Objective
To evaluate systemic exposures associated with molar incisor hypomineralization (MIH).
Methods
This systematic review was performed using published observational studies that evaluated the ...systemic exposures associated with MIH. The sources of articles searched were PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and Grey literature. The risk of bias was analysed according to the Newcastle‐Ottawa Scale for quality assessment. The meta‐analysis was performed considering the exposures during the prenatal, perinatal and postnatal periods using the CMA software.
Results
A total of 4207 articles were identified. Twenty‐nine studies were eligible for inclusion and 27 were included in the meta‐analysis. The studies presented low and moderate risks of bias, except for one that was classified as having a high risk of bias. Maternal illness during pregnancy (OR 1.40; 95% CI 1.18‐1.65, P < 0.0001) and psychological stress (OR = 2.65; 95% CI 1.52‐4.63; P = 0.001) was observed to be significantly associated with higher odds of MIH. During the perinatal period, caesarean delivery (OR = 1.32, 95% CI 1.11‐1.57, P = 0.001) and delivery complications (OR = 2.06; 95% CI 1.47‐2.88, P < 0.0001) were also associated with MIH. In the postnatal period, only respiratory diseases (OR = 1.98; 95% CI 1.45‐2.70, P < 0.0001) and fever (OR = 1.50; 95% CI 1.22‐1.84; P < 0.0001) were associated with higher prevalence of MIH. The evidence was graded as very low quality.
Conclusions
Maternal illness, psychological stress, caesarean delivery, delivery complications, respiratory diseases and fever during the first years of a child's life were significantly associated with a higher odds of MIH. However, this should be interpreted with caution, once the primary studies were observational, with serious limitations according to the risk of bias, imprecision, and inconsistency. Further, well‐designed cohort studies are still required.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objectives
The purpose of this cross-sectional study was to investigate whether polymorphisms in vitamin D receptor (
VDR
) genes increase the prevalence of dental caries, molar incisor ...hypomineralization (MIH), and hypomineralized primary second molars (HPSM).
Material and methods
A representative population-based sample of 731 schoolchildren, 8 years of age, was randomly selected in Curitiba, Paraná, Brazil. MIH, HPSM, and dental caries were clinically assessed by four calibrated examiners (kappa > 0.80) using European Academy of Pediatric Dentistry (2003) criteria, the modified Developmental Defects of Enamel (DDE) index, and the Decayed, Missing, or Filled Teeth (DMFT) index by the World Health Organization (2013), respectively. The
VDR rs739837
and
rs2228570
polymorphisms were genotyped using real-time polymerase chain reaction. Associations were analyzed by Poisson regression with robust variance (
α
= 0.05).
Results
Schoolchildren with MIH presented a higher prevalence of dental caries (DMFT > 1, PR = 2.52, confidence interval = 1.60–3.97,
p
≤ 0.001). No association was observed between MIH, HPSM, and dental caries, with
rs739837
and
rs2228570
polymorphisms. Individuals with the GT/GG genotype in
rs739837
polymorphism presented a higher prevalence of MIH in molars and incisors than individuals TT (PR = 2.34, confidence interval = 1.08–5.07,
p
= 0.03).
Conclusion
Children with MIH presented a significant higher prevalence of dental caries than children without MIH. To carry at least one G allele in
rs739837
was associated to higher prevalence of MIH in molars and incisors.
Clinical relevance
Our findings suggested that more severe cases with incisors affected by MIH could be associated with polymorphism in
VDR
gene.
Polymorphisms in the COMT gene can alter enzymatic functions, raising levels of endogenous catecholamines, which stimulates beta-adrenergic receptors related to pain. This study aimed to evaluate ...whether a polymorphism in the COMT gene (rs4818) is associated with dental pain in children.
A cross-sectional study was conducted with a representative sample of 731 pairs of children and parents randomly selected from a population-based sample of eight-year-old children. Reports of dental pain was evaluated using a question directed at the parents and self-reported pain using the Faces Pain Scale - Revised. Dental caries experience was determined using the Decayed, Missing, and Filled Teeth (DMFT) index. For genetic analysis, DNA was obtained from oral mucosa epithelial cells of 352 children randomly selected from the initial sample.
Children with the CC genotype had higher odds of reporting moderate to intense pain than those with the GG genotype (OR=3.60; 95% CI=0.80-16.20; p=0.03). These same children had greater odds of parental reports of pain (OR=1.93; 95% CI=0.91-4.08; p=0.02). Moreover, lower schooling of parents/guardians and caries experience in the primary dentition were significantly associated with greater odds of a parental report of dental pain (OR=2.06; 95% CI=1.47-2.91; p<0.001; OR=6.26; 95% CI=4.46-8.78; p<0.001).
The rs4818 polymorphism of the COMT gene is associated with dental pain. Children with the C allele are more likely to report higher levels of pain. Clinical Relevance: Even though the experience of pain is subjective and multifactorial, this study raises the hypothesis that there is a genetic predisposition to dental pain that should be considered in clinical practice.
Abstract Background Polymorphisms in genes related to enamel formation and mineralization may increase the risk of developmental defects of enamel (DDE). Aim To evaluate the existing literature on ...genetic polymorphisms associated with DDE. Design This systematic review was registered in the PROSPERO (CRD42018115270). The literature search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and in the gray literature. Observational studies assessing the association between DDE and genetic polymorphism were included. The Newcastle–Ottawa Scale was used to assess the risk of bias. Results One thousand one hundred and forty‐six articles were identified, and 28 met the inclusion criteria. Five studies presented a low risk of bias. Ninety‐two genes related to enamel development, craniofacial patterning morphogenesis, immune response, and hormone transcription/reception were included. Molar–incisor hypomineralization (MIH) and/or hypomineralization of primary second molars (HPSM) were associated with 80 polymorphisms of genes responsible for enamel development, immune response, morphogenesis, and xenobiotic detoxication. A significant association was found between the different clinical manifestations of dental fluorosis (DF) with nine polymorphisms of genes responsible for enamel development, craniofacial development, hormonal transcription/reception, and oxidative stress. Hypoplasia was associated with polymorphisms located in intronic regions. Conclusion MIH, HPSM, DF, and hypoplasia reported as having a complex etiology are significantly associated with genetic polymorphisms of several genes.
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Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This cross-sectional study aimed to assess the prevalence of molar incisor hypomineralization (MIH) and its relationship with the number of primary teeth with developmental defects of enamel (DDE). A ...representative population-based sample of 731 schoolchildren was randomly selected from the public school system in Curitiba, Brazil. Schoolchildren aged 8 years with fully erupted permanent first molars and incisors were eligible for the study. MIH and DDE were classified by four calibrated examiners (kappa > 0.75) according to EAPD criteria and to the FDI-modified DDE index. Clinical data were collected in a school environment. Socioeconomic information was collected through a self-administered semistructured questionnaire applied to the children's caregivers. Statistical analyses were carried out using Poisson multiple regression with robust variance (α = 0.05). MIH prevalence was 12.1% (95%CI: 10-15), and opacities were the most prevalent defect. Socioeconomic factors were not associated with MIH. Children with demarcated opacity in primary teeth presented a higher prevalence of MIH than those without DDE in primary teeth. In the multiple analysis, the increase of one primary tooth affected by demarcated opacity increased the prevalence of MIH by 33% (PR = 1.33, 95%CI: 1.15-1.53, p < 0.001). Asian children had a higher prevalence of MIH (PR = 2.91, 95%CI: 1.08-8.09 p = 0.035) than did Caucasian children.Conclusion: Based on these findings, the prevalence of MIH in Curitiba was 12.1%. Demarcated opacity in primary teeth could be considered a predictor of MIH.
ABSTRACT Objective: To evaluate the systemic factors associated with Molar-Incisor Hypomineralization (MIH) etiology. Material and Methods: A total of 731 8-year-old schoolchildren enrolled in the ...public school system in Curitiba, Brazil, was randomly selected. The MIH diagnosis was performed by calibrated examiners (Kappa >0.80) according to the European Academy of Pediatric Dentistry criteria (2003). The systemic factors were collected through a semi-structured questionnaire and applied to the children’s mothers, addressing the medical history from pregnancy to the first three years of children’s life. Associations were analyzed by Poisson regression analysis with robust variance (p<0.05). Results: The systemic factors in the prenatal and perinatal periods were not associated with MIH (p>0.05). The children who used medications during the first years of life had a significantly higher prevalence of MIH (PRc = 2.18 CI = 95% 1.06-4.48; p=0.033). Conclusion: The use of medications during the first three years of children’s life is associated with a higher prevalence of MIH.
Abstract Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 ...records of children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation. Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively). Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.
Purpose: There are several restorative modalities for molar hypomineralization, but there is no consensus on the best approach. The purpose of this review was to describe restorative approaches ...applied to permanent first molars (PFM) with molar hypomineralization (MH). Methods:
This review was registered (PROSPERO database CRD42017078336). Searches were conducted in the PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane Library databases and grey literature. From a total of 1,751 studies, 12 that compared restorative treatments for PFM with MH were included.
The risk of bias of the studies was assessed using the Cochrane Collaboration and the Newcastle-Ottawa Scale. The success rate was the primary outcome. Results: The restorative treatment options were direct restorations with amalgam, glass ionomer cement, and resin-based composite as
well as indirect restorations with stainless steel, porcelain, ceromer, and gold crowns. The restorative techniques, considering the type of isolation and the removal of caries and hypomineralization, vary between the study. There was also a lack of standard clinical criteria for restorative
evaluation. The follow-up period ranged from six to 216 months. The success of direct restorations ranged from 86.3 to 100 percent. For indirect restorations, success ranged from 91.3 to 100 percent. Conclusions: There were multiple clinical protocols for MH. The studies presented heterogeneity
in the restoration technique, time, and clinical criteria for restorative follow-up. Direct restorations with glass ionomer cement and resin-based composite could be the first choices for restoration. Further randomized clinical trials on a restorative treatment for MH are needed.
Objective: To identify the clinical and radiographic conditions associated with failure of pulp therapy in primary teeth through a survival analysis. Material and Methods: A total of 1000 records of ...children assisted at the pediatric dentistry clinic of the Federal University of Parana, Brazil, from the years 2000 to 2010, were analyzed. The mean evaluation time was 10.61 months (minimum/maximum: 1/28) from the report of pulp therapy. The different types of treatments analyzed included indirect pulp treatment (IPT), direct pulp treatment (DPT), pulpotomy and pulpectomy. The Kaplan-Meyer method and log-rank test were used for the survival analysis. Exodontia was considered as the outcome variable and censors included: traumatic tooth loss, presence of the tooth in the oral cavity and physiologic tooth exfoliation. Results: A total of 122 records reporting pulp therapy in the primary teeth were selected. From this, 16 teeth (13.12%) were extracted. Survival analysis showed that pulpectomy presented lower survival rates when compared to conservative therapies (p=0.0297). Teeth with furcal lesions and pathological root resorption before pulp therapy had lower survival rates when compared to those that did not present these conditions (P=0.006). Presence of fistula and abscess after pulp therapy were also associated with lower survival rates (P=0.0062 and 0.0143, respectively). Conclusion: Signals of pulp necrosis were associated to lower survival rates in primary teeth submitted to pulp therapy.
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