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da Costa Rosa T, Spinelli LR, da Silva FMF, de Castro Costa M, de Almeida Neves A. Perceptions, attitudes, and clinical experiences of Brazilian dental practitioners towards molar incisor hypomineralisation: a cross-sectional study. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00945-z. [PMID: 39266901 DOI: 10.1007/s40368-024-00945-z] [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: 09/15/2023] [Accepted: 08/30/2024] [Indexed: 09/14/2024]
Abstract
PURPOSE To evaluate perceptions, attitudes, and clinical experience of Brazilian dental practitioners regarding molar incisor hypomineralisation (MIH). METHODS An online survey with 27 questions, covering professional profile data, perceptions, and knowledge on clinical management of MIH, was employed. Descriptive analyses, chi-square, Fisher's exact, and Cramer's V tests were used. RESULTS Sample comprised 100 participants, equally distributed between those working in private or public sectors. Most private sector practitioners had 21-30 years of clinical experience (28%) and master's degree (50%), while most public sector practitioners had 11-20 years of clinical experience (32%) and a PhD degree (32%). Most participants (86%) recognized MIH in their practice. Statistically significant differences were observed in frequency (p = 0.001), incidence (p = 0.039), and lesion type (p = 0.043) between practitioners from both sectors. Uncertainly in management was reported by 49%, mainly in public sector. For mild MIH in incisors, no treatment was chosen (43%), and the treatment longevity was the only significant factor reported (p = 0.012). In cases of mild MIH in first permanent molars (FPMs), 51% of respondents opted to keep the affected tissue and apply fissure sealant. Glass ionomer (GI) restoration was commonly indicated for FPMs with severe MIH with moderate loss of structure and sensitivity (38%). In cases with substantial structural loss and pulpal involvement, the most chosen treatment was endodontic intervention combined with preformed crowns. CONCLUSION Brazilian dental practitioners face MIH in clinical practice. Although, public sector professionals are less confident in diagnosis and treatment, no significant differences in treatment preferences between public and private sector dental practitioners were identified.
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Affiliation(s)
- Thamirys da Costa Rosa
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Rua Professor Rodolpho Paulo Rocco Universidade Federal Do Rio de Janeiro, 325 - Cidade Universitária, CEP, Rio de Janeiro, RJ, 21941-971, Brazil
| | - Larissa Ribeiro Spinelli
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Rua Professor Rodolpho Paulo Rocco Universidade Federal Do Rio de Janeiro, 325 - Cidade Universitária, CEP, Rio de Janeiro, RJ, 21941-971, Brazil
| | - Fernanda Mafei Felix da Silva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Rua Professor Rodolpho Paulo Rocco Universidade Federal Do Rio de Janeiro, 325 - Cidade Universitária, CEP, Rio de Janeiro, RJ, 21941-971, Brazil
| | - Marcelo de Castro Costa
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Rua Professor Rodolpho Paulo Rocco Universidade Federal Do Rio de Janeiro, 325 - Cidade Universitária, CEP, Rio de Janeiro, RJ, 21941-971, Brazil
| | - Aline de Almeida Neves
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Rua Professor Rodolpho Paulo Rocco Universidade Federal Do Rio de Janeiro, 325 - Cidade Universitária, CEP, Rio de Janeiro, RJ, 21941-971, Brazil.
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Voinot J, Bedez M. Pretreatments to bonding on enamel and dentin disorders: a systematic review. Evid Based Dent 2024:10.1038/s41432-024-01037-z. [PMID: 39044008 DOI: 10.1038/s41432-024-01037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/07/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION This systematic review focuses on structural anomalies of enamel and dentin such as fluorosis (F), molar-incisor hypomineralization (MIH), amelogenesis imperfecta (AI), dentinogenesis imperfecta (DI), osteogenesis imperfecta (OI), and X-linked hypophosphatemia (XLH). These pathologies affect up to 31% of the population, posing challenges in the adhesion of direct restorations. The primary objective of this analysis is to examine the survival rate and/or bonding resistance of direct restorations on tissues affected by enamel and dentin disorders in humans. We aim to provide precise clinical recommendations for dentists to choose the appropriate bonding pretreatment for various enamel and dentin disorders. METHODS We systematically searched the medical literature to identify abstracts of interest indexed between 1993 and May 2024, from 4 databases (PubMed, PMC-PubMed, Web of Science and Cochrane Library). The results are reported following the PRISMA statement. The GRADE approach was used to assess the risk of bias. RESULTS The two authors included 27 studies out of the 600 identified. The data extracted from these studies are highly heterogeneous, and the mentioned bonding protocols are all different. 15 articles pertain to F, 7 to MIH, 5 to AI, and none focus on HSPM, dentin disorders and XLH. We identified 12 pretreatments of enamel or dentin (7 for F, 2 for MIH, and 3 for AI), including 3 strong recommendations. Additional studies are necessary to confirm the effectiveness of certain pretreatments. In developmental enamel defects, the main recommendation we collected is to bond on enamel with an etch-and-rinse technique on F and MIH. Considerations with lower strength of evidence include a deproteinization step on enamel on F, MIH and AI and modifications of the etching parameters on F and AI. The research strategy was registered on the Prospero platform (CRD42023447502).
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Affiliation(s)
- Jeanne Voinot
- Univ. Lille, CHU Lille, Odontologie, F-59000 Lille, France
| | - Maxime Bedez
- Univ. Lille, CHU Lille, Odontologie, F-59000 Lille, France.
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Conto Quispe PN, Tapia Martinez AC, Vilcapoma Guerra HJ, Lavado García L, Torres Ramos G. Aesthetic oral rehabilitation of the upper-anterior sector with supra-nano filling resin in a patient with woolly hair syndrome: case report. SPECIAL CARE IN DENTISTRY 2024; 44:1065-1073. [PMID: 38375899 DOI: 10.1111/scd.12979] [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: 10/24/2023] [Revised: 12/08/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Woolly Hair Syndrome (WHS) is a rare birth condition that affects the structure of hair in non-black people. The pathogenesis is not yet defined. It is postulated that the hair follicle's desmosomes (specifically desmoplaquine, placoglobin and placofilin-1, which are cell structural proteins that keep the adhesion among close cells) would be altered in this pathology, leading to fragility in the cellular union. It is subdivided into two large groups: the localized or circumscribed variant and the generalized variant. From birth or first months of life, patients with WHS are clinically characterized by the presence of a portion or entire scalp area of very short frizzy hair, usually of a smaller diameter, brittle and lighter color. The most frequent skin manifestations are pilar keratosis and palmo-plantar keratodermia. The diagnosis is based on the clinical findings, and it is facilitated by trichotoscopic examination. However, a definitive diagnosis of WHS requires genetic testing. Oral agenesis, enamel defects (such as hypomineralization), atypical caries, dental inclusion, and malformed pin-shaped teeth may occur. OBJECTIVE To describe an aesthetic alternative of oral rehabilitation using the mock-up technique in a patient with WHS. CLINICAL CASE A 5-year-old female patient diagnosed with WHS from the National Institute of Child Health NIHCH: Breña, Lima, who was referred from the Genetic service to the Pediatric Dentistry service in order to screen outbreaks of infection associated with odontogenic origin and dental anomalies. At the ectoscopy, a patient with short capillary length, brittle and curly hair, dry skin, and nail dystrophy was observed. At the intraoral clinical examination, anterior pieces of 52, 51, 61, 62, and enamel hypomineralization were observed in all teeth. The radiographic examination showed agenesis of parts 41, 34, and 45. Integral dental treatment was performed in the operating room under general anesthesia due to the complexity of the case. Pulpectomy in pieces 52, 51, 61, 62, post of composite resin, and rehabilitation with supra-nanow filling resin using the mock-up technique were proposed as alternative treatments. CONCLUSION The making of supra-nano filling resin-based crowns using the mock-up technique is an alternative treatment for aesthetic oral rehabilitation in deciduous dentition of patients with WHS. The aesthetic treatment was achieved using supra nano-filling resins. After 12 months of dental treatment, a favorable response was observed, improving the chewing, phonation and aesthetics of the patient.
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Affiliation(s)
| | - Akemy Celeste Tapia Martinez
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, National Police Hospital of Peru Luis N. Saenz, Lima, Peru
| | - Henry Jesús Vilcapoma Guerra
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, Central Hospital of the Peruvian Air Force, Lima, Peru
| | - Lenny Lavado García
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru and Dentistry Department, Instituto Nacional de Salud del Niño, Lima, Peru
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Karaaslan H, Walker AR, Gil-Bona A, Depalle B, Bidlack FB. Posteruptive Loss of Enamel Proteins Concurs with Gain in Enamel Hardness. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.23.595034. [PMID: 38979313 PMCID: PMC11230172 DOI: 10.1101/2024.05.23.595034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Tooth enamel maturation requires the removal of proteins from the mineralizing enamel matrix to allow for crystallite growth until full hardness is reached to meet the mechanical needs of mastication. While this process takes up to several years in humans before the tooth erupts, it is greatly accelerated in in the faster developing pig. As a result, pig teeth erupt with softer, protein-rich enamel that is similar to hypomineralized human enamel but continues to harden quickly after eruption.Proteins, such as albumin, that bind to enamel crystals and prevent crystal growth and enamel hardening have been suggested as cause for hypomineralized human enamel that does not naturally harden after eruption. However, albumin is abundant in pig enamel. It is unclear whether fast posteruptive enamel hardening in pigs occurs despite the high protein content or requires a facilitated protein loss to allow for crystal growth. This study asked how the protein content in porcine enamel changes after eruption in relation to saliva. Based on previous data demonstrating the high albumin content in erupted porcine enamel, we hypothesize that following pre-eruptive maturation, enamel and saliva derived enzymes facilitate protein removal from porcine enamel after eruption. We analyzed enamel and the saliva proteome at three critical timepoints: at the time of tooth eruption, 2 weeks after eruption, and enamel 6 weeks after eruption. We used only fourth deciduous premolars and saliva samples from animals sacrificed at the respective time points to determine the organic content in tooth enamel, saliva, and saliva proteins within enamel. We found a decrease in the number of proteins and their abundancy in enamel with posteruptive time, including a decrease in serum albumin within enamel. The rapid decrease in the first two weeks is in line with previously reported rapid increase in mineral density of porcine enamel after eruption. In addition to the enamel proteases KLK-4 and MMP-20, we identified serine-, cysteine-, aspartic-, and metalloproteases. Some of these were only identified in enamel, while almost half of the enzymes are in common with saliva at all timepoints. Our findings suggest that the fast posteruptive enamel maturation in the porcine model coincides with saliva exchange and influx of saliva enzymes into porous enamel.
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da Costa Rosa T, Cavalcanti YW, de Castro Costa M, de Almeida Neves A. Cost-effectiveness of restorative treatments for permanent molars with severe molar incisor hypomineralization: perspectives for the Brazilian public health system. Clin Oral Investig 2024; 28:301. [PMID: 38710794 DOI: 10.1007/s00784-024-05652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/03/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES To undertake a cost-effectiveness analysis of restorative treatments for a first permanent molar with severe molar incisor hypomineralization from the perspective of the Brazilian public system. MATERIALS AND METHODS Two models were constructed: a one-year decision tree and a ten-year Markov model, each based on a hypothetical cohort of one thousand individuals through Monte Carlo simulation. Eight restorative strategies were evaluated: high viscosity glass ionomer cement (HVGIC); encapsulated GIC; etch and rinse adhesive + composite; self-etch adhesive + composite; preformed stainless steel crown; HVGIC + etch and rinse adhesive + composite; HVGIC + self-etch adhesive + composite, and encapsulated GIC + etch and rinse adhesive + composite. Effectiveness data were sourced from the literature. Micro-costing was applied using 2022 USD market averages with a 5% variation. Incremental cost-effectiveness ratio (ICER), net monetary benefit (%NMB), and the budgetary impact were obtained. RESULTS Cost-effective treatments included HVGIC (%NMB = 0%/ 0%), encapsulated GIC (%NMB = 19.4%/ 19.7%), and encapsulated GIC + etch and rinse adhesive + composite (%NMB = 23.4%/ 24.5%) at 1 year and 10 years, respectively. The benefit gain of encapsulated GIC + etch and rinse adhesive + composite in relation to encapsulated GIC was small when compared to the cost increase at 1 year (gain of 3.28% and increase of USD 24.26) and 10 years (gain of 4% and increase of USD 15.54). CONCLUSION Within the horizon and perspective analyzed, the most cost-effective treatment was encapsulated GIC restoration. CLINICAL RELEVANCE This study can provide information for decision-making.
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Affiliation(s)
- Thamirys da Costa Rosa
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil
| | - Yuri Wanderley Cavalcanti
- Department of Clinical and Social Dentistry, School of Dentistry, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | - Marcelo de Castro Costa
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325, Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-971, Brazil.
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Altner S, Milutinovic I, Bekes K. Possible Etiological Factors for the Development of Molar Incisor Hypomineralization (MIH) in Austrian Children. Dent J (Basel) 2024; 12:44. [PMID: 38534268 DOI: 10.3390/dj12030044] [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: 08/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Molar incisor hypomineralization (MIH) is a developmental enamel defect that primarily affects the first permanent molars and sometimes the incisors. Its increasing prevalence worldwide has raised clinical concerns, yet its exact cause remains unknown. This study aimed to assess potential factors influencing MIH development by analyzing the medical history of children aged 6 to 12 years using a questionnaire. METHODS This study included 100 children aged 6-12 years diagnosed with MIH during dental examination, and 100 age-matched children in the non-MIH (healthy) group from the Department of Pediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna. The parents of the participants completed a two-page questionnaire regarding possible etiological factors of MIH. RESULTS The data analysis involved 100 children with MIH (mean age 8.5; ±1.3; 52% female) and 100 children in the healthy group (mean age 9.2; ±1.3; 42% female). The optimized binary logistic regression analysis revealed a significant association between MIH development and cesarean-section delivery (OR = 3; CI = [1.5-6.2]) and sixth disease (roseola) (OR = 3.5; CI = [1.5-8.0]). CONCLUSIONS This study suggests that cesarean-section delivery and sixth disease (roseola) might increase the likelihood of MIH development in children.
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Affiliation(s)
- Sarra Altner
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
- Clinic of General, Special Care, and Geriatric Dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Ivan Milutinovic
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Katrin Bekes
- Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
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Hajdarević A, Čirgić E, Robertson A, Sabel N, Jälevik B. Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7-8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists. Eur Arch Paediatr Dent 2024; 25:93-103. [PMID: 38315353 PMCID: PMC10942915 DOI: 10.1007/s40368-023-00860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/16/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). METHODS An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. RESULTS A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. "When root furcation is under development of the second permanent molar on radiographs" was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. CONCLUSION Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.
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Affiliation(s)
- A Hajdarević
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Clinic of Pediatric Dentistry, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
| | - E Čirgić
- Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Robertson
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N Sabel
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Folktandvården Björkekärr, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - B Jälevik
- Department of Pediatric Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Mandetta ARH, Bortoletto CC, Sobral APT, Gonçalves MLL, Motta LJ, Horliana ACRT, Ferrari RAM, Prates RA, Deana AM, Cordeiro RDCL, Pinto LAMDS, Fernandes KPS, Bussadori SK. Evaluation of antimicrobial photodynamic therapy and minimal intervention associated with deproteinisation in permanent teeth with molar incisor hypomineralisation: study protocol for a clinical, controlled, blinded trial. BMJ Open 2023; 13:e076226. [PMID: 38101830 PMCID: PMC10729058 DOI: 10.1136/bmjopen-2023-076226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel development that occurs in the mineralisation phase. MIH affects one or more permanent molars and, occasionally, permanent incisors. The aim of the proposed study is to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) on permanent teeth with MIH through decontamination and sensitivity control. METHODS AND ANALYSIS Patients from 8 to 12 years of age with permanent molars will be randomly allocated to three groups. Group 1: selective chemical-mechanical removal of carious dentinal tissue around the walls of the cavity with Papacárie Duo and a curette followed by the application of aPDT and deproteinisation with Papacárie Duo; group 2: selective removal of carious dentinal tissue around the walls of the cavity with a curette, followed by the application of aPDT and deproteinisation with a 5% sodium hypochlorite solution; group 3: selective removal of carious dentinal tissue using a curette. The selected teeth must have a carious lesion in the dentin and posteruptive enamel breakdown on one or more surfaces with an indication for clinical restorative treatment. The teeth will subsequently be restored using a mixed technique with resin-modified glass ionomer cement and bulk-fill composite resin. The data will be submitted to descriptive statistical analysis. Associations with age and sex will be tested using either the χ2 test or Fisher's exact test. Pearson's correlation coefficients will be calculated to determine the strength of correlations between variables. Comparisons of the microbiological results (colony-forming units) will be performed using analysis of variance and the Kruskal-Wallis test. Kaplan-Meier survival analysis will be performed to assess the performance of the restorations. ETHICS AND DISSEMINATION This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 61027522.0.0000.5511/approval date: 23 August 2022). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT05443035.
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Affiliation(s)
- Amanda Rafaelly Honório Mandetta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | | | - Ana Paula Taboada Sobral
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos, Santos, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Marcela Letícia Leal Gonçalves
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos, Santos, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | | | - Raquel Agnelli Mesquita Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Renato Araujo Prates
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Alessandro Melo Deana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Rita de Cássia Loiola Cordeiro
- Research of Department of Pediatric Dentistry, Universidade Estadual Paulista Júlio de Mesquita Filho, Campus de Araraquara, Araraquara, SP, Brazil
| | | | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, Campus Vergueiro, São Paulo, SP, Brazil
- School of Dentistry, Universidade Metropolitana de Santos, Santos, SP, Brazil
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Bekes K, Steffen R, Krämer N. Update of the molar incisor hypomineralization: Würzburg concept. Eur Arch Paediatr Dent 2023; 24:807-813. [PMID: 37856065 PMCID: PMC10657291 DOI: 10.1007/s40368-023-00848-5] [Citation(s) in RCA: 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: 08/21/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index-the MIH Treatment Need Index (MIH-TNI)-and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice. METHODS The authors reviewed the available literature, including clinical and laboratory studies and published guidelines. RESULTS The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction. CONCLUSIONS This is intended to help guide the practitioner and will need to be further validated by clinical trials.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Paediatric Dentistry, Justus Liebig University, Giessen, Germany
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Inchingolo AM, Inchingolo AD, Viapiano F, Ciocia AM, Ferrara I, Netti A, Dipalma G, Palermo A, Inchingolo F. Treatment Approaches to Molar Incisor Hypomineralization: A Systematic Review. J Clin Med 2023; 12:7194. [PMID: 38002806 PMCID: PMC10671994 DOI: 10.3390/jcm12227194] [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: 10/11/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
AIM This systematic review aimed to comprehensively evaluate the available literature on treating molar incisor hypomineralization (MIH) or enamel hypomineralization published between 2013 and 2023, focusing on identifying relevant studies and their characteristics. MATERIALS AND METHODS The search process encompassed reputable academic databases, including PubMed, Scopus, Cochrane Library, and Web of Science, using a precise keyword strategy ("((molar incisor hypomineralization) OR (enamel hypomineralization)) AND (treatment)"). A total of 637 articles were initially retrieved, followed by a strict selection process adhering to PRISMA guidelines. The inclusion criteria encompassed Randomized Control Trials (RCTs), case series with more than five clinical cases (CSs), studies involving human participants, availability as free full-text or accessible with university credentials, and English-language publications. Exclusion criteria included systematic or literature reviews, editorials, single-case reports, studies conducted in vitro, those involving animals, paid articles, and non-English-language publications. RESULTS The search yielded 864 articles, of which 23 met the stringent inclusion criteria after a meticulous selection process. These studies will serve as the basis for a comprehensive analysis of MIH treatment approaches. The systematic review ensures the quality and relevance of the chosen studies for a detailed assessment of MIH treatment strategies. CONCLUSIONS This systematic review will provide valuable insights into the characteristics of selected studies, patient profiles, and available treatment options for molar incisor hypomineralization, contributing to a better understanding of this dental condition's management.
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Affiliation(s)
- Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Anna Netti
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (F.V.); (A.M.C.); (I.F.); (A.N.)
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11
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Hakmi A, Dashash M. Direct or indirect composite for restoring permanent first molars affected by Molar Incisor Hypomineralisation (MIH): a randomized clinical controlled trial. BDJ Open 2023; 9:37. [PMID: 37573344 PMCID: PMC10423268 DOI: 10.1038/s41405-023-00165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 08/14/2023] Open
Abstract
AIM This study was undertaken to compare direct composite resin restorations (DCRR) and indirect composite resin restorations (ICRR) for treating permanent first molars affected by MIH in terms of clinical performance. MATERIALS AND METHODS This was a controlled, randomized, clinical split-mouth study. The studied sample consisted of 40 asymptomatic first permanent hypomineralised mandibular molars in 20 children aged between 7-11 years, these cases were divided randomly into two groups: Group 1 (experimental): 20 first permanent mandibular molars were restored with ICRR, and Group 2 (control): 20 first permanent mandibular molars that were restored with DCRR. The cavity was prepared using a diamond bur on a high-speed handpiece, and the prepared cavity was wiped with cotton moistened with sodium hypochlorite. The composite was applied directly with a total-etch bonding system. In the ICRR group, an impression for the prepared cavity was taken using a silicon-based material, and the restoration was adhesive with self-adhesive resin cement. The child's satisfaction with each of the two application techniques was assessed through the scale FACES. Restorations were evaluated during follow-up periods (3, 6, and 12 months) according to Modified USHPH criteria. RESULTS The clinical success rate was 90% in the ICRR group versus 85% in the DCRR group after 12 months of follow-up without statistically significant differences (P = 0.218). Children were significantly more satisfied (P = 0.0351) with ICRR than DCRR. CONCLUSIONS Both DCRR and ICRR can be considered effective restorations with acceptable clinical performance in the restoration of hypomineralised first permanent molars with an advantage of ICRR in terms of child acceptance of the restoration application technique.
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Affiliation(s)
- Abdulrhman Hakmi
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Damascus, Syria.
| | - Mayssoon Dashash
- Department of Pediatric Dentistry, College of Dentistry, Damascus University, Damascus, Syria
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12
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Mazzitelli C, Josic U, Maravic T, Mancuso E, Goracci C, Cadenaro M, Mazzoni A, Breschi L. An Insight into Enamel Resin Infiltrants with Experimental Compositions. Polymers (Basel) 2022; 14:polym14245553. [PMID: 36559920 PMCID: PMC9782164 DOI: 10.3390/polym14245553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Resin infiltration is a conservative treatment of initial enamel carious lesions. Only one infiltrant material is available on the market (Icon, DMG), and research is now investigating new chemical compositions so as to further exploit the benefits of the resin infiltration technique. A literature search of the articles testing the effects of different formulations on mechanical properties, resin penetration ability, remineralizing, and antibacterial activities was conducted. Of 238 articles, 29 resulted in being eligible for the literature review. The formulations investigated were all different and consisted in the inclusion of hydrophobic monomers (i.e., BisEMA, UDMA), solvents (ethanol, HEMA), alternative etchants (PAM) or molecules with antibacterial or bioactivity features (i.e., AgNP, YbF3, MTZ, chitosan, DMAMM, HAp, MC-IL, NACP, PUA, CHX) and microfilled resins. Information on the long-term performances of the tested experimental materials were scarce. The combination of TEGDMA with hydrophobic monomers and the inclusion of a solvent alternative to ethanol reinforced mechanical properties of the materials. Hybrid-glass materials demonstrated an enhanced remineralization capacity. Techniques such as tunnelization increased the penetration depth and preserved the recourse to less-conservative treatments. Combining the min-invasive infiltrant approach with remineralizing and bacteriostatic properties would be beneficial for therapeutic and economical aspects, according to the principles of minimally invasive dentistry.
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Affiliation(s)
- Claudia Mazzitelli
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
| | - Uros Josic
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
| | - Tatjana Maravic
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
- Correspondence:
| | - Edoardo Mancuso
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
| | - Cecilia Goracci
- Dipartimento di Biotecnologie Mediche, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100 Siena, Italy
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Strada di Fiume 447, 34125 Trieste, Italy
- Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy
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13
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de Farias AL, Rojas-Gualdrón DF, Mejía JD, Bussaneli DG, Santos-Pinto L, Restrepo M. Survival of stainless-steel crowns and composite resin restorations in molars affected by molar-incisor hypomineralization (MIH). Int J Paediatr Dent 2022; 32:240-250. [PMID: 34115431 DOI: 10.1111/ipd.12849] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently, there is no consensus on the superiority of any material for the restorative treatment of molars affected by molar-incisor hypomineralization (MIH). AIM To evaluate the survival of restorations with stainless-steel crown (SSC) or composite resin (CR) in first permanent molars affected by MIH for 24 months. DESIGN In this retrospective cohort study, 61 CR and 54 SSC restorations placed on molars affected by MIH of patients, aged between 7 and 10, that were treated and overseen at a university dental clinic in the period of 2017-2020 were evaluated. The primary outcome was the failure-free survival time. Parametric survival models were used for data censored by interval, and the comparison between SSC and CR was performed using the hazard ratio function with a 95% confidence interval. RESULTS The survival of SSC and CR restorations after 24 months was 94.4% and 49.2%, respectively. This difference was influenced by the presence of previous restoration (aHR = 3.4; 95% CI: 1.2-9.4) and cusp involvement (aHR = 4.0; 95% CI: 1.5-11.2). CONCLUSION In molars with MIH and the need for restorative treatment, SSC had a significantly higher survival rate than CR over 24 months.
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Affiliation(s)
- Aline Leite de Farias
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | | | - Juan Diego Mejía
- Basic and Clinical Research Group in Dentistry, School of Dentistry, CES University, Medellín, Colombia
| | - Diego Girotto Bussaneli
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | - Lourdes Santos-Pinto
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
| | - Manuel Restrepo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, São Paulo, Brazil
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14
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Lee YL, Li KC, Yiu CKY, Boyd DH, Ekambaram M. Evaluation of developmentally hypomineralised enamel after surface pretreatment with Papacarie Duo gel and different etching modes: an in vitro SEM and AFM study. Eur Arch Paediatr Dent 2022; 23:117-131. [PMID: 34586616 DOI: 10.1007/s40368-021-00671-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed at investigating the surface morphology and nanotopography of normal enamel (NE) and developmentally hypomineralised enamel (HE) when subjected to various pretreatment protocols under scanning electron microscopy (SEM) and atomic force microscopy (AFM). METHODS Sixteen NE, 16 creamy/white (CW) HE and 16 yellow/brown (YB) HE specimens sectioned from extracted hypomineralised first permanent molars (FPMs) were included in this study. They were randomly distributed into 12 experimental groups (n = 4). Each group involved the following: (1) deproteinisation with Papacarie Duo® gel or no deproteinisation, and (2) the use of Scotchbond™ Universal Adhesive (Scotchbond) in self-etch (SE) mode or 37% phosphoric acid etchant. Subsequently, the surface morphology and nanotopography of pretreated enamel specimens were evaluated under SEM and AFM, respectively. RESULTS SEM observation showed that deproteinisation with Papacarie Duo® gel before phosphoric acid etching led to favourable etching patterns. This was consistent across all groups irrespective of the type of enamel specimen and the severity of hypomineralisation. In contrast, AFM results identified three factors that influenced surface parameters: (1) type of enamel specimen, (2) severity of hypomineralisation and (3) etching mode. YB HE recorded higher surface roughness values than CW HE and NE when subjected to the same pretreatment protocol. Deproteinisation and the application of Scotchbond in SE mode led to minimal topographic changes; however, acid etching was associated with an increase in surface roughness. CONCLUSION Deproteinisation with Papacarie Duo® gel followed by acid etching contributed to improved etching patterns on HE.
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Affiliation(s)
- Y-L Lee
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - K C Li
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - C K Y Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong (SAR), People's Republic of China
| | - D H Boyd
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - M Ekambaram
- Discipline of Paediatric Dentistry, Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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15
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Somani C, Taylor GD, Garot E, Rouas P, Lygidakis NA, Wong FSL. An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2022; 23:39-64. [PMID: 34110615 PMCID: PMC8927013 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
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Affiliation(s)
- C Somani
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E Garot
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - P Rouas
- Univ. de Bordeaux, UFR Des Sciences Odontologiques, Bordeaux, France
| | - N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece
| | - F S L Wong
- Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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16
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Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent 2022; 23:3-21. [PMID: 34669177 PMCID: PMC8926988 DOI: 10.1007/s40368-021-00668-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/16/2022]
Abstract
AIM To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' METHODS Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. RESULTS (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. CONCLUSIONS MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
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Affiliation(s)
- N A Lygidakis
- Private Paediatric Dental Clinic, 2 Papadiamantopoulou Street, 11528, Athens, Greece.
| | - E Garot
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - C Somani
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - G D Taylor
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P Rouas
- Univ. de Bordeaux, UFR des Sciences Odontologiques, Bordeaux, France
- CHU de Bordeaux, Pôle médecine et chirurgie bucco-dentaire, Pellegrin, Bordeaux, France
- Univ. de Bordeaux, PACEA, UMR 5199, Pessac, France
| | - F S L Wong
- Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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17
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Nogueira VKC, Mendes Soares IP, Fragelli CMB, Boldieri T, Manton DJ, Bussaneli DG, Cordeiro RDCL. Structural integrity of MIH-affected teeth after treatment with fluoride varnish or resin infiltration: An 18-Month randomized clinical trial. J Dent 2020; 105:103570. [PMID: 33385533 DOI: 10.1016/j.jdent.2020.103570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/28/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To evaluate the influence of fluoride varnish (FV) therapies or resin infiltration (RI) to maintain the structural integrity of Molar Incisor Hypomineralization (MIH) -affected teeth. METHODS Fifty-one children aged 6-12 years with at least one incisor and one first permanent molar with yellow/brown MIH opacities were included. Patients were randomly allocated into three groups: FV - Fluoride Varnish (Duraphat); FV+etch - Fluoride Varnish (Duraphat) after enamel etching with 37% phosphoric acid; or RI - Resin Infiltration system (Icon). Opacities were monitored for 18 months. The primary outcome was the loss of integrity due to post-eruptive enamel breakdown (PEB). Covariables included sex, age, DMFT index, opacity colour, plaque index, number of MIH-affected teeth, and number of MIH-affected surfaces. Fisher's Exact was used to test the association of treatments with PEB, the Kaplan-Meyer method analysed the survival rates and Cox-regression determined which covariables would predict failure (α=0.05). RESULTS From a total of 235 teeth, the PEB rate for RI (6.1%) was significantly lower (p<0.05) than FV (17.9%; OR 3.0, 95%CI 1.07, 8.48) and FV+etch (17.3%; OR 3.1, 95%CI 1.13, 8.73). DMFT index >3, brown opacities, cusp involvement, and age between 6-8 years predicted PEB (p<0.05). CONCLUSIONS Resin infiltration positively influenced the structural integrity maintenance of MIH-affected teeth by decreasing the risk of enamel breakdown over18 months follow-up. Registry of Clinical Trials (RBR-8wwk3n). CLINICAL RELEVANCE Resin infiltration proved to be a more efficacious intervention to maintain the structural integrity of MIH-affected teeth than fluoride varnish therapies.
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Affiliation(s)
- Vinícius Krieger Costa Nogueira
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (UNESP). Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Camila Maria Bullio Fragelli
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Talita Boldieri
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - David John Manton
- Melbourne Dental School, The University of Melbourne, Victoria, 3010, Australia; Cariology and Paediatric Dentistry, Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen.
| | - Diego Girotto Bussaneli
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
| | - Rita de Cássia Loiola Cordeiro
- Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
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18
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Wang L, Freitas MCCDA, Prakki A, Mosquim V, González AHM, Rios D, Honório HM. Experimental self-etching resin infiltrants on the treatment of simulated carious white spot lesions. J Mech Behav Biomed Mater 2020; 113:104146. [PMID: 33125956 DOI: 10.1016/j.jmbbm.2020.104146] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate the penetration depth (μm) of experimental resin infiltrants containing different percentages of triethylene glycol dimethacrylate (TEGDMA) and phosphoric acid 2-hydroxyethyl methacrylate ester (PAM) in artificial carious white spot lesions (WSL). METHODS WSL were produced in 65 bovine flat enamel specimens by pH cycling protocol, which were treated with either Icon (control) or experimental acidic infiltrants based on different percentages of TEGDMA and PAM monomers (acidic), and their association or not with previous acid-etching with phosphoric acid. Ten readings using Confocal Laser Scanning Microscopy were conducted on each specimen and the penetration depth was calculated from the surface until the deepest point with the fluorescent dye Rhodamine B (0.02 mg/mL). The pH and the viscosity of the experimental infiltrants were also tested. Data were statistically analyzed with two-way ANOVA and Tukey tests (α < 0.05). RESULTS The material factor and the interaction material*acid-etching were statistically significant. The lowest penetration depth was observed for the samples treated with the commercial infiltrant after etching with 15% hydrochloric acid. When specimens were pre-treated with PA, highest penetration was seen for specimens treated with 100% TEGDMA, which differed from all other groups. The lowest penetration was seen for those treated with 50:50 TEGDMA:PAM infiltrants. When specimens were not previously etched, highest penetration was seen for Icon, which differed only from those treated with 25% TEGDMA 75% PAM, where the lowest values were seen. The values of viscosity increased and the pH decreased with the addition of PAM in the infiltrant formulations. CONCLUSION the association between TEGDMA and PAM seems to allow similar infiltration depth reached by Icon infiltrant without acid etching the enamel surface.
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Affiliation(s)
- Linda Wang
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil.
| | - Maria Cristina Carvalho de Almendra Freitas
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil; DeVry FACID, DeVry Education Group, Teresina-PI, Brazil
| | - Anuradha Prakki
- Faculty of Dentistry, University of Toronto, Restorative Department, Toronto-ON, Canada
| | - Victor Mosquim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | | | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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19
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Alkhalaf R, Neves ADA, Banerjee A, Hosey MT. Minimally invasive judgement calls: managing compromised first permanent molars in children. Br Dent J 2020; 229:459-465. [PMID: 33037366 DOI: 10.1038/s41415-020-2154-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022]
Abstract
This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.
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Affiliation(s)
- Reem Alkhalaf
- Centre of Oral, Clinical & Translational Science, Faculty of Dentistry, Oral and Craniofacial Research, King's College London, London, UK
| | - Aline de Almeida Neves
- Clinical Lecturer in Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK; Adjunct Professor in Paediatric Dentistry, Federal University of Rio de Janeiro, Brazil.
| | - Avijit Banerjee
- Professor of Cariology & Operative Dentistry, Honorary Consultant/Clinical Lead, Restorative Dentistry, Conservative & MI Dentistry/Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marie Therese Hosey
- Professor of Paediatric Dentistry, Honorary Consultant, Chair of Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Linner T, Khazaei Y, Bücher K, Pfisterer J, Hickel R, Kühnisch J. Comparison of four different treatment strategies in teeth with molar-incisor hypomineralization-related enamel breakdown-A retrospective cohort study. Int J Paediatr Dent 2020; 30:597-606. [PMID: 32112475 DOI: 10.1111/ipd.12636] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 12/21/2019] [Accepted: 02/13/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is little information available on the longevity of non-invasive glass ionomer cement (GIC) and composite restorations as well as conventional composite and ceramic restorations placed on permanent teeth with enamel breakdowns due to molar-incisor hypomineralization (MIH). AIM To compare the longevity of the abovementioned treatment procedures. DESIGN Of 377 identified MIH patients, 118 individuals received restorative treatment and were invited for clinical examination, including caries and MIH status. Finally, survival data from 204 MIH-related restorations placed on 127 teeth were retrospectively collected from 52 children, monitored between 2010 and 2018. Descriptive and explorative analyses were performed, including Kaplan-Meier estimators and the Cox regression model. RESULTS The mean patient observation time was 42.9 months (SD = 35.1). The cumulative survival probabilities after 36 months-7.0% (GIC, N = 28), 29.9% (non-invasive composite restoration, N = 126), 76.2% (conventional composite restoration, N = 27) and 100.0% (ceramic restoration, N = 23)-differed significantly in the regression analysis. CONCLUSIONS Conventional restorations were associated with moderate-to-high survival rates in MIH teeth. In contrast, non-invasive composite restorations, which were predominately used in younger or less cooperative children, were linked to lower survival rates.
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Affiliation(s)
- Thomas Linner
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Yeganeh Khazaei
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig Maximilians University of Munich, Munich, Germany
| | - Katharina Bücher
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Jan Pfisterer
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig Maximilians University of Munich, Munich, Germany
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Molar Incisor Hypomineralisation-To Extract or to Restore beyond the Optimal Age? CHILDREN-BASEL 2020; 7:children7080091. [PMID: 32781715 PMCID: PMC7464986 DOI: 10.3390/children7080091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
Abstract
The management of compromised first permanent molars (FPMs) in children presents a clinical challenge to the dental team. Hypomineralised FPMs in molar incisor hypomineralisation (MIH) conditions could undergo post-eruptive breakdown, making them susceptible to caries, leading to their subsequent loss. The planned extraction of compromised FPMs is a valid alternative to complex restorative treatment. However, establishing the presence or absence of third permanent molars, amongst other considerations, is crucial to reaching a successful outcome. Clinicians should understand the importance of an orthodontic examination around the age of 8 years old with regard to establishing a differential therapeutic decision about the ideal timing of MIH-affected FPMs’ extraction in children. The aim of this article is to highlight that, with an interdisciplinary approach, a good outcome can be achieved following the extraction of poorly prognosed FPMs. The most cost-effective way of addressing MIH-affected FPMs is extraction, followed by orthodontic space closure when indicated. This obviates the need for the repeated restorative replacement and saves perfectly healthy premolars from being extracted for space creation in orthodontic treatment in several clinical scenarios.
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Sundfeld D, da Silva L, Kluppel OJ, Santin GC, de Oliveira R, Pacheco RR, Pini N. Molar Incisor Hypomineralization: Etiology, Clinical Aspects, and a Restorative Treatment Case Report. Oper Dent 2020; 45:343-351. [PMID: 32053452 DOI: 10.2341/19-138-t] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2019] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Total-etch adhesive systems and resin composite are clinically viable dental materials for esthetic restorations in teeth presenting white/yellow/brown hypomineralization stains. SUMMARY Molar-incisor hypomineralization (MIH) is a condition that negatively affects enamel and dentin, especially the first molars and permanent incisors, causing esthetic and functional problems. The present clinical case report presents and discusses the etiology and clinical characteristics of MIH and describes a restorative protocol for MIH-affected teeth.
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Lagarde M, Vennat E, Attal JP, Dursun E. Strategies to optimize bonding of adhesive materials to molar-incisor hypomineralization-affected enamel: A systematic review. Int J Paediatr Dent 2020; 30:405-420. [PMID: 31990108 DOI: 10.1111/ipd.12621] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 01/17/2020] [Accepted: 01/22/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Children with first permanent molar affected by molar-incisor hypomineralization (MIH) show high treatment failure rate. AIM To conduct a systematic review on bonding of adhesive materials to MIH-affected enamel, so as to identify all the methods suggested to optimize it and to determine the best bonding protocol(s). DESIGN An exhaustive literature search was conducted on MEDLINE/PubMed, the Cochrane Library, and Web of Science databases, up to October 2018. Laboratory and clinical studies, involving adhesive restorations bonded to MIH-affected enamel, with at least a comparative group were included. Two authors independently selected studies, collected data, and assessed bias risk. RESULTS After title and abstract review and duplicate exclusion, 14 articles were selected on the 496 eligible papers. After full reading, 4 articles were excluded. Finally, 10 studies (6 laboratory and 4 clinical studies) were included. CONCLUSIONS Bond strength of composite was not significantly different when using self-etch compared with etch-and-rinse adhesives. Deproteinization after etching for etch-and-rinse adhesives enhanced bond strength; this could allow to keep MIH-affected enamel. Icon® showed an erratic penetration; however, a preliminary deproteinization after etching could improve bond strength. A study reported no significant differences in sealant retention rate, whereas another recommended to previously apply an adhesive.
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Affiliation(s)
- Marianne Lagarde
- Faculty of Dental Surgery, Paris Descartes University, Montrouge, France.,Henri Mondor Hospital, Créteil, France.,Innovative Dental Materials and Interfaces Research Unit (EA 4462), Montrouge, France
| | - Elsa Vennat
- Innovative Dental Materials and Interfaces Research Unit (EA 4462), Montrouge, France.,Centrale-Supélec, MSSMat Laboratory, Gif-sur-Yvette, France
| | - Jean-Pierre Attal
- Faculty of Dental Surgery, Paris Descartes University, Montrouge, France.,Innovative Dental Materials and Interfaces Research Unit (EA 4462), Montrouge, France.,Charles Foix Hospital, Ivry-sur-Seine, France
| | - Elisabeth Dursun
- Faculty of Dental Surgery, Paris Descartes University, Montrouge, France.,Henri Mondor Hospital, Créteil, France.,Innovative Dental Materials and Interfaces Research Unit (EA 4462), Montrouge, France
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Wall A, Leith R. A questionnaire study on perception and clinical management of molar incisor hypomineralisation (MIH) by Irish dentists. Eur Arch Paediatr Dent 2020; 21:703-710. [PMID: 32185633 DOI: 10.1007/s40368-020-00519-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/04/2020] [Indexed: 01/28/2023]
Abstract
AIM Molar incisor hypomineralisation (MIH) is a significant global health problem frequently encountered by dentists. The aim of this questionnaire-based study was to gain a better understanding of how dentists in the Republic of Ireland perceive and manage MIH. In addition, to compare these findings with results of existing international studies. METHODS Following ethical approval, an online survey was created consisting of 16 questions based on previous surveys regarding perception and treatment of MIH. Photographs and information regarding three specific cases were also included. The questionnaire was distributed by email and the data were analysed using SPSS statistical software. RESULTS The total number of respondents was 230, of which 204 were general dentists. The majority of dentists (58%) reported that they observe MIH on a weekly basis. Those dentists exclusively in private practice and respondents aged 36 and older were less likely to note frequent MIH (p = 0.042). The vast majority of respondents felt either confident or very confident in diagnosing MIH (91%). Overall, 71% reported to feel comfortable managing MIH; however, those in private practice only (p = 0.023) and those aged 36 and older (p = 0.011) were less likely to report being comfortable managing MIH. The most commonly cited barrier to care was the child's behaviour, followed by difficulty in achieving local anaesthesia. Composite resin was the most commonly selected material used to restore teeth affected by MIH (84%). In the scenario on cavity design, the results showed a similar number of dentists selected the most conservative and the most aggressive preparation indicating a disparity among choices. CONCLUSIONS MIH is frequently encountered by Irish general dentists. The overall wide disparity of responses is in line with other studies, and further highlights the need for the development of strong treatment guidelines and continuing dental education to assist dentists in treatment planning for MIH.
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Affiliation(s)
- A Wall
- Paediatric Department, Dublin Dental Hospital, Lincoln Place, Dublin 2, Ireland.
| | - R Leith
- Paediatric Department, Dublin Dental Hospital, Lincoln Place, Dublin 2, Ireland
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Elhennawy K, Krois J, Jost-Brinkmann PG, Schwendicke F. Outcome and comparator choice in molar incisor hypomineralisation (MIH) intervention studies: a systematic review and social network analysis. BMJ Open 2019; 9:e028352. [PMID: 31377700 PMCID: PMC6687020 DOI: 10.1136/bmjopen-2018-028352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Outcome and comparator choice strongly determine the validity and implementation of clinical trial results. We aimed to assess outcome and comparator choice in intervention studies on molar incisor hypomineralisation (MIH) using systematic review and social network analysis (SNA). DESIGN AND DATA SOURCES Medline, Embase, Cochrane Central, Google Scholar, opengrey.eu as well as DRKS.de and Clinicaltrials.gov were searched for MIH intervention studies. The search covered the period from 1980 to 2019. ELIGIBILITY CRITERIA Clinical single-arm/multiarm, controlled/uncontrolled studies reporting on the management of MIH were included. Reported outcomes and comparators were extracted and categorised. SNA was used to evaluate comparator choice and the resulting trial networks. DATA EXTRACTION Of the 7979 identified records, 100 were evaluated in full text and 35 studies (17 randomised controlled trials, 14 prospective and 4 retrospective cohort studies) were included. RESULTS In total, 2124 patients with a mean age of 11 years (min/max 6/70 years) were included. Outcomes fell in one of 11 different outcome categories: restoration success, aesthetic improvement, pain/hypersensitivity/discomfort, mineral gain, space management, anaesthesia effectiveness, preventive success, efficiency, quality of life, gingival and periodontal health and patient satisfaction. Comparators were mainly restorative interventions (17 studies), remineralisation (3), treatment of hypersensitivity (10), aesthetic interventions (5) and orthodontic interventions (3). Two highly clustered comparator networks emerged; many interventions were not robustly linked to these networks. CONCLUSIONS MIH intervention studies recorded both clinically centred and patient-centred outcomes. Core outcome set development should consider these and supplement them with outcomes on, for example, applicability. The high number of compared interventions tested in only few studies and our SNA results implicate that the current evidence may not be robust.
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Affiliation(s)
- Karim Elhennawy
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Dhareula A, Goyal A, Gauba K, Bhatia SK, Kapur A, Bhandari S. A clinical and radiographic investigation comparing the efficacy of cast metal and indirect resin onlays in rehabilitation of permanent first molars affected with severe molar incisor hypomineralisation (MIH): a 36-month randomised controlled clinical trial. Eur Arch Paediatr Dent 2019; 20:489-500. [DOI: 10.1007/s40368-019-00430-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/05/2019] [Indexed: 11/29/2022]
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da Cunha Coelho ASE, Mata PCM, Lino CA, Macho VMP, Areias CMFGP, Norton APMAP, Augusto APCM. Dental hypomineralization treatment: A systematic review. J ESTHET RESTOR DENT 2018; 31:26-39. [PMID: 30284749 DOI: 10.1111/jerd.12420] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/08/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. OBJECTIVE To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. MATERIALS AND METHODS PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. RESULTS From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. CONCLUSIONS Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). CLINICAL SIGNIFICANCE Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.
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Affiliation(s)
- Ana Sofia Estima da Cunha Coelho
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,iCBR, Coimbra Institute of Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Carolina Alves Lino
- Dentistry Area, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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