Correlation between Molar-Incisor Hypomineralization, Stress, and Family Functioning.

Aim: This study aims to assess the relationship between stress, family functioning, and molar-incisor hypomineralization (MIH). Materials and Methods: A total of 162 children between the ages of 7 and 9 years were included in this retrospective study, as were their respective parents; the children were examined for MIH while questionnaires centering on stress and family functioning were given to the parents. Statistical analysis was performed using the Mann-Whitney U test and independent samples T-test. Results: A significant correlation between stress as a contributing factor and MIH was concluded; children with higher stress scores had higher occurrences of MIH. On the contrary, family functioning quality was not found to have a direct correlation with MIH. Conclusions: Stress is correlated to MIH and is potentially one of the main causal factors that contribute to the development of the defect.

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations.

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15−25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean's Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

Esthetic and Functional Rehabilitation of an Adolescent Patient with Severe Dental Fluorosis: A Clinical Report.

Dental fluorosis is a developmental defect affecting amelogenesis. It presents clinically in different forms depending on the concentration, duration, and time of exposure to fluoride. Several therapeutic modalities have been described to manage mild and moderate forms of dental fluorosis; however, limited literature is available on the restorative management of severe forms of dental fluorosis, specifically in young individuals. This clinical report describes a complete prosthodontic rehabilitation of an adolescent patient with severe dental fluorosis affecting his permanent dentition. The patient was treated with a combination of monolithic, minimally-veneered zirconia crowns and direct composite resins. At the 1-year follow-up appointment, there were no complications, and both the patient's oral health and the integrity of the restorations remained stable.

Association Study on Nutrition in the First Year of Life and Molar-Incisor Hypomineralization (MIH)-Results from the GINIplus and LISA Birth Cohort Studies.

Molar-incisor hypomineralization (MIH) is a condition with specific clinical presentation whose etiology to date still remains unknown. This study prospectively investigated the association between nutrition during the 1st year of life and the presence of MIH in the permanent dentition. Data from 1070 10-year-old children from two prospective birth cohort studies were included. Information on exclusive breastfeeding (EBF) and introduction of 48 food items into the child's diet was assessed at 4-, 6-, and 12-month time-points. Food diversity was defined according to the number of food items or food groups introduced into the child's diet and then subsequent categorization into low-, middle- and high-diversity groups was performed. MIH was scored in the permanent dentition at age of 10 years. The statistical analysis included logistic and Poisson hurdle regression models adjusted for potential confounders. EBF, food item and food group diversity at 4-, 6-, 12-month time-points were found to be non-significant in most of the categories for the development of MIH. However, significantly higher odds for the presence of MIH were found for certain categories. Despite the limitation of this study, such as arbitrary cut-offs for categorization of food items, the results of this study suggest the lack of an association between early nutrition in the first year of life and MIH in the permanent dentition.

Association between Dental Anomalies and Orofacial Clefts: A Meta-analysis.

OBJECTIVES: To conduct a systematic review and meta-analysis to assess whether individuals with nonsyndromic orofacial clefts (OCs) display a higher frequency of dental anomalies (DAs) when compared with individuals without OCs. METHODS: A literature search of indexed databases (PubMed, Cochrane, Web of Science, Embase, Scopus, and LILACS) was conducted without language restriction up to and including February 1, 2020. Cross-referencing was used to further identify articles. Several cleft teams across the United States and Europe were contacted to obtain unpublished data. The eligibility criteria were observational studies with original data that statistically compared individuals with OC without syndromes and those without OC on any type of DA in primary and/or permanent dentition. Random effects meta-analysis through the Mantel-Haenszel estimator was used to evaluate the association between OC and DA based on odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The literature search generated 933 records, and 75 full-text articles were reviewed. Twenty-six studies encompassing 15,213 individuals met the inclusion criteria. The meta-analysis revealed statistically significant associations between OC and agenesis (OR, 14.2; 95% CI, 9.4 to 21.3), supernumerary teeth (OR, 5.7; 95% CI, 3.3 to 9.7), developmental enamel defects (OR, 5.6; 95% CI, 3.5 to 9.0), microdontia (OR, 14.8; 95% CI, 4.0 to 54.6), peg-shaped anterior teeth (OR, 12.2; 95% CI, 3.6 to 41.2), taurodontism (OR, 1.7; 95% CI, 1.0 to 2.7), tooth malposition and/or transposition (OR, 5.6; 95% CI, 2.8 to 11.5), tooth rotation (OR, 3.2; 95% CI, 1.3 to 8.2), and tooth impaction (OR, 3.6; 95% CI, 1.1 to 12.2). The OR estimates of the reviewed studies exhibited significant heterogeneity (P < 0.0001). No association was observed between OC and fusion and/or gemination. CONCLUSION: Within the limitations of this study, the available evidence suggests that individuals with OCs are more likely to present with a range of DAs than their unaffected peers. KNOWLEDGE TRANSFER STATEMENT: The findings of the current review suggest that individuals with orofacial clefts (OCs) are more likely to present with a range of dental anomalies than their unaffected peers. Understanding the association between OCs and dental anomalies is essential in guiding clinicians during treatment-planning procedures and is important in raising our awareness of the possible need for future dental treatment for patients with OCs.

Developmental Enamel Defects (DDE) and Their Association with Oral Health, Preventive Procedures, and Children's Psychosocial Attitudes towards Home Oral Hygiene: A Cross-Sectional Study.

BACKGROUND: Developmental enamel defects (DDE) exert significant effects both on esthetics and occlusal function and prevention should be the general clinical approach to DDE. The purpose of this cross-sectional study was, therefore, to detect, within a pediatric sample, any significant association between DDE and children's psychosocial attitudes towards home oral hygiene, as well as potential associations between primary preventive procedures and DDE. METHODS: 394 schoolchildren (197 males and 197 females, 8.9 ± 1.4 years) underwent an intra-oral examination; they were then interviewed with a brief questionnaire. RESULTS: 5-6% and 12-14% of participants had, respectively at least one molar and one incisor affected by DDE. In general, no associations were observed in the examined clinical categories (caries and other oral health indices). A strong relationship was found between the presence of molar DDE and children's positive vs. negative psychosocial attitudes towards home oral hygiene. CONCLUSIONS: The probability of finding DDE in our sample of examined children was approximately more than doubled for children with negative psychosocial attitudes towards home oral hygiene, than for children with positive attitudes towards home oral hygiene.

Exposure to persistent organic pollutants during tooth formation: molecular mechanisms and clinical findings.

Persistent organic pollutants (POPs) constitute a relevant part of environmental pollution. POPs are chemical compounds that persist for a long time in the environment, bio-accumulate in the human body and determine significant adverse consequences to human health. The characteristics of these substances are lipo-affinity, semi-volatility and resistance to the degradation processes. Results deriving from several different studies attest that exposure to the main classes of POPs results in multiple toxic effects on humans and experimental animal models. Among the various alterations caused by exposition to and bio-accumulation of POPs, there are abnormalities in tooth formation and related hard dental tissue structure, especially enamel. This review aimed to describe the close association between the exposure of these compounds during the development of the tooth germ and the occurrence of tooth structural anomalies. Indeed, structural defects of the enamel have as possible consequences higher susceptibility of the tooth to caries disease and higher fragility of the crown to the occlusal trauma.

A Study of Enamel Defects and Dental Caries of Permanent Dentition in School Children with Intellectual Disability.

Data concerning the prevalence of developmental enamel defects and their association with dental caries in individuals with intellectual disability are scarce. This paper aims to evaluate the prevalence and distribution of developmental enamel defects and dental caries in the permanent dentition of special-care school children from Poznan (Poland). Out of 1091 students attending all special-care schools in the city, the study covered 268 subjects with intellectual disability (mild, moderate, severe, and profound) with permanent dentition, aged 10-20. One calibrated dentist performed dental examinations. The Statistica Software v10 was used for statistical analysis, assuming the level of statistical significance p ≤ 0.05. Among the subjects of the study, 19.40% presented developmental enamel defects. The number of teeth with changes ranged from 1 to 28, with maxillary incisors most frequently affected. Students without developmental enamel defects had more teeth observed with active caries compared to those with such changes (10.92% vs. 7.82%, p < 0.01). The highest number of students with developmental defects of enamel was observed in the group of individuals with mild intellectual disabilities. The present study revealed that in special-care students from Poznan, enamel defects and dental caries were frequently observed. However, individuals with developmental enamel defects did not show higher dental caries indices.

The effect of pulp inflammation and premature extraction of primary molars on the successor permanent teeth. A retrospective study.

BACKGROUND: Untreated caries on primary molars often leads to pulp inflammation and extraction. AIM: To retrospectively investigate the effect of pulp inflammation and extraction of primary molars on their successors regarding alignment in the dental arch and developmental enamel defects (DED). DESIGN: The participants in this study were children at public schools in Petropolis (Brazil), who participated in a 3-year longitudinal clinical trial. Children (N = 44) were selected for the present study if they had at least one erupted premolar of which the predecessor primary molar presented pulp inflammation at baseline or during any of the 6-month follow-up assessments. All premolars were examined for DED and misalignment. Distinction was made between extraction performed before (E <8) or after the age of 8 years (E ≥8). Distinction was also made between pulp inflammation occurred before (P < 7) or after the age of 7 years (P ≥ 7). A logistic regression analysis was performed, and the odds ratio was calculated. RESULTS AND CONCLUSIONS: Misalignment occurred more frequently in E <8 as compared to E ≥8 (OR = 2.85; P = .03). There was no significant difference in DED between P < 7 and P ≥ 7. CONCLUSION: Misalignment of premolars occurs more frequently when the predecessor primary molars are extracted before the age of 8 years.

Er:YAG laser for the aesthetic treatment of developmental enamel defects in frontal teeth: a case report.

BACKGROUND AND AIMS: Several studies highlighted how the ameloblasts, secretory cells responsible of the tooth enamel formation, are highly sensitive to changes in their environment. Due to enamel maturation, their dysfunctions during a limited period of tooth development may lead to permanent morphological consequences, namely Developmental Enamel Defects (DED). The aim of this study was to show the advantages of Er:YAG laser for DED treatment. SUBJECTS AND METHODS: The case report presented describes the treatment, by Er:YAG laser, of some DED lesions present in the upper incisors of a young patient. The settings used were: 1W power, 100mJ energy, 10 Hz frequency corresponding to a Fluence of 0.318 J/cm2 per pulse or 3, 18 J/cm2. RESULTS: The patient, even in absence of local anesthesia, did not feel any pain or discomfort during and after intervention. Follow-up at 2, 6 and 12 months did not show any problems in an aesthetic point of view as well as regarding hypersensitivity. CONCLUSIONS: The use of Er:YAG laser for the treatment of developmental enamel defects in frontal teeth is a safe, painless and minimally invasive; moreover, it is able to assure a good aesthetic result.

Molar Incisor Hypomineralization: Prevalence and Risk Factors Among 7-9 Years Old School Children in Muradnagar, Ghaziabad.

BACKGROUND: The aim of this school-based, cross-sectional survey was to investigate the prevalence and risk factors of permanent Molar Incisor Hypomineralization among 7-9 years old school children in Muradnagar. METHODS: This cross-sectional study was performed among 7-9 years old school children in Muradnagar. Estimated sample size was 992 in this study. Multistage cluster sampling technique was used in this study in which schools were the clusters which were selected randomly. The study proforma was divided into 2 parts, first part comprised of demographic status, socio-economic status, questionnaires on risk factors of Molar Incisor Hypomineralisation such as prenatal, perinatal and postnal history upto 3 years, feeding pattern, fluoride and other pollutants exposure history, dental history, history of trauma to teeth/face, family history of enamel defects which was asked to the mothers and filled by one examiner in a face to face interview. The second part comprised of recording format of clinical variables assessed by investigator to be recorded by the recording clerk. Molar incisor hypomineralisation were recorded using Modified Developmental Defect of Enamel index developed by Clarkson J.J. and O' Mullane D.M. in 1989 and dental caries by using Decayed Missing Filled Tooth index (World Health Organization Modification 1997) in which WHO probe was used for examination of dental caries as recommended by WHO in the Oral Health Surveys, Fourth edition; 1997 (Spanish version). Before 1997 modification dental explorer was used for the examination of dental caries. Chi square test, Pearson's Correlation test, Logistic Regression Analysis and Unpaired t-test were used for analysing the data. RESULTS: The overall prevalence rate of Molar incisor hypomineralisation was 21.4% in this study. Age, problems during pregnancy, normal delivery and childhood illness/ infections are the risk factors which have highest strength of association. CONCLUSION: In the present study Molar incisor hypomineralisation was found to affect 2 out of every 10 children examined which was higher than that observed in other studies on Indian children.

Hypomineralized second primary molars: prevalence, defect characteristics and relationship with dental caries in Melbourne preschool children.

BACKGROUND: Dental caries and enamel defects (DDE) are prevalent amongst children. The presence of DDE, especially enamel hypomineralization, may increase caries experience. The reported prevalence of hypomineralized second primary molars (HSPM) is 2.7-21.8%, although the occurrence in Australian children remains unknown. These HSPM represent a potential predictive factor for molar-incisor hypomineralization (MIH). METHODS: In total, 623 children aged 3-5 years from 30 randomly selected kindergartens participated. The HSPM were recorded using an index combining the European Academy of Paediatric Dentistry MIH Judgment Criteria and modified DDE Index. Caries was recorded using International Caries Detection and Assessment System criteria. RESULTS: In total, 144 HSPM were observed in 88 of the 623 (14.1%) children, a tooth-level prevalence of 5.8%. The prevalence of dentinal carious lesions was 13.2%, and caries prevalence (d2-6 mft > 0) was 36.4%. Cavitated carious lesions affected 30.7% of HSPM. CONCLUSIONS: The relationship between an increase in HSPM lesion extent and increasing number of HSPM per child was statistically significant. A positive association between HSPM severity and extent at tooth level existed (P < 0.05). There was a positive relationship between the extent of HSPM and carious lesion severity (P < 0.05). In this population, children with HSPM did not have overall greater caries experience.

Background factors of molar-incisor hypomineralization in a group of Finnish children.

OBJECTIVE: Molar-Incisor Hypomineralization (MIH) is a common developmental enamel defect characterized by demarcated opacities in permanent molars and incisors. Its etiology still remains unclear. The aim of this retrospective cohort study was to assess if the socioeconomic environment of the child is associated with MIH. MATERIALS AND METHODS: The study was located in two rural towns and three urban cities in Finland. A total of 818 children, between 7-13 years old, were examined for MIH using the evaluation criteria in line with those of the European Academy of Paediatric Dentistry, but excluding opacities smaller than 2 mm in diameter. The mothers filled in a questionnaire which included questions related to the family's way of living (e.g. area of residency, farming, day care attendance) and socioeconomic status (family income, number of mother's school years, level of maternal education). RESULTS: The prevalence of MIH in the study population was 17.1%. Family income, urban residency and day care attendance were associated with MIH in the univariate analysis. In the multivariate analysis using binary logistic regression, only urban residency during a child's first 2 years of life remained associated with MIH. The prevalence of MIH in urban areas was 21.3% and in rural areas 11.5% (OR = 2.18, CI = 1.35-3.53, p = 0.001). CONCLUSIONS: The prevalence of MIH was related to urban residency and could not be explained by any other factor included in the study.

Molar incisor hypomineralization: a study of prevalence and etiology in a group of Iranian children.

OBJECTIVE: The aim of this study was to investigate the prevalence of molar incisor hypomineralization (MIH) and its relationship with systemic conditions in a group of Iranian children. METHODS: The study population comprised of 433 7-9 year olds, from four schools in Zahedan, Iran. Subjects were evaluated clinically by one examiner, and at a separate session, their mothers completed a coded medical history questionnaire. Hypo-mineralized molars and incisors were recorded based on DDE (developmental defects of enamel) index and DMFT (number of decayed, filled and missing teeth) was determined. Statistical analyses were performed using Chi-square and independent sample t-tests. FINDINGS: Fifty-five (12.7%) children showed MIH. The overall mean number of affected teeth was 0.2. The mean value of DMFT in MIH children was greater than in normal children. Demarcated opacities were the most frequent (76%) enamel defect. Mother's and child's medical problems during prenatal, perinatal and post natal period were significantly remarkable in MIH children. CONCLUSION: The prevalence of MIH in a group of Iranian children was 12.7%. Prenatal, perinatal and post natal medical conditions were more prevalent in children affected by MIH.

Impacto de la posición socioeconómica sobre los defectos de desarrollo del esmalte en dentición primaria / Impact of socioeconomic position on the developmental enamel defects on primary dentition

Introducción y ObjetivoLos defectos de desarrollo del esmalte (DDE) son alteraciones del esmalte dental que resulta de diversosdisturbios durante la amelogénesis.Determinar el impacto de la posición socioeconómica (PSE) sobre los DDE en la dentición primaria deniños escolares de 6 a 9 años de edad.Material y MétodosSe realizó un estudio transversal en 925 escolares de seis a nueve años de edad. El criterio utilizado paraDDE fue el propuesto por la Federación Dental Internacional, específicamente las opacidades marcadasy difusas e hipoplasias, excluyendo fluorosis dental y otras decoloraciones, a través de un examen clínicorealizado por tres examinadores previamente estandarizados (kappa> 0,80). Se utilizó un cuestionariodirigido a las madres/tutores de los niños se recogieron diversas variables sociodemográficas ysocioeconómicas. La PSE fue determinada con la ocupación y escolaridad de los padres. El análisisestadístico se realizó calculando razones de momios con regresión logística en STATA 9.0.ResultadosLa edad promedio fue 7,56±1,13 años y 50,3% fueron varones. El promedio de DDE fue 0,17±0,75, y laprevalencia de 9,9%. En el análisis multivariado de regresión logística, se observó que los momios depresentar DDE en los dientes primarios aumentaron (p<0,05) en los niños de 8-9 años, en los que visitanal dentista con mayor frecuencia y los de peor PSE.ConclusionesEste estudio permitió identificar que la PSE tiene un impacto en la presencia de DDE en la denticiónprimaria. Es necesario realizar más estudios que confirmen esta asociación y clarifiquen la relación,preferentemente de tipo longitudinal.

Introduction and objectiveDevelopmental enamel defects (DED) can be defined as any alteration of tooth enamel resulting fromvarious disturbances during amelogenesis. The objective of this report was to determine the impact ofsocioeconomic position (SEP) on the DEDin primary teeth of 6 to 9 year old school children.Material and MethodsA cross-sectional study in 925 school children from six to nine years old was carried out. The diagnosticcriteria used for DED was proposed by the FDI, specifically marked and diffuse opacities and hypoplasia,excluding dental fluorosis and other discolorations, through a clinical examination conducted by threetrained and calibrated examiners (kappa> 0,80). Sociodemographic and socioeconomic variables werecollected through a questionnaire directed to mothers / guardians of children. Socioeconomic position(SEP) was determined with the parental occupation and schooling. Statistical analysis was performed bycalculating odds ratios with logistic regression in STATA 9.0.ResultsThe mean age was 7,56±1,13 years and 50,3% were male. Average DED was 0,17 ± 0,75, and theprevalence of 9,9%. Multivariate logistic regression analysis indicated that the odds presenting DED inprimary teeth increased (p <0,05) in children between 8-9 years old, visiting the dentist more often andthe worst SEP.ConclusionsThis study has shown that the PSE has an impact on the presence of DED in the primary dentition.Further studies, which are preferably longitudinal, are needed to confirm this association and clarify therelationship.