Challenges of Using Scoring Systems for the Assessment of Molar Incisor Hypomineralisation.

The dental professional is exposed to complex challenges daily, posed by molar incisor hypomineralisation (MIH). These range from understanding its etiology through to determining the most effective strategies for clinical management of the problem. Beyond any doubt, the choice of the diagnostic scoring system to be used for recording the condition is included among these challenges. To a certain degree, this is understandable since the development of specific diagnostic tools for recording the occurrence of MIH takes place parallel to the ongoing discoveries about the problem. Therefore, the aim of this chapter is to present different MIH scoring systems that have previously been proposed in the literature for detecting MIH and discuss their applications, advantages, and limitations.

Use of bulk fill resin composite and universal adhesive for restoring primary teeth after selective carious tissue removal to soft dentin: A randomized clinical trial.

PURPOSE: To investigate the survival of adhesive restorations after selective carious tissue removal to soft dentin in primary molars. METHODS: This two-arm randomized clinical trial included 62 subjects (5.9 years ± 1.7) and 144 primary molars presenting deep active dentin carious lesions. The sample was randomly assigned based on restorative material: universal adhesive (Scotchbond Universal) plus bulk fill resin composite (Filtek Bulk Fill Posterior Restorative) and resin-modified glass-ionomer cement (Vitremer). Two operators performed all restorative procedures. Restorations were evaluated at 6, 12, and 18 months using the FDI World Dental Federation criteria. Survival estimates for restorations' longevity were evaluated with Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (P< 0.05). RESULTS: Restorative material did not influence the restorations' survival (HR 1.56 95% CI 0.78-3.13; P= 0.12). The survival rates at 18 months of follow-up were 62.9% and 76.8% (AFR: 26.6% and 16.1%) for resin-modified glass-ionomer cement and bulk fill resin composite restorations, respectively (long-rank P= 0.14). Boys had higher risk of failure in their restorations (HR: 2.64, 95% CI: 1.29-5.40). Restorations performed by a less experienced operator had 3.26 times more risk of failure (P= 0.001). CLINICAL SIGNIFICANCE: The effectiveness of resin-modified glass-ionomer cement (Vitremer) and bulk fill resin composite (Filtek Bulk Fill Posterior Restorative) restorations after selective removal of carious tissue to soft dentin in primary molars was similar at 18 months of follow-up.

Erosive Tooth Wear and Erosive Esophagitis in Children: An Observational Study in Porto Alegre, Brazil.

The aim of this study was to establish and compare the prevalence and severity of erosive tooth wear (ETW) in children with and without erosive esophagitis. Children aged 5-12 years, scheduled for upper digestive endoscopy at the Pediatric Gastroenterology Service of the Children's Hospital Santo Antonio, Porto Alegre, Brazil, were eligible to participate in this study. Patients who presented erosive esophagitis at endoscopy were defined as gastroesophageal reflux disease (GERD) carriers, and the severity was described according to the Los Angeles classification. The oral cavity examination was performed by a trained and calibrated dentist and ETW was classified using the Basic Erosive Wear Examination (BEWE) index. Parents/guardians answered a questionnaire about the patients' diets and frequency of consumption of acidic foods and beverages. A total of 110 children were included in the study. Erosive esophagitis was observed in 24 patients (21.8%) and all of them (100%) presented ETW, showing a statistically significant association between these 2 conditions (p < 0.05). Among children who did not present with erosive esophagitis (n = 86), 54 (64.3%) had an ETW risk level of none according to their BEWE scores (0-2). The results of this study showed a statistically significant association between erosive esophagitis and ETW, thus it can be concluded that it is important to recognize groups at risk of ETW and act together with medical professionals to ensure adequate oral health for these patients.