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.

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.

Molar-incisor hypomineralisation: Knowledge and perception of Syrian undergraduate and postgraduate dental students.

INTRODUCTION: Dentists' knowledge and expertise, especially in their early career, are primarily shaped during undergraduate studies. This cross-sectional study aimed to assess the knowledge and perception of Syrian under- and postgraduate students regarding diagnosing and managing molar-incisor hypomineralisation (MIH)-affected teeth. MATERIALS AND METHODS: Final-year dental students (FY-students), postgraduates in paediatric dentistry (PD-postgraduates) and postgraduates in other lines of specialty (OS-postgraduates) in all Syrian dental schools were invited to participate in an established web-based survey covering the knowledge and attitudes regarding the prevalence, aetiology, diagnosis and management of MIH. Data were analysed with descriptive statistics and Fisher's exact/chi-squared tests at 5%. RESULTS: In total, 1142 post- and undergraduate students from six public and five private dental schools in Syria participated in this study (867 FY-students, 74 PD-postgraduates and 201 OS-postgraduates). PD-postgraduates were found to present statistically significantly better knowledge regarding MIH compared with the two other groups. Only 19% of FY-students and 54% of OS-postgraduates reported themselves familiar with MIH (compared with 97% of PD-postgraduates). Similarly, 18% of FY-students and 27% of OS-postgraduates were capable of diagnosing MIH (compared with 81% of PD-postgraduates). Stainless-steel crowns and direct composite fillings were chosen as most suitable for treating MIH-affected molars from all responders. CONCLUSIONS: FY-students and even OS-postgraduates in Syria lack knowledge and confidence when confronted with MIH. The university curricula need to include more educational materials to equip the students with the necessary tools to manage MIH clinically.

A cross-sectional survey on knowledge and attitudes of Greek dentists regarding molar incisor hypomineralisation diagnosis and treatment.

BACKGROUND: Molar Incisor Hypomineralisation (MIH) remains a challenge for clinicians underlining the gap in the literature regarding the condition. The study aimed to record knowledge and attitudes of Greek dentists regarding diagnosis and treatment of MIH and correlate findings with non-dental characteristics. METHODS: It is a cross-sectional study based on a questionnaire consisting of 37 multiple-choice questions. Data regarding diagnosis, aetiopathogenesis, and clinical management of MIH were collected from active members of three Greek Dental Associations. Chi-square and student's t-test were used to correlate responses with practitioners' characteristics and odds ratios calculated to evaluate differences on treatment of MIH-affected teeth (p < 0.05). RESULTS: From the 360 participants (response rate = 94%), 185 were general dental practitioners (GDPs) and 175 dental specialists (59 paediatric dentists (PDs), 38 orthodontists and 78 of other specialties).MIH was commonly encountered as a clinical problem, with GDPs reporting genetics and fluoride intake as common aetiological factors at significantly higher percentages as compared to PDs (p < 0.05). Permanent molars and incisors (44%) were the teeth most commonly affected, with yellow/brown demarcated opacities (68%) the most common clinical feature with PDs reporting them in a significantly higher percentage (p < 0.05). Dentists with specialisation, dentists that treat > 10 children per week and children with MIH-affected teeth had a 2-5.5 times greater probability to report difficulty achieving sufficient anaesthesia and hypersensitivity problems (p < 0.001). Agreement between GDPs' and dental specialists' views was found on less invasive treatment of anterior lesions. Non-PDs reported bulk-fill restorations and onlays as the ideal treatment of severely-affected posterior teeth, as compared to PDs that preferred preformed metal crowns (p < 0.05). Multivariate logistic regression analysis revealed that the age of the clinician, years of experience and number of children treated per week were the factors significantly associated with the decision for the treatment of only severely-affected posterior MIH teeth. CONCLUSIONS: Most participants had encountered MIH-affected teeth in their clinical practice and were able to recognize main aetiological factors and clinical findings related to the condition. Nevertheless, their knowledge regarding treatment is limited.

Artificial intelligence system for training diagnosis and differentiation with molar incisor hypomineralization (MIH) and similar pathologies.

OBJECTIVES: Molar incisor hypomineralization (MIH) is a difficult-to-diagnose developmental disorder of the teeth, mainly in children and adolescents. Due to the young age of the patients, problems typically occur with the diagnosis of MIH. The aim of the present technical note was to investigate whether a successful application of a neural network for diagnosis of MIH and other different pathologies in dentistry is still feasible. MATERIALS AND METHODS: For this study, clinical pictures of four different pathologies were collected (n = 462). These pictures were categorized in caries (n = 118), MIH (n = 115), amelogenesis imperfecta (n = 112) and dental fluorosis (n = 117). The pictures were anonymized and a specialized dentist taking into account all clinical data did the diagnosis. Then, well-investigated picture classifier neural networks were selected. All of these were convolutional neural networks (ResNet34, ResNet50, AlexNet, VGG16 and DenseNet121). The neural networks were pre-trained and transfer learning was performed on the given datasets. RESULTS: For the vgg16 network, the precision is the lowest with 83.98% as for the dense121 it shows the highest values with 92.86%. Comparing the different pathologies between the investigated neural networks, there is no trend detectable. CONCLUSION: In the long term, an implementation of artificial intelligence for the detection of specific dental pathologies is conceivable and sensible. CLINICAL RELEVANCE: Finally, this application can be integrated in the area of training and teaching in order to teach dental students as well as general practitioners for MIH and similar dental pathologies.

"Knowledge, clinical experience, and perceived need for training regarding molar-incisor hypomineralization among a group of Egyptian dental students: a cross-sectional study".

BACKGROUND: Molar-Incisor Hypomineralization (MIH) is a common oral health condition that can lead to difficulties and complications for both dental professionals and patients. It also has a negative impact on the oral health-related quality of life. The present study aimed to assess the knowledge, clinical experience, and perceived need for training of a group of Egyptian dental students regarding MIH. METHODS: Paper-based survey administration method was used to collect the responses of dental students regarding their knowledge, clinical experience, and perceived need for training about MIH. The survey consisted of two sections of questions regarding clinical features, etiological factors, prevalence, materials used in treating these teeth, factors affecting the choice of restorative materials, and their preferences regarding clinical training of MIH. Descriptive statistics was used for the data analysis by using SPSS® Statistics Version 26. RESULTS: About two-thirds of the respondents were familiar with MIH (69.2%). The vast majority of students (87.8%) had difficulty distinguishing MIH as a developmental defect that differs from other tooth conditions (p < 0.001); most commonly enamel hypoplasia. The most common defects seen by the respondents were yellow/brown opacities (59.1%). Nearly half of the students (45.2%) choose composite resin as the material of choice for the treatment of MIH-affected teeth with aesthetics being the most common factor affecting the selection of restorative material. Almost all students expressed their needs for further clinical training on MIH, especially on treatment aspects. CONCLUSIONS: Most students are familiar with MIH theoretically. However, there is an urgent need to include clinical training on MIH diagnosis in the practical sessions of pediatric dentistry courses.

Knowledge, perception, and clinical experiences on molar incisor hypomineralization amongst Portuguese dentists.

AIM: Molar incisor hypomineralization (MIH) is a prevalent oral health condition whose knowledge by dentists is key to the best clinical outcome. This study aimed to evaluate the knowledge, perceptions and clinical experiences of MIH among Portuguese dentists. METHODS: A cross-sectional structured questionnaire was distributed nationally through a web-based survey platform. Data concerning demographic variables, years of experience, dental specialty, MIH prevalence, diagnosis, severity, training demands and clinical management of MIH were collected. We calculated a knowledge score (KS), and compared data between Pediatric Dentists (PDs), General Dental Practitioners (GDPs) and other dental specialties (ODS). RESULTS: Overall, 2.2% of Portuguese dentists (n = 257) answered the questionnaire. Most participants reported having identified MIH in their practice (82.5%), with PD reporting the prevalence appeared to have increased, and practically all (91.7%) considered it a public health problem. Resin composite was often the used material to restore MIH teeth (56.0%), however PDs indicated glass ionomer cements as the preferred and preformed crowns a better option. The average KS on MIH was 41.3 (± 5.7), with GDPs having a similar score than PDs. Most respondents (94.9%) reported a lack of information about MIH and were willing to receive appropriate clinical training. CONCLUSIONS: The average knowledge on MIH was considered low among Portuguese dentists. Respondents perceived an increased incidence of MIH, despite the lack of prevalence data in Portugal. The material of choice was Glass Ionomer and performed crowns, by PDs, while GDPs and ODS reported poor confidence to manage MIH. These results may serve future programs to increase knowledge, perceptions and clinical experiences towards MIH.

Relationship between molar incisor hypomineralization, intrapartium medication and illnesses in the first year of life.

Molar incisor hypomineralization (MIH) affects the first permanent molars and permanent incisors whose formative embryological process develops around birth and the first year of life. This study's main objective is to assess the relationship between MIH, on the one hand, with the administration during childbirth of epidural bupivacaine, intramuscular meperidine with haloperidol, synthetic intravenous oxytocin, and prostaglandins such as dinoprostone vaginally, and on the other hand, with suffered pathologies during the first year of life. Cross-sectional retrospective study was carried out on 111 children who attended dental check-ups. Oral examination was carried out to determine MIH involvement. Data on the administration of medications during delivery and the illnesses suffered by the children in the first year of life were taken from the hospital records. Significant relationship with Pearson's chi-square was found between the presence of MIH and the administration of meperidine with haloperidol intramuscularly and the vaginal administration of dinoprostone during labour. Also in children who have suffered serious infections and those who have received antibiotics in early childhood. In recent years there has been a growing trend in many countries to medicalize childbirth even above what the World Health Organization recommends. Some of the drugs used in these protocols could be involved in the appearance of dental mineralization alterations of the MIH type and this would help to explain the increase in its prevalence.

Diagnosis training and calibration for epidemiological studies on primary and permanent teeth with hypomineralization.

PURPOSE: The objective of this study was to assess the impact on diagnostic accuracy and Kappa values improvement during the three-phase training and calibration process for MIH/HSPM. METHODS: Thirty dentists were calibrated as examiners for diagnosis of Molar Incisor Hypomineralization (MIH) using Ghanim's index. The whole process was divided into three phases. Phase 1: three meetings with the dentists for the first diagnosis training and calibration (sessions 1a and 1b); phase 2: for a period of 1 month, the dentists started practicing MIH/HSPM diagnosis in the Basic Health Units and an online follow-up group was created to discuss cases and resolve doubts; phase 3: two meetings with the dentists for the second calibration (sessions 2a and 2b). A webpage with educational material was prepared as support during the whole process to improve the dentists' skills in diagnosing MIH/HSPM. The examiners' responses were compared to a gold standard and the Kappa value was obtained. RESULTS: The average clinical criteria kappa value of the examiners was 0.76 ± 0.19 for the first calibration and 0.93 ± 0.07 (p < 0.05) for the second calibration. For the eruption criteria, the average kappa value was 0.89 ± 0.14 for the first calibration and 0.98 ± 0.08 for the second calibration. Extension criteria had an average kappa value of 0.59 ± 0.15 during the first calibration and 0.75 ± 0.14 during the second calibration. CONCLUSION: This study demonstrated that the methodology used was an effective tool for improving the diagnostic accuracy of MIH/HSPM.

A survey on knowledge and attitudes towards molar-incisor hypomineralization among undergraduate and postgraduate students at the School of Stomatology, Wuhan University.

BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental dental disease, and its clinical management challenges dentists. This study aimed to investigate the knowledge about MIH and the attitudes towards learning more about MIH among undergraduate and postgraduate students attending the School of Stomatology, Wuhan University. METHODS: This survey was based on a questionnaire modified based on previous studies. The questionnaire was sent to 540 undergraduate and postgraduate students from the School of Stomatology, Wuhan University. The questions covered their clinical experience, perceptions, clinical management, and preferences for further training. Data were analysed with the Chi-square test. RESULTS: We collected 368 questionnaires (response rate: 68%). Among them, 89% (328/368) were eligible for analysis. Most respondents (80%) had heard of MIH, primarily from classroom teaching. However, only 40% of the students had observed the disease clinically, and a relatively low proportion of students were familiar with the aetiology, prevalence, differential diagnosis, and treatment of MIH. Most respondents were highly enthusiastic and had great expectations about further systematic teaching about MIH. CONCLUSION: Most students in this study had heard of MIH, but few were familiar with the principles of its differential diagnosis. Systematic teaching about MIH is warranted.

Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists.

OBJECTIVES: To obtain the views and opinions of specialist members of the British Orthodontic Society (BOS) and British Society of Paediatric Dentistry (BSPD) in relation to (1) the multidisciplinary management of patients affected by molar incisor hypomineralisation (MIH) and (2) the diagnosis and management of MIH-affected first permanent molars (FPMs) in four clinical scenarios, and compare the responses to those of an expert panel consensus. DESIGN: A prospective cross-sectional study. SETTING: Part 1: Eastman Dental Institute and part 2: online questionnaire. METHODS: Four clinical scenarios showing patients with differing severities of MIH affected FPMs were considered by a panel of orthodontists and paediatric dentists to agree on the severity of MIH and management. A 21-item online questionnaire sent to both specialist groups, after pilot study. The questionnaire covered demographics, access to multidisciplinary clinics, clinicians' opinions on various management aspects, and questions relating to the management of the same 4 clinical scenarios. RESULTS: The overall response was 21.9% (20% of the orthodontists and 45% of the paediatric dentists). Approximately half of the respondents from both groups felt that these patients should be managed through a multidisciplinary treatment type clinic (49.0% of the orthodontists and 47.2% of the paediatric dentists). Only 40.3% of the orthodontists and 35.0% of the paediatric dentists agreed completely with the panel consensus on all management options. When assessing overall agreement on all four FPMs for all scenarios, agreement was predicted by severity of MIH (P<0.001) and complexity of malocclusion (P<0.001) where more complex malocclusions and more severe MIH resulted in poorer agreement, but specialty was not a significant predictor (P=0.21). CONCLUSION: The majority of the respondents from both groups, felt that managing patients with MIH affected FPMs is challenging. Approximately half of the orthodontists and the paediatric dentists, felt that MIH affected patients should be managed through a multidisciplinary type clinic. Managing more severe cases on multidisciplinary clinics is indicated, to incorporate specialist input into decision making.

Virtual learning object for developing knowledge about the diagnosis and management of molar incisor hypomineralization.

AIM: To develop, apply, and evaluate a virtual learning object (VLO) for teaching undergraduate dental students and paediatric dentists to diagnose and manage molar incisor hypomineralization (MIH). DESIGN: This controlled educational intervention included 170 undergraduate dental students and 50 paediatric dentists. The student intervention group (VLOG) was trained by the VLO, the control group of students (CG) received a synchronous virtual class, and the group of paediatric dentists (PDG) was trained by the VLO. Pre-test and post-test data were analyzed with a mixed one-way and Tukey's post hoc ANOVA test (α = 0.05). The answers to the questionnaire were analyzed with the one-way ANOVA test and Tukey's post hoc test (α = 0.05). RESULTS: The values obtained in the pre-test were significantly lower than those obtained in the post-test for all groups. The specialists showed a higher level of knowledge before and after the MIH training compared with the students (p < .001). Similarly, statistical differences were found in the level of knowledge, which increased after MIH training (p < .001). There were no differences between the CG and VLOG. CONCLUSIONS: The level of knowledge increased in all groups after training regardless of the method used. VLOG works similar to traditional teaching approaches.

The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis.

Molar-Incisor Hypomineralization (MIH) is a qualitative defect of enamel of unknown etiology, affecting one or more permanent molars and may include incisors. This condition is a clinical challenge and its prevalence is still uncertain given the recent increase in research. Thus, we aimed to comprehensively estimate the overall prevalence of MIH and associated characteristics. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS and TRIP databases, until July 2021. Heterogeneity and publication bias were computed via I2 test statistics and Egger's significance test, respectively. Random-effects meta-analysis of prevalence were processed. We used the Strength of Recommendation Taxonomy [SORT] to grading the strength of evidence. Overall, 116 observational studies were included, with one study with moderate methodological quality and the remaining of high methodological quality. Subgroup analysis confirmed an influence of not using the 2003 MIH case definition (p = 0.0066). The pooled prevalence of MIH was 13.5% (95% CI 12.0-15.1, I2 = 98.0%). Affected incisors were seen in 36.6% (95% CI 30.0-43.7, I2 = 92.5%) of the cases. Lastly, the prevalence of hypomineralization of the second primary molars was observed in 3.6% of the MIH cases (95% CI 1.9-6.8, I2 = 96.3%). America was the continent with highest prevalence (15.3, 95% CI 12.8-18.3, p < 0.001, I2 = 96.3%) and Asia had the lowest prevalence (10.7, 95% CI 8.5-13.5, p < 0.001, I2 = 98.7%), however no continental differences were found. Sample size and year of publication were slight contributing factors to the heterogeneity in the analysis. Overall, these results were classified with a SORT A recommendation.

Knowledge, experience and perception regarding molar incisor hypomineralisation (MIH) among dentists and dental hygienists in Oslo, Norway.

AIM: The aim of this study is to gather baseline information on knowledge, perceptions, clinical experience and treatment options regarding MIH among dental care providers in Oslo, Norway, before a larger epidemiological study. METHODS: An electronic questionnaire was distributed to dentists (n = 88) and dental hygienists (n = 47) working in the Public Dental Service (PDS) in Oslo. The questionnaire consisted of five sections related to sociodemographic, clinical experience, perceptions, clinical management and preferences for further training. Descriptive statistics with chi-squared test was used, and level of statistical significance was set to 5%. RESULTS: Replies were obtained from 74.1% (n = 100) after two reminders. All respondents encountered MIH in their practice. The respondents' perception of the prevalence of MIH in Oslo varied. The majority felt confident when diagnosing MIH (86%). The clinicians qualified in the last 10 years felt more confident than those who had qualified earlier (p = 0.016). Most were self-confident when treating these patients (68.3%), however, nearly all (88%) agreed that MIH was a clinical problem. The clinician's treatment of MIH varied. Difficulties achieving adequate local anaesthetic (71.4%) and the child's behavioural problems (84.1%) were treatment barriers for the dentists. Approximately two thirds (69%) would like further training, in particular on the aetiology (70%), diagnosis (57%) and treatment (77%) of the developmental disorder. CONCLUSION: All clinicians were familiar with the diagnosis of MIH and experienced the condition to be a clinical problem. Continuing education on aetiology, diagnosis and treatment of MIH is requested by dental health personnel.

[Molar incisor hypomineralisation (MIH)-discussion of prevalence and etiology with special reference to the results from the Munich birth cohorts GINIplus and LISA]. / Molaren-Inzisiven-Hypomineralisation (MIH). Häufigkeit und mögliche Ursachen unter besonderer Berücksichtigung der Ergebnisse aus den Münchner Geburtskohorten GINIplus und LISA.

After caries, molar incisor hypomineralisation (MIH)-also known as chalky teeth-is one the most common dental diseases in children and adolescents. In addition to aesthetic limitations, especially on the anterior teeth, hypersensitivities and enamel breakdowns on permanent molars are of functional importance. While the MIH prevalence rates range from ~ 10% to ~ 30% and is well described, the situation regarding aetiology is unsatisfactory. Although efforts have been made in the past to clarify the aetiology, no plausible reason is available so far. Aetiology research has to be judged as methodologically challenging, since it should ideally be embedded in prospectively planned birth cohort studies. The aim of this article is to summarize typical clinical characteristics of MIH, epidemiological findings and potential causes with special reference to the earlier published results from the two Munich birth cohort studies GINIplus and LISA.

Molar Incisor Hypomineralisation: Current Knowledge and Practice.

BACKGROUND: Molar incisor hypomineralisation (MIH) is a common developmental dental condition that presents in childhood. Areas of poorly formed enamel affect one or more first permanent molars and can cause opacities on the anterior teeth. MIH presents a variety of challenges for the dental team as well as functional and social impacts for affected children. OBJECTIVES: Here, we provide an up-to-date review of the epidemiology, aetiology, diagnosis and clinical management of MIH. MATERIALS AND METHODS: A review of the contemporary basic science and clinical literature, relating to MIH, was undertaken using information obtained (up to 10 April 2020) from the electronic databases PubMed, Scopus, Web of Science and the Cochrane Library. RESULTS: There is a growing body of evidence relating to the aetiology, presentation and clinical management of MIH. Current knowledge appears to be focused on potential genetic aspects, as well as the development and validation of indices for the diagnosis and management of MIH. There has also been increasing recognition of the global and individual burden of this common condition. CONCLUSIONS: Dental health professionals should regularly appraise the basic science and clinical MIH literature to ensure that they provide the best possible short- and long-term care for their young patients.

Molar-incisor hypomineralization: an umbrella review.

OBJECTIVE: In recent years, Molar Incisor Hypomineralization (MIH) has become a subject that concerns the Paediatric Dentistry Community. The aim of the present umbrella review was to analyse previously published systematic reviews (SRs) on MIH in children and adolescents. METHODS: Electronic database search was conducted (including PubMed, Embase, Scopus, Cochrane, Web of Science, and LILACS) until July 2020. Studies were included, if they were SR on MIH in children and adolescents. The methodological quality of SRs was judged by use of the MeaSurement Tool to Assess systematic Reviews 2. The primary outcomes included prevalence, aetiology, and clinical management of MIH. Data extraction and methodological quality assessment were performed. RESULTS: Eighteen systematic reviews were included for data extraction. Among these, two were focussing on prevalence, five addressed aetiology, one highlighted the mechanical and chemical characteristics of enamel in MIH, one underlined the association between MIH and dental caries, six addressed the treatment, and one focussed on hypomineralization of primary teeth as a predictor of MIH. The results showed a high worldwide prevalence of MIH and an unknown aetiology of MIH, but reporting that the aetiology is most likely multifactorial. Different treatment approaches used were desensitizing and remineralizing products, resin infiltration, fissure sealant, atraumatic restorative treatment, resin composite restoration, and stainless steel crown (SSC), but also extraction associated with orthodontic treatment of the permanent first molars (PFMs) was reported on. The AMSTAR criteria 2 was applied, where six studies were assessed as having critically low quality, two studies as having low quality, and nine studies as having moderate quality. CONCLUSIONS: MIH is highly prevalent worldwide and has most likely a multifactorial aetiology. Different treatment approaches according to the degree of severity of lesion(s) are reported on. The quality of evidence produced by the available SRs was not favourable. More well-designed clinical trials and high standard systematic reviews are necessary to elucidate better MIH characteristics and treatment outcomes.

Generalised hypomineralisation of enamel in oculodentodigital dysplasia: comprehensive dental management of a case.

Oculodentodigital dysplasia (ODDD) is a rare congenital disorder characterised by developmental abnormalities of the eye, dentition and digits of the hands and feet, with neurological symptoms reported in 30% of individuals. Dental anomalies associated with ODDD include enamel hypoplasia and subsequent caries, microdontia, missing teeth, amelogenesis imperfecta, pulp stones and delayed tooth development. Here, we describe the comprehensive dental management of a 3-year-old girl who presented with rapid deterioration of the primary dentition due to generalised enamel hypomineralisation. Conservative, comprehensive restorative management was performed under general anaesthesia. Within 6 months, further breakdown of the remaining unrestored enamel was noted. This case documents the challenges of conservative management in dental anomalies that are not well documented due to the extreme rarity of the disorder.

Knowledge of dental enamel defects amongst undergraduate dental students-a cross-sectional survey.

INTRODUCTION/OBJECTIVES: Enamel defects are disturbances in the quantity or quality of enamel, due to disruption or damage to the enamel organ during amelogenesis. The correct diagnosis of enamel defects is critical as diverse management options could be required for different conditions. Difficulties in diagnosis can happen, because these defects may have similar clinical presentations. This study evaluated the diagnostic skills in enamel defects of dental students of a prominent Australasian school. METHODS: A questionnaire consisting of clinical photographs of the affected teeth/dentition in multiple views and four standardised questions for each case of enamel defect were given to Year 4 and Year 5 students. RESULTS: Localised/Chronological Hypoplasia had the lowest percentage of correct diagnosis (20.5%), whilst Enamel White Spot Lesions (EWSLs) had the highest (85%). Localised/Chronological Hypoplasia had the lowest aetiology score (20.5%), and the highest was obtained for EWSLs (85%). In regard to which question to ask to gain insight into the conditions, Enamel Hypomineralisation/MIH had the lowest score for both Year 4 and Year 5 respondents (35.4% and 21.3%). Most respondents agreed more teaching in this topic was needed, with further clinical sessions to observe the enamel defects, workshops/seminars, lectures and student-driven presentations suggested. CONCLUSION: Final-year dental students showed variable knowledge in diagnosis, aetiology and clinical management of enamel defects. Further didactic and clinical teaching should be incorporated in the undergraduate curriculum on this topic .

ORAL HYGIENE IN CHILDREN WITH DISTURBANCES IN TOOTH FORMATION WHO WERE AFFECTED AS A CONSEQUENCE OF THE ChNPP ACCIDENT. / STAN GIGIIeNY POROZhNYNY ROTA U DITEI Z PORUShENNIaMY FORMUVANNIa ZUBIV, POSTRAZhDALYKh VNASLIDOK AVARIÏ NA ChAES.

OBJECTIVE: evaluation of oral hygiene to enhance the prophylaxis of complications specifically of dental caries inchildren with disturbances in tooth formation (DTF) who live on radiologically contaminated territories after theChornobyl NPP (ChNPP) accident. MATERIALS AND METHODS: Children aged 6-14 years (n = 1470) with DTF were the study subjects examined in 2012-2016. Among them there were (n = 528) residents of the zones III and IV of radiological contamination after theChNPP accident with 137Cs soil contamination density 1-15 Ci/km2. The effective radiation dose in them was notexceeding 1 mSv/year. The Green-Vermillion and Silness-Loe oral hygiene indices were assesses within clinicalexamination methods. RESULTS: The worth oral hygiene was revealed in children having got the DTF, compensated chronic diseases oforgans and systems, and in those with burdened radiation history. The Green-Vermilion and Silness-Loe indices were1.7 ± 0.51 and 1.65 ± 0.46 respectively. CONCLUSIONS: A significant deterioration in oral hygiene confirmed by the highest values of the Green-Vermillion index (1.7 ± 0.51; p < 0.001 - «unsatisfactory oral hygiene¼ criterion) and Silness-Loe index (1.65 ± 0.46; p < 0.001 -«poor oral hygiene¼ criterion) was found in children with DTF aged 6-14 years being residents of contaminated areasas a result of the Chernobyl accident. The revealed deterioration may be due to a set of negative factors, includingthe impact of ionizing radiation in low doses and peculiarities of social status. Results of the questioning of surveyed pediatric contingents both having got an DTF and with no defects of the hard tissues of teeth indicate aninsufficient level of knowledge and skills in hygienic care of oral cavity regardless of the area of residence.Development of a set of measures to prevent the DTF complications in children should be carried out taking intoaccount the state of oral hygiene, level of knowledge and skills in oral care, and include the use of hygiene products, namely toothpastes and anti-caries mouthwashes.