Relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren.

The aim of this study was to identify the relationship between Molar Incisor Hypomineralization (MIH) severity and cavitated carious lesions in schoolchildren. This crosssectional study included 506 schoolchildren selected from public schools. The prevalence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry criteria (EAPD), while the prevalence and severity of caries was evaluated by applying the ICDAS (International Caries Detection and Assessment System). The prevalence of MIH was 42.4%, with a severity of 21.7% mild, 7.7% moderate, and 13.0% severe. Prevalence was 61.6% for incipient lesions and 34.0% for cavitated lesions. The prevalence of ICDAS II ≥4 lesions was higher in schoolchildren with MIH than in those without MIH (55.8% vs. 44.2%, p<0.001). In the multinomial model, children with MIH in the moderate/ severe category were more likely (OR=3.28; CI95% 1.01 - 10.6, p<0.048) to present cavitated lesions. The presence of MIH at mild levels was not associated with cavitated carious lesions. A high prevalence of MIH was observed. Moderate and severe levels of MIH were associated with cavitated carious lesions. To prevent dental caries, it is important to identify MIH in children, particularly in the moderate and severe categories.

El objetivo de este estudio fue identificar la asociación entre la severidad de la Hipomineralización IncisivoMolar (HIM) y las lesiones cavitadas de caries en escolares. Estudio transversal que incluyó a 506 escolares seleccionados de escuelas públicas. La prevalencia y la severidad de HIM se evaluó utilizando los criterios de la European Academy of Pediatric Dentistry (EAPD), mientras que la prevalencia y severidad de caries se evaluó mediante los criterios del ICDAS (International Caries Detection and Assessment System). La prevalencia de HIM fue del 42.4%, por severidad: 21.7% leve; 7.7% moderado y 13.0% severo. La prevalencia de lesiones incipientes fue de 61.6% y 34.0% para lesiones cavitadas de caries. La prevalencia de ICDAS II ≥4 lesiones fue mayor en escolares con HIM que en aquellos sin HIM (55.8% vs 44.2%, p<0.001). En el modelo multinomial, los niños con HIM en la categoría moderada / severa tienen mayor probabilidad (RM = 3.28; IC95% 1.0110.6, p<0.048) de presentar lesiones cavitadas de caries. La presencia de HIM en niveles leves no se asoció con la presencia de lesiones cavitadas de caries. Se observó una alta prevalencia de HIM. Los niveles moderados y severos de HIM se asociaron con lesiones cavitadas de caries. Para prevenir la caries dental, es importante identificar la HIM en los niños, particularmente en las categorías moderada y severa.

Global burden of molar incisor hypomineralization.

OBJECTIVES: We aimed to systematically review and meta-analyze the global, super-regional, regional and national prevalence of molar-incisor-hypomineralization (MIH) and to determine the numbers of prevalent and incident cases on different spatial scales. The review was registered (PROSPERO CRD42017063842). SOURCES: Five electronic databases (Medline, EMBASE, LILACS, Web of Science, Google Scholar) were searched systematically. STUDY SELECTION: Observational studies on the prevalence of MIH were included and the prevalence on different spatial scales (global, super-regional, regional, national) synthesized using random-effects meta-analyses. The prevalence was then regressed on a large set of methodological, socioeconomic and environmental variables to estimate the global burden (incident and prevalent cases) of MIH. DATA: Of 2239 identified studies, 99 studies on 113,144 participants from 43 countries were included. The meta-analysis yielded a mean (95% CI) prevalence of 13.1% (11.8-14.5%), with significant differences between super-regions, regions and countries. The number of prevalent cases in 2015 was estimated at 878 (791-971) million people, while the number of incident cases in 2016 was 17.5 (15.8-19.4) million. Of these, 27.4% (23.5-31.7%) (in mean, 240 million prevalent and 4.8 million incident cases, respectively) were or will be in need of therapy due to pain, hypersensitivity or posteruptive breakdown. Heavily populated countries contribute significantly to the burden of prevalent cases, while growing countries like India, but also Pakistan or Indonesia rank first with respect to the number of incident cases. CONCLUSIONS: MIH is highly prevalent across the globe. Certain (mainly low- and middle income) countries shoulder the majority of this burden. Clinical significance The consistently high prevalence and the large proportion of cases in need of care should be considered by both clinicians in their daily practice and healthcare planners and policy makers.

Further evidence for specific IFIH1 mutation as a cause of Singleton-Merten syndrome with phenotypic heterogeneity.

Singleton-Merten syndrome (MIM 182250) is an autosomal dominant inherited disorder characterized by early onset periodontitis, root resorption, osteopenia, osteoporosis, and aortic valve or thoracic aorta calcification. The disorder can have significant intrafamilial phenotypic variability. Here, we present a mother and daughter with Singleton-Merten syndrome harboring a previously described pathogenic missense mutation, c.2465G>A p.(Arg822Gln), in IFIH1 (interferon induced with helicase C domain 1), encoding MDA5 (Melanoma Differentiation-Associated protein 5). These data confirm the pathogenicity of IFIH1 c.2465G>A p.(Arg822Gln) for Singleton-Merten syndrome and affirm the striking phenotypic heterogeneity of this disorder. In addition, we expand the Singleton-Merten phenotype by adding severe systemic lupus erythematosus (SLE) to the clinical picture. Investigations of known SLE genes as well as a single nucleotide polymorphism suggested to be involved in development of SLE were normal.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren.

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Do We Really Know the Prevalence of MIH?

AIM: To analyze the existing variability on molar incisor hypomineralization prevalence in the literature; to distinguish the various molar incisor hypomineralization prevalence rates in different countries, areas, and regions of the world; and to know the valid diagnostic criteria used for the correct identification of molar incisor hypomineralization prevalence. STUDY DESIGN: A literature review from Medline and Cochrane Library online databases was performed using five terms individually or in combination. Articles not reporting diagnostic criteria employed and articles not written English were excluded. The results were analyzed by country, region, year of study, sample size, range of age, and prevalence rate. RESULTS: A total of 37 articles in English were selected from 1987 to 2014 and from those only 14 employed the EAPD's 2003 diagnostic criteria. The reported age range varied from 5.5 to 17 years; the most frequently range used was 7 to 9 years. A wide prevalence range from 2.8% to 44% was found and 82.61% of the articles reported calibrated examiners. CONCLUSIONS: Comparison among the results of the studies is difficult due to the use of different indexes and diagnostic criteria, the analysis variability, selection methods, and different age groups. In reality, we are probably far from knowing the real MIH prevalence.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

Abstract This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Adhesión en molares permanentes hipomineralizados. Puesta al día / Dental adhesion in permanent hipomineralized molars. Update

El síndrome incisivo molar o MIh se describe como una hipomineralización de origen sistémico que afecta de 1 a 4 de los primeros molares permanentes y que se asocia frecuentemente con alteraciones de los incisivos, siendo su aparición cada vez más frecuente. Los dientes afectados van a presentar un aumento de su contenido proteico y una disminución del contenido mineral. El tratamiento del MIh supone un reto para el odontólogo. Las características clínicas de este desorden, como la ruptura posteruptiva o la formación de cavidades atípicas, complican la obtención de un resultado duradero. Los últimos estudios apuntan a que los sistemas adhesivos de autograbado consiguen una fuerza de adhesión mayor que otros sistemas. El pretratamiento de la lesión puede producir un aumento de la fuerza adhesiva, aunque los resultados observados no permiten estandarizar este procedimiento. Las opciones más prometedoras son el hipoclorito sódico y las resinas infiltrantes. La mejor opción terapéutica para el MIh actualmente consiste en la realización de una reconstrucción con resina compuesta, utilizando un sistema adhesivo de autograbado, valorando la posibilidad de realizar un pretratamiento con hipoclorito sódico o resinas infiltrantes (AU)

The molar incisor syndrome (MIh) is described as a hypomineralization of systemic origin affecting 1 to 4 of the first permanent molars that is frequently associated with alterations of the incisors, and its appearance is increasing. Affected teeth will file a raise of its protein content and decreased mineral content. The treatment of MIh is a challenge for the dentist. The clinical features of this disorder, as posteruptive rupture or the formation of atypical cavities complicate obtaining a lasting result. Recent studies suggest that selfetching adhesive systems achieve a greater adhesion force than other systems. Pretreatment of injury may result in increased adhesive strength, although the observed results do not allow to standardize this procedure. The most promising options are sodium hypochlorite and infiltrating resins. The best therapeutic option for MIh is currently performing a reconstruction with composite resin using a self-etching adhesive system, seeing the possibility of pretreatment with sodium hypochlorite or infiltrating resins (AU)

Long term clinical outcome of dental implants placed in a patient with Singleton-Merten syndrome.

PATIENTS: Singleton-Merten syndrome is an extremely rare autosomal dominant condition with less than 10 reported cases in the literature. It is characterized by abnormal aortic calcifications and dental abnormalities. The goal of this case report is to discuss the abnormal oral clinical features and the modified treatment protocol that was used in order to achieve osseointegration of dental implants in a patient having abnormal bone density and bone turnover associated with Singleton-Merten Syndrome. DISCUSSION: Following extraction of the remaining teeth, titanium implants (Friadent GmbH, Mannheim, Germany and Straumann(®), Basel, Switzerland) were placed in the upper and lower jaw of the patient. The upper jaw which was treated with dental implants, received a bar supported implant retained prosthesis and the lower jaw an implant retained telescopic prosthesis. The patient was regularly followed up for the past 13 years during which, clinical and radiological evaluation of osseointegration was undertaken. All the loaded implants showed clinical and radiographic evidence of osseointegration. With a follow up of 13 years after insertion of the first implant, the patient reported functioning well with no complications. CONCLUSION: The treatment with dental implants in the extremely rare Singleton-Merten syndrome patients is a reasonable treatment option to rehabilitate maxillofacial aesthetics and establish normal function of the jaws.

[Enamel: a unique self-assembling in mineral world]. / L'émail - Un autoassemblage unique dans le monde du minéral.

Enamel is a unique tissue in vertebrates, acellular, formed on a labile scaffolding matrix and hypermineralized. The ameloblasts are epithelial cells in charge of amelogenesis. They secrete a number of matrix proteins degraded by enzymes during enamel mineralization. This ordered cellular and extracellular events imply that any genetic or environmental perturbation will produce indelible and recognizable defects. The specificity of defects will indicate the affected cellular process. Thus, depending on the specificity of alterations, the teratogenic event can be retrospectively established. Advances in the field allow to use enamel defects as diagnostic tools for molecular disorders. The multifunctionality of enamel peptides is presently identified from their chemical roles in mineralization to cell signaling, constituting a source of concrete innovations in regenerative medicine.

Timing of mineralization of homologues permanent teeth--an evaluation of the dental maturation in panoramic radiographs.

Clinically the condition Molar Incisor Hypomineralization (MIH),varies considerably between individuals, where any number of molars, from one to all four permanent first molars, may be affected with different degrees of hypomineralized enamel within the same dentition. An explanation to these variations could be that the start of the enamel mineralization differs between homologues teeth. The aim of this study was to compare the dental development between homologues teeth in digital panoramic radiographs (PRs),from children aged 7 to 11 years, using the Gleiser & Hunt method on second and third molars and to calculate the crown/root ratio for the mandibular premolars.77 PRs, from individuals between 7.3 and 11.0 years of age, were studied. Differences in developmental stages between homologues teeth (second and third molars) were studied. In 72 of these PRs, the crown/root ratio of mandibular premolars was also compared. In 31 of the PRs, a difference in development was found between the right and left maxillary second molar. In 22 PRs, a difference in development between the right and left mandibular second molar was found. In 17 of the PRs, a difference in development was found between the right and left maxillary third molars. In 26 PRs,a difference in-between the right and left mandibular third molar was found. In 72 PRs, the crown/root ratio of mandibular premolars was measured and differences were found. All these differences were significant. A possible explanation to the variations in expressivity of MIH may be a result of differences in the start of mineralization between homologues teeth. Timing of mineralization of homologues permanent teeth--An evaluation of the dental maturation in panoramic radiographs.

Dental development in children with severe molar-incisor hypomineralization in Samsun, Turkey.

Anomalies in amelogenesis may be due to developmental defects or abnormalities in different components of developing teeth and can affect dental development. We compared dental development in a group of children with molar-incisor hypomineralization (MIH) with that in age- and sex-matched controls. Dental age was determined using panoramic radiographs of 105 children (59 girls, 46 boys) aged 7-11 years with severe MIH, and the findings were compared with those from 105 healthy age- and sex-matched controls. Although accelerated dental development was noted in the MIH group, the difference between the MIH and control groups was not statistically significant (P < 0.05). Furthermore, no relationship was found between number of affected teeth and the difference between dental and chronological age. In conclusion, children with severe MIH had slightly accelerated dental development as compared with controls.

Dental caries experience and Molar-Incisor Hypomineralization.

OBJECTIVE: This cross-sectional study assessed the prevalence and severity of the enamel defects, known as Molar-Incisor Hypomineralization (MIH) and its relationship to dental caries. MATERIALS AND METHODS: A sample of 1157 schoolchildren (population based), aged 6-12 years, of the Araraquara city-Brazil, was evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria by two trained examiners. The dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). Data were analyzed using ANOVA and Chi-square tests (p < 0.05). The socioeconomic status was collected using a questionnaire answered by parents. RESULTS: The prevalence of MIH was 12.3%. Mild impairment was the most frequent diagnosis. DMFT of children with MIH was 0.89 (± 1.18), which are higher than those of the unaffected group (0.43 ± 1.01). An association was found between dental caries only in the permanent dentition of children with MIH (p = 0.0001). Family income was considered low in 85% of the families of children with MIH in the public system, while in private school it was 18% (p < 0.05). CONCLUSION: The prevalence of MIH in Araraquara was associated with greater caries experience in the permanent dentition.

Preterm infants--odontological aspects.

Preterm birth is associated with medical complications and treatments postnatally and disturbances in growth and development. Primary and permanent teeth develop during this postnatal period. The overall aim of the present thesis was to elucidate the effects of preterm birth and postnatal complications on oral health and the dentoalveolar development during adolescence, and to study the effects of preterm birth on caries during childhood, in a well-defined group of preterm infants. In the same group, explore the development of the primary and permanent teeth and compare the results with a matched control group and control teeth. The subjects consisted of 40 (45) of 56 surviving infants, born < 29 weeks of gestational age (GA), and matched healthy children born at term. The material consisted of 44 teeth from 14 of the preterm adolescents and 36 control teeth from healthy children. Clinical examinations and dental cast analysis were performed during adolescence and morbidity was noted. Retrospective information from medical and dental records was obtained. Dental enamel was analyzed in a polarized light microscopy, and scanning electron microscopy. Further, chemical analyses of enamel and dentin were performed with X-ray microanalysis. The results showed that during adolescence, more preterms had plaque and gingival inflammation, lower salivary secretion, more S. mutans and severe hypomineralization. Retrospectively, less caries was noted at six years of age, but more children had hypomineralization in the primary dentition. Angle Class II malocclusion, large over-bite and deep bite associated with medical diagnoses were frequent. Furthermore, smaller dental arch perimeters in girls, at 16 years of age, and smaller tooth size in the incisors, canines and first molars were found. The morphological findings were confirmed in the XRMA analyses. In postnatal enamel, varying degrees of porosities > 5% and incremental lines were seen. Lower values of Ca and Ca/C ratio and higher values of C were found. Ca/P ratio in both enamel and dentine indicates normal hydroxyapatite in both groups. No single medical diagnosis, postnatal treatment or morbidity in adolescents could explain the findings. As a conclusion, there are indications for poor oral outcome in this group of preterm infants during adolescence, and disturbed mineralization in primary teeth.

Linear enamel hypoplasia at Xcambó, Yucatán, during the Maya Classic period: An evaluation of coastal marshland impact on ancient human populations.

Non-specific stress markers such as linear enamel hypoplasia (LEH) have been associated in the literature with a large number of possible conditions disrupting the individual's homeostasis, though metabolic strain originating synergistically by disease and malnutrition has been held to be the main cause behind enamel disruption. The analysis of LEH in the Maya Classic period site of Xcambó, located along the northern coast of the Yucatán peninsula, reveals high exposure to stressful conditions during infancy regardless of age and sex. Yet, the inhabitants of the site were of a medium to high social and economic status, with access to balanced and protein-rich nutritional resources, which should have functioned as a cultural buffer to the impact of stress. In the light of this apparent contradiction, this paper discusses the impact of environmental conditions on the record of metabolic stress. Our conclusions pose a cautionary caveat for inferring nutrition and status in ancient pre-antibiotic populations solely from the occurrence of linear enamel hypoplasia.

Amelogenesis imperfecta: revisión / Amelogenesis imperfecta: a review

Con la denominación de Amelogénesis Imperfecta(AI) se define un grupo de enfermedades hereditarias heterogéneas clínica y genéticamente que se caracterizan por alteraciones del esmalte. También pueden observarse otras alteraciones orales y extraorales. La maloclusión más frecuente en estos pacientes es la mordida abierta. Algunos casos forman parte de un síndrome. Hasta el momento se han identificado mutaciones en cinco genes, AMELX, ENAM, KLK4, MMP20 yDLX3, que participan en la formación del esmalte normal, pero quedan otros por identificar. Los autores actualizan los conocimientos sobre la etiopatogenia, clasificación, manifestaciones clínicas, diagnóstico y tratamiento interdisciplinar de la AI (AU)

Amelogenesis imperfecta (AI) is a collective designation for a clinically and genetically diverse group of disorders displaying enamel malformations. Other oral and extraoral aberrations have been reported, and open bite is the most common malocclusion. Some cases present as a part of a syndrome. Mutations in five genes involved in normal enamel formation(AMELX, ENAM, MMP20, KLK4 and DLX3) have been identified as cause of amelogenesis imperfecta, but some others remain to be identified. This paper reviews current knowledge about etiopathogenesis, classification, clinical manifestations, diagnosis and interdisciplinary treatment of AI (AU)

What can variation in stature reveal about environmental differences between prehistoric Jomon foragers? Understanding the impact of systemic stress on developmental stability.

This study reconstructs patterns of stress and phenotypic variation in prehistoric Japan. Greater evidence for stress is indicated by elevated enamel hypoplasia frequency among Jomon foragers from western compared to eastern Japan. Geographic variation in stress between Jomon people is related to plant-based diets and resource scarcity in western Japan. The hypothesis that Jomon people from western Japan had shorter stature than those from the east is, therefore, tested. Relationships between individual stature, geographic location, and enamel hypoplasia presence/absence are also explored. In addition, increased population density and reliance on plant foods are observed during the Late/Final Jomon period in western Japan. A second hypothesis proposing shorter stature for Late/Final Jomon people compared to those from the Middle Jomon period is tested. Statistically significant differences in stature between males and females from eastern and western Japan were not observed. Individual relationships between enamel hypoplasia and stature were rejected. Stature decreased significantly over time in western Japan. It is possible that stature between the eastern and western Jomon did not differ because the western Jomon experienced catch up growth after childhood stress episodes. It is also likely that variation in stress between the two groups was not severe enough to warrant stature reduction. Decreases in stature through time in western Japan are related to increased exposure to chronic infection and dietary stress. Overall, these results indicate that enamel hypoplasia frequencies provide an adequate index of general stress but may fail to predict the impact of stress on the human phenotype.

[Evaluation of the dental eruption pattern and of enamel defects in the premature child]. / Os defeitos do esmalte e a erupção dentária em crianças prematuras.

BACKGROUND: The purpose of this study was to analyze the relation between enamel defects and delay of dental eruption with prematurity. METHODS: the sample consisted of 100 premature children ranging from six months to six years of age, observed in the Children Institute of the Medical School of the USP. An anamnesis of the oral cavity was carried out by just one observer who analyzed the chronology of teeth eruption as well as the occurrence of enamel defects. A medical evaluation was also conducted in order to detect potential problems during the prenatal, neonatal and postnatal periods. The statistical assessment included descriptive analysis, average frequency and a confidence interval of 95%. RESULTS: Defects appeared in 35% of the premature children; 51.43% of those affected had been born with a low weight (< 2500g), compared to 14.29% born with normal weight (> 2500g). No relationship was found between the occurrence of defects with a low Apgar score during the first minute, second minute and five minutes (p=0.628; p=0.308;p=0.,193). The most common defects were white opacities, in the deciduous (19.0%) as well as in the permanent dentition (100%). The incisor and cervical halves of the vestibular faces were the most affected reaching values of 88.04% for the deciduous dentition and of 100% for the permanent one. In about 42% of children eruption of teeth took place between 6 to 10 months of age. CONCLUSIONS: Premature children may have enamel defects caused by different factors that appear during pregnancy with a possible association between low weight and enamel defects. Furthermore, premature children had teeth eruption in a normal period, nevertheless, until 36 months of age with less teeth total than children born at normal term.

Os defeitos do esmalte e a erupcão dentária em criancas prematuras / Evaluation of the dental eruption pattern and of enamel defects in the premature child

OBJETIVO: A proposta do trabalho foi verificar a relacão entre defeitos do esmalte e atraso da erupcão dentária com prematuridade. MÉTODOS: A amostra consistiu de 100 criancas prematuras, entre seis meses a seis anos de idade em acompanhamento no Instituto da Crianca da Faculdade de Medicina da USP. Foi feita uma anamnese da cavidade bucal por apenas um observador, avaliando o tempo da erupcão dentária e a ocorrência de defeitos no esmalte. Realizou-se também uma avaliacão médica, com dados referentes a possíveis problemas durante o período pré-natal, neonatal e pós-natal. A avaliacão estatística utilizou análise descritiva, freqüência média e intervalo de confianca de 95 por cento. RESULTADOS: Defeitos apareceram em 35 por cento das criancas prematuras; 51,43 por cento das que tinham defeitos haviam nascido com peso baixo (< 2500g) comparados aos 14,29 por cento que haviam nascido com peso normal (>2500g) . Não houve relacão entre ocorrência de defeitos com baixo Boletim de Apgar em 1 minuto, 2 minutos e 5 minutos (p=0,628; p=0,308; p=0,193). Os defeitos mais comuns foram as opacidades brancas, tanto na denticão decídua (19 por cento) quanto na permanente (100 por cento). Os tercos incisais e cervicais das superfícies vestibulares foram os mais afetados com valores de 88,04 por cento na denticão decídua e 100 por cento na permanente. Cerca de 42 por cento das criancas tiveram dentes irrompidos entre 6 e 10 meses. CONCLUSAO: Criancas prematuras podem apresentar defeitos do esmalte causados por diferentes fatores durante a gravidez com uma possível associacão entre baixo peso e defeito. Os dentes irromperam em tempo normal, no entanto, o número total de dentes até os 36 meses foi menor do que os encontrados em criancas nascidas a termo.

Las anomalías del esmalte dentario y su relación con enfermedades generales / Dental anomalies and its relationship with systemic diseases

El esmalte dentario es uno de los tejidos más duros del organismo, sin embargo las células formadoras del esmalte, los ameloblastos, son muy sensibles a los cambios que ocurren durante el periodo de formación del diente. Son muchas las patologías que pueden alterar el funcionamiento del ameloblasto provocando lesiones de hipoplasia o hipomineralización, y a diferencia de lo que ocurre en otros tejidos, el esmalte dentario carece de mecanismos de reparación. En este artículo, revisamos las principales causas genéticas y ambientales que pueden ser responsables de las anomalías en esmalte dentario, así como el aspecto clínico que pueden presentar estas anomalías

Dental enamel is one of the hardest tissues in thehuman body. However, ameloblast cels wich compraisthe enamel, are extremely sensitive to the changes occurring during dental development. There are many pathologys that can alter the normal function in ameloblast cels and cause hypoplasia orhypomineralization. In contrast to other tissue enamel tissue does not have its own repair mechanisms. In this article we review the principal genetic andenvirolmental causes that may contribute to dental anomalies as well as the clinical aspect of these anomalies