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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Sen Yavuz B, Kaya R, Kodaman Dokumacigil N, Ozgur EG, Bekiroglu N, Kargul B. Clinical performance of short fiber reinforced composite and glass hybrid on hypomineralized molars: A 36-month randomized split-mouth study. J Dent 2024; 144:104919. [PMID: 38431187 DOI: 10.1016/j.jdent.2024.104919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES This study aimed to assess the clinical performance outcome at 36 months of molars with molar incisor hypomineralization and carious lesions, treated with two different restorative approaches following selective caries removal. METHODS The children aged 6 to 12 years (18 female, 13 male) included in the study had at least two carious permanent first molars diagnosed with molar incisor hypomineralization. Sixty-two molars were restored in a split-mouth design. In all subjects, selective caries removal was performed so that caries was completely removed from the cavosurface walls and only soft dentin was left above the pulp chamber. Short fiber reinforced composite (SFRC; EverX Flow™) covered by micro-hybrid composite (G-Aenial® posterior composite) and Glass Hybrid (GH; Equia Forte® HT) were used as restorative materials. The restorations were evaluated according to modified United States Public Health Service (USPHS) criteria at baseline, 6, 12, 18, 24, and 36 month follow-ups. RESULTS During the 36-month follow-up, eight GH and four SFRC restorations failed. The clinical success of both restorations decreased statistically over time (p < 0.001 for both). When variables such as restoration type, sex, age, tooth type, and time were included in the model, the risk of failure of the restorations of the left lower first molar was statistically significantly higher than that of the left upper first molar (p < 0.002). CONCLUSION Direct composite restorations with SFRC and GH restorations perform similar clinical success with selective caries removal in the management of permanent molars affected by molar incisor hypomineralization. CLINICAL SIGNIFICANCE SFRC or GH restorations with similar clinical success might be preferred for the management of MIH-affected molars.
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Affiliation(s)
- Betul Sen Yavuz
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Basibuyuk yolu, 9/3, Maltepe, Istanbul 34854, Turkey.
| | | | - Nur Kodaman Dokumacigil
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Basibuyuk yolu, 9/3, Maltepe, Istanbul 34854, Turkey
| | - Emrah Gokay Ozgur
- Department of Biostatistics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nural Bekiroglu
- Department of Biostatistics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Betul Kargul
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Basibuyuk yolu, 9/3, Maltepe, Istanbul 34854, Turkey
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Sekundo C, Jung M, Muscholl C, Frese C. Oral health-related quality of life and survival analysis after preventive and restorative treatment of molar-incisor hypomineralisation. Sci Rep 2024; 14:777. [PMID: 38191504 PMCID: PMC10774292 DOI: 10.1038/s41598-024-51223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Abstract
The aim of this study was to assess the impact of molar-incisor hypomineralisation (MIH) on oral health-related quality of life (OHRQoL) in children and adolescents, including information on restorative care, tooth sensitivity, as well as sociodemographic factors. Thirty-five patients aged between 7 and 17 years underwent a comprehensive oral examination. Severity of MIH was graded using the MIH Treatment Need Index (MIH-TNI), OHRQoL using the Child Oral Health Impact Profile (COHIP-19). Clinical quality of restorations was assessed according to modified FDI-criteria, tooth sensitivity using the Schiff Cold Air Sensitivity Scale (SCASS). The mean age was 11.3 ± 3.0 years, 34% were female. On average, 6.9 ± 2.8 teeth were affected, 62,9% had hypersensitive teeth (SCASS ≥ 1). Eighty-nine percent of patients had received restorative care, with a mean of 3.3 ± 2.1 teeth restored, most often with composite, followed by fissure sealing. Nine percent of restorations failed by the FDI-criteria. Mean estimated survival times for success were 4.9 years (95% CI 3.5; 6.2) and 5.6 years (95% CI 5.0; 6.3) for fissure sealants and composite restorations, respectively. The mean COHIP-19 score was 64.3 ± 8.2 (max. possible score = 76). A higher severity of MIH-TNI correlated significantly with impaired OHRQoL (rs = - 0.38, p = 0.013). However, this was not mirrored in multiple regression analysis. Despite the high rate of restorative treatment with an acceptable failure rate, OHRQoL is reduced in children with MIH. Many teeth affected by MIH remain sensitive. Further studies are needed to assess the benefits of different restorative options.
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Affiliation(s)
- Caroline Sekundo
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Marina Jung
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Clara Muscholl
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Cornelia Frese
- Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Sezer B. Does the scientific literature provide sufficient information on incisors affected by molar incisor hypomineralisation? Eur Arch Paediatr Dent 2023; 24:147-149. [PMID: 36588126 DOI: 10.1007/s40368-022-00779-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/20/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Berkant Sezer
- Department of Paediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
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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 Odontol Latinoam 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] [What about the content of this article? (0)] [Affiliation(s)] [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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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: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Jälevik B, Sabel N, Robertson A. Can molar incisor hypomineralization cause dental fear and anxiety or influence the oral health-related quality of life in children and adolescents?-a systematic review. Eur Arch Paediatr Dent 2022; 23:65-78. [PMID: 34110616 PMCID: PMC8927003 DOI: 10.1007/s40368-021-00631-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Molar Incisor Hypomineralization (MIH) are first molars with developmental enamel defects and are common findings in many child populations. The porous nature of MIH enamel and the presence of post-eruptive enamel breakdown leads to the presence of hypersensitivity and pain, which is often the patient's main complaint and can result in dental fear and affect the quality of life. The present review aims to summarise the evidence for the ability of MIH to cause problems, such as dental fear and anxiety (DFA) and to summarise the evidence for a possibly negative impact on the oral health-related quality of life (OHRQoL) of MIH affected children and adolescents, in a systematic review. METHOD Two searches, (1) MIH AND dental anxiety and (2) MIH AND Quality of life, were performed in MEDLINE/PubMed and Scopus. Selection demands were fulfilling the MIH diagnosis criteria using validated instruments and questionnaires for assessing DFA and OHRQoL, respectively. RESULTS After removing duplicates and articles not fulfilling the selection demands, 6 studies concerning MIH and DFA and 8 studies concerning MIH and OHRQoL remained. CONCLUSION Children and adolescents with diagnosed MIH did not seem to suffer from increased dental fear and anxiety, but indicated an impaired oral health-related quality of life.
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Affiliation(s)
- B Jälevik
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - N Sabel
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Specialist Clinics for Pediatric Dentistry, Public Dental Service, VGR, Mölndal, Sweden
| | - A Robertson
- Department of Pediatric Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Vicioni-Marques F, Paula-Silva FWGD, Carvalho MR, Queiroz AMD, Freitas OD, Duarte MPF, Manton DJ, Carvalho FKD. Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. J Appl Oral Sci 2022; 30:e20210538. [PMID: 35476115 PMCID: PMC9040738 DOI: 10.1590/1678-7757-2021-0538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia.
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12
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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: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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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 DOI: 10.1007/s40368-021-00635-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?' METHODS An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. RESULTS Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. CONCLUSION The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
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Olgen IC, Sonmez H, Bezgin T. Effects of different remineralization agents on MIH defects: a randomized clinical study. Clin Oral Investig 2021; 26:3227-3238. [PMID: 34821978 DOI: 10.1007/s00784-021-04305-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to present a comparative evaluation of the long-term efficacy of fluoride varnish and pastes containing CPP-ACP and CPP-ACP with fluoride (CPP-ACFP) in the remineralization of creamy-white and yellow-brown defects in permanent first molars with MIH. MATERIALS AND METHODS The study included 120 teeth with yellow-brown or creamy-white defects in 67 children (37 girls, 30 boys) aged 6-9 years (mean, 7.2) who were newly diagnosed with MIH with no substance loss or caries or prior restorative treatment. The patients were randomly divided into the experiment groups; control (oral hygiene motivation only), fluoride varnish, and pastes containing CPP-ACP and CPP-ACPF, and followed up for 24 months. The evaluations were made based on the ICDAS criteria and the measurements which were performed using the laser fluorescence method (DIAGNOdent, KaVo, Biberach, Germany) in the follow-ups. RESULTS The research was completed with 49 patients (23 females, 26 males; mean age, 7.7) and 90 teeth. All remineralization agents increased remineralization rates in both creamy-white and yellow-brown colored defects without presenting any statistically significant difference at the end of the follow-up period (p > 0.05). However, the effects of fluoride varnishes were late to observe when compared to pastes containing CPP-ACP and CPP-ACPF. CONCLUSIONS Pastes containing calcium and phosphate may be recommended for the longer-term preservation of teeth with yellow-brown defects which showed a post-eruptive breakdown in a shorter time. CLINICAL RELEVANCE There is a lack of studies investigating MIH treatments in which lesion appearance was recorded. This study evaluated creamy-white and yellow-brown MIH defects separately and reported long-term results of different remineralization agents.
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Affiliation(s)
- Irem Can Olgen
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hayriye Sonmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Tugba Bezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey.
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Ballikaya E, Ünverdi GE, Cehreli ZC. Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig 2021. [PMID: 34743243 DOI: 10.1007/s00784-021-04236-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
Objectives This study evaluated and compared the effect of silver diamine fluoride (SDF) and silver-modified atraumatic restorative treatment (SMART) sealants for the treatment of initial carious lesions of permanent molars affected by molar incisor hypomineralization (MIH). Methods One hundred and twelve hypomineralized permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF and SMART sealant groups (n = 56 teeth/group) in a split-mouth fashion. Hypersensitivity, formation of caries, and enamel breakdown were evaluated in both groups. Hypersensitivity was assessed by Schiff Cold Air Sensitivity Scale (SCASS), and clinical assessments of SMART sealants were performed according to modified USPHS criteria at 1, 6, and 12 months. The data were analyzed statistically using Fisher’s exact test, Kaplan–Meier analysis, Mann–Whitney U test, and Friedman test. Results Twenty-six hypomineralized molars with marked baseline hypersensitivity showed significantly lower SCASS scores at all evaluation periods (p < 0.001). There was no significant difference in hypersensitivity scores between the groups at the repeated applications of SDF at 1, 6, and 12 months. The cumulative survival rates of SMART sealants on occlusal and palatal surfaces were 88.7% and 58.8%, respectively. Conclusions In hypomineralized molars, both SDF and SMART sealants showed favorable short-term prevention against dental caries while providing effective desensitization. Marginal discoloration was the most common side effect of the SMART sealants as a result of SDF application. Clinical Significance Both SDF and SMART sealants showed similar short-term effectiveness as non-aerosol procedures in arresting enamel caries and reducing hypersensitivity in hypomineralized molars. Trial registration Clinical Trials Registration Number: NCT03862014.
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