Developmental Defects Of Enamel Research Articles

Neonatal stunting and early childhood caries: A mini-review.

The nutritional status of pregnant women greatly determines their newborn outcome. Deficiencies of several micronutrients are associated with stunting in early childhood, affecting health into adulthood. However, apart from the systemic disease that has been a concern so far, fetal undernutrition can also be associated with dental caries in a child's early life, especially since the primary teeth begin to form during the mother's gestation period. The important thing to underline regarding the intrauterine formation of primary teeth is especially in terms of enamel formation. One of the causes of developmental enamel defects that will contribute to the emergence of early childhood caries is the malnutrition of the pregnant mother. This mini-review aims to understand the linkage mechanism behind neonatal stunting to early childhood caries. This concept is expected to generate further research to help prevent both growth stunting and early childhood caries. In addition, with some evidence-based research, the importance of the first dental visit can be further promoted.

The phosphorylation of serine55 in enamelin is essential for murine amelogenesis

Amelogenesis imperfecta (AI) is an inherited developmental enamel defect affecting tooth masticatory function, esthetic appearance, and the well-being of patients. As one of the major enamel matrix proteins (EMPs), enamelin (ENAM) has three serines located in Ser-x-Glu (S-x-E) motifs, which are potential phosphorylation sites for the Golgi casein kinase FAM20C. Defects in FAM20C have similarly been associated with AI. In our previous study of EnamRgsc514 mice, the Glu57 in the S55-X56-E57 motif was mutated into Gly, which was expected to cause a phosphorylation failure of Ser55 because Ser55 cannot be recognized by FAM20C. The severe enamel defects in ENAMRgsc514 mice reminiscent of Enam-knockout mouse enamel suggested a potentially important role of Ser55 phosphorylation in ENAM function. However, the enamel defects and ENAM dysfunction may also be attributed to distinct physicochemical differences between Glu57 and Gly57. To clarify the significance of Ser55 phosphorylation to ENAM function, we generated two lines of Enam knock-in mice using CRISPR-Cas9 method to eliminate or mimic the phosphorylation state of Ser55 by substituting it with Ala55 or Asp55 (designated as S55A or S55D), respectively. The teeth of 6-day or 4-week-old mice were subjected to histology, micro-CT, SEM, TEM, immunohistochemistry, and mass spectrometry analyses to characterize the morphological, microstructural and proteomic changes in ameloblasts, enamel matrix and enamel rods. Our results showed that the enamel formation and EMP expression in S55D heterozygotes (Het) were less disturbed than those in S55A heterozygotes, while both homozygotes (Homo) had no mature enamel formation. Proteomic analysis revealed alterations of enamel matrix biosynthetic and mineralization processes in S55A Hets. Our present findings indicate that Asp55 substitution partially mimics the phosphorylation state of Ser55 in ENAM. Ser55 phosphorylation is essential for ENAM function during amelogenesis.

ESTHETIC MANAGEMENT OF DEVELOPMENTAL ENAMEL DEFECT WITH RESIN INFILTRATION TECHNIQUE

Developmental defects cause color changes in enamel, compromising the esthetic appearance of the tooth and therefore affecting the child's quality of life. The resin inltration technique has shown a positive esthetic effect in the treatment of developmental enamel defects with different etiologies and is regarded as micro invasive procedure since only a small amount of enamel is removed in this procedure. The present paper reports the effectiveness of the resin inltration technique (Icon, DMG) in the management of localised enamel hypomineralisation of permanent teeth after trauma to the primary predecessor.

Dental Enamel Alterations in Preschool Children from Salvador-Ba: Occurrence and Associated Factors

Objective: To describe the prevalence and distribution of Developmental Defects of Enamel (DDE) in children aged 3 to 5 years old in the city of Salvador-BA-Brazil, and to identify potential associated factors, considering socioeconomic, pregnancy, care characteristics childbirth and child behavior. Methodology: This cross-sectional study investigated the DDE in children aged 3 to 5 years, who attended municipal public daycare centers and Family Health Units, in 2018. The oral examination was carried out and it was applied a questionnaire to the respondent about characteristics of children and families. Descriptive and multivariate regression analyzes were performed, assuming a confidence level of 95%. Results: 1591 preschoolers were examined, with a mean age of 54 months. Most children were male (50.41%) and had brown or black skin color (93.34%). The prevalence of DDE was 9.24%. In the multivariate analysis, it was found that the male sex had a negative association with the DDE, while the age greater than or equal to 54 months and the presence of caries in the primary dentition showed a positive association with the DDE. Conclusion: DDEs are shown to be an important oral disease among preschoolage children to be monitored in the city of Salvador-BA, and strongly associated with dental caries.

Tooth abnormalities associated with non-syndromic cleft lip and palate: systematic review and meta-analysis.

To evaluate the association between orofacial clefts (OFC) and tooth abnormalities (TA). We searched PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and BBO, and in the gray literature and selected observational studies that evaluated the association between TA and OFC. The risk of bias was analyzed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed comparing the presence and absence of OFC, cleft type-cleft palate (CP) and cleft lip with or without palate (CL/P)-and cleft laterality-unilateral and bilateral. The certainty of evidence was evaluated using the GRADE approach. A total of 99 studies were included in the qualitative analysis, and 37 were included in the meta-analysis. Only four studies were classified as low risk of bias. Significant associations were observed between the presence of OFC and tooth agenesis (OR = 19.46; 95%CI = 4.99-75.96), supernumerary teeth (OR = 4.04; 95%CI = 1.26-12.99), developmental defects of enamel (OR = 3.15; 95%CI = 1.28-7.80), microdontia (OR = 15.57; 95%CI = 1.06-228.51), and taurodontism (OR = 1.74; 95%CI = 1.74-2.86). Individuals with CP had a lower frequency of supernumerary teeth (OR = 0.22; 95%CI = 0.08-0.64), peg-shaped tooth (OR = 0.31; 95%CI = 0.12-0.80), and morphological TA (OR = 0.13; 95%CI = 0.04-0.45) than individuals with CL/P. No TA was significantly associated with cleft laterality (p > 0.05). The quality of the evidence was very low in all analyses. Individuals with OFC had a higher frequency of TA than those without OFC. Individuals with CP had a lower frequency of TA than individuals with CL/P. No TA was associated to cleft laterality. Help to identify the treatment needs of individuals affected by OFC, improving the services provided to this population.

Prevalence of Molar-incisor hypomineralization in Iranian children – A systematic review and narrative synthesis

IntroductionMolar-incisor hypomineralization is a developmental defect of enamel with clinical features vary from demarcated opacities to severe tissue breakdown which calls for considerable preventive and interceptive measures. The aim of this article was to systematically review the literature on the prevalence of MIH in Iran and highlight the condition in Iranian children.Materials and MethodsA systematic search of literature was conducted in Scopus, Pubmed, Ovid, Embase, Web of Science, and Google-Scholar as well as national Iranian database and digital archives of dental schools from the beginning of 2000 to the end of 2021 for published and unpublished studies. Data from cross-sectional, cohort, and case-control studies on prevalence of molar-incisor hypomineralization among 6–13-year-old children was gathered, using the following MeSH terms and keywords and their Persian equivalents: Prevalence, Hypomineralisation, Hypomineralization, MIH, “molar incisor”, “molar-incisor”, “cheese molars”, “Hypomineralised first permanent molars”, “Hypomineralized first permanent molars”, “developmental defects of enamel”, “enamel developmental defects”, Iran*. Methodological quality and the risk of bias of quantitative studies was assessed using a modified version of Newcastle-Ottawa Scale. Due to the considerable clinical and statistical heterogeneity of the included studies, pooling of data through meta-analysis was not possible. Therefore, a descriptive synthesis of data was performed.ResultsFifteen cross-sectional studies with a total number of 12011 participants were included in the systematic review. The prevalence of MIH ranged from 5.1% to 25.6%. All of the included studies were at a moderate risk of bias (NOS of 4-6). The lowest prevalence of MIH was reported in Kerman (5.14%) and the highest in Tehran (25.6%). Substantial methodological, clinical and statistical heterogeneity was observed.ConclusionThis is the first study to systematically review the available literature on MIH prevalence in Iran. However, the present review has some limitations such as limited number of included studies, large heterogeneity of the research, and moderate quality of included studies. Further high-quality research is warranted.

Developmental defects of enamel among Slovenian asthmatic children.

Asthma is a chronic lung disease characterised by reversible airway obstruction, inflammation of the airway, and increased responsiveness of the airways to stimuli. It is a growing global health problem, and its prevalence is high among children. The results from studies evaluating the effect of asthma on the prevalence of developmental defects of enamel (DDE) are inconclusive. The objective of this cross-sectional study aimed to investigate the influence of childhood asthma on the prevalence of DDE and study some general and asthmatic factors on the prevalence of DDE. The study population consisted of children aged 2-17 years (n = 138) under treatment for asthma who had used anti-asthmatic medications for at least one year; 140 controls were their healthy siblings. For studying different factors on DDE, 308 asthmatic children were added to the cohort thus forming a group of 446 asthmatic children. Developmental defects of enamel were determined with the DDE index. All primary and permanent teeth were evaluated. Questionnaires completed by parents and data from the patients' medical records provided information on various confounding factors. The results showed that asthmatic children have a higher prevalence of DDE on permanent teeth compared to their healthy siblings. The DDE in asthmatic children are more related to the asthma disease instead of its treatment. Asthmatic children need a unique dental approach to prevent further loss of dental substance.

Major clinical results of the application of icon® in dental enamel hypoplasia: a systematic review

Introduction: In the scenario of dental enamel hypoplasia, Molar Incisor hypomineralization (MIH) represents qualitative enamel developmental defects. The prevalence of MIH is approximately 13% worldwide. In addition, children affected by MIH undergo dental treatment on their first permanent molars nearly ten times as often as children without MIH. Objective: It was to carry out a systematic review of clinical studies on the use of ICON® in dental enamel hypoplasia, to discuss the advantages of this resin in patients. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found. A total of 46 articles were fully evaluated and 25 were included in this study. Based on recent findings in the literature, the aesthetic results of ICON® infiltration proved to be effective, both in visual qualitative and quantitative spectrophotometric assessment. Furthermore, the infiltration of ICON® positively influenced the maintenance of the structural integrity of teeth affected by MIH, reducing the risk of enamel breakage. It also proved to be a minimally invasive treatment for tooth discoloration, less aggressive than conventional procedures. In addition to masking enamel white spot lesions, resin infiltration can involve residual enamel crystallites forming a hybrid enamel layer. Regarding the highest penetration and the highest percentages of penetration area, ICON® proved to be better than other resins such as Biscover LV (Bisco), Optiguard (Kerr Hawe), and Permaseal (Ultradent).

Use of amoxycillin in pediatric dentistry and knowledge and attitude of practitioners toward developing resistance

Antibiotics are prescribed to patients in dentistry to combat various infections and pain. Antibiotics cure disease by killing, injuring, or inhibiting the growth of bacteria at very low concentrations. Unwarranted use of antibiotics is reported in children, mostly for ear and dental infections. However, in children, this insufficient knowledge of the appropriate clinical indications leads to increase in microbial resistance to antibiotics. A set of questionnaire was prepared based upon the antibiotics written by dentists. Total 95 dentist actively took part in the study. Questions were both open and close ended. Statistical analysis was done for the answers given. It was seen that there was a lack of knowledge among practitioners about the side effects and resistance of antibiotics. It concludes that better use of diagnostic services; surveillance and improvements in dental education are required now to lessen the impact of antibiotic resistance in the future. In the present study about 41% dentists prescribed amoxicillin to pediatric patients. amoxicillin use is associated with developmental enamel defects. The duration of antibiotic treatment should be kept shortest. Most acute infections are resolved in 3-7 days.

Microcephaly as a risk factor for dental alterations: A case-control study.

This study aimed to assess whether microcephaly is a risk factor for alterations in the chronology and sequence of tooth eruption and for developmental defects of enamel. In this case-control study, 81 children aged 30-36months, including 40 normoreactive children and 41 with microcephaly, were submitted to oral clinical examination to determine the frequency of alterations in the chronology and sequence of tooth eruption and developmental enamel defects. The sample was matched for sex and age (1:1) and allocated to the case (presence of dental alterations) and control (absence of dental alterations) groups. Gestational age, birthweight and socioeconomic characteristics were also analyzed. Chi-square test and Fisher's exact test were applied (α=0.05). Microcephaly was significantly associated with delayed tooth eruption, alterations in the sequence of tooth eruption, and defects in dental enamel (p<0.001). Low birthweight also showed a significant association with this alterations (p<0.005) and prematurity was associated with defects in enamel development (p<0.005). Microcephaly is a risk factor for alterations in the tooth eruption process and enamel formation in primary teeth.

Assessment of the oral health status of children with chronic kidney disease.

There are various oral symptoms related to the disease and its management in individuals with chronic kidney disease (CKD). The aim of the study was to investigate the oral health status of children with different stages of CKD, kidney transplant recipients (KTR), and healthy children. A total of seventy-one children diagnosed with CKD and fifty-two healthy children were included in the study. Each patient was examined for dental caries by the decayed-missing-filled-teeth (DMFT/dmft) index and the International Caries Detection and Assessment System (ICDAS-II), developmental defects of enamel (DDE) by the DDE index, and oral hygiene by the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indices. The median number of DMFT/dmft was 1.00 (interquartile range (IQR):1.00-4.00) in children with stage 1-3 CKD, 0.00 (IQR: 0.00-2.50) in stage 4-5 children, 0.00 (IQR: 1.00-3.00) in KTR, and 8.00 (IQR: 1.00-13.00) in healthy children. According to ICDAS-II categories, the percentage of children with severe caries was 53.8% in healthy children, while it was 44.4% in KTR, 25.9% in stage 1-3, and 11.4% in stage 4-5 children. While the percentage of children with DDE was 88.8% in KTR, 80% in stage 4-5, and 66.7% in stage 1-3 children, this rate was 44.2% in healthy children. The highest mean OHI-S score was observed in stage 4-5 children (2.10 ± 1.08), followed by KTR (1.46 ± 1.19), stage 1-3 (1.27 ± 0.61), and healthy children (0.45 ± 0.44), respectively. Compared to healthy children, children with CKD had more debris accumulation, calculus formation, and more DDE but a lower severity of dental caries. A higher resolution version of the Graphical abstract is available as Supplementary information.

Molar Incisor Hypomineralization: Prevalence, Associated Risk Factors, Its Relation with Dental Caries and Various Enamel Surface Defects in 8–16-year-old Schoolchildren of Lucknow District

IntroductionThe decreased rate in dental caries cases across the world has created an enthusiasm in many clinicians to relate and study different developmental disorders. In past years, defects that are commonly associated with dentistry are hypomineralized areas commonly seen in central incisors and first molars. Molar incisor hypomineralization (MIH) is a defect of the enamel, which is qualitative in nature and systemic in origin characterized by advanced and concurrent hypomineralization of the enamel affecting the first permanent molars together with frequent association of the incisors.AimTo evaluate the prevalence of molar incisor hypomineralization (MIH), its possible risk factors and its association with dental caries and enamel surface defects (attrition and abrasion) in schoolchildren aged between 8 and 16 years in Lucknow district.MethodologyIndexed teeth (first permanent molars and incisors) of 5,585 schoolchildren, selected by stratified random sampling technique between the age-group of 8 and 16 years, were examined by a trained and calibrated examiner. The data was recorded in a predesigned pro forma by examiner, which consisted of mainly two parts. The first part comprised of general information, while the second part comprised of questions related to risk factors related to MIH (prenatal, perinatal, and postnatal history). For the diagnosis of MIH, the Developmental Defects of Enamel (DDE) Index was used for diagnosis of MIH, while the decay-missing-filled teeth index (DMFT) criteria were used for assessing dental caries. Enamel surface defects were recorded using the Smith and Knight tooth wear index.ResultsA prevalence of 7.6% was reported wherein females were found to be more affected by MIH. A strong significant correlation was found between MIH prevalence and childhood infection.ConclusionEarly diagnosis of MIH is necessary to prevent the rapid destruction of the tooth morphology resulting in complicated treatment. Further studies with greater samples are needed to investigate the different etiological factors and determine the biological molecular mechanism that they may cause.Clinical significanceThe data obtained from the current study does not portray a clear consideration of the infants’ medical history in the initial 4 years of life. Further studies may be performed to surpass these shortcomings by using more elaborate medical records of the child in addition to profound recollection of the parents. Due to paucity of literature on this issue in Lucknow District, our current study may provide some information at a baseline level for conducting an extensive research involving different regions pan-India.How to cite this articleVerma S, Dhinsa K, Tripathi AM, et al. Molar Incisor Hypomineralization: Prevalence, Associated Risk Factors, Its Relation with Dental Caries and Various Enamel Surface Defects in 8-16-year-old Schoolchildren of Lucknow District. Int J Clin Pediatr Dent 2022;15(1):1-8.

Prevalence of Developmental Defects of Enamel Among Children With Down Syndrome in Damascus, Syria

Background: Down syndrome (DS) is a disorder which has conditions that may contribute to the developmental defects of enamel (DDE) etiologies. The aim of this study was to assess the prevalence of DDE among children with DS. Methods: This study cross-sectional observational study examined a total of 88 children with DS and 87 healthy children. A modified DDE index for screening surveys was employed in this regard. Demarcated opacities, diffuse opacities, dysplasia, and combinations between types were recorded, and finally, data were analyzed by chi-square and Mann-Whitney U tests using SPSS software. Results: The prevalence of enamel defects in DS and control groups was obtained as 45% and 34%, respectively, with no statistically significant differences between the groups (P=0.139). The mean number of teeth with DDE was 2.48±3.79 and 1.09±2.11 in the DS and control groups, respectively. Based on the results, statistically significant differences were found between DDE means (P=0.009). Demarcated opacities were the most frequent type of enamel defects in both groups. Eventually, a statistically significant relationship was observed between diffuse opacities and DS (P=0.000). Conclusions: In general, DS had no influence on DDE prevalence; however, it increases affected dental units. Diffuse opacities are more frequent among children with DS compared to healthy children. Further studies are required on the DDE prevalence in Syria.

Developmental Abnormalities of Teeth in Children With Nephrotic Syndrome

IntroductionTreatment with glucocorticoids in children with nephrotic syndrome can be the cause of developmental disorders of the masticatory organ and bone or teeth abnormalities. The aim was to assess the frequency and type of dental abnormalities and the correlation of their occurrence with a dosage of glucocorticoids and treatment time in children with idiopathic nephrotic syndrome. MethodsThe study group consisted of 31 patients aged 5 to 17 diagnosed with idiopathic steroid-sensitive nephrotic syndrome and 33 overall healthy children. The studies included clinical evaluation of dentition, radiologic diagnostics, and statistical analysis. ResultsIn the study group, 77.4% of patients were diagnosed with abnormalities in dental development. Tooth number disorders, presence of persistent deciduous teeth and impacted teeth, abnormal crown or root shape, developmental defects of enamel, pulp stones, and bone structure disorders were identified. Statistical analysis showed significant differences in the average treatment time of glucocorticoids in patients without and with tooth developmental abnormalities. ConclusionsLong-term use of glucocorticoids in children with nephrotic syndrome promotes the occurrence of developmental abnormalities of the teeth, calcification of the pulp, and disorders of bone tissue metabolism. For this reason, patients with steroid-sensitive nephrotic syndrome should be under the constant care of a dentist.

Applications of Optical Coherence Tomography in the Diagnosis of Enamel Defects.

Developmental defects of enamel (DDEs) are deviations from the normal appearance in terms of the quantity and quality of tooth enamel. They may be genetic or acquired. The most important DDEs are hypomineralization and hypoplasia. The aim of this study was to produce “in vivo” DDE in Wistar rats by administering amoxicillin to pregnant females and to highlight these lesions after sacrifice of the pups by macroscopic and microscopic examination and optical coherence tomography (OCT). Amoxicillin (100 mg/kg) was administered to two pregnant Wistar female rats for the production of DDEs. When the pups were 2 months old, they were sacrificed, and their jaws were harvested together with their teeth. The jaws were examined macroscopically, microscopically, and by OCT. Following the macroscopic and microscopic examination, it was established that four pups had a total of 42 DDE lesions. At the OCT examination, the hypomineralization was characterized by an intense, inhomogeneous OCT signal, and the hypoplasia was characterized by the absence of the signal. Administration of amoxicillin to pregnant females of Wistar rats resulted in DDEs in their offspring. The OCT examination confirmed the presence of these lesions in the teeth of rat pups.

Factors and Mechanisms Involved in Acquired Developmental Defects of Enamel: A Scoping Review

BackgroundDevelopmental Defects of Enamel (DDE) is a pathology of the teeth that can greatly alter the quality of life of patients (hypersensitivity, esthetic issues, loss of function, etc.). The acquired DDE may occur as a result of a wide range of acquired etiological factors and his prevalence of this pathology may reach up to 89.9%. The main objective of this research was to identify and analyze, in current literature, the factors related to acquired DDE, in order to propose a general theory about the mechanisms involved.MethodsThe search of the primary literature was conducted until [December 31, 2021]. Our search strategy uses the Pubmed/MEDLINE database and was structured around 3 terms [“Development,” “Defect,” and “Enamel”]. To be included, references had to be primary studies, written in English. Exclusion criteria were reviews, in vitro, animal, genetic or archeology studies, and studies focused on clinical management of DDE. One hundred and twenty three articles were included in this scoping review: 4 Randomized clinical trials, 1 letter, 5 cases reports, 2 fundamentals studies, and 111 observational studies (33 Cross-sectional studies, 68 Cohort study and 10 Case-control study). The quality of evidence was assessed using the PEDro scale for clinical trials, the Newcastle-Ottawa scale for observational studies, and a published tool to assess the quality of case reports and case series.ResultsA scoping review of the literature identified 114 factors potentially involved in acquired DDE. The most frequently encountered pathologies are those causing a disorder of calcium homeostasis or a perturbation of the ARNT pathway in mother or child. The link between the ARNT pathway and metabolism deficiency in uncertain and needs to be defined. Also, the implication of this mechanism in tissue impairment is still unclear and needs to be explored.ConclusionsBy identifying and grouping the risk factors cited in the literature, this taxonomy and the hypotheses related to the mechanism allow health practitioners to adopt behaviors that limit the risk of developing aDDE and to set up a prevention of dental pathology. In addition, by reviewing the current literature, this work provides guidance for basic research, clinical studies, and literature searches.

Decrypting the Role of Systemic Illnesses in Developmental Defects of Enamel

Decrypting the Role of Systemic Illnesses in Developmental Defects of Enamel

Label-free quantitative proteomics reveals molecular correlates of altered biomechanical properties in molar incisor hypomineralization (MIH): an in vitro study.

Molar-incisor hypomineralization (MIH) is a qualitative developmental defect of enamel that affects first permanent molars with or without affecting permanent incisors. We aimed to carry out a quantitative proteomics-based study to compare and evaluate proteins in sound and MIH-affected enamel. Ten blocks each of the MIH-affected enamel and sound enamel were processed and prepared for LC-MS/MS analysis. Label-free quantitation was carried out to evaluate the differentially expressed proteins in the two groups of samples. A significant increase in the number of proteins in MIH-affected enamel (50.3 ± 29.6) was observed compared to the sound enamel (21.4 ± 3.2). While proteins like collagens, α1-anti-trypsin, kallikrein-4 (KLK4), matrix metalloprotease-20 (MMP-20), alpha-2-macroglobulin, and alpha-2-HS-glycoprotein were upregulated in sound enamel, there was over-expression of albumin, calcium-binding proteins, anti-thrombin III, and dentin sialophosphoprotein (DSPP), along with proteins implicated in stress response and inflammatory processes in MIH. We propose that altered biomechanical properties of the enamel in MIH samples arise due to (i) down-regulation of proteins contributing to collagen biosynthesis and fibril formation; (ii) an overall imbalance in required levels of proteases (KLK4 and MMP-20) and anti-proteases (anti-thrombin-III which inhibits KLK-4), essential for optimal mineralization; (iii) very low levels of alpha-2-macroglobulin with important consequences in enamel mineralization and amelogenesis; and (iv) increased albumin in MIH, preventing proper growth of hydroxyapatite crystals. Increased inflammatory component was also seen in MIH; however, whether inflammation is a cause or consequence of the poor mineralization process needs to be assessed.

Developmental defect of email in children and adolescent: a review

ABSTRACT Developmental defect of enamel (DDE) is a defect on the surface of the enamel layer thatoccurs during tooth development due to various genetic and environmental factors. Defects that occurresult in changes in color and texture on the enamel surface so that it interferes with aesthetics. Thedefect level that happens can be classified based on the DDE index to determine the option of a casetreatment plan consisting of enamel microabrasion, conservative aesthetic restoration, and bleaching.This review aims to analyze and review studies related to DDE in primary and permanent teeth. Anelectronic search was conducted through PubMed/Medline, Google Scholar, Semantic Scholar,SpringerLink, and Wiley Online Library using the keywords “defect email”, “developmental defectemail”, and “defect on primary teeth” for research published between January 2011 and April 2020, thesame article was eliminated, the initial search resulted in a total of 55 articles. The exclusion of articleswas carried out based on the title and abstract so that finally, 45 relevant articles were obtained. Threestudies were included in this review for qualitative analysis. The results show that Enamel (DDE)Developmental defects can occur in both primary and permanent teeth with the same prevalence rate. KEYWORDS: Developmental Defect of Email (DDE), DDE Index, defect to primary teeth, defect topermanent teeth

Developmental defects of enamel and dental anomalies in five-year-old cleft patients

INTRODUCTION Children born with cleft lip and/or palate (CLP) have a higher prevalence of developmental defects of enamel and dental anomalies, and are at an increased risk of developing dental caries. The aim of this study was to establish the prevalence of dental anomalies and developmental defects of enamel in children born with CLP, and to assess compliance with dental prevention. METHODS Data were collected retrospectively for children who attended the five-year-old dental review clinic at the South Thames cleft service over a four-year period. Records of 162 children were analysed. RESULTS Unilateral CLP was the most common type of cleft. Two-thirds (65%) of the children in this service evaluation had developmental defects of enamel affecting the upper incisors. A third (32%) had enamel hypomineralisation. Between 90% and 100% of children over the four-year study period were registered with a dentist. Regular fluoride varnish application was received by 64% to 81% of children and toothpaste with an appropriate concentration of fluoride was used by 72% to 91% of children. CONCLUSIONS Improvements in shared care arrangements between primary dental care clinicians and specialist paediatric dentists are needed to ensure that caries risk is reduced in children born with CLP. This allows the specialist dental services to focus on the complex dental issues that are seen more frequently in CLP and often require a multidisciplinary approach.