Comparing the effectiveness of caries arrest by micro-operative treatment to operative treatment: A 2-year randomized controlled clinical trial.

OBJECTIVES: To compare the effectiveness of caries arrest by micro-operative treatment (sealing) to operative treatment (flowable resin composite restoration) through a 2-year randomized controlled clinical trial. MATERIALS AND METHODS: A prospective randomized controlled trial was conducted among 7-9-year-old children. At baseline, 630 subjects were screened and 92 children who had at least one carious lesion classified as ICDAS 3 on the pit and fissure of first permanent molar were included. Then they were randomly assigned to the sealant group (73 lesions) and the flowable resin composite group (76 lesions) to receive the corresponding intervention. Lesions status in each group was evaluated every 6 months up to 24 months. Clinical progression of dental caries and materials retention were the outcomes used for group comparisons at p-value < 0.05. RESULTS: After 24 months, three lesions (4.1%) in the sealant group clinically progressed to dentin caries. No lesion in the flowable composite group was observed a progression. The results of Life-table survival analysis show that the cumulative caries arrest rate had no statistically significant difference between the two groups (p = 0.075). However, the cumulative retention rate was 57.5% in the sealant group and 92.1% in the flowable composite group, with significant differences (p < 0.001). The multilevel mixed model showed the sealant had higher risk of retention failure than the flowable composite (OR = 8.66, p < 0.001), while tooth position did not influence material retention (p = 0.083). In addition, the results of Fisher Exact test show that dentin lesions had more retention failure than enamel lesions in the sealant group (p = 0.026). CONCLUSION: Although sealing microcavitated carious lesions of the first permanent molar achieved lower retention rate than resin composite restoration, both sealing and restoration effectively arrested caries progression for two years. CLINICAL RELEVANCE: To preserving dental structure and delaying or eliminating the need for operative procedures, microcavitated carious lesion can be arrested by sealing. TRIAL REGISTRATION: Registered at http://www.chictr.org.cn ; Feb 15th, 2020; No. ChiCTR2000029862.

Knowledge and perception regarding molar incisor hypomineralisation among dental students and dental hygienist students in Spain: a cross-sectional study.

BACKGROUND: Molar incisor hypomineralisation (MIH) has a high prevalence in the Spanish pediatric population and is a precursor of carious lesions in teeth in which it is present. Although this pathology is included in the curricula of the Degree in Dentistry and the Training Cycle in Oral Hygiene in our country, the contents currently taught seem to be insufficient in relation to the level of knowledge that we have today about this condition. METHODS: A digital questionnaire of 18 questions was sent to a sample of 448 students attending the 4th and 5th year of the Degree in Dentistry and 2nd year of the Training Cycle in Oral Hygiene from different universities and vocational training centers in the Valencian Community. Descriptive and multivariate statistical analysis of the data was subsequently performed. RESULTS: Of the 290 questionnaires that were obtained, 53.8% were from students attending the 2nd year of a training course in oral hygiene and 46.2% were from students pursuing a degree in dentistry. Most of the respondents had heard about MIH (75.2%), mainly through master classes. However, most students had difficulties distinguishing MIH lesions from other lesions (58.3%). The degree of knowledge about MIH was greater among dental students in all the aspects evaluated: prevalence, diagnosis, prevention, and treatment. Of all the students, 83.8% were interested in increasing their training on MIH, especially in the areas of diagnosis and treatment. CONCLUSION: The results of the present study justify the need to expand the content on MIH, both theoretical and practical, in the educational curricula of the Degree in Dentistry and Integrated Vocational Training Centers in Spain.

Selective excavation and ozone therapy: new frontier of mini-invasive caries treatment in MIH paediatric patients. A case report.

BACKGROUND: The term hypomineralisation of molars and incisors (MIH), introduced in 2001 by Weerheijm et al., describes a clinical state of hypomineralisation of permanent molars with frequent involvement of the incisors. MIH is considered a global dental problem with a prevalence ranging from 2.4% to 40.2% in the entire world paediatric population. The continuous increase in the prevalence of enamel anomalies, including MIH, indicates the need to define new intervention protocols based on the technological advances that are revolutionising paediatric dentistry. The use of ozone associated with the selective and minimally invasive excavation of the dental tissue combines the antibacterial properties of the gas with an ultra-conservative approach aimed at the maximum conservation of the dental tissue. The operative protocol described can be an important tool in the prevention and treatment of MIH. The aim of this work is to illustrate an operative clinical protocol based on the combined use of selective excavation and ozone for the treatment of carious lesions in paediatric patients with MIH.

Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data.

Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.

Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization.

INTRODUCTION: One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS: In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS: The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION: Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

The relationship of the position of mandibular third molar impaction with the development of dental and periodontal lesions in adjacent second molars.

OBJECTIVE: The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age. MATERIALS AND METHODS: This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis. RESULTS: Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively). CONCLUSIONS: The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.

Cemental and alveolar bone defects after chronic exposure to amoxicillin in rats (histopathologic and radiographic study).

OBJECTIVES: This study aimed to shed new light on the potential detrimental effects on cementum and adjacent alveolar bone after chronic exposure to amoxicillin. METHODS: Six pregnant adult Albino rats were equally divided into two groups. Saline solution and amoxicillin (100 mg/Kg) were given to rats of control and amoxicillin group, respectively from the 13th to the 21st day of pregnancy. The same treatment was given to the pups till the 42nd day. The cementum of the first molar teeth and the surrounding alveolar bone were examined qualitatively by histopathological and scanning electron microscope, and quantitatively by energy dispersive X-ray spectroscopy and cone beam computed tomography. RESULTS: Amoxicillin group depicted cemental and alveolar bone defects along with resorption lacunae. Statistically significant decreases in calcium and calcium/phosphorus ratio in cementum and in calcium only in alveolar bone were evident (p ≤ 0.05). Overall cementum and alveolar bone densities also showed statistically significant decreases (p ≤ 0.05). CONCLUSION: Chronic amoxicillin administration displayed destructive effects on cementum and the surrounding alveolar bone which may disturb tooth attachment integrity. Therefore, it is recommended to minimize its haphazard usage during pregnancy and early childhood.

Knowledge, experience, and perception of molar incisor hypomineralisation among dentists in the metropolitan area of Mexico City: a cross-sectional study.

BACKGROUND: Molar-incisor hypomineralisation (MIH) is the most common developmental abnormality observed in teeth. Being a relatively new condition, its treatment can present a challenge for the dentist. There is currently no study available that has evaluated the knowledge of Mexican dental personnel. This study aimed to evaluate the knowledge, experience, and perceptions of dental surgeons regarding the detection, assessment, and treatment of MIH in the metropolitan area of Mexico City. METHODS: A cross-sectional study was designed. Dentists from Mexico City and its metropolitan area were invited through social networks to answer a questionnaire of 30 questions related to MIH. Participants were classified into general practice dentists, paediatric dentists, and other speciality dentists. Pearson's chi-square test was used for data analysis. RESULTS: The questionnaire was answered by 391 dentists. A total of 86% (338 out of 391) of them identified MIH lesions, while 84% of them reported having observed MIH lesions in their practice. The most frequently observed lesions were yellow-brown opacities which accounted for 47% of the lesions, 46% were white opacities, while only 7% were observed as post-eruptive fractures in the enamel as part of the manifestations of MIH. The most frequently reported problem in the management of teeth with MIH was insufficient training for treating children with MIH. A total of 84% of dentists stated that they would like more information on the treatment of MIH lesions. CONCLUSIONS: Most of the surveyed dentists recognised MIH and reported having observed MIH lesions in their practice. Most of the dentists indicated that the main problem for the management of the MIH is the lack of training.

Evaluation of antimicrobial photodynamic therapy and minimal intervention associated with deproteinisation in permanent teeth with molar incisor hypomineralisation: study protocol for a clinical, controlled, blinded trial.

INTRODUCTION: Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel development that occurs in the mineralisation phase. MIH affects one or more permanent molars and, occasionally, permanent incisors. The aim of the proposed study is to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) on permanent teeth with MIH through decontamination and sensitivity control. METHODS AND ANALYSIS: Patients from 8 to 12 years of age with permanent molars will be randomly allocated to three groups. Group 1: selective chemical-mechanical removal of carious dentinal tissue around the walls of the cavity with Papacárie Duo and a curette followed by the application of aPDT and deproteinisation with Papacárie Duo; group 2: selective removal of carious dentinal tissue around the walls of the cavity with a curette, followed by the application of aPDT and deproteinisation with a 5% sodium hypochlorite solution; group 3: selective removal of carious dentinal tissue using a curette. The selected teeth must have a carious lesion in the dentin and posteruptive enamel breakdown on one or more surfaces with an indication for clinical restorative treatment. The teeth will subsequently be restored using a mixed technique with resin-modified glass ionomer cement and bulk-fill composite resin. The data will be submitted to descriptive statistical analysis. Associations with age and sex will be tested using either the χ2 test or Fisher's exact test. Pearson's correlation coefficients will be calculated to determine the strength of correlations between variables. Comparisons of the microbiological results (colony-forming units) will be performed using analysis of variance and the Kruskal-Wallis test. Kaplan-Meier survival analysis will be performed to assess the performance of the restorations. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 61027522.0.0000.5511/approval date: 23 August 2022). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05443035.

An Observational Study on Cystic Alterations in Normal Dental Follicles Associated with Impacted Lower Third Molar for Early Intervention.

AIM: To evaluate the cystic changes in the radiographically normal dental follicle associated with impacted mandibular third molar. MATERIALS AND METHODS: This study was conducted on 80 patients. Samples were selected using a convenient sampling technique from the patients who had impacted mandibular third molars in Pell and Gregory's positions B and C, with follicular space less than 2.5 mm in diameter. After surgical removal of an impacted tooth, the dental follicle was sent for histopathologic evaluation. RESULTS: Pathologic alterations were found in 19% of cases out of 80 samples. Odontogenic keratocystic and dentigerous cystic changes were found in 7% of cases. A statistically significant cystic alteration was found in female patients and distoangular impacted teeth. CONCLUSION: This study shows a significant cystic alteration in the radiologically normal dental follicles. Clinical and radiographic features alone may not be a reliable indicator of the absence of pathology. Early intervention of impacted teeth will help to reduce morbidity due to the development of pathology. CLINICAL SIGNIFICANCE: This study will help educate patients on the risks of retaining impacted teeth, based on scientific facts, in order to minimize the risks and to assess the correlation of pathologic alterations with the depth of impaction and angular position of the impacted tooth.

Sensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children.

BACKGROUND: Most studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test. METHODS: One hundred sixty children, ages 7-12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared. RESULTS: For all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively). CONCLUSIONS: The sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.

Torque changes of anchorage units in preadolescent patients treated with a digitally designed tooth-borne expander anchored to deciduous vs. permanent molars.

AIM: To compare the effects on permanent or deciduous anchorage dental units in patients treated with a digitally designed palatal expander. METHODS: Inclusion criteria were the following: presence of maxillary transverse deficiency, no previous orthodontic treatment, no extractions, absence of agenesis, congenital pathologies and cranio-maxillofacial malformations. Twenty patients (11 males, 9 females, 11 ± 1.8 years) received a digitally designed and metal printed palatal expander anchored on first permanent molars and 1 activation per day for 30 days (Group 1). Twenty-one patients (12 males, 9 females, 8.6 ± 1.4 years) received a digitally designed and metal printed palatal expander anchored on second deciduous molars and 2 activations per day for 14 days (Group 2). Digital intraoral scans were taken before expansion and after device removal, and torque and the palatal transverse diameter were digitally measured. The FDI notation was used to indicate each tooth CONCLUSION: Less dental torque augmentation was produced in Group 2. RESULTS: Significant intragroup differences over time were found in Group 1 considering the torque of teeth 1.6, 1.4, 1.3, 2.1, 2.4, 2.5, 2.6. Significant differences between groups were found regarding the longitudinal change in torque of teeth 1.5, 2.4 and 2.5. Significant intragroup differences over time were found in both groups considering all transverse diameter parameters. No significant differences were found between groups in the transverse diameter modifications over time. CONCLUSION: Less dental torque augmentation was produced in Group 2.

Outcomes of coronal pulpotomy on permanent first molars in children: a retrospective cohort study.

OBJECTIVES: To investigate the survival probability of permanent first molars (PFMs) after coronal pulpotomy (CP) using two outcome definitions: success-focused and functional survival-focused, and to identify factors influencing tooth survival. MATERIALS AND METHODS: A retrospective cohort study reviewing records of children undergoing CP with calcium silicate-based cements (CSCs) on PFMs. Each CP-treated PFM was classified as success, uncertain, failure, or censored. Survival probability was analyzed using Kaplan-Meier estimators. Success-focused definition considered failures and uncertain outcomes as events, while functional survival-focused definition considered only failures as events. Prognostic factors were analyzed using Cox regression analysis. RESULTS: Seventy-seven CP-treated PFMs with a follow-up period of 6-111 months. Using the success-focused definition (two failures and 12 uncertain outcomes as events), survival probabilities were 93.1% (95% CI 84.3-97.1%) at 12 months, 78.7% (95% CI 65.6-87.3%) at 36 months, and 74.9% (95% CI 59.5-89.0%) at 60-111 months. However, with the functional survival-focused definition, survival probabilities were 100% at 12 months and 96.6% (95% CI 86.9-99.1%) at 24-111 months. In multivariable analysis, proximal lesions increased failure risk compared to occlusal lesions (HR 17.17, 95% CI 2.18-135.31, p < 0.01), and resin composite restorations had higher failure risk than stainless steel crowns (HR 13.97, 95% CI 1.49-130.69, p < 0.05). CONCLUSIONS: CP using CSCs shows long-term survival potential as an alternative treatment for cariously exposed PFMs in children. CLINICAL RELEVANCE: Proximal lesions and resin composite restoration could contribute to the lower survival, indicating the need for careful consideration of restoration options and lesion location during treatment planning.

Clinical and radiographic features of external cervical resorption - An observational study.

AIM: To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR). METHODOLOGY: This study involved 215 ECR lesions in 194 patients referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK). The clinical and radiographic findings (periapical [PA] and cone beam computed tomography [CBCT]) were readily accessible for evaluation. A checklist was used for data collection. Inferential analysis was carried out to determine if there was any potential association between type and location of tooth in the jaw as well as sex, age of the patient and ECR presentation and radiographic feature. RESULTS: Eighty-eight patients (94 teeth) were female and 106 patients were male (121 teeth), the mean age (±SD) was 41.5 (±17.7) years. Fifteen patients (7.7%) had more than one ECR lesion. The most affected teeth were maxillary central incisors (21.4% [46 teeth]) and mandibular first molars (10.2% [22 teeth]). ECR was most commonly detected as an incidental radiographic finding in 58.1% [125 teeth] of the cases. ECR presented with symptoms of pulpal/periapical disease in 23.3% [n = 50] and clinical signs (e.g. pink spot, cavitation) in 16.7% [36 teeth] of the cases. Clinical signs such as cavitation (14%), pink spot (5.1%) and discolouration (2.8%) were uncommon, but their incidence increased up to 24.7% when combined with other clinical findings. ECR was detected in the resorptive and reparative phases in 70.2% and 29.8% of the cases respectively. CONCLUSION: ECR appears to be quiescent in nature, the majority being asymptomatic and diagnosed incidentally from PA or CBCT. When assessed with the Patel classification, most lesions were minimal to moderate in relation to their height (1 or 2) and circumferential spread (A or B). However, the majority of ECRs were in (close) proximity to the pulp. Symptoms and clinical signs were associated with (probable) pulp involvement rather than the height and circumferential spread of the lesion. Clinical signs were more frequently associated when ECR affected multiple surfaces.

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars-A randomized controlled trial.

OBJECTIVE: To compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. METHOD: Children (4-8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. RESULTS: A total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. CONCLUSION: There was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. CLINICAL SIGNIFICANCE: SMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Underlying Dentin Shadows (ICDAS 4) in Occlusal Surface of Permanent Teeth Have Low Progression Rate after 1-2 Years.

The aim of this prospective cohort study was to assess the radiographic progression of underlying dentin shadows (UDS) on the occlusal surfaces of permanent posterior teeth of adolescents and young adults over 1-2 years and to identify possible risk factors. A total of 149 UDS lesions (from 101 individuals) were included at baseline. Each participant had to present at least one UDS to be considered eligible for the study. Data collection included the application of a questionnaire, clinical examination, and bilateral bitewing radiographs, performed at baseline and after 1-2 years. The association between possible predictors and UDS progression (defined radiographically as an increase in the radiographic score from baseline to follow-up) was assessed using Weibull regression models. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were estimated. A total of 81 individuals (mean age: 24.0, standard deviation: 8.03) were reexamined after 1-2 years (742 occlusal surfaces, of which 118 were UDS). The overall progression rate was 8.6% after 1-2 years, being 12.6% for UDS without baseline radiolucency and 20% for UDS with baseline radiolucency. The risk analysis showed that UDS without radiolucency at baseline had a similar likelihood of progression (adjusted HR = 1.71, 95% CI = 0.68-4.32, p = 0.26) while UDS with radiolucency at baseline were more likely to progress (adjusted HR = 2.96, 95% CI = 1.06-8.26, p = 0.04) than the reference category (sound occlusal surfaces without radiolucency). These estimates were adjusted for caries prevalence, tooth type, and arch. This study showed low progression rates of UDS after 1-2 years. The presence of radiolucency at baseline was found to predict UDS progression.

A clinical and statistical study on enamel hypomineralization of the first permanent molar in the period of mixed dentition.

BACKGROUND: The first permanent molar (FPM) is the first tooth in the permanent dentition that emerges in the oral cavity, at around the age of six and behind the deciduous teeth, thus converting the primary dentition into a mixed dentition. Its early formation represents a risk factor for the onset of hard dental tissues disorders, the most common being the molar incisor hypomineralization (MIH). AIM: The aim of the study was to assess the hypomineralization type of developmental defects of enamel at FPM level during the mixed dentition stage, in a group of Romanian children. PATIENTS, MATERIALS AND METHODS: The research was conducted on 87 patients, 44 females and 43 males, divided into the following age groups: 5-6 years, 6-7 years, 7-8 years, 8-9 years, 9-10 years, 10-11 years, 11-12 years and older than 12 years. All children were examined in the dental office by a pediatric dentist. RESULTS: Of the subjects, 40.2% presented hypomineralization lesions on the FPM. Among the affected children, 62.9% were girls and 37.1% were boys. Mild forms were the most prevalent, being found in 71.4% of the affected subjects. Moderate forms were present in 22.9% and severe forms in 5.7% of the affected children. MIH prevalence significantly decreased with increasing age. Only two children belonging to the group 8-9 years and 10-11 years, respectively, showed severe MIH lesions. Statistically significant differences were determined in what regards the distribution of MIH children according to the severity of the lesions in relation to age (p=0.007). CONCLUSIONS: Children 6- to 7-year-old have been the most affected by FPM hypomineralization, which indicates the need for early management of the disease, through a thorough diagnosis, and preventive and interceptive therapeutic approaches.

Iron level participates in the pathological damages of dental caries in infant rats by affecting enamel mineralization.

Iron deficiency anemia (IDA) is a common nutritional disease associated with early childhood caries. This study aimed to explore the role of iron levels in pathological changes of dental caries in childhood. Rats were divided into four groups based on their iron content: IDA, positive control (PC), high iron (HI), and negative control (NC). Except for the rats in the NC group, rats in the other groups were inoculated with Streptococcus mutans and fed cariogenic high-sugar fodder to induce caries. Three months later, the caries status of the molars was evaluated at both the smooth and sulcal surfaces according to Keyes scores. Scanning electron microscopy (SEM) was performed to reveal microstructural changes in caries. Energy-dispersive spectroscopy (EDS) was used to determine the elemental composition of the enamel and dentin. In addition, the histopathology of the salivary gland was detected using hematoxylin and eosin (HE) staining.The results showed that rats in the PC group exhibited obvious carious lesions. The carious score was significantly higher in the IDA group than in the PC group but was lower in the HI group. SEM revealed complete destruction of the enamel and damage to the middle dentin in the IDA group. In contrast, the molars in the HI group exhibited some degree of enamel demineralization, but the underlying dentin was almost intact. In addition, the elemental compositions of the enamel and dentin were similar among the four groups, and iron was detected only in the HI group. No differences were observed in the morphological structures of the salivary glands of rats from the different groups. In conclusion, ID enhanced the pathological damage of caries, whereas HI weakened it. Iron may participate in the pathological damage caused by childhood caries by affecting enamel mineralization.

Evaluation of mid-buccal gingival recessions and occlusal interferences.

BACKGROUND: Dental malocclusions may cause disruption in occlusal harmony, and destructive interferences during mandibular functional movements can be seen. Ideal occlusal contacts during dynamic mandibular movements may be crucial for preventing the occurrence of mid-buccal gingival recession (mbGR). While determining mbGR risk factors in young adults, the effect of occlusal interferences on mbGR has not yet been focused on. Based on this gap, this field needs to be clarified with new studies. OBJECTIVE: The aim of this case-control study was to evaluate the relationships between the presence, extent and severity of mbGRs to dental malocclusions, occlusal interferences in anterior (AG) and lateral guidance (LG) and to determine the potential risk indicators in a young population. METHODS: A total of 149 dental students were comprised and 70 of them presented mbGR(s) and 79 did not (18-25 years, 4553 teeth). Periodontal status was assessed with full mouth bleeding (FMBS) and plaque score (FMPS), probing depth, clinical attachment level, recession depth and keratinised tissue width (KTW) by a periodontist. Malocclusions and occlusal interferences were evaluated by an orthodontist. Logistic regression analyses provided data on the effect of occlusal interferences and the other indicators towards mbGR. RESULTS: The mean of the number of teeth with mbGR(s) per subject was 4.3. The mean of the overall extent of teeth with mbGR(s) was 14.2%. FMBS, decreased KTW, self-reported bruxism, group function occlusion, increased contact number of all teeth and only premolars/molars in AG or LG and Class III malocclusions were significantly associated with the presence of mbGR. Decreased KTW presenting mbGR in the mandible and non-carious cervical lesion adjunct to mbGR significantly increased the odds of the severity of mbGR. Group function occlusion revealed higher mbGRs in premolar/molars than canine guided occlusion. CONCLUSION: Increase in the occlusal interferences in premolars/molars during lateral and anterior guidance may have an effect on the presence and severity of mbGR. Further studies should be designed to confirm these findings.

Prevalence and severity of Molar-Incisor Hypomineralisation in children in Fujairah, United Arab Emirates.

AIM: This study aims to find the prevalence of MIH in children in the city of Fujairah, United Arab Emirates, utilising the current standardised guidelines for diagnosis and calibration. BACKGROUND: Molar-Incisor Hypomineralization (MIH) prevalence in paediatric patients has been widely studied. However, most of the available studies have utilised criteria that did not offer consistent diagnostic and calibration tools, which resulted in incomparable results. METHODS: Cross-sectional study. One hundred sixty-two school children aged 7-9 years in the city of Fujairah, UAE have been randomly selected and orally examined for the presence of MIH lesions. This was conducted following Ghanim et al. [2015] guidelines and after calibrating examiners following Ghanim et al. [2017] training manual. CONCLUSION: MIH prevalence was high in the city of Fujairah, UAE. More studies utilising the standardised criteria are required for valid comparisons. Further research on the aetiology of MIH is also needed.