Potential Association of Molar-Incisor Hypomineralization (MIH) with Dental Agenesis and Infraoccluded Deciduous Molars: Is MIH Related to Dental Anomaly Pattern (DAP)? An Observational Cross-Sectional Study.

Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8-14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis.

Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both Developmental Defects of Dental Enamel.

Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6-43.6%), and specificity of 88.7% (95% CI = 84.5-93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications.

Changes in orthodontics during the COVID-19 pandemic that have come to stay.

The coronavirus disease 2019 pandemic will have a long-lasting impact on orthodontic practice. Some of the adaptations needed will improve the orthodontist's line of work when the pandemic will be defeated, but others will not be sufficiently cost-effective. These changes concern 4 areas of orthodontic practice: (1) microbiologic control measures, with increased use of personal protective equipment, stricter protocols inside and outside of the clinical area, and minimization of procedures that generate aerosols; (2) social distancing measures by redistributing spaces and decreasing the number of patients and companions in the clinics; (3) increasing teleorthodontics and use of appliances and techniques that require fewer scheduled and urgent appointments; and (4) bioethical considerations that promote a broader view of the psychosocial aspects of patients, their families, and the community. Some of these important adaptations, implemented while we are still suffering the effects of the pandemic, may be reversible, but others have come to stay.

Capacity of dermatologists to diagnose oral and perioral lesions compared with orthodontists, primary care physicians, and pediatricians.

Oral pathology is an interdisciplinary field of unclear boundaries. Only a few studies have been previously published comparing the diagnostic capacity among different specialists taking care of the disorders involving oral mucosa and perioral skin. The goal of this study was to assess the capacity for diagnosing dermatologic conditions involving the oral mucosa and perioral skin in children and adults among orthodontists, dermatologists, and primary care physicians. Samples of orthodontists (n = 118), dermatologists (n = 100), pediatricians (n = 75), and family doctors (n = 68) were selected for the study. Two tests of 30 color clinical photographs each were prepared, one containing oral lesions in children and other one in adults. Statistical and comparative analyses of correct and incorrect answers were performed in each group and subgroup of participants. Dermatologists were clearly better trained than other specialists in oral and perioral pathology. This advantage over their counterparts in other specialties was seen in both residents and board-certified dermatologists. Though by small margin, orthodontists showed better performance than pediatricians and family doctors. Dermatologists showed higher capacity to achieve the right diagnosis in common oral and perioral disorders than orthodontists, pediatricians, and family doctors.