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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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Romo Pérez C, Lobo Cortés L, Morales Rojas MJ, Martín López ALS, Ramírez Vera KG. [Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]. Rev Cient Odontol (Lima) 2023; 10:e130. [PMID: 38390611 PMCID: PMC10880695 DOI: 10.21142/2523-2754-1004-2022-130] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/24/2022] [Indexed: 02/24/2024] Open
Abstract
Introduction Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems. Objective to evaluate the effect of MIH on oral health-related quality of life in children and adolescents. Materials and methods A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality. Results Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life. Conclusions The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.
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Affiliation(s)
- Camilo Romo Pérez
- Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS), Universidad del Magdalena. Santa Marta, Colombia. , Universidad del Magdalena Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS) Universidad del Magdalena Santa Marta Colombia
| | - Luis Lobo Cortés
- Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS), Universidad del Magdalena. Santa Marta, Colombia. , Universidad del Magdalena Unidad de Investigación en Medicina Estomatológica Preventiva y Social (UIMEPS) Universidad del Magdalena Santa Marta Colombia
| | - María José Morales Rojas
- Programa de Odontología, Universidad del Magdalena. Santa Marta, Colombia. Universidad del Magdalena Programa de Odontología Universidad del Magdalena Santa Marta Colombia
| | - Alma Luz San Martín López
- Facultad de Odontología, Universidad Veracruzana, Poza Rica, México. , Universidad Veracruzana Facultad de Odontología Universidad Veracruzana Poza Rica Mexico
| | - Karem Guadalupe Ramírez Vera
- Facultad de Odontología, Universidad Veracruzana, Poza Rica, México. , Universidad Veracruzana Facultad de Odontología Universidad Veracruzana Poza Rica Mexico
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McCarra C, Olegário IC, O'Connell AC, Leith R. Prevalence of hypomineralised second primary molars (HSPM): A systematic review and meta-analysis. Int J Paediatr Dent 2022; 32:367-382. [PMID: 34432910 DOI: 10.1111/ipd.12892] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 06/09/2021] [Revised: 07/21/2021] [Accepted: 07/31/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the prevalence of HSPM worldwide on a child and a tooth level and investigate the influence of diagnostic criteria on the prevalence of HSPM. DESIGN A comprehensive literature search was performed through MEDLINE/PubMed, Scopus, and Web of Science databases. The grey literature was also screened as were the reference lists of included studies. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of HSPM. RESULTS The search strategy identified 1,988 articles, 487 were retrieved for full-text evaluation, and 37 studies were included in the meta-analysis (32 for child and 23 for tooth level prevalence), providing data from 26,805 individuals and 81,107 molars. The prevalence of HSPM was 6.8% (95% CI 4.98%-8.86%) on a child level and 4.08% on a tooth level (95% CI = 2.80%-5.59%). The diagnostic criteria used did not seem to influence the prevalence results (P > .05). The majority of the papers (75%) showed a low-to-moderate risk of bias. CONCLUSION There was a broad variation in the prevalence reported that may be attributed to differences in the study population. The present meta-analysis showed a HSPM prevalence worldwide of 6.8% on a child level and 4.1% on a tooth level.
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Affiliation(s)
- Charlotte McCarra
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Isabel Cristina Olegário
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Anne C O'Connell
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Rona Leith
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
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Lopes LB, Machado V, Mascarenhas P, Mendes JJ, Botelho J. The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Sci Rep 2021; 11:22405. [PMID: 34789780 PMCID: PMC8599453 DOI: 10.1038/s41598-021-01541-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 07/08/2021] [Accepted: 10/06/2021] [Indexed: 12/28/2022] Open
Abstract
Molar-Incisor Hypomineralization (MIH) is a qualitative defect of enamel of unknown etiology, affecting one or more permanent molars and may include incisors. This condition is a clinical challenge and its prevalence is still uncertain given the recent increase in research. Thus, we aimed to comprehensively estimate the overall prevalence of MIH and associated characteristics. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS and TRIP databases, until July 2021. Heterogeneity and publication bias were computed via I2 test statistics and Egger's significance test, respectively. Random-effects meta-analysis of prevalence were processed. We used the Strength of Recommendation Taxonomy [SORT] to grading the strength of evidence. Overall, 116 observational studies were included, with one study with moderate methodological quality and the remaining of high methodological quality. Subgroup analysis confirmed an influence of not using the 2003 MIH case definition (p = 0.0066). The pooled prevalence of MIH was 13.5% (95% CI 12.0-15.1, I2 = 98.0%). Affected incisors were seen in 36.6% (95% CI 30.0-43.7, I2 = 92.5%) of the cases. Lastly, the prevalence of hypomineralization of the second primary molars was observed in 3.6% of the MIH cases (95% CI 1.9-6.8, I2 = 96.3%). America was the continent with highest prevalence (15.3, 95% CI 12.8-18.3, p < 0.001, I2 = 96.3%) and Asia had the lowest prevalence (10.7, 95% CI 8.5-13.5, p < 0.001, I2 = 98.7%), however no continental differences were found. Sample size and year of publication were slight contributing factors to the heterogeneity in the analysis. Overall, these results were classified with a SORT A recommendation.
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Affiliation(s)
- Luísa Bandeira Lopes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
| | - Vanessa Machado
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - Paulo Mascarenhas
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511, Almada, Portugal.
- Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, CRL, 2829-511, Almada, Portugal.
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Fernandes IC, Forte FDS, Sampaio FC. Molar-incisor hypomineralization (MIH), dental fluorosis, and caries in rural areas with different fluoride levels in the drinking water. Int J Paediatr Dent 2021; 31:475-482. [PMID: 32965763 DOI: 10.1111/ipd.12728] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/07/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 11/28/2022]
Abstract
AIM This study determined the prevalence of molar-incisor hypomineralization (MIH) and its association with dental fluorosis and caries in children living in rural areas in north-eastern Brazil who are exposed to residual fluoride (F) levels in the drinking water. DESIGN A census was carried out with 610 schoolchildren aged 6 to 12 years. The European Academy of Paediatric Dentistry criteria, Thysltrup and Fejerskov index, and World Health Organization index were used for diagnosis of MIH, dental fluorosis, and caries detection, respectively. The association between the outcome and exposure variables was determined by robust Poisson regression (P < .05). RESULTS Water F-levels varied from 0.06 to 1.98 ppm. MIH was not related to fluoride levels in the drinking water, but it showed an inverse and direct correlation with dental caries and fluorosis, respectively. Children with MIH had a higher DMFT, and severe MIH cases were most frequent in children with dental fluorosis. CONCLUSION Drinking water F-levels were not directly related to the occurrence of MIH in schoolchildren. The severity of MIH, however, was likely to be associated with dental fluorosis in areas with moderate to high fluoride levels in the drinking water.
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Affiliation(s)
- Igor Cartaxo Fernandes
- Post-graduation Program in Dentistry, Federal University of Paraíba, João Pessoa, Brazil
| | | | - Fábio Correia Sampaio
- Post-graduation Program in Dentistry, Federal University of Paraíba, João Pessoa, Brazil
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Fonseca-Souza G, Fatturi AL, Fraiz FC, Assunção LRDS, Feltrin-Souza J. What are the Systemic Factors Associated with the Molar-Incisor Hypomineralization Etiology? Pesqui Bras Odontopediatria Clín Integr 2021. [DOI: 10.1590/pboci.2021.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Rolim TZC, da Costa TRF, Wambier LM, Chibinski AC, Wambier DS, da Silva Assunção LR, de Menezes JVBN, Feltrin-Souza J. Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial. Clin Oral Investig 2020; 25:1513-1524. [PMID: 32696210 DOI: 10.1007/s00784-020-03459-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/10/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety. MATERIAL AND METHOD FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods. RESULTS A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE. CONCLUSION Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels. CLINICAL RELEVANCE A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.
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Affiliation(s)
- Tatiane Zahn Cardoso Rolim
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - Thays Regina Ferreira da Costa
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | | | | | | | - Luciana Reichert da Silva Assunção
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - José Vitor Borges Nogara de Menezes
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil
| | - Juliana Feltrin-Souza
- Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil.
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Fatturi AL, Menoncin BL, Reyes MT, Meger M, Scariot R, Brancher JA, Küchler EC, Feltrin-Souza J. The relationship between molar incisor hypomineralization, dental caries, socioeconomic factors, and polymorphisms in the vitamin D receptor gene: a population-based study. Clin Oral Investig 2020; 24:3971-3980. [PMID: 32236726 DOI: 10.1007/s00784-020-03263-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 09/18/2019] [Accepted: 03/13/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The purpose of this cross-sectional study was to investigate whether polymorphisms in vitamin D receptor (VDR) genes increase the prevalence of dental caries, molar incisor hypomineralization (MIH), and hypomineralized primary second molars (HPSM). MATERIAL AND METHODS A representative population-based sample of 731 schoolchildren, 8 years of age, was randomly selected in Curitiba, Paraná, Brazil. MIH, HPSM, and dental caries were clinically assessed by four calibrated examiners (kappa > 0.80) using European Academy of Pediatric Dentistry (2003) criteria, the modified Developmental Defects of Enamel (DDE) index, and the Decayed, Missing, or Filled Teeth (DMFT) index by the World Health Organization (2013), respectively. The VDR rs739837 and rs2228570 polymorphisms were genotyped using real-time polymerase chain reaction. Associations were analyzed by Poisson regression with robust variance (α = 0.05). RESULTS Schoolchildren with MIH presented a higher prevalence of dental caries (DMFT > 1, PR = 2.52, confidence interval = 1.60-3.97, p ≤ 0.001). No association was observed between MIH, HPSM, and dental caries, with rs739837 and rs2228570 polymorphisms. Individuals with the GT/GG genotype in rs739837 polymorphism presented a higher prevalence of MIH in molars and incisors than individuals TT (PR = 2.34, confidence interval = 1.08-5.07, p = 0.03). CONCLUSION Children with MIH presented a significant higher prevalence of dental caries than children without MIH. To carry at least one G allele in rs739837 was associated to higher prevalence of MIH in molars and incisors. CLINICAL RELEVANCE Our findings suggested that more severe cases with incisors affected by MIH could be associated with polymorphism in VDR gene.
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Affiliation(s)
- Aluhê Lopes Fatturi
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, PR, Brazil.,School of Dentistry, Guairaca College, Guarapuava, PR, Brazil
| | | | | | - Michelle Meger
- School of Health and Biological Sciences, Universidade Positivo, Curitiba, PR, Brazil
| | - Rafaela Scariot
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, PR, Brazil.,School of Health and Biological Sciences, Universidade Positivo, Curitiba, PR, Brazil
| | - João Armando Brancher
- School of Health and Biological Sciences, Universidade Positivo, Curitiba, PR, Brazil
| | - Erika Calvano Küchler
- School of Health and Biological Sciences, Universidade Positivo, Curitiba, PR, Brazil
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