A, Joester D, Babajko S. Multi-scale characterization of Developmental Defects of Enamel and their clinical significance for diagnosis and treatment. Acta Biomater 2023; 169:155-167. [PMID: 37574156 DOI: 10.1016/j.actbio.2023.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
Developmental Defects of Enamel (DDE) such as Dental Fluorosis (DF) and Molar Incisor Hypomineralization (MIH) are a major public health problem. Their clinical aspects are extremely variable, challenging their early and specific diagnosis and hindering progresses in restorative treatments. Here, a combination of macro-, micro- and nano-scale structural and chemical methods, including, among others, Atom Probe Tomography recently applied on tooth enamel, were used to study and compare MIH, DF and healthy teeth from 89 patients. Globally, we show that DF is characterized by an homogenous loss of mineral content and crystallinity mainly disrupting outside layer of enamel, whereas MIH is associated with localized defects in the depth of enamel where crystalline mineral particles are embedded in an organic phase. Only minor differences in elemental composition of the mineral phase could be detected at the nanoscale such as increased F and Fe content in both severe DDE. We demonstrate that an improved digital color measurement of clinical relevance can discriminate between DF and MIH lesions, both in mild and severe forms. Such discriminating ability was discussed in the light of enamel composition and structure, especially its microstructure, organics presence and metal content (Fe, Zn). Our results offer additional insights on DDE characterization and pathogenesis, highlight the potentiality of colorimetric measurements in their clinical diagnosis and provide leads to improve the performance of minimally invasive restorative strategies. STATEMENT OF SIGNIFICANCE: Developmental Defects of Enamel (DDE) are associated to caries and tooth loose affecting billions of people worldwide. Their precise characterization for adapted minimally invasive care with optimized materials is highly expected. Here In this study, first we propose the use of color parameters measured by a spectrophotometer as a means of differential clinical diagnosis. Second, we have used state-of-the-art techniques to systematically characterize the structure, chemical composition and mechanical optical properties of dental enamel teeth affected by two major DDE, Dental Fluorosis (DF) or Molar Incisor Hypomineralization (MIH). We evidence specific enamel structural and optical features for DF and MIH while chemical modifications of the mineral nanocrystals were mostly correlated with lesion severity. Our results pave the way of the concept of personalized dentistry. In the light of our results, we propose a new means of clinical diagnosis for an adapted and improved restoration protocol for these patients.
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Affiliation(s)
- Sophia Houari
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Unité de Formation et de Recherche d'Odontologie, Université Paris Cité, APHP, Service d'Odontologie - Hôpital La pitié-Salpetrière, Paris, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France.
| | - Karen DeRocher
- Department of Materials Science and Engineering, Northwestern University, IL, USA
| | - Tran Thu Thuy
- Faculty of Odonto-stomatology, HochiMinh University of Medicine and Pharmacology, HôchiMinh Ville, Viet Nam
| | - Thibaud Coradin
- Laboratoire de Chimie de la Matière Condensée, Sorbonne Université, CNRS, Paris, France
| | - Vesna Srot
- Stuttgart Center for Electron Microscopy, Max Planck Institute for Solid State Research, Stuttgart, Germany
| | - Peter A van Aken
- Stuttgart Center for Electron Microscopy, Max Planck Institute for Solid State Research, Stuttgart, Germany
| | - Hélène Lecoq
- CNRS UPR3079, Université d'Orléans, Conditions Extrêmes et Matériaux: Haute Température et Irradiation, Orléans, France
| | - Thierry Sauvage
- CNRS UPR3079, Université d'Orléans, Conditions Extrêmes et Matériaux: Haute Température et Irradiation, Orléans, France
| | - Etienne Balan
- Sorbonne Université, CNRS, Institut de Recherche pour le Developpement, Museum National d'Histoire Naturelle, Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Paris, France
| | - Julie Aufort
- Sorbonne Université, CNRS, Institut de Recherche pour le Developpement, Museum National d'Histoire Naturelle, Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Paris, France
| | | | - Nicolas Roubier
- Laboratoire de Mécanique Paris-Saclay, CNRS, Centrale-Supélec, Université Paris-Saclay, Châtenay-Malabry, France
| | - Julia Bosco
- Unité de Formation et de Recherche d'Odontologie, Université Paris Cité, APHP, Service d'Odontologie - Hôpital La pitié-Salpetrière, Paris, France
| | - Katia Jedeon
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France
| | - Ariane Berdal
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France
| | - Derk Joester
- Department of Materials Science and Engineering, Northwestern University, IL, USA
| | - Sylvie Babajko
- Laboratoire de Pathophysiologie Orale Moleculaire, Centre de Recherche des Cordeliers, INSERM UMRS, Université Paris Cité, Sorbonne Université, Paris 1138, France; Fédération Hospitalo-Universitaire DDS-ParisNet, INSERM, Université Paris Cité, Assistance Publique-Hôpitaux de Paris, France; UR2496, Biomedical research in Odontology, Université Paris Cité, Montrouge, France
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Garot E, Lopez Onaindia D, Couture C, Morales JI, Cebrià A, Oms X, Manton DJ, Lozano M. Insights into molar-incisor hypomineralisation in past populations: A call to anthropologists. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 42:18-26. [PMID: 37523814 DOI: 10.1016/j.ijpp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/27/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Molar incisor hypomineralisation (MIH) is a developmental defect of enamel affecting the first permanent molars and often the incisors and affecting approximately 13% of the current population worldwide. Here, we aim to highlight potential differential diagnoses of MIH in archaeological collections (taphonomic discoloration, amelogenesis imperfecta, fluorosis, rachitic teeth, etc.). METHODS Causative factors of dental discolourations are identified through a literature review. RESULTS In an archaeological context, the sediments contained in the burial soil can lead to tooth discoloration. Taphonomic staining of the dentition may have a similar appearance to enamel hypomineralisation, and thus is a confounding factor that has the potential to cause miscalculation of the true prevalence of MIH within archaeological collections. Some rare medieval cases are reported in the modern literature but without microanalysis, misdiagnosis is possible. The aetiological factors of MIH are unknown but probably follow the multifactorial model involving systemic medical and genetic factors. CONCLUSIONS Systematic detection and diagnosis of MIH during anthropological studies is therefore of great interest. SIGNIFICANCE The hypotheses that only contemporary agents are causative factors of MIH could be refuted by the discovery of individuals living before medication or pollutants. The identification of MIH in a group of individuals also provides information regarding the health status of a population and reflects stress occurring during the period of mineralisation of the first permanent molars after secretion of the enamel matrix. LIMITATIONS Taphonomic alterations of archaeological remains prevent MIH diagnosis. SUGGESTIONS FOR FUTURE RESEARCH MIH diagnosis can be difficult in archaeological series and further non-destructive methods (microtomography, elemental analyses, etc.) are required.
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Affiliation(s)
- Elsa Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France; Univ. Bordeaux, CNRS, MCC, PACEA, UMR 5199, Pessac F-33600, France; Centre de Compétence des Maladies Rares Orales et Dentaires, CCMR O-Rares, C.H.U. de Bordeaux, Bordeaux, France.
| | | | | | - Juan Ignacio Morales
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Zona Educacional 4, Campus Sescelades URV (Edifici W3), Tarragona 43007, Spain; Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Avinguda de Catalunya 35, Tarragona 43002, Spain
| | - Artur Cebrià
- Department Història i Arqueologia, Seminari d'Estudis i Recerques Prehistòriques (SERP). Facultat de Geografia i Història, Universitat de Barcelona, C/ Montalegre 6-8, 08001 Barcelona, Spain
| | - Xavier Oms
- Department Història i Arqueologia, Seminari d'Estudis i Recerques Prehistòriques (SERP). Facultat de Geografia i Història, Universitat de Barcelona, C/ Montalegre 6-8, 08001 Barcelona, Spain
| | - David John Manton
- University of Groningen, University Medical Centre Groningen (UMCG), Cariology and Paediatric Dentistry, Centre for Dentistry and Oral Hygiene, the Netherlands; Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, the Netherlands
| | - Marina Lozano
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Zona Educacional 4, Campus Sescelades URV (Edifici W3), Tarragona 43007, Spain; Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Avinguda de Catalunya 35, Tarragona 43002, Spain
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10
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Biondi AM, Cortese SG, Babino L, Ortolani AM. Follow-up of first permanent molar restorative treatment with and without Molar Hypomineralization. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2022; 35:75-79. [PMID: 36260937 DOI: 10.54589/aol.35/2/75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/01/2022] [Indexed: 06/16/2023]
Abstract
Hypomineralization (MH) are controversial. The aim of this study was to compare need for treatment and status of restorations performed on first permanent molars in patients with and without MH. Retrospective design based on the clinical records of 153 patients who had received comprehensive care in 2014 at the Clinic of the Children's Comprehensive Dentistry Department (FOUBA) by 3 pediatric dentists (Kappa MH 0.94), and who attended periodical follow-up visits for at least 24 months. Need for treatment in first molars, and type and longevity of treatment were recorded (modified Ryge criteria /USPHS, Kappa 0.78). Results were compared between patients with MH and without MH. The Kruskal Wallis test was used to compare follow-up time, the asymptotic test was performed to compare proportions, and relative risk (RR) was calculated to compare need for treatment. Mean follow-up times for the 595 teeth analyzed were 61.7±20.1 months for Group without MH, and 57.5±23.9 months for Group with MH (p=0.0504). The percentages of teeth requiring at least one treatment were 7.2% in Group without MH and 27.5% in Group with MH (RR = 3.80, p <0.001). Of the teeth treated in Group with MH 23.1% required retreatment, while none of the teeth in Group without MH did. The need for treatment was approximately 4 times higher in molars affected with MH, with greater probability of retreatment.
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Affiliation(s)
- Ana M Biondi
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra Odontología Integral Niños, Buenos Aires, Argentina.
| | - Silvina G Cortese
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra Odontología Integral Niños, Buenos Aires, Argentina
| | - Lucía Babino
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra Odontología Integral Niños, Buenos Aires, Argentina
| | - Andrea M Ortolani
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra Odontología Integral Niños, Buenos Aires, Argentina
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11
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Analysis of Human and Microbial Salivary Proteomes in Children Offers Insights on the Molecular Pathogenesis of Molar-Incisor Hypomineralization. Biomedicines 2022; 10:biomedicines10092061. [PMID: 36140166 PMCID: PMC9495719 DOI: 10.3390/biomedicines10092061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
Molar incisor hypomineralization is a complex developmental enamel defect that affects the permanent dentition of children with significant functional and aesthetic implications. Saliva is an ideal diagnostic tool and ensures patients’ compliance by diminishing the discomfort especially in pediatric population. Lately, salivary proteome analysis has progressively evolved in various biomedical disciplines. As changes in saliva composition are associated with oral diseases, it is reasonable to assume that the saliva proteome of MIH-affected children might be altered compared to healthy children. This study analyzed the human and microbial salivary proteome in children with MIH in order to identify salivary markers indicative of the pathology. The conducted proteomic analysis generated a comprehensive dataset comprising a total of 1515 high confidence identifications and revealed a clear discrimination between the two groups. Statistical comparison identified 142 differentially expressed proteins, while the pathway analysis indicated deregulation of inflammation, immune response mechanisms, and defense response to bacteria in MIH patients. Bacterial proteome analysis showed a lower diversity for the microbial species, which highlights the dysbiotic environment established in the MIH pathology.
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12
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Athayde GDS, Reis PPGD, Jorge RC, Americano GCA, Fidalgo TKDS, Soviero VM. Impact of masking hypomineralization opacities in anterior teeth on the esthetic perception of children and parents: A randomized controlled clinical trial. J Dent 2022; 123:104168. [PMID: 35643218 DOI: 10.1016/j.jdent.2022.104168] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of treating demarcated opacities in anterior teeth on the esthetic perception of children and their parents. Additionally, the masking effect was evaluated quantitively and qualitatively. METHODS Thirty-nine patients, 8-18 years-old, presenting white-creamy opacity in permanent incisors were randomly allocated to test or control group. Test received resin infiltration and control received a placebo. The questionnaire Child's and Parent's Questionnaire about Teeth Appearance was used. The masking effect was quantitatively analyzed using the Lab System to calculate the color difference (ΔE) between the opacity and the surrounding enamel in Photoshop. Fisher's, Chi-square, Wilcoxon, Mann-Whitney tests and Spearman's correlation were applied to data analysis. RESULTS In the test group, a significant impact on physical and psychological domains in parents' and in social domain in parents' and children's perception was observed (p<0.05). Significant difference in ΔE between test and control groups was seen from 15 min of application onwards (p<0.05). After treatment, the mean ΔE was 4.07 (SD=3.07) in the test and 7.35 (SD=3.54) in the control group (p<0.01). One month later, the mean ΔE was 4.22 (SD=2.96) in the test and 6.06 (SD=2.52) in the control group (p<0.01). Total masking was seen only in the test group (p<0.01). CONCLUSION Aesthetic treatment of hypomineralization opacities in anterior teeth with resin infiltration impacted positively on parents and children. Resin infiltration reduced the color difference between opacities and sound enamel significantly after an application time of at least fifteen minutes. CLINICAL SIGNIFICANCE Opacities in anterior teeth impact the self-image of children and parents negatively. This study demonstrated that 15 min resin infiltration can mask opacities in permanent incisors and recover social wellbeing. This minimally invasive approach can be offered to MIH children who report dissatisfaction with their incisors.
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Affiliation(s)
- Glaucia Dos Santos Athayde
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Serra dos Órgãos, Teresópolis, Brazil
| | - Patrícia Papoula Gorni Dos Reis
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil
| | - Roberta Costa Jorge
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil
| | | | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vera Mendes Soviero
- Department of Preventive and Community Dentistry, Dental School, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil; Dental School, Centro Universitário Arthur Sá Earp Neto, Petrópolis, Brazil.
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13
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Bussaneli DG, Vieira AR, Santos-Pinto L, Restrepo M. Molar-incisor hypomineralisation: an updated view for aetiology 20 years later. Eur Arch Paediatr Dent 2022; 23:193-198. [PMID: 34392496 DOI: 10.1007/s40368-021-00659-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The term Molar-Incisor Hypomineralisation (MIH) was introduced in 2001 by Weerheijm, Jälevik and Alaluusua, and describes a defect of systemic origin that affects one to four first permanent molars, often associated with permanent incisors. In the past 20 years, this definition dictated the work regarding MIH prevalence, associated risk factors, association with dental caries, impact on quality of life, and therapeutic options. PURPOSE In this report, we offer an updated and comprehensive view of MIH centred on the patient and the tooth. CONCLUSION MIH today is globally recognized as a potential public health problem and it is not a defect of purely systemic origin but rather a condition with complex aetiology that in some instances may be the result of gene-environmental interactions.
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Affiliation(s)
- D G Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - A R Vieira
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - L Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil
| | - M Restrepo
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia.
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14
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part II: Enamel White Spots, Cavitated Caries, and Bone Infection. Curr Osteoporos Rep 2022; 20:106-119. [PMID: 35156182 PMCID: PMC8930953 DOI: 10.1007/s11914-022-00723-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Compare noninfectious (part I) to infectious (part II) demineralization of bones and teeth. Evaluate similarities and differences in the expression of hard tissue degradation for the two most common chronic demineralization diseases: osteoporosis and dental caries. RECENT FINDINGS The physiology of demineralization is similar for the sterile skeleton compared to the septic dentition. Superimposing the pathologic variable of infection reveals a unique pathophysiology for dental caries. Mineralized tissues are compromised by microdamage, demineralization, and infection. Osseous tissues remodel (turnover) to maintain structural integrity, but the heavily loaded dentition does not turnover so it is ultimately at risk of collapse. A carious tooth is a potential vector for periapical infection that may be life-threatening. Insipient caries is initiated as a subsurface decalcification in enamel that is not detectable until a depth of ~400μm when it becomes visible as a white spot. Reliable detection and remineralization of invisible caries would advance cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- American Board of Orthodontics, Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- Translational Proteomics Laboratory, Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Melbourne, Victoria 3010 Australia
| | - Paul M. Schneider
- American Board of Orthodontics, Melbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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15
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Mukhtar U, Goyal A, Luthra-Guptasarma M, Gauba K, Kapur A, Thakur AK. Label-free quantitative proteomics reveals molecular correlates of altered biomechanical properties in molar incisor hypomineralization (MIH): an in vitro study. Eur Arch Paediatr Dent 2022; 23:179-191. [PMID: 35013981 DOI: 10.1007/s40368-021-00687-2] [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: 07/01/2021] [Accepted: 12/13/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Molar-incisor hypomineralization (MIH) is a qualitative developmental defect of enamel that affects first permanent molars with or without affecting permanent incisors. We aimed to carry out a quantitative proteomics-based study to compare and evaluate proteins in sound and MIH-affected enamel. MATERIALS AND METHODS Ten blocks each of the MIH-affected enamel and sound enamel were processed and prepared for LC-MS/MS analysis. Label-free quantitation was carried out to evaluate the differentially expressed proteins in the two groups of samples. RESULTS A significant increase in the number of proteins in MIH-affected enamel (50.3 ± 29.6) was observed compared to the sound enamel (21.4 ± 3.2). While proteins like collagens, α1-anti-trypsin, kallikrein-4 (KLK4), matrix metalloprotease-20 (MMP-20), alpha-2-macroglobulin, and alpha-2-HS-glycoprotein were upregulated in sound enamel, there was over-expression of albumin, calcium-binding proteins, anti-thrombin III, and dentin sialophosphoprotein (DSPP), along with proteins implicated in stress response and inflammatory processes in MIH. CONCLUSION We propose that altered biomechanical properties of the enamel in MIH samples arise due to (i) down-regulation of proteins contributing to collagen biosynthesis and fibril formation; (ii) an overall imbalance in required levels of proteases (KLK4 and MMP-20) and anti-proteases (anti-thrombin-III which inhibits KLK-4), essential for optimal mineralization; (iii) very low levels of alpha-2-macroglobulin with important consequences in enamel mineralization and amelogenesis; and (iv) increased albumin in MIH, preventing proper growth of hydroxyapatite crystals. Increased inflammatory component was also seen in MIH; however, whether inflammation is a cause or consequence of the poor mineralization process needs to be assessed.
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Affiliation(s)
- U Mukhtar
- 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.
| | - M Luthra-Guptasarma
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gauba
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Kapur
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A K Thakur
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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16
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Hubbard MJ, Mangum JE, Perez VA, Williams R. A Breakthrough in Understanding the Pathogenesis of Molar Hypomineralisation: The Mineralisation-Poisoning Model. Front Physiol 2022; 12:802833. [PMID: 34992550 PMCID: PMC8724775 DOI: 10.3389/fphys.2021.802833] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Popularly known as "chalky teeth", molar hypomineralisation (MH) affects over 1-in-5 children worldwide, triggering massive amounts of suffering from toothache and rapid decay. MH stems from childhood illness and so offers a medical-prevention avenue for improving oral and paediatric health. With a cross-sector translational research and education network (The D3 Group; thed3group.org) now highlighting this global health opportunity, aetiological understanding is urgently needed to enable better awareness, management and eventual prevention of MH. Causation and pathogenesis of "chalky enamel spots" (i.e., demarcated opacities, the defining pathology of MH) remain unclear despite 100 years of investigation. However, recent biochemical studies provided a pathomechanistic breakthrough by explaining several hallmarks of chalky opacities for the first time. This article outlines these findings in context of previous understanding and provides a working model for future investigations. The proposed pathomechanism, termed "mineralisation poisoning", involves localised exposure of immature enamel to serum albumin. Albumin binds to enamel-mineral crystals and blocks their growth, leading to chalky opacities with distinct borders. Being centred on extracellular fluid rather than enamel-forming cells as held by dogma, this localising pathomechanism invokes a new type of connection with childhood illness. These advances open a novel direction for research into pathogenesis and causation of MH, and offer prospects for better clinical management. Future research will require wide-ranging inputs that ideally should be coordinated through a worldwide translational network. We hope this breakthrough will ultimately lead to medical prevention of MH, prompting global health benefits including major reductions in childhood tooth decay.
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Affiliation(s)
- Michael J Hubbard
- Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, VIC, Australia.,Melbourne Dental School, The University of Melbourne, Parkville, VIC, Australia
| | - Jonathan E Mangum
- Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, VIC, Australia
| | - Vidal A Perez
- Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, VIC, Australia.,Department of Pediatric Stomatology, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Rebecca Williams
- Department of Pharmacology & Therapeutics, The University of Melbourne, Parkville, VIC, Australia.,Melbourne Dental School, The University of Melbourne, Parkville, VIC, Australia
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Extraction of first permanent molars severely affected by molar incisor hypomineralisation: a retrospective audit. Eur Arch Paediatr Dent 2022; 23:89-95. [PMID: 34170497 PMCID: PMC8927005 DOI: 10.1007/s40368-021-00647-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/08/2021] [Indexed: 12/16/2022]
Abstract
AIM The aim of this study was to evaluate possible spontaneous space closure after extraction of first permanent molars in children and their eventual need for orthodontic treatment. METHODS Twenty-seven children with at least one first permanent molar planned for extraction were enrolled in the study. The children were referred to the Department of Paediatric Dentistry, University of Oslo, between 2009 and 2017. All extracted teeth were severely affected by Molar Incisor Hypomineralisation and/or caries. The children and their parents had consented to extraction and follow-up. Data were analysed with SPSS 26. RESULTS The age of the children was between 5.5 and 12.1 years (mean 8.7) at extraction. The mean follow-up time was 3.2 years (range 1.1-6.3). Sixteen children (59.3%) had all four molars extracted, five (18.5%) had three, five had two and one had one molar extracted. In the maxilla, the second permanent molar had erupted in the place of the first molar in all the children, and none of them needed orthodontic space closure. In the mandible, eight children (29.6%) needed orthodontic treatment to close the spaces after extraction. In three children, the second molar was not yet erupted and treatment need was not settled. CONCLUSION Extraction of severely affected first permanent molars before the eruption of the second molar is a treatment option causing little additional treatment in the majority of cases.
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Tarannum, Ravichandra KS, Muppa R, Srikanth K, Kantipudi MJN, Ram KC. Molar Incisor Hypomineralization Prevalence in the Schoolchildren of Gannavaram Mandal, Krishna District, Andhra Pradesh, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2021; 14:737-740. [PMID: 35110863 PMCID: PMC8783217 DOI: 10.5005/jp-journals-10005-2097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM AND OBJECTIVES To evaluate the prevalence of molar incisor hypomineralization (MIH) in schoolchildren of the ages between 8 and 14 years of Gannavaram Mandal, Krishna district, Andhra Pradesh, India. MATERIALS AND METHODS A total of 2,250 children of ages between 8 and 14 years were selected randomly from different schools. After obtaining requisite permissions from Mandal Educational Officer (MEO), children was screened for the prevalence of MIH according to European Academy of Paediatric Dentistry (EAPD) 2003 diagnostic criteria and severity for MIH was examined using Wetzel and Reckel scale. RESULTS Prevalence of MIH was observed to be 2.1% with higher cases of mild severity and with no sex predilection (p > 0.05). CONCLUSION Early diagnosis and treatment can significantly reduce complications associated with MIH. Very few studies have been conducted in India and studies encompassing extensive population are warranted to better understand its etiology. CLINICAL SIGNIFICANCE MIH lesions lead to carious development. Hence there is need to identify MIH in children as early as possible to reduce the clinical complications. HOW TO CITE THIS ARTICLE Tarannum, Ravichandra KS, Muppa R, et al. Molar Incisor Hypomineralization Prevalence in the Schoolchildren of Gannavaram Mandal, Krishna District, Andhra Pradesh, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(6):737-740.
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Affiliation(s)
- Tarannum
- Department of Pedodontics and Preventive Dentistry, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram Mandal, Krishna, Andhra Pradesh, India
| | - KS Ravichandra
- Department of Pedodontics and Preventive Dentistry, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram Mandal, Krishna, Andhra Pradesh, India
| | - Radhika Muppa
- Department of Pedodontics and Preventive Dentistry, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram Mandal, Krishna, Andhra Pradesh, India
| | - Koya Srikanth
- Department of Pedodontics and Preventive Dentistry, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram Mandal, Krishna, Andhra Pradesh, India
| | - Mrudhula JN Kantipudi
- Department of Pedodontics and Preventive Dentistry, Drs Sudha & Nageswara Rao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram Mandal, Krishna, Andhra Pradesh, India
| | - K Chaitanya Ram
- Department of Pedodontics, Anil Neerukonda Institute of Dental Sciences, Visakhapatnam, Andhra Pradesh, India
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Alshami AA, Sawan NM, Alhamed SA, Helmi M, Mustafa OSE, Alsagob EI. Shear bond strength of resin modified glass ionomer cement following photodynamic therapy, Er,Cr:YSGG and chlorhexidine in hypoplastic primary teeth. Photodiagnosis Photodyn Ther 2021; 36:102593. [PMID: 34673269 DOI: 10.1016/j.pdpdt.2021.102593] [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: 09/09/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study investigates the micro shear bond strength of resin-modified glass ionomer cement (RMGIC) bonded to hypoplastic teeth after the application of chlorhexidine (CHX), sodium hypochlorite (NaOCl), Er;Cr:YSGG and methylene blue mediated antimicrobial photodynamic therapy (APDT). METHODS A total sample of 60 erupted and extracted hypoplastic teeth collected from < 16 years children were subjected to different conditioning protocols including control group that involved bonding of hypoplastic teeth with RMGIC; CHX and NaOCl groups that included hypoplastic enamel being treated with 0.2% CHX and 2% NaOCl solution for 30 s followed by rinsing and drying for 5 s, MB-PDT group involved methylene blue photosensitizer and Er,Cr:YSGG group. All specimens were processed for microshear bond strength in a universal tester. The fractured surface was examined using a stereomicroscope at 40 × magnification and categorized under adhesive, cohesive and mixed. RESULTS The highest microshear bond strength was noted for the control group (∼29 MPa). Whereas the specimens conditioned by NaOCl showed the lowest microshear bond strength (∼17 MPa). Among the treatment groups, APDT showed the highest bond strength values (∼22 MPa) as compared to chemical disinfection protocols. However, Er, Cr:YSGG showed slightly lower microshear bond strength as compared to APDT. No significant difference was noted between CHX and NaOCl groups (p > 0.05). There was a statistically significant difference when all the groups were compared together (p < 0.05). Microscopic analysis revealed that specimens bonded after APDT showed the highest adhesive failures (70%). The highest cohesive failures were seen in NaOCl group (40%). The mixed type of failures was seen in the control groups with none appearing for chemical disinfection protocols. CONCLUSIONS This study concludes that APDT could be a potential therapeutic strategy for increasing the microshear bond strength of RMGIC to hypoplastic enamel.
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Affiliation(s)
- Abeer A Alshami
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nozha M Sawan
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sanaa A Alhamed
- Diagnostic Science Department, Faculty of Dentistry, King Abdulaziz University, Riyadh, Saudi Arabia
| | - Mohammad Helmi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Eman I Alsagob
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Li Q, Shen J, Qin T, Zhou G, Li Y, Chen Z, Li M. A Qualitative and Comprehensive Analysis of Caries Susceptibility for Dental Fluorosis Patients. Antibiotics (Basel) 2021; 10:antibiotics10091047. [PMID: 34572628 PMCID: PMC8464924 DOI: 10.3390/antibiotics10091047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Dental fluorosis (DF) is an endemic disease caused by excessive fluoride exposure during childhood. Previous studies mainly focused on the acid resistance of fluorotic enamel and failed to reach a consensus on the topic of the caries susceptibility of DF patients. In this review, we discuss the role of DF classification in assessing this susceptibility and follow the “four factors theory” in weighing the pros and cons of DF classification in terms of host factor (dental enamel and saliva), food factor, bacteria factor, and DF treatment factor. From our analysis, we find that susceptibility is possibly determined by various factors such as the extent of structural and chemical changes in fluorotic enamel, eating habits, fluoride levels in diets and in the oral cavity, changes in quantity and quality of saliva, and/or oral hygiene. Thus, a universal conclusion regarding caries susceptibility might not exist, instead depending on each individual’s situation.
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Affiliation(s)
- Qianrui Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Jiaqi Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Tao Qin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Ge Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Yifeng Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
| | - Zhu Chen
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi 563000, China;
| | - Mingyun Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Q.L.); (J.S.); (T.Q.); (G.Z.); (Y.L.)
- Correspondence:
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21
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Hubbard MJ, Perez VA, Ganss B. 100 Years of Chalky Teeth Research: From Pioneering Histopathology to Social Good. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2020.632534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One hundred years ago, histopathology pioneer Bernhard Gottlieb described developmentally disrupted teeth as having “chalky enamel” and “chalky spots” that “crumble” easily. He also asked pivotal questions about the pathogenesis of “enamel hypoplasia” that remained enigmatic for almost a century. Today, breakthrough pathomechanistic investigations of chalky enamel are revealing surprising answers, and an allied translational initiative—The D3 Group for developmental dental defects (“D3s”) —is converting such scientific knowledge into social good surrounding prevention of tooth decay. Molar hypomineralisation (MH) affects 1-in-5 children worldwide and is well-evidenced, but poorly recognised, as a principal risk factor for childhood tooth decay. Given MH is causally linked to infantile illness, an exciting corollary is that medical prevention would lead to substantial reductions in decay. Here we reflect on the past century of chalky teeth research and retrace the path leading to recognition of MH as a global health concern. Five research eras, today's four major D3s, and diverse experimental attacks are outlined alongside translational wins that have benefitted global health. Addressing hopes for medical prevention of MH, this centennial year's pathomechanistic discovery is contextualised against past accomplishments and new opportunities. Finally, we note the translational value of accessible infographics for guiding future work, and forecast exciting prospects for the next century.
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Martignon S, Bartlett D, Manton DJ, Martinez-Mier EA, Splieth C, Avila V. Epidemiology of Erosive Tooth Wear, Dental Fluorosis and Molar Incisor Hypomineralization in the American Continent. Caries Res 2021; 55:1-11. [PMID: 33440378 DOI: 10.1159/000512483] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/18/2020] [Indexed: 11/19/2022] Open
Abstract
Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.
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Affiliation(s)
- Stefania Martignon
- UNICA - Caries Unit Research, Research Department, Universidad El Bosque, Bogotá, Colombia,
| | - David Bartlett
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - David J Manton
- Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands.,Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - E Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Christian Splieth
- Section of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Viviana Avila
- UNICA - Caries Unit Research, Research Department, Universidad El Bosque, Bogotá, Colombia
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Affiliation(s)
- Ashima Goyal
- Oral Health Sciences Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
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24
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Chalky teeth 100 years on: What comes next? J Am Dent Assoc 2020; 151:803-805. [PMID: 33121592 DOI: 10.1016/j.adaj.2020.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 11/20/2022]
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25
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Perez VA, Mangum JE, Hubbard MJ. Pathogenesis of Molar Hypomineralisation: Aged Albumin Demarcates Chalky Regions of Hypomineralised Enamel. Front Physiol 2020; 11:579015. [PMID: 33101060 PMCID: PMC7556231 DOI: 10.3389/fphys.2020.579015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/04/2020] [Indexed: 11/13/2022] Open
Abstract
Molar hypomineralisation (MH) is becoming globally recognised as a significant public health problem linked to childhood tooth decay. However, with causation and pathogenesis unclear after 100 years of investigation, better pathological understanding is needed if MH is to become preventable. Our studies have implicated serum albumin in an extracellular pathomechanism for chalky enamel, opposing longheld dogma about systemic injury to enamel-forming cells. Hypothesising that chalky enamel arises through developmental exposure to serum albumin, this study used biochemical approaches to characterise demarcated opacities from 6-year molars. Addressing contradictory literature, normal enamel was found to completely lack albumin subject to removal of surface contamination. Querying surface permeability, intact opacities were found to lack salivary amylase, indicating that “enamel albumin” had become entrapped before tooth eruption. Thirdly, comparative profiling of chalky and hard-white enamel supported a dose-response relationship between albumin and clinical hardness of opacities. Moreover, albumin abundance delineated chalky enamel from white transitional enamel at opacity borders. Finally, addressing the corollary that enamel albumin had been entrapped for several years, clear signs of molecular ageing (oxidative aggregation and fragmentation) were identified. By establishing aged albumin as a biomarker for chalky enamel, these findings hold methodological, clinical, and aetiological significance. Foremost, direct inhibition of enamel-crystal growth by albumin (here termed “mineralisation poisoning”) at last provides a cogent explanation for the clinical presentation of demarcated opacities. Together, these findings justify pursuit of an extracellular paradigm for the pathogenesis of MH and offer exciting new prospects for alleviating childhood tooth decay through medical prevention of MH.
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Affiliation(s)
- Vidal A Perez
- Department of Pharmacology and Therapeutics, The University of Melbourne, Parkville, VIC, Australia.,Department of Pediatric Stomatology, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Jonathan E Mangum
- Department of Pharmacology and Therapeutics, The University of Melbourne, Parkville, VIC, Australia
| | - Michael J Hubbard
- Department of Pharmacology and Therapeutics, The University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.,Melbourne Dental School, The University of Melbourne, Parkville, VIC, Australia
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Huilcapi M, Armas-Vega A, Cardenas AFM, Araujo LCR, Ocampo JB, Bandeca MC, Siqueira FSFD, Loguercio A. Effect of surface treatments on the adhesive properties of metallic brackets on fluorotic enamel. Dental Press J Orthod 2020; 25:59-67. [PMID: 32965388 PMCID: PMC7510489 DOI: 10.1590/2177-6709.25.4.059-067.oar] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/20/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of the pretreatment with sandblasting and deproteinization with NaOCl on bond strength (SBS), in situ conversion degree (CD) of brackets in fluorotic enamel, and enamel etching pattern. METHODS A total of 90 non-carious maxillary premolars were used. The teeth were then assigned to six experimental groups according to: enamel surface (sound and fluorotic enamel); surface treatment (Regular etch with 37% phosphoric acid [RE]; 5.2% sodium hypochlorite + phosphoric acid [NaOCl + RE]; sandblasting + phosphoric acid [sandblasting + RE]). After storage in distilled water (37°C/24h), the specimens were tested at 1 mm/min until failure (SBS). Enamel-resin cement interfaces were evaluated for CD using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a scanning electron microscope. Data from SBS and in situ CD values were analyzed using ANOVA two-away and Tukey test (α=0.05). The enamel etching pattern was evaluated only qualitatively. RESULTS For sound enamel, RE showed the highest SBS values, when compared to NaOCl + RE and Sandblasting + RE groups (p< 0.01). Regarding CD, only NaOCl + RE significantly compromised the mean DC, in comparison with other groups (p= 0.002). For fluorotic enamel, the Sandblasting + RE group significantly increased the mean SBS values, in comparison with RE group (p= 0.01) and no significant change was observed for CD (p> 0.52). CONCLUSIONS The application of NaOCl or sandblasting associated to phosphoric acid improved the SBS of the brackets in fluorotic enamel without compromising the CD of the resin cement, with improving of enamel interprismatic conditioning.
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Affiliation(s)
- Mariana Huilcapi
- Escuela Odontologia, Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE (Quito, Ecuador)
| | - Ana Armas-Vega
- Escuela Odontologia, Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE (Quito, Ecuador)
| | | | | | - Jessica Bedoya Ocampo
- Universidade Estadual de Ponta Grossa, Departamento de Odontologia Restauradora (Ponta Grossa/PR, Brazil)
| | | | | | - Alessandro Loguercio
- Escuela Odontologia, Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE (Quito, Ecuador)
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Molar-incisor hypomineralization: parent's and children's impact perceptions on the oral health-related quality of life. Eur Arch Paediatr Dent 2020; 22:273-282. [PMID: 32862363 DOI: 10.1007/s40368-020-00556-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 08/19/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE To evaluate the perception of parents and children and the impact of molar and incisor hypomineralization (MIH) on the oral health-related quality of life (OHRQoL). METHODS A cross-sectional study was conducted with a group of 253 children aged 6-12 years presenting MIH and their parents or guardians who initially answered an interview containing socioeconomic and demographic questions as well as the Parental-Caregiver's Perceptions Questionnaire (P-CPQ). The children answered the Child Perceptions Questionnaire (CPQ8-10) and Child Perceptions Questionnaire (CPQ11-14) and the clinical evaluation of MIH was performed. Poisson regression with robust variance was used in the data analysis. RESULTS The parent's perception showed that the impact felt by the children regarding caries leads to a higher oral symptom impact, functional limitation, emotional well-being and total PCPQ score domains, as well. For children with severe MIH, a higher prevalence of impact was felt regarding the functional limitation and emotional well-being. For CPQ8-10, the oral symptoms domain presented the highest mean score, while CPQ11-14 showed the functional limitations domain and P-CPQ the emotional well-being domain. CONCLUSION Considering the perception of parents or guardians, it was concluded that MIH promotes a negative impact on the OHRQoL. MIH had no significant impact on OHRQoL according to children's perceptions.
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The possible influence of genetic aetiological factors on molar-incisor hypomineralisation. Arch Oral Biol 2020; 118:104848. [PMID: 32777581 DOI: 10.1016/j.archoralbio.2020.104848] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The present study searched for evidence of possible associations between some genetic factors that could affect the development of molar-incisor hypomineralisation (MIH). METHODS In 113 patients who were surgically treated at an Otorhinolaryngology and Cervicofacial Surgery Clinic (ORL) during early childhood, human leukocyte antigen (HLA) DQ2 and DQ8 haplotypes and single nucleotide polymorphisms (SNP) of eight amelogenesis-related genes were searched in genomic DNA. Genotypes were determined by high resolution melting (HRM), TaqMan genotyping assays, and Sanger sequencing. Association between MIH and the HLA DQ2 and DQ8 alleles was tested using a univariate logistic regression. The significance of genetic variants was analysed using the Cochran-Armitage tests for trend and the Fisher exact tests. RESULTS We identified MIH in 22 (19.5 %) of the 113 children. Among the evaluated genetic variants, SNP rs2245803 in the MMP20 gene in a homozygous form in a recessive model was associated with MIH development (OR, 2.796; 95 %CI, 1.075 - 4.783; p = 0.0496) with the genotype distribution of TT(3), TG(6) or GG(13) in children with MIH and distribution of TT(18), TG(42) or GG(31) in children without MIH. CONCLUSIONS While the aetiology of MIH remains unclear, our findings suggest that variants of genes associated with amelogenesis may play important roles in susceptibility to MIH.
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Rolim TZC, da Costa TRF, Wambier LM, Chibinski AC, Wambier DS, da Silva Assunção LR, de Menezes JVBN, Feltrin-Souza J. Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial. Clin Oral Investig 2020; 25:1513-1524. [PMID: 32696210 DOI: 10.1007/s00784-020-03459-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/10/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety. MATERIAL AND METHOD FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods. RESULTS A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE. CONCLUSION Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels. CLINICAL RELEVANCE A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.
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Affiliation(s)
- Tatiane Zahn Cardoso Rolim
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - Thays Regina Ferreira da Costa
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | | | | | | | - Luciana Reichert da Silva Assunção
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - José Vitor Borges Nogara de Menezes
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - Juliana Feltrin-Souza
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil.
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Gil-Bona A, Bidlack FB. Tooth Enamel and its Dynamic Protein Matrix. Int J Mol Sci 2020; 21:ijms21124458. [PMID: 32585904 PMCID: PMC7352428 DOI: 10.3390/ijms21124458] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 12/12/2022] Open
Abstract
Tooth enamel is the outer covering of tooth crowns, the hardest material in the mammalian body, yet fracture resistant. The extremely high content of 95 wt% calcium phosphate in healthy adult teeth is achieved through mineralization of a proteinaceous matrix that changes in abundance and composition. Enamel-specific proteins and proteases are known to be critical for proper enamel formation. Recent proteomics analyses revealed many other proteins with their roles in enamel formation yet to be unraveled. Although the exact protein composition of healthy tooth enamel is still unknown, it is apparent that compromised enamel deviates in amount and composition of its organic material. Why these differences affect both the mineralization process before tooth eruption and the properties of erupted teeth will become apparent as proteomics protocols are adjusted to the variability between species, tooth size, sample size and ephemeral organic content of forming teeth. This review summarizes the current knowledge and published proteomics data of healthy and diseased tooth enamel, including advancements in forensic applications and disease models in animals. A summary and discussion of the status quo highlights how recent proteomics findings advance our understating of the complexity and temporal changes of extracellular matrix composition during tooth enamel formation.
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Affiliation(s)
- Ana Gil-Bona
- The Forsyth Institute, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA
- Correspondence: (A.G.-B.); (F.B.B.)
| | - Felicitas B. Bidlack
- The Forsyth Institute, Cambridge, MA 02142, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA 02115, USA
- Correspondence: (A.G.-B.); (F.B.B.)
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31
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Williams R, Perez VA, Mangum JE, Hubbard MJ. Pathogenesis of Molar Hypomineralisation: Hypomineralised 6-Year Molars Contain Traces of Fetal Serum Albumin. Front Physiol 2020; 11:619. [PMID: 32595522 PMCID: PMC7303361 DOI: 10.3389/fphys.2020.00619] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/18/2020] [Indexed: 11/16/2022] Open
Abstract
Molar Hypomineralisation (MH) is gaining cross-sector attention as a global health problem, making deeper enquiry into its prevention a research priority. However, causation and pathogenesis of MH remain unclear despite 100 years of investigation into “chalky” dental enamel. Contradicting aetiological dogma involving disrupted enamel-forming cells (ameloblasts), our earlier biochemical analysis of chalky enamel opacities implicated extracellular serum albumin in enamel hypomineralisation. This study sought evidence that the albumin found in chalky enamel reflected causal events during enamel development rather than later association with pre-existing enamel porosity. Hypothesising that blood-derived albumin infiltrates immature enamel and directly blocks its hardening, we developed a “molecular timestamping” method that quantifies the adult and fetal isoforms of serum albumin ratiometrically. Applying this novel approach to 6-year molars, both isoforms of albumin were detectable in 6 of 8 chalky opacities examined (corresponding to 4 of 5 cases), indicating developmental acquisition during early infancy. Addressing protein survival, in vitro analysis showed that, like adult albumin, the fetal isoform (alpha-fetoprotein) bound hydroxyapatite avidly and was resistant to kallikrein-4, the pivotal protease involved in enamel hardening. These results shift primary attention from ameloblast injury and indicate instead that an extracellular mechanism involving localised exposure of immature enamel to serum albumin constitutes the crux of MH pathogenesis. Together, our pathomechanistic findings plus the biomarker approach for onset timing open a new direction for aetiological investigations into the medical prevention of MH.
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Affiliation(s)
- Rebecca Williams
- Department of Pharmacology & Therapeutics, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia
| | - Vidal A Perez
- Department of Pharmacology & Therapeutics, The University of Melbourne, Melbourne, VIC, Australia.,Department of Pediatric Stomatology, University of Talca, Talca, Chile
| | - Jonathan E Mangum
- Department of Pharmacology & Therapeutics, The University of Melbourne, Melbourne, VIC, Australia
| | - Michael J Hubbard
- Department of Pharmacology & Therapeutics, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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32
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Moynihan PJ, Jakubovics N. Around the World in 100 Years: The Global Expansion of the IADR and Regional Contributions to Oral Health Research. J Dent Res 2020; 99:355-359. [PMID: 32125923 DOI: 10.1177/0022034520909355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- P J Moynihan
- Adelaide Dental School, Faculty of Health & Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - N Jakubovics
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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33
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Pang L, Li X, Wang K, Tao Y, Cui T, Xu Q, Lin H. Interactions with the aquaporin 5 gene increase the susceptibility to molar-incisor hypomineralization. Arch Oral Biol 2019; 111:104637. [PMID: 31884335 DOI: 10.1016/j.archoralbio.2019.104637] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/14/2019] [Accepted: 12/18/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether individual genetic factors involved in amelogenesis, the immune response and water channel proteins may increase the susceptibility to Molar-Incisor Hypomineralization (MIH) in Chinese children. DESIGN DNA samples were collected from 86 cases with MIH cases and 344 controls. Sixteen single-nucleotide polymorphisms (SNPs) were investigated. Logistic regression analysis was performed to assess association between SNPs and the risk of MIH. RESULTS Our results showed that the risk of MIH in the rs13115627-AA genotype carriers and the rs1784418-TT genotype carriers were significantly higher than that among those with the rs13115627-GG genotype (OR (95 % CI)) = 4.942 (0.658-37.131) and the rs1784418-CT genotype (OR (95 % CI)) = 2.023 (1.63-3.521). The population with the rs1800972-CC genotype and the rs1800972-C allele had a higher risk to develop MIH, OR (95 % CI) = 2.284 (1.267-4.115), OR (95 % CI) = 2.427 (1.493-3.953) respectively. In the Aquaporin 5(AQP5) gene, we individually analyzed two SNPs, rs1996315 and rs923911. We found no significant associations between them and MIH. However, in the analysis of the gene-gene interactions, we discovered a significant two-locus model (P = 0.023) involving rs1996315 and rs923911. Participants with the rs1996315-AG and rs923911-AC genotypes had the highest MIH risk, compared to participants with the rs1996315-GG and rs923911-CC genotypes, OR (95 % CI) = 3.603 (1.147-11.318). CONCLUSION This study showed that genetic variants in the AMBN, MMP20 and DEFB1 genes may contribute to MIH in the permanent dentition of children. Moreover, interactions among AQP5 gene may also increase the MIH susceptibility.
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Affiliation(s)
- Liangyue Pang
- Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, 510050 Guangzhou, China; Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 510080, Guangzhou, China
| | - Xia Li
- Foshan Stomatology Hospital, School of Stomatology and Medicine, Foshan University, Foshan, China
| | - Ketian Wang
- Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, 510050 Guangzhou, China; Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 510080, Guangzhou, China
| | - Ye Tao
- Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, 510050 Guangzhou, China; Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 510080, Guangzhou, China
| | - Tianqiang Cui
- Foshan Stomatology Hospital, School of Stomatology and Medicine, Foshan University, Foshan, China
| | - Qiong Xu
- Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 510080, Guangzhou, China.
| | - Huancai Lin
- Department of Preventive Dentistry, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, 510050 Guangzhou, China; Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 510080, Guangzhou, China.
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Molar hypomineralization: What is the US experience? J Am Dent Assoc 2019; 149:329-330. [PMID: 29703275 DOI: 10.1016/j.adaj.2018.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/07/2018] [Accepted: 03/09/2018] [Indexed: 11/20/2022]
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Fernando JR, Shen P, Walker GD, Yuan Y, Stanton DP, Reynolds C, Reynolds EC. Effects of Bovine Serum Albumin and High pH Pre-Treatment on the Remineralisation of Enamel Subsurface Lesions in vitro. Caries Res 2019; 54:36-42. [PMID: 31487735 DOI: 10.1159/000502337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/24/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulated intra-lesion protein such as serum albumin has been speculated to impede remineralisation of carious enamel lesions. The aim of this study was to assess whether intra-lesion bovine serum albumin (BSA) affected subsequent remineralisation of enamel subsurface lesions. Confocal microscopy was used to confirm localisation of BSA in artificial enamel subsurface lesions and its subsequent degradation by a high pH sodium hypochlorite treatment. An in vitro remineralisation experiment tested the effect of intra-lesion BSA, and its degradation by sodium hypochlorite, on remineralisation of subsurface lesions by casein phosphopeptide stabilised amorphous calcium fluoride phosphate. In addition, lesions without BSA were pre-treated with one of 2 high pH solutions (sodium hypochlorite or sodium hydroxide) prior to remineralisation to test whether the high pH pre-treatment influenced remineralisation. Data were obtained on remineralisation using transverse microradiography and were analysed with a one-way ANOVA. Intra-lesion BSA had no significant effect on remineralisation compared with that of control lesions. Pre-treatment of BSA-containing lesions with sodium hypochlorite significantly increased remineralisation. The lesions without BSA that were pre-treated with either sodium hypochlorite or sodium hydroxide also showed the same level of remineralisation as the BSA-containing lesions pre-treated with sodium hypochlorite indicating that the increased remineralisation was pH related. Hence, it was concluded that intra-lesion BSA did not affect remineralisation of artificial enamel subsurface lesions in this model system and that a high pH pre-treatment enhanced remineralisation.
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Affiliation(s)
- James R Fernando
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peiyan Shen
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Glenn D Walker
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yuan
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - David P Stanton
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Coralie Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eric C Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia,
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Li J, Yang H, Lu Q, Chen D, Zhou M, Kuang Y, Ying S, Song J. Proteomics and N‐glycoproteomics analysis of an extracellular matrix‐based scaffold‐human treated dentin matrix. J Tissue Eng Regen Med 2019; 13:1164-1177. [DOI: 10.1002/term.2866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/07/2018] [Accepted: 02/13/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jie Li
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Hefeng Yang
- Department of Dental ResearchThe Affiliated Stomatological Hospital of Kunming Medical University Kunming China
| | - Qi Lu
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Duanjing Chen
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Mengjiao Zhou
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Yunchun Kuang
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Siqi Ying
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
| | - Jinlin Song
- College of StomatologyChongqing Medical University Chongqing China
- Chongqing Key Laboratory for Oral Diseases and Biomedical SciencesChongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher EducationChongqing Medical University Chongqing China
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37
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Malmberg P, Norén JG, Bernin D. Molecular insights into hypomineralized enamel. Eur J Oral Sci 2019; 127:340-346. [DOI: 10.1111/eos.12619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Per Malmberg
- Department of Chemistry and Chemical Engineering Chalmers University of Technology Gothenburg Sweden
| | - Jörgen G. Norén
- Department of Pediatric Dentistry Institute of Odontology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Diana Bernin
- Department of Chemistry and Chemical Engineering Chalmers University of Technology Gothenburg Sweden
- Swedish NMR Centre University of Gothenburg Gothenburg Sweden
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Bakry AS, Abbassy MA. The efficacy of a bioglass (45S5) paste temporary filling used to remineralize enamel surfaces prior to bonding procedures. J Dent 2019; 85:33-38. [PMID: 31039386 DOI: 10.1016/j.jdent.2019.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES The efficacy of using a 45S5 Bioglass paste as a remineralizing temporary filling material was compared to fluoride gel (1.23% acidulated-phosphate-fluoride, Gelato Gel, NJ, USA) applied for 24 h and for 4 min and to a temporary filling material (Caviton; GC, Tokyo, Japan). METHODS 66 extracted human premolars were used. All specimens were sectioned mesio-distally. All specimens were challenged by a demineralization solution (pH4.5) for 4 days. The specimens were divided into 4 groups: (Bioglass), (Fluoride 4-minutes), (Fluoride 24-Hours), and (Temp) (n = 33). 10 specimens were examined by TMR (Transversal Microradiography)to test remineralization capacity of each agent. 8 specimens were assigned to determine the acid resistance of a bonded resin-enamel interface after the various treatment methods. 15 samples were assigned to determine the effect of each agent on the shear bond strength of a single bottle self-etch adhesive system. One way ANOVA was used to compare the obtained results (p < 0.05). RESULTS Specimens treated with 45S5 bioglass showed statistically significant reductions in (delta z) values when compared to the other three groups (p < 0.05). Treatment of demineralized enamel by fluoride prior to bonding significantly decreased shear bond strength values, however 45S5 bioglass treatment did not affect the shear bond strength of adhesive system to enamel (p < 0.05). The acid-resistance of the interface between resin-enamel was significantly improved when fluoride or bioglass were applied onto the enamel surface prior to demineralization. CONCLUSIONS 45S5 bioglass paste has high potential to be used as a remineralizing temporary filling material.
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Affiliation(s)
- Ahmed S Bakry
- Operative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mona A Abbassy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Alexandria University, Alexandria, Egypt
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39
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Vieira AR, Manton DJ. On the Variable Clinical Presentation of Molar-Incisor Hypomineralization. Caries Res 2019; 53:482-488. [PMID: 30943522 DOI: 10.1159/000496542] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/15/2018] [Indexed: 11/19/2022] Open
Abstract
Molar-incisor hypomineralization (MIH) is a condition that is defined based on its peculiar clinical presentation. Original reports on the etiology of the condition and possible risk factors were inconclusive, and we refuted the original suggestion that MIH is an idiopathic condition and suggested that MIH has complex inheritance and is due to the interaction of more than one gene and the environment. Our group was the first to suggest MIH has a genetic component that involves genetic variation in genes expressed during dental enamel formation. Later we expanded this work to include genes related to the immune response. In this report, we provide a rationale to explain the variation seen in the clinical presentation of MIH, which can affect just one molar out of the four or just a portion of a particular molar.
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Affiliation(s)
- Alexandre Rezende Vieira
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA,
| | - David J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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40
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Almuallem Z, Busuttil-Naudi A. Molar incisor hypomineralisation (MIH) - an overview. Br Dent J 2018; 225:sj.bdj.2018.814. [PMID: 30287963 DOI: 10.1038/sj.bdj.2018.814] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2018] [Indexed: 11/09/2022]
Abstract
Recent data indicates that molar-incisor hypomineralisation (MIH) is a frequently - encountered dental condition worldwide. The condition could be associated with dental complications that might affect patients' quality of life as well as create treatment challenges to dentists. The affected teeth are more prone to caries and post-eruptive enamel breakdown, therefore, it is believed that this condition might be responsible for a substantial proportion of childhood caries since the condition has high prevalence. MIH is common, and as such it should be diagnosed and managed in primary care wherever possible. Early diagnosis can lead to more effective and conservative management. This article aims to highlight different aspects related to MIH, from its prevalence to treatment options in young patients.
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Affiliation(s)
- Z Almuallem
- East Riyadh Specialized Dental Center, Paediatric dental department, Riyadh, Riyadh 13226, Saudi Arabia
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41
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Schneider PM, Silva M. Endemic Molar Incisor Hypomineralization: a Pandemic Problem That Requires Monitoring by the Entire Health Care Community. Curr Osteoporos Rep 2018; 16:283-288. [PMID: 29728996 DOI: 10.1007/s11914-018-0444-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW This review brings a major, previously under-recognized dental and general health problem to the attention of the medical and scientific community. The goals are to help clinicians make early diagnoses, thereby improving treatment outcomes, and to stimulate increasing research efforts to understand the etiology and ultimately prevention. RECENT FINDINGS There are two recent systematic reviews of molar incisor hypomineralization (MIH). One reveals the global burden of the condition; mean global prevalence is 13% with 878 million people affected, with 4.8 million cases per year requiring treatment. The review into etiology found a lack of definitive knowledge, but that it is likely to be multifactorial, with childhood illness including fever possibly implicated. The review presents details of MIH sufficient to enable clinicians to recognize it and understand its impact on affected children, its management, and the importance of early intervention. Much further research is needed.
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Affiliation(s)
- Paul M Schneider
- Melbourne Dental School, University of Melbourne, Melbourne, Australia.
| | - Margarita Silva
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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Perez VA, Mangum JE, Hubbard MJ. Direct evidence that KLK4 is a hydroxyapatite-binding protein. Biochem Biophys Res Commun 2017; 495:1896-1900. [PMID: 29229389 DOI: 10.1016/j.bbrc.2017.12.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/07/2017] [Indexed: 11/17/2022]
Abstract
The protease kallikrein 4 (KLK4) plays a pivotal role during dental enamel formation by degrading the major enamel protein, amelogenin, prior to the final steps of enamel hardening. KLK4 dysfunction is known to cause some types of developmental defect in enamel but the mechanisms responsible for transient retention of KLK4 in semi-hardened enamel matrix remain unclear. To address contradictory reports about the affinity of KLK4 for enamel hydroxyapatite-like mineral, we used pure components in quasi-physiological conditions and found that KLK4 binds hydroxyapatite directly. Hypothesising KLK4 self-destructs once amelogenin is degraded, biochemical analyses revealed that KLK4 progressively lost activity, became aggregated, and autofragmented when incubated without substrate in both the presence and absence of reducer. However, with non-ionic detergent present as proxy substrate, KLK4 remained active and intact throughout. These findings prompt a new mechanistic model and line of enquiry into the role of KLK4 in enamel hardening and malformation.
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Affiliation(s)
- Vidal A Perez
- Department of Pharmacology & Therapeutics, The University of Melbourne, Victoria, Australia; Department of Pediatric Stomatology, University of Talca, Talca, Chile
| | - Jonathan E Mangum
- Department of Pharmacology & Therapeutics, The University of Melbourne, Victoria, Australia
| | - Michael J Hubbard
- Department of Pharmacology & Therapeutics, The University of Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Victoria, Australia.
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Krämer N, Bui Khac NHN, Lücker S, Stachniss V, Frankenberger R. Bonding strategies for MIH-affected enamel and dentin. Dent Mater 2017; 34:331-340. [PMID: 29208311 DOI: 10.1016/j.dental.2017.11.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 07/11/2017] [Accepted: 11/12/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Aim of the present study was to evaluate resin composite adhesion to dental hard tissues affected by molar incisor hypomineralisation (MIH). METHODS 94 freshly extracted human molars and incisors (53 suffering MIH) were used. 68 teeth (35 with MIH) were used for μ-TBS tests in enamel and dentin, 26 (18 with MIH) for qualitative evaluation. Specimens were bonded with Clearfil SE Bond, Scotchbond Universal, and OptiBond FL. For MIH affected enamel, additional OptiBond FL groups with NaOCl and NaOCl+Icon were investigated. Beside fractographic analysis, also qualitative evaluations were performed using SEM at different magnifications as well as histological sectioning. RESULTS Highest μ-TBS values were recorded with dentin specimens (ANOVA, mod. LSD, p<0.05). Results were independent of adhesive and dentin substrate (p>0.05). Pre-test failures did not occur in dentin specimens. Sound enamel specimens exhibited significantly higher μ-TBS values than MIH enamel (p<0.05). The two-step self-etch adhesive (Clearfil SE Bond) and the two-step etch-and-rinse adhesive (Scotchbond Universal) showed the lowest values in affected enamel specimens (p<0.05) with most pre-test failures (p<0.05). OptiBond FL on affected enamel showed better results than Clearfil SE Bond (p<0.05). An additional pre-treatment of affected enamel with NaOCl or NaOCl and Icon did not enhance enamel bonding (p>0.05), however, it caused less pre-test failures (p<0.05). Micromorphological analyses revealed that conventional phosphoric acid etching produces a much less pronounced etching pattern in affected enamel and a porous structure as weak link for the resin-enamel bond was identified. SIGNIFICANCE Bonding to porous hypomineralized MIH enamel is the limiting factor in adhesion to MIH teeth. MIH-affected dentin may be bonded conventionally.
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Affiliation(s)
- Norbert Krämer
- Department of Pediatric Dentistry, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, D-35392 Giessen, Germany
| | - Ngoc-Han Nana Bui Khac
- Department of Pediatric Dentistry, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, D-35392 Giessen, Germany
| | - Susanne Lücker
- Department of Pediatric Dentistry, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, D-35392 Giessen, Germany; Department of Operative Dentistry and Endodontics, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Vitus Stachniss
- Department of Operative Dentistry and Endodontics, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontics, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany.
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44
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Comparison of deproteinization agents on bonding to developmentally hypomineralized enamel. J Dent 2017; 67:94-101. [DOI: 10.1016/j.jdent.2017.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/26/2017] [Accepted: 10/10/2017] [Indexed: 11/22/2022] Open
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45
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Elhennawy K, Manton DJ, Crombie F, Zaslansky P, Radlanski RJ, Jost-Brinkmann PG, Schwendicke F. Structural, mechanical and chemical evaluation of molar-incisor hypomineralization-affected enamel: A systematic review. Arch Oral Biol 2017; 83:272-281. [DOI: 10.1016/j.archoralbio.2017.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/15/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
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46
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Kumar H, Palamara JEA, Burrow MF, Manton DJ. An investigation into the effect of a resin infiltrant on the micromechanical properties of hypomineralised enamel. Int J Paediatr Dent 2017; 27:399-411. [PMID: 27813257 DOI: 10.1111/ipd.12272] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Resin infiltration may alter the mechanical properties of enamel hypomineralised lesions (HL); however, variable surface layer (SL) thickness may affect resin penetration. AIMS To determine the thickness of the SL of HL and to investigate the effect of resin infiltration on the mechanical properties of HL. DESIGN The thickness of the SL over HL was determined using polarised light microscopy. Etching time using 15% HCl gel to remove the SL of 52 samples was determined. Selected HL and control areas of 21 teeth were infiltrated with Icon® resin infiltrant, and cross-sectional Knoop microhardness (KHN) measurements were recorded before and after resin infiltration. RESULTS Ninety-six point five per cent of HL had a detectable SL with mean thickness of 58 ± 29 μm. Application of HCl for 120 s produced a mean MIH erosion depth of 58 ± 12 μm. Eleven of 21 samples had evidence of infiltration using visual examination. The infiltrant penetrated some of the HL leading to an increase in KHN (111 ± 75 KHN) which, when compared to adjacent non-infiltrated HL (96 ± 52 KHN), was not statistically significantly different (P = 0.56). CONCLUSIONS There was marked variation in the SL thickness of HL. Resin infiltration of HL did not increase microhardness significantly.
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Affiliation(s)
- Harleen Kumar
- Oral Health Cooperative Research Centre, Melbourne Dental School, The University of Melbourne, Melbourne, Australia.,Boston Children's Hospital and Harvard School of Dental Medicine, Boston, MA, USA
| | | | - Michael Francis Burrow
- Oral Health Cooperative Research Centre, Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - David John Manton
- Oral Health Cooperative Research Centre, Melbourne Dental School, The University of Melbourne, Melbourne, Australia
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47
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Hubbard MJ, Mangum JE, Perez VA, Nervo GJ, Hall RK. Molar Hypomineralisation: A Call to Arms for Enamel Researchers. Front Physiol 2017; 8:546. [PMID: 28824445 PMCID: PMC5540900 DOI: 10.3389/fphys.2017.00546] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/14/2017] [Indexed: 11/20/2022] Open
Abstract
Developmental dental defects (DDDs, hereafter “D3s”) hold significance for scientists and practitioners from both medicine and dentistry. Although, attention has classically dwelt on three other D3s (amelogenesis imperfecta, dental fluorosis, and enamel hypoplasia), dental interest has recently swung toward Molar Hypomineralisation (MH), a prevalent condition characterised by well-delineated (“demarcated”) opacities in enamel. MH imposes a significant burden on global health and has potential to become medically preventable, being linked to infantile illness. Yet even in medico-dental research communities there is only narrow awareness of this childhood problem and its link to tooth decay, and of allied research opportunities. Major knowledge gaps exist at population, case and tooth levels and salient information from enamel researchers has sometimes been omitted from clinically-oriented conclusions. From our perspective, a cross-sector translational approach is required to address these complex inadequacies effectively, with the ultimate aim of prevention. Drawing on experience with a translational research network spanning Australia and New Zealand (The D3 Group; www.thed3group.org), we firstly depict MH as a silent public health problem that is generally more concerning than the three classical D3s. Second, we argue that diverse research inputs are needed to undertake a multi-faceted attack on this problem, and outline demarcated opacities as the central research target. Third, we suggest that, given past victories studying other dental conditions, enamel researchers stand to make crucial contributions to the understanding and prevention of MH. Finally, to focus geographically diverse research interests onto this nascent field, further internationalisation of The D3 Group is warranted.
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Affiliation(s)
- Michael J Hubbard
- Department of Paediatrics, University of MelbourneMelbourne, VIC, Australia.,Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia
| | - Jonathan E Mangum
- Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia
| | - Vidal A Perez
- Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia.,Department of Pediatric Stomatology, University of TalcaTalca, Chile
| | - Garry J Nervo
- Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia
| | - Roger K Hall
- Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia
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48
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Salmon CR, Giorgetti APO, Paes Leme AF, Domingues RR, Kolli TN, Foster BL, Nociti FH. Microproteome of dentoalveolar tissues. Bone 2017; 101:219-229. [PMID: 28527949 DOI: 10.1016/j.bone.2017.05.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/12/2017] [Accepted: 05/15/2017] [Indexed: 01/18/2023]
Abstract
Proteomic analysis of extracellular matrices (ECM) of dentoalveolar tissues can provide insights into developmental, pathological, and reparative processes. However, targeted dissection of mineralized tissues, dental cementum (DC), alveolar bone (AB), and dentin (DE), presents technical difficulties. We demonstrate an approach combining EDTA decalcification and laser capture microdissection (LCM), followed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS), to analyze proteome profiles of these tissues. Using the LCM-LC-MS/MS approach, a total of 243 proteins was identified from all tissues, 193 proteins in DC, 147 in AB, and 135 proteins DE. Ninety proteins (37% of total) were common to all tissues, whereas 52 proteins (21%) were overlapping in only two. Also, 101 (42%) proteins were exclusively detected in DC (60), AB (15), or DE (26). Identification in all tissues of expected ECM proteins including collagen alpha-1(I) chain (COL1A1), collagen alpha-1(XII) chain (COL12A1), biglycan (BGN), asporin (ASPN), lumican (LUM), and fibromodulin (FMOD), served to validate the approach. Principal component analysis (PCA) and hierarchical clustering identified a high degree of similarity in DC and AB proteomes, whereas DE presented a distinct dataset. Exclusively and differentially identified proteins were detected from all three tissues. The protein-protein interaction network (interactome) of DC was notable for its inclusion of several indicators of metabolic function (e.g. mitochondrial proteins, protein synthesis, and calcium transport), possibly reflecting cementocyte activity. The DE proteome included known and novel mineralization regulators, including matrix metalloproteinase 20 (MMP-20), 5' nucleotidase (NT5E), and secreted phosphoprotein 24 (SPP-24 or SPP-2). Application of the LCM-LC-MS/MS approach to dentoalveolar tissues would be of value in many experimental designs, including developmental studies of transgenic animals, investigation of treatment effects, and identification of novel regenerative factors.
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Affiliation(s)
- Cristiane R Salmon
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Ana Paula O Giorgetti
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil
| | - Adriana F Paes Leme
- National Biosciences Laboratory, Brazilian Synchrotron Light Laboratory, Campinas, SP, Brazil
| | - Romênia R Domingues
- National Biosciences Laboratory, Brazilian Synchrotron Light Laboratory, Campinas, SP, Brazil
| | - Tamara N Kolli
- Biosciences Division, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Brian L Foster
- Biosciences Division, College of Dentistry, Ohio State University, Columbus, OH, United States
| | - Francisco H Nociti
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.
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49
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Orellana C, Pérez V. Modified glass ionomer and orthodontic band: An interim alternative for the treatment of molar incisor hypomineralization. A case report. JOURNAL OF ORAL RESEARCH 2017. [DOI: 10.17126/joralres.2017.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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50
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Lelis IMP, Molina GF, Souza C, Perez WB, Laure HJ, Rosa JC, Gerlach RF. Peptide Characterization of Mature Fluorotic and Control Human Enamel. Braz Dent J 2017; 27:66-71. [PMID: 27007349 DOI: 10.1590/0103-6440201600424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 01/25/2016] [Indexed: 11/22/2022] Open
Abstract
Exposure to high fluoride levels during amelogenesis causes enamel fluorosis. This study aimed to determine and compare the amino acid sequences in the enamel of fluorotic and control teeth. This investigation included enamel samples obtained from erupted and non-erupted third molars with either TF grade 4-6 (n=7) fluorosis or no sign of fluorosis (controls, n=7). The samples were kept frozen at -20 °C until protein extraction. Samples were etched and processed with a cocktail of proteinase inhibitors and immediately analyzed. Matrix Assisted Laser Desorption/Ionization-Time-Of-Flight/Time-of-Flight Mass Spectrometry (MALDI-TOF/TOF) followed by MASCOT search aided the peptides analysis. The more abundant peptides bore the N-terminal amelogenin sequences WYQSIRPPYP (which is specific for the X-encoded amelogenin) and MPLPPHPGHPGYINF (which does not show sexual dimorphism) were not different in control or fluorotic enamel. There was no missing proteolytic cleavage in the fluorotic samples, which suggested that the increased amount of protein described in fluorotic enamel did not stem from the decreased ability of proteinases to cleave the proteins in humans. This study showed how to successfully obtain peptide from superficial enamel. A relatively low number of teeth was sufficient to provide good data on the actual peptides found in mature enamel.
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Affiliation(s)
- Isabel Maria Porto Lelis
- Department of Morphology, Dental School of Piracicaba, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Gabriela F Molina
- Departament of Morphology, Physiology and Basic Patology, Dental School of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Walter B Perez
- Department of Stomatology, Health Sciences Center, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Helen J Laure
- Departament of Cellular and Molecular Biology and Bio-Agents Pathogens, Medical School of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - José C Rosa
- Departament of Cellular and Molecular Biology and Bio-Agents Pathogens, Medical School of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Raquel F Gerlach
- Departament of Morphology, Physiology and Basic Patology, Dental School of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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