Is there an association between dental caries, fluorosis, and molar-incisor hypomineralization?

Abstract Objective: This cross-sectional study aimed to determine the prevalence of dental caries, dental fluorosis, and molar-incisor hypomineralization, and their associations in a group of Brazilian schoolchildren. Methodology: Adolescents (n=411) were evaluated by two calibrated examiners for dental caries (DC), dental fluorosis (DF), and molar-incisor hypomineralization (MIH) using the CAST (Caries Assessment Spectrum and Treatment) instrument, Thylstrup and Fejerskov (TF) index, and MIH Severity Scoring System (MIH-SSS), respectively. Descriptive statistics, chi-square tests, and logistic regression were used for statistical analysis. Results: The sample comprised 42.75% boys and 57.25% girls. The prevalence of DC in permanent dentition was 94.75%, of which 29% were represented by dentin lesions. For DF, a prevalence of 40.75% was observed, with 69.32% mild, 12.88% moderate, and 17.79% severe. A positive association between the source of water and fluorosis was detected (p=0.01). The prevalence of MIH was 18%. Thirty adolescents (41.7%) presented with severe MIH. No association was found between DF or MIH and dentin DC or between MIH and DF at the individual level. However, a significant negative relationship was detected between DF and dentin carious lesions ( p <0.005) and DF and MIH ( p <0.00001) at the tooth level, whereas a positive association was observed between MIH and dentin carious lesions ( p <0.00001). A positive association was also observed between the severity of both conditions ( p <0.00001). Mild DF was the most prevalent problem observed. Cases of teeth with mild MIH were the most predominant in MIH-affected teeth. Conclusions: No association was observed among the dentin carious lesions, MIH, and DF at the participant level. However, a positive association between MIH and dentin carious lesions was found at the tooth level, whereas MIH, DF, and DF and dentin carious lesions showed a negative relationship.

Análisis de la relación entre la hipomineralización incisivo molar y los factores asociados a su etiología / Analysis of the relationship between molar incisor hypomineralization and the factors associated with its etiology

RESUMEN El objetivo de este artículo es analizar la relación entre la hipomineralización incisivo molar (HIM) y los factores asociados a su etiología publicados en la literatura. Material y métodos: El estudio se basó en una búsqueda de estudios epidemiológicos de casos y controles de HIM que describieron un factor etiológico asociado para obtener las odds ratio (OR) necesarias para analizar la prevalencia del factor afectado y su posible papel en la etiología de la condición. Resultados: Ocho artículos cumplieron los criterios para el análisis. La población total analizada consistió en una muestra de 7,901 sujetos, de los cuales 992 tenían HIM. En estos sujetos fueron reportados como factor asociado (FA) para HIM: asma (OR = 4.4954), uso de antibióticos (OR = 5.5348), fiebre (OR = 4.0545) y neumonía. Conclusión: Los resultados del presente estudio sugieren que un FA común a todos los casos de HIM estudiados es un proceso inflamatorio que conduce a una mayor concentración de agentes en el microambiente en el que se desarrollan las células formadoras del esmalte, lo que aumenta la presencia de proteínas en la matriz del esmalte o interfieren con su hidrólisis y eliminación y produce como resultado una deficiente mineralización.

ABSTRACT Hypomineralization enamel of the first permanent molars is the most common developmental abnormalities observed in the teeth. The aetiology of MIH remains unclear and may have a multifactor aetiology. The aim of this paper is to analyze the relationship between MIH and associated factors published in the literature. Material and methods: The study was based on a search for epidemiological case-control studies of MIH that described an associated etiological factor, in order to obtain the odds ratios needed to analyze the prevalence of the factor concerned and its possible role in the etiology of the condition. Results: The initial search produced 50 articles, eight of which met the criteria for the analysis. The total population analyzed consisted of a sample of 7,901 subjects, 992 of whom had MIH (i.e., a prevalence of 12.55%). Asthma was reported as an etiological factor in five papers, which included 474 subjects with MIH with an OR of 4.4954 (p < 0.0001). Antibiotic use was reported as an etiological factor in three papers, which reported on a population of 231 subjects with MIH and OR of 5.5348 (p < 0.0001). Fever was reported as an etiological factor in two papers, involving a population of 176 subjects with MIH and an OR of 4.0545 (p < 0.0001). Pneumonia was reported as an etiological factor in two papers, which dealt with a population of 454 cases of MIH and produced an OR of 2.285 (p < 0.0001). Conclusion: The results of the present study suggest that one etiological factor common to all of the MIH cases studied is an infl ammatory process, in which the presence of agents that cause alterations in ameloblasts can lead to higher concentrations of these agents in the microenvironment in which enamel forming cells develop, thus increasing the presence of proteins in the enamel matrix or interfering with their hydrolysis and removal, producing defects in enamel mineralization.

Rehabilitación oral de hipomineralización incisivo molar

El Objetivo es conocer e investigar el manejo odontológico y las posibles opciones de rehabilitación en los casos de Hipomineralización Incisivo Molar. Como metodología se usó el Reporte Clínico de un caso de Hipomineralización Incisivo Molar, en un paciente masculino de 8 años de edad con Diagnostico Sistémico de: Comunicación Interauricular, Retraso Psicomotor Global, Síndrome de Brown, Enfermedad por Reflujo Esofágico, TBC Latente; y Diagnostico Estomatológico de: Hipomineralización Incisivo Molar; atendido en el Instituto Nacional de Salud del Niño, en el servicio de Odontología de Pacientes Medicamente Comprometidos. El paciente presenta Hipomineralización en primeras molares y en incisivos centrales inferiores permanentes; debido a la complejidad de las lesiones a restaurar y la poca capacidad del paciente para mantener la apertura bucal por mucho tiempo se opta por rehabilitar al paciente en sala de operaciones, colocándose coronas de acero preformadas en molares más afectados y restaurando con Resina Composite los molares e incisivos menos afectados. Como resultados, en los controles realizados al paciente se puede observar que ha mejorado la calidad de vida, ya que no presenta más sensibilidad dentinaria, tampoco molestias al comer, encontrando a un paciente y sus padres muy satisfechos con los tratamientos realizados, considerando hasta ahora el tratamiento exitoso, tanto clínico como radiográfico. Conclusión: La ejecución de medidas preventivas individuales puede posponer el inicio del tratamiento restaurador y reducir la incomodidad del paciente a largo plazo. El diagnóstico precoz permite el seguimiento y la instauración de dichas medidas preventivas tan pronto las superficies afectadas sean accesibles.

Infiltration of white-spot-lesions and developmental enamel defects

ABSTRACT: Purpose: To provide an overview of different indications suitable for treatment with the technique of resin infiltration (Icon, DMG), such as white-spot lesions (WSL), enamel fluorosis, and molar-incisor hypomineralisation (MIH), and to propose a valid and strategy feasible in dental surgeries for screening of dental color improvement and -stability. Method: A non-systematic review of the literature was performed to characterise inhibition of lesion progression, and the esthetic effects induced by resin infiltration of decalcified enamel, enamel fluorosis, and molar-incisor hypomineralisation (MIH), using the online database Pubmed and a suitable search strategy. Database search was complemented by a hand-search of references of retrieved articles. Results: Of 34 retrieved articles, 29 were included in the review. Evidence of an assimilation of WSL color to surrounding enamel following infiltration is available on the level of RCTs, and the results were found to be stable in color with no significant changes over at least twelve months. Evidence of an esthetic improvement of fluorotic or MIH affected teeth is available on the level of case reports and case control studies. Conclusion: As a micro-invasive approach to infiltrate and seal different types of enamel lesions, with a subsequent improvement of the esthetic appearance, resin infiltration is considered to be a useful complementation of the dental therapeutic specter.

Odontopediatría y enfermedad celíaca: diagnóstico y tratmaiento de las lesiones bucales / Pediatric dentistry and celiac disease: diagnosis and treatment of the oral lesions

La enfermedad celíaca es una alteración de base inmunológica que puede presentarse en cualquier etapa de la vida. La causa es la intolerancia al gluten en aquellas personas predispuestas genéticamente. El diagnóstico precoz en niños permite adherir auna dieta libre de gluten y evitar consecuencias vinculadas con la enfermedad. El objetivo de este trabajo es orientar sobre las lesiones en tejidos blandos y duros de la cavidad bucal o retardo en la cronología de la erupción, que podrían asociarse a enfermedad celíaca (EC) y realizar la derivación oportuna al médico pediatra...