ABSTRACT
The prevalence of Molar Incisor Hypomineralization (MIH) still remains unknown in Argentina. The objectives of this work were to: estimate prevalence of MIH in a group of children seeking dental care in the city of Buenos Aires, analyze distribution according to year of birth and compare prevalence and severity of MIH in children with different access to health care services. A prospective, observational, transversal, descriptive study was designed, to be conducted on children seeking attention at Department of Comprehensive Children's Dentistry at the School of Dentistry of Buenos Aires University and at 3 pediatric dentistry offices attended by members of the team, located in Buenos Aires city (Kappa 0.933 0.911-0.952), from April to August 2010. The study included all children born between 1993 and 2003, whose 4 first molars and 8 permanent incisors had erupted. After prophylaxis and drying, the teeth were clinically evaluated and specially designed charts were used to record sex, year of birth, type of access to dental care, presence of MIH, number of affected incisors and molars, and maximum degree of severity for each tooth. The data obtained were analyzed using percentages, Fisher's Exact Test and Linear regression. 1098 children, mean age 11.3 years (11.08-11.39) were evaluated. Prevalence of MIH in this study was 15.9% (13.8-18.2). A highly significant positive correlation was obtained between MIH and year of birth (p<0.0001). Group A (private sector: prepaid medical insurance) was made up of 586 children (age: 10.92 6.22-15.62) while group B (public sector: university hospital) was made up of 512 children (age: 11.59 5.31-16.90). In Group A, MIH prevalence was 24.40% (20.9-27.9) while in Group B it was 6.44% (4.31-8.56) (p<0.0001). Of the affected molars, 37% (32.2-42) in A and 13.7% (6.7-23.8) in B had grade 3 lesions, with loss of enamel (p<0.0001). In this study, MIH was a frequent pathology (15.9%) and a significant increase was found according to year of birth during the study period. Patients with better access to health care had greater prevalence and degree of severity of MIH.
Subject(s)
Dental Enamel Hypoplasia/epidemiology , Argentina , Child , Cross-Sectional Studies , Female , Health Services Accessibility/statistics & numerical data , Humans , Male , Prevalence , Prospective Studies , Urban HealthABSTRACT
La displasia ectodérmica pertenece a un grupo heterogéneo de trastornos congénitos. La más frecuente es la displasia ectodérmica hipoidrótica, hipotricosis y alteraciones dentarias. La disminución de la cantidad de piezas dentarias, al igual que las anomalías en la forma de las mismas(dientes conoides), son relevantes para el diagnóstico y tratamiento odontológico. La reheabilitación debería comenzar a edades tempranas, alrededor de los 3 años. Consiste en reponer las piezas dentarias ausentes con prótesis de acrílico, las cuales deben renovarse periódicamente. De esta manera, se logra aumenttar la dimensión vertical, regular las funciones foniátricas y masticatorias, mejorando así la dicción y la autoestima de los pacientes. Para ello, de fundamental importancia el rol del dentista pediatra en el manejo interdisciplinario del niño afectado. Cuando finalice la etapa de crecimiento, se optará por el tratamiento definitivo más adecuado.
Ectodermal dysplasia is a heterogeneous group of congenital disorders. Hypohidrotic ectodermal dysplasia is the most common type. It is characterized by the triad of signs comprising hypohidrosis, hypotrichosis and dental abnormalities. The lack of teeth and conical or pointed teeth are important for diagnosis and clinical management. Treatment should be started as soon as possible. Early placement of partial or full dentures is commonly recommended from the age of three years. Removable protheses must be periodically modified. Prosthodontic rehabilitation is fundamental in these situations, attempting to provide a functional and aesthetic solution and to control the vertical dimension, which will improve patients diction and self-steem. For these reasons it is important to consider the role of the paediatric dentist in interdisciplinary management of the affected child patient. At the time the patient finishes growing, the possibility of definite treatment should be considered.
