Abstract
The objective of this study was to evaluate the clinical survival of sealants applied in first permanent molars (FPMs) affected by molar-incisor hypomineralization (MIH), at 18 months of follow-up. Forty-one first permanent molars were selected from 21 children, 6-8 years of age. MIH was classified by one calibrated examiner (kappa = 0.80) according to EAPD criteria. The inclusion criteria were fully erupted FPMs with MIH or sound FPMs (without MIH) for which sealant treatment was indicated. The FPMs were assigned to two groups: CG (control group) and HG (MIH group). Both groups were treated with sealant (FluroShield). Clinical follow-up was performed from baseline to 18 months to assess anatomical form, marginal adaptation, retention and presence of caries, according to criteria set by the United States Public Health Service-Modified, and was conducted by a blinded examiner (kappa = 0.80). The actuarial method was used to evaluate the survival of the sealants. The survival rates for the groups were compared using Fisher's exact test (α = 5%). The cumulative survival rates were 81% at 1 month, 68.8% at 6 months, 68.8% at 12 months, and 62.6% at 18 months for CG, and 88% at 1 month, 84% at 6 months, 76% at 12 months, and 72% at 18 months for HG. No significant difference was found between the groups. The sealants in molars affected by MIH presented a survival rate similar to the sealants in the control, suggesting that sealants may be an adequate approach for preventing carious lesions in MIH-affected molars.
Highlights
IntroductionMolar-incisor hypomineralization (MIH) is a congenital alteration of tooth enamel that affects one or more first permanent molars (FPMs) and often permanent incisors, with varying degrees of severity.[1,2,3] The affected enamel presents demarcated opacities of different colors, which occasionally undergo post-eruptive breakdown because of enamel porosity,[4] leading to results ranging from mild atypical cavities to severe coronary destruction[4,5,6] that may require a more in-depth MIH diagnosis and preventive treatment with fluoride and sealants in patients affected by MIH.[6,7] The studies have suggested that FPMs affected by MIH are more susceptible to dental caries than non-affected
The studies have suggested that first permanent molars (FPMs) affected by Molar-incisor hypomineralization (MIH) are more susceptible to dental caries than non-affected
Patients with MIH should be viewed as having a high risk of caries, requiring preventive treatment as soon as FPMs erupt in their mouth.[6,7,13]
Summary
Molar-incisor hypomineralization (MIH) is a congenital alteration of tooth enamel that affects one or more first permanent molars (FPMs) and often permanent incisors, with varying degrees of severity.[1,2,3] The affected enamel presents demarcated opacities of different colors, which occasionally undergo post-eruptive breakdown because of enamel porosity,[4] leading to results ranging from mild atypical cavities to severe coronary destruction[4,5,6] that may require a more in-depth MIH diagnosis and preventive treatment with fluoride and sealants in patients affected by MIH.[6,7] The studies have suggested that FPMs affected by MIH are more susceptible to dental caries than non-affected. Teeth, mainly because of the lower resistance to caries lesion and enamel fracture, which can lead to enamel breakdown.[6,8,9,10,11]. Another fundamental aspect is related to chronic inflammation of FPM pulp affected by MIH. The aim of the present study was to assess sealant survival in FPMs affected by MIH, and compare the survival rate with sealants applied to sound molars at 18 months of follow-up
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