Degree of severity of molar incisor hypomineralization and its relation to dental caries.

Molar incisor hypomineralization is a developmental defect of dental enamel associated with rapid caries progression. In order to discover whether molar incisor hypomineralization predisposes to dental caries, a cross-sectional cohort study was conducted in a sample of 414 children aged between eight and nine years. It was found that 24.2% of the children presented molar incisor hypomineralization. Of these, 72% had a mild form and 28% a severe form. Caries prevalence was greater among the children with severe form (60.7%) than in those with mild form (43.1%) or no molar incisor hypomineralization (45.5%). The caries indices were higher in out molar incisor hypomineralization (1.18) or with mild form (1.08). The tooth-surface caries ratio was significantly higher in surfaces with severe hypomineralization than in those with no hypomineralization or mild hypomineralization. A linear regression model showed that cariogenic food intake and the presence of severe molar incisor hypomineralization were significantly associated with DMFS. Consequently, an association was found to exist between dental caries and the presence of surfaces affected by severe molar incisor hypomineralization, which should be considered a risk factor within the multifactorial etiology of caries.

Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization.

Molar incisor hypomineralization (MIH) is a developmental defect of dental enamel that shares features with hypomineralized second primary molars (HSPM). Prior to permanent tooth eruption, second primary molars could have predictive value for permanent molar and incisor hypomineralization. To assess this possible relationship, a cross-sectional study was conducted in a sample of 414 children aged 8 and 9 years from the INMA cohort in Valencia (Spain). A calibrated examiner (linear-weighted Kappa 0.83) performed the intraoral examinations at the University of Valencia between November 2013 and 2014, applying the diagnostic criteria for MIH and HSPM adopted by the European Academy of Paediatric Dentistry. 100 children (24.2%) presented MIH and 60 (14.5%) presented HSPM. Co-occurrence of the two defects was observed in 11.1% of the children examined. The positive predictive value was 76.7% (63.9-86.6) and the negative predictive value 84.7% (80.6-88.3). The positive likelihood ratio (S/1-E) was 10.3 (5.9-17.9) and the negative likelihood ratio (1-S/E) 0.57 (0.47-0.68). The odds ratio was 18.2 (9.39-35.48). It was concluded that while the presence of HSPM can be considered a predictor of MIH, indicating the need for monitoring and control, the absence of this defect in primary dentition does not rule out the appearance of MIH.

Predictores de conducta en odontopediatría / Behaviour predictors in child dentistry

La colaboración del niño es necesaria para llevar a cabo un tratamiento dental de calidad en la consulta; los factores que influyen sobre la conducta del paciente infantil son muchos y variados. Resultaría importante poder establecer qué variables ayudarían a predecir con cierta fiabilidad si el niño que requiere tratamiento odontológico, puede presentar problemas de conducta durante el mismo. Con este objeto se realizó un estudio sobre un total de 104 niños, 50 varones y 54 mujeres con edades comprendidas entre 6 y 12 años. En la primera visita se recogieron datos personales y familiares, antecedentes médico-dentales, se elaboró un análisis del perfil psicológico del niño y se realizó el diagnóstico de salud buco-dental. En la segunda visita se realizó el tratamiento dental previsto y la valoración del nivel de aceptación del mismo. Para la obtención de predictores, se estudió la relación entre unas y otras variables mediante un análisis de regresión múltiple. Se concluyó que las variables mas predictivas fueron, entre las dentales, la necesidad de tratamientos pulpares previstos; entre las psicológicas, el comportamiento en la primera visita de diagnóstico, antecedentes del niño de miedos a situaciones extrañas, cosas o personas desconocidas y el miedo a las inyecciones (AU)

Child collaboration is essential to carry out a good treatment and should be integrated into dental practice. Relevant influencing factors in child behavior are several and varied. It could be very useful if these variables were identified and quantified. These would help predict with high reliability if a young patient was at risk of developing behavioral problems during dental therapy. The aim of this study was to identify and quantify the behavioral variables by screening 104 children, 50 boys and 54 girls, between 6 and 12 years old. On the first visit, personal and family data were collected, previous medical-dental experiences, child’s psychological profile analysis and a full mouth diagnosis. On the second visit, the established dental treatment was performed and an acceptance rating was recorded. To obtain predictors, the relationship between variables was subject to multiple regression analysis. It was concluded that the dental variable most predictive was the need for pulp treatment while the psychological variables were fear of strange surroundings, people, things and fear of injections (AU)

[Recessive dystrophic epidermolysis bullosa. Oral manifestations apropos of 3 cases]. / Epidermolisis ampollar distrófica recesiva. Estudio de sus manifestaciones orales. A propósito de 3 casos.

Epidermolysis Bullosa (EB) constitutes a group of genetic disorders characterized by bullae and vesicle formation on the skin and mucosa. Three cases of recessive EB that may be clinically classified as recessive dystrophic EB (RDEB) are described. In two cases dental treatment consisted of extractions and restorative therapy under local anesthesia. In all three cases individual home and professional preventive programs were established and no new decays were observed during the next years. Dental management under local anesthesia is emphasized by the authors.

[Preformed crowns in pedodontics. A classic and valid option]. / Las coronas preformadas en odontopediatría: una opción clásica y vigente.

Stainless steel crowns are even now, the best available option to restore deciduous molars with extense decay involving at least one proximal surface. Composites restorations are only an alternative to stainless steel crowns in those cases with vaste occlusal decay with no proximal involvements, even when a pulpal therapy has to be performed. With a standard technique which has remained almost unchanged, the gingival tissues response to crowns and its long term clinical results, are excellents. Preformed or non preformed ones are not two different options to work with, but two choices to consider depending the professional aptitudes and the particular condition of the tooth to be restored. Finally in those cases where the deciduous molar cannot be acceptably restored with a stainless steel crown, no new material has shown to be a reasonably alternative; then, extraction of the tooth has to be considered and adecuate measures will be taken in order to maintain the physiological occlusal development of the child inaltered.