Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review.

Molar incisor hypomineralization (MIH) is a significant health problem that can affect the child's quality of life by negatively affecting their esthetics and function. This review aimed to summarize the etiology and pathogenesis of MIH. It also aimed to summarize the recent studies on MIH in children and adolescents, focusing on diagnosis, prevention, and clinical management. An electronic search on the PubMed, Cochrane Database of Systematic Reviews, MEDLINE, MedlinePlus, WHO reports, and Google Scholar databases was performed. The volume of research on the etiology, presentation, and clinical management of MIH is still expanding. The creation and validation of indices for the diagnosis and management of MIH, as well as any potential genetic aspects appear to be the main areas of current research. Notably, MIH was linked to childhood illnesses, the use of antibiotics, and early childhood fever. Although many studies discuss the different options for managing MIH lesions, evidence-based studies that address the long-term outcomes of MIH are still lacking. Indeed, future clinical studies should be directed to evaluate the impact of each systemic etiological factor and its different types of management on normal amelogenesis. Regarding the diagnosis, future research should focus on the pre-eruption diagnosis and early approaches to prevent the post-eruption breakdown and caries. Regarding the treatment of MIH, future investigations should emphasize further improvements in adhesion and the use of new materials and techniques, such as digital dentistry.

Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey.

BACKGROUND: Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. METHODS: A multi-country online survey collected data from caregivers of children in 2020-21 about children's use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). RESULTS: A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother's education and area of residence (P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region. CONCLUSIONS: The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.

Assessment of dental caries and salivary characteristics among type 1 diabetic Saudi children.

Background/purpose: Type 1 diabetes mellitus (DM1) is considered the most common chronic disease in childhood. This study aimed to assess dental caries and salivary characteristics among a group of Saudi children with DM1. Materials and methods: Forty children with DM1 and 40 age- and gender-matched healthy controls were enrolled. A saliva sample was obtained to measure flow rate of saliva, buffering capacity, potential of hydrogen (pH), and bacterial counts. Oral examination and dental caries were recorded using Decayed, Missing, and Filled Teeth (dmft/DMFT) indices for primary/permanent teeth. Results: Children with DM1 showed higher DMFT scores with a mean of 3.5 compared to 2.8 in healthy children. The differences between both groups were not statistically significant (P = 0.14). Regarding dmft score, children with DM1 showed a significantly lower mean score of 4.5 compared to 6.5 in healthy children (P = 0.019). The flow rate of saliva showed a non-significant reduction in children with DM1 compared to healthy children with a mean of 0.86 and 0.96, respectively (P = 0.24). The mean salivary pH was found to be higher in the healthy group, but this was statistically non-significant (P = 0.118). The buffering capacity was significantly lower in children with DM1 compared to healthy children (P = 0.013). Mutans streptococci (MS) and Lactobacilli counts were found to be not significantly different between both groups (P = 0.422, P = 0.118 respectively). Conclusion: Children with DM1 showed remarkably lower caries experience in primary teeth and lower buffering capacity compared to healthy children.

Effect of resin infiltration application on early proximal caries lesions in vitro.

BACKGROUND/PURPOSE: Resin infiltration (RI) material ICON is used in treating early proximal caries lesions, as it depends on a micro-invasive infiltration technology. This in vitro study aimed to evaluate the effect of ICON resin infiltration (RI) on early proximal caries by comparing surface roughness and hardness before and after treatment with RI using atomic force microscopy (AFM), automated microhardness testing system (AMHTS), and scanning electron microscopy (SEM) in vitro. MATERIALS AND METHODS: Twenty seven premolars extracted for orthodontic reasons were sectioned buccolingually, creating 54 specimens. Each specimen was immersed in demineralizing solution to induce caries. Only teeth with "International Caries Detection and Assessment System" codes 1 and 2 were selected. The specimens were divided randomly into either AFM, AMHTS or SEM groups, which examined demineralized enamel before and after treatment with ICON. RESULTS: The mean average surface roughness and root mean square roughness values of demineralized enamel treated with ICON were significantly higher than untreated lesions (P < 0.001). The mean Vickers hardness values for demineralized enamel treated with ICON was significantly higher than untreated lesions (P < 0.001). SEM showed irregular, pitted and rough demineralized enamel surface with destruction of enamel rods and dissolution of enamel crystals. After ICON application, the surface showed complete blockage of enamel rods with RI and irregular, rough uneven topography. CONCLUSION: RI application on proximal incipient caries increased surface roughness and hardness significantly.

BiodentineTM versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial.

BACKGROUND: The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars. METHODS: A randomized, split-mouth study design was used with a sample of 37 healthy children aged 4- to 8-year-old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed-up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05. RESULTS: At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12-month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively. CONCLUSIONS: Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference. TRIAL REGISTRATION: Registered on NCT03779698 . Date of Registration: 18 December 2018.

Efficacy of two mouth rinse sprays in inhibiting Streptococcus mutans growth on toothbrush bristles.

OBJECTIVE: To compare the efficacy of two types of mouth rinse sprays (Periogard and Plax) in inhibiting the growth of Streptococcus mutans (S. mutans) on toothbrush bristles used by children. METHODS: An experimental comparative study was performed. The sample included 60 children aged 6-8 years with high caries index. Children were divided randomly into 3 groups (20 each) according to materials applied on toothbrush. Each group was further subdivided into 2 subgroups A and B (10 each) according to the laboratory standards for processing microbiological specimens. Each toothbrush was placed in phosphate buffered saline, vortexed then serially diluted. Mitis salivarius bacitracin (MSB) agar plates were inoculated and incubated for 48 h. S. mutans colonies were identified by morphology, gram stain and biochemical tests. RESULTS: Statistically, significant difference was observed between the three groups either when toothbrushes were processed immediately or when processed after 24 h. Group I showed highest bacterial count followed by group III whereas group II showed least bacterial count. Bacterial counts were significantly decreased by time in group I and group III while in group II no significant decrease as both subgroups showed very low bacterial count. CONCLUSIONS: Although both mouth rinses were effective against S. mutans toothbrush contamination, chlorhexidine gluconate proved to be better.

Dentists' intention to report suspected violence: a cross-sectional study in eight Arab countries.

OBJECTIVES: This study assessed dentists' intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. METHODS: A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists' perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. RESULTS: The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. CONCLUSION: Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources, policies and guidelines is needed to ensure that practices similar to international guidelines are consistently adopted by dentists across Arab countries.

Efficacy of 10 percent Carbamide Peroxide as an Intracoronal Bleaching Agent in Nonvital Discolored Primary Teeth: An In Vitro Study.

PURPOSE: The purpose of this study was to evaluate, in vitro, the efficacy of 10 percent carbamide peroxide used as an intracoronal bleaching agent in blood-stained primary teeth. METHODS: Thirty extracted primary canines were stained using rabbit blood and randomly divided into two groups of 15 teeth each. Stained teeth in the test group were bleached intracoronally using 10 percent carbamide peroxide for 21 days. The bleaching agent was replaced at days seven and 14. The control group was not subjected to bleaching, and a cotton pellet damped with distilled water was placed in the pulp chamber. Shade alteration from the prestaining value was evaluated using a VITA Easyshade spectrophotometer at days zero, seven, 14, and 21. RESULTS: All specimens in the test group returned to the initial baseline shade, with no significant differences from the prestaining values (P=0.097). Teeth in the control group did not undergo any shade alteration after staining, with no significant differences noted from the prestaining values (P<0.001). CONCLUSIONS: Intracoronal bleaching using 10 percent carbamide peroxide is an effective approach for whitening discolored extracted primary teeth.

Comparison between biodentine and formocresol for pulpotomy of primary teeth: A randomized clinical trial.

OBJECTIVE: To assess and compare the clinical and radiographic success rates of biodentine and formocresol for pulpotomy in human primary teeth. METHOD AND MATERIALS: A randomized, split-mouth, double-blind, controlled clinical trial was carried out in 37 healthy 4- to 8-year-old children with 56 pairs (112 teeth) of contralateral primary molars indicated for pulpotomy. Matched teeth in each pair were randomized to undergo either biodentine (n = 56 teeth) or formocresol (n = 56 teeth) pulpotomy. In both groups, the teeth were restored with stainless steel crowns. The teeth were evaluated clinically and radiographically at 3 and 6 months by two blinded, standardized, and calibrated examiners. The data were analyzed using chi-square and McNemar tests with a P value of < .05 considered significant. RESULTS: At both the 3- and 6-month follow-ups, all the 37 children with 112 treated teeth were evaluated. Clinical and radiographic success was similar for biodentine (100%) and formocresol (100%), without any statistically significant difference (P = 1). Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the biodentine and formocresol groups, respectively. CONCLUSION: Both pulpotomy techniques showed favorable clinical and radiographic outcomes at 3 and 6 months posttreatment without any significant difference. Hence, biodentine has the potential to become a substitute for formocresol in primary molar pulpotomies.