European Academy Of Paediatric Dentistry Research Articles

Assessment of the salivary level of glutathione and the feeding pattern in molar incisor hypomineralization among 7-9 years of age: an analytical cross-sectional study

Background: The study aimed to assess salivary glutathione levels and the pattern of feeding on molar incisor hypomineralization among healthy children aged 7-9 years. Materials and Methods: The study was a cross-sectional study. A total of 90 children sample was further sub classified into two groups: the study group, including 60 children with molar incisor hypomineralization, classified into two subgroups, 30 children with mild type and 30 children with severe type of molar incisor hypomineralization. In addition to the control group involving 30 children without incisor hypomineralization and free of caries. Examination and diagnostic criteria for hypominerlization of the molar incisor and assessment of severity were according to European Academy of Pediatric Dentistry (EAPD) guidelines in 2003. The salivary glutathione ELISA kit was used to assess the amount of glutathione in unstimulated saliva samples. After an oral examination, the parents of each child completed a self-administered questionnaire that included information on the child's feeding pattern during the first year of life. The questionnaires were returned to the researcher the following day. The child who received a mixed feeding pattern was excluded from the study. Results: The ordinal logistic regression model (Overall model test: p < 0.001) presented that salivary glutathione (p < 0.001), saliva pH (p = 0.014) and saliva flow rate (p = 0.009) were significant predictors of hypomineralization of the molar incisor. The feeding pattern (p = 0.625) and gender (p = 0.394) were not significant predicators for hypomineralization of the molar incisor hypomineralization. Conclusion: In children aged 7 to 9 years, salivary glutathione level is a negative predicator for the degree of hypomineralization of the molar incisor. Moreover, child feeding pattern, and gender, are not significant predicators of hypomineralization of the incisor hypomineralization.

Is SDF better than the SMART (silver modified atraumatic restorative technique) in the management of molar incisor hypomineralisation molars with initial caries?

A prospective, randomized, split-mouth clinical study by thetwo previously trained and calibrated pediatric dentists without blinding operators and patients due to different protocols in both treatment groups. An SDF + potassium iodide (KI) and SDF + KI + glass ionmer cement(GIC) on International Caries Detection and Assessment System (ICDAS) 1/2 molar was received by each patient on either sideof mouth. The local Ethics Committee approved this study. Sample size calculation was not performed due to the lack of published studies on the longevity of SMART sealant on MIH-affected molarsand the absence of research on the apparent difference between the effectiveness of SMART and SDF treatments in preventing further caries and sensitivity. These were children between the ages of 6 years to 13 years, who visited the Pediatric Dentistry Clinic at XX University School of Dentistry for routine exams and treatment between July 2019 to May 2020. They were in good health and had at least two fully erupted permanent first molars with MIH as per the European Academy of Pediatric Dentistry, ICDAS code 1/2. This study recorded 12 months of treatment outcomes on hypomineralised molars of 48 children with a follow-up of three years. Children were excluded with specific syndromes associated with enamel malformation, lack of cooperation, ongoing orthodontic treatment, and teeth with ICDAS 3/4/5/6 lesions, existing restorations, fluorosis, or pulpal symptoms. Mann-Whitney U Test was used to assess differences between independent groups (SDF and SMART) and the Friedman Test between dependent groups at different time points. Kaplan-Meier analysis to evaluate the cumulative survival of SMART sealants and survival of caries-free hypomineralised molars in both groups. Chi-Square test was used to compare the success percentages of the SDF and SMART groups. To assess the changes in success percentages at three different time intervals for the caries preventive effect of SDF and SMART, and to evaluate the retention percentages for the SMART group. McNemar's test with a Bonferroni correction was used for significant differences. Cohen's kappa test indicated that the inter-examiner reliability determining the presence of MIH was 0.87. The intra-examiner reliability for US Public Health Service (USPHS)-Modified criteria was 0.90. The statistical significance level was set at p < 0.05 for all statistical analyses. At 12, 24 and 36 months the caries preventive effect was 100%, 67.9%, and 65.4% for SDF + KI-treated teeth; and 100%, 97.6%, and 94.7% for SMART (SDF + KI + GIC) respectively. During the recall period, there was no substantial difference in hypersensitivity scores between the groups. There was no hypersensitivity in teeth at 18 months and beyond. Compared to the baseline Schiff Cold Air Sensitivity Scale (SCASS) score 26 molar with initial hypersensitivity to hypomineralisation had a massive reduction at evaluation periods. The mean survival probabilities for the caries-preventive effect were considerably lower in SDF + KI-treated teeth (31.01 months) than in SMART-treated teeth (35.61 months) (p < 0.001). Considering the limitation of the study, both SMART (SDF + KI + GIC) sealants and 6-monthly application of SDF + KI, provided similar and substantial levels of desensitisation on the permanent MIHmolars. When used as a sealing material on non-cavitated permanent MIHmolars, the clinical retention rate for SMART was 88.7%, 73.1%, and 66.6% at 1, 2, and 3 years respectively. The caries preventive effect of SMART (SDF + KI + GIC) sealants was superior to SDF + KI application in hypomineralised teeth, however, a long-term monitoring and review is essential due to the gradual decrease in retention of SMART sealants.

Enamel Hypomineralization: Prevalence, Defect Characteristics in Primary Dentition in a Northern Indian Region.

No data is available on hypomineralization in the full complement of primary dentition. To report on the prevalence and clinical presentation of enamel hypomineralization (EH) in the primary dentition. A cross-sectional observational study with a random sample of 948, 4-6-year-old schoolchildren of Gautam Buddh Nagar, Uttar Pradesh, India, was conducted after approval from the Institutional Ethics Committee. European Academy of Paediatric Dentistry (EAPD) (2003) criteria were employed to score EH in all primary teeth. A single experienced examiner conducted an entire clinical examination of the study population. Data were expressed as the prevalence, type, extent, and distribution. Further analyses were conducted to compare the prevalence and distribution of different types of lesions in affected subjects using student t-tests and analysis of variance (ANOVA). An overall prevalence of 7.51% (71/948) was reported. A total of 2.75 ± 1.735 teeth/subject were reported to be affected. The most common lesion was creamy white opacity (p = 0.002), while posteruptive breakdown (PEB) was observed in 40.85% (29/71) of affected subjects. The prevalence of EH in primary dentition was 7.51%. Further studies mapping the prevalence as well as possible links with molar incisor hypomineralization (MIH) in other geographical locations of the world are required. Mittal N, Gupta N, Goyal A. Enamel Hypomineralization: Prevalence, Defect Characteristics in Primary Dentition in a Northern Indian Region. Int J Clin Pediatr Dent 2024;17(S-1):S67-S72.

Caries experience in children with molar-incisor hypomineralisation in Fujairah, United Arab Emirates and its association with hypomineralised teeth number.

Molar-incisor hypomineralisation (MIH) has been found associated with an increase in dental caries. Studies utilising the recent MIH diagnosis and calibration criteria recommended by the EAPD in 2021 are very scarce. Additionally, the available data in literature about the relationship between the hypomineralised teeth number (HTN) and caries come from only one study. To assess the relationship between MIH and caries experience among children in the city of Fujairah, UAE, utilising the recent criteria recommended by the European Academy of Paediatric Dentistry (EAPD) in 2021, and to assess the relationship between the number of teeth affected with MIH, and dental caries. One hundred and sixty-two children were included in this cross-sectional study, aged 7-9years old. Children were examined for MIH according to Ghanim et al. (Eur Arch Paediatr Dent 16:235-246, 2015. 10.1007/s40368-015-0178-8) criteria and Ghanim et al. (Eur Arch Paediatr Dent 18:225-242. 10.1007/s40368-017-0293-92017) training manual. Caries experience was assessed with decayed, missing, filled (dmft, DMFT) scoring system. dmft mean was 6.56 (SD ± 3.78) and DMFT mean was 0.91 (SD ± 1.23). Children with MIH had significantly higher dmft (p = 0.003) scores. Children with higher HTN had significantly higher dmft (p = 0.008) scores. Children in Fujairah have extremely high caries scores. Children with MIH have more decayed, missing and filled teeth. Hypomineralised teeth number was positively associated with caries experience.

Prevalence and clinical presentation of molar incisor hypomineralisation among a population of children in the community of Madrid

ObjectiveThe main objective of this study was to estimate the prevalence of molar incisor hypomineralisation (MIH), an alteration of tooth enamel with an estimated worldwide prevalence rate of 14%, among children using primary care services in the Community of Madrid, Spain.Materials and methodsThis was a descriptive, cross-sectional and multicentre study. After calibrating all researchers and following the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD), children aged between 8 and 16 years who were users of the dental services at 8 primary oral health units of the Madrid Health Service (SERMAS) were included. The children underwent a dental examination, and the parents were asked to complete a questionnaire.ResultsThe prevalence of MIH was 28.63% (CI: 24.61–32.65%). The age cohorts most affected by MIH were 8 years (21.4%) and 11 years (20.7%). The presence of MIH was greater among girls (85; 60.71%) than among boys (55; 39.28%). The mean number of affected teeth per patient was 4.46 ± 2.8. The most frequently affected molar was the upper right first molar (74.3%), and the upper left central incisor was the most affected incisor (37.85%). Opacities were the defects most frequently recorded (63.57%).ConclusionsThe prevalence of MIH in this study is the highest of all relevant studies conducted in Spain.

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.

Exposure and protection protocols of dentomaxillofacial imaging applied by paediatric dentists in Europe.

Evaluate exposure and protection practices regarding dentomaxillofacial imaging among pediatric dentists in Europe and determine the effect of different clinician specific characteristics on their implementation. A cross-sectional study involving an electronic questionnaire addressed to paediatric dentists, participating in a seminar on dental radiology organized by the European Academy of Paediatric Dentistry. Participants were asked to respond to questions regarding dentomaxillofacial imaging in terms of applied radiation dose, adoption of radiation protection techniques, and different patterns of radiographic studying and exchange between patients and colleagues. Data analysis was performed and distribution of responses was tested using chi-square and Fisher's exact tests. A total of 151 paediatric dentists, 119 females and 32 males, with a mean chronological age of 42.8years (s.e. 11.3years), successfully completed the questionnaire (response rate = 82%). Regardless of the type of radiograph, majority of respondents (68%), reported that they perform the radiographs themselves, while 21% reported that they refer the patients. Half of the respondents (51%), indicated requesting a small (localized) field of view (FOV) when referring for a cone beam computed tomography (CBCT) with only a small proportion (11%) reporting a large (maxillofacial) FOV. Thyroid collars and optimizing exposure settings were the most commonly reported patient protection measures used. Lastly, paediatric dentists have adopted the latest technological capacities for the study of dental images. Dentomaxillofacial imaging protection and exposure protocols used are common among paediatric dentists with none of their specific characteristics having a significant effect.

An inverse relationship between dental fluorosis and Molar Incisor Hypomineralization in Mexican schoolchildren in an area with a high concentration of fluoride in drinking water: A cross-sectional study.

To evaluate the association between the frequency and severity of dental fluorosis and Molar Incisor Hypomineralization (MIH) in 8-12-year-old schoolchildren living in an area with a high concentration of fluoride in the drinking water. The present cross‑sectional study was conducted on Mexican children (n = 573) selected from one community presenting a drinking water fluoride concentration of 1.39 ppm/F. The prevalence of dental fluorosis was ascertained using the Thylstrup and Fejerskov Index (TFI). The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using the severity of MIH as the result. The prevalence of MIH was 37.7% and, by severity, was 16.1% mild, 14.3% moderate, and 7.3% severe. The prevalence of dental fluorosis in permanent dentition was 70.9% (TFI ≥1) and, by severity, was 29.2% (TFI = 0), 45.6% (TFI 1-3) and 25.3% (TFI ≥4), while 54.5% of subjects were found to have poor oral hygiene. Schoolchildren with fluorosis (TFI ≥4) were 49% less likely [OR = 0.51; p = 0.025] to present mild MIH than children with fluorosis (TFI <4). Similarly, children with fluorosis (TFI ≥4) were 53% [OR = 0.47; p = 0.019] and 62% [OR = 0.38; p = 0.036] less likely to present moderate and severe MIH than children with fluorosis (TFI <4). An inverse relationship between the presence of fluorosis and MIH was found. The results obtained by the present study may contribute to both the early identification of disorders affecting the enamel and the creation and implementation of long-term oral health prevention, promotion, and intervention programs in the affected population.

Molar incisor hypomineralization and oral health-related quality of life in Brazilian children: A narrative review of current evidence

The aim of this narrative review was to explore the association between Molar Incisor Hypomineralisation (MIH) and Oral Health-Related Quality-of-Life (OHRQoL) in Brazilian children aged 8-10 years. The study was developed considering the PRISMA guidelines (2020). Five databases were consulted to identify potential studies that used clinical parameters for the detection of MIH; and (b) studies that described aspects of the experience and severity of MIH; (c) records that adopted instruments recommended in the literature to explore OHRQoL in children, according to their respective age groups. The risk of bias of the included studies was analyzed using the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies. Of the 155 initially found, three were included. Of these, two were cross-sectional and one was a case-control study. The diagnosis of MIH was made according to the criteria of the European Academy of Paediatric Dentistry, and OHRQoL was identified using the Child Perceptions Questionnaire (CPQ8-10). The qualitative synthesis of the findings shows that no statistically significant association was identified between MIH and OHRQoL. Only the "oral symptoms domain" of the CPQ8-10 was associated with MIH. The studies were classified as having a low risk of bias (mean: 6.6★/7★). Thus, this study concluded that no significant association was identified between MIH and OHRQoL in Brazilian children. However, MIH may have a negative effect on the perception of oral symptoms in this population group.

The prevalence and characteristics of molar-incisor hypomineralisation in Natal, Brazil

ObjectivesTo determine the prevalence and presentation patterns of molar-incisor hypomineralisation (MIH) in Brazilian children. MethodsA cross-sectional study was carried out with 715 individuals aged 8–17 years. MIH was diagnosed according to European Academy of Paediatric Dentistry (EAPD) criteria, using intraoral photographs. Data were analysed using Chi Square and Pearson's Correlation tests at α = 0.05. ResultsThe prevalence of MIH was 15.66 %. Mild defects represented by demarcated yellow and brown opacities comprised 83.5 % of the total MIH lesions and the severity of MIH lesions increased significantly as age increased. The average number of first molars affected by MIH per child was 2.26, and 36 children (32.14 %) had at least one affected incisor. With the increase of affected molars, the number of incisors with opacities showed an obvious increasing. The maxillary left first molar was the most affected tooth, and the maxillary central incisors were the anterior teeth most frequently affected by MIH. ConclusionThe prevalence of MIH was within the range of published studies and the severity of the defects was mostly mild.

Introduction and application of European Academy of Paediatric Dentistry judgment criteria and scoring system for molar-incisor hypomineralization

Molar-incisor hypomineralization (MIH) is defined as an enamel mineralization defect caused by systemic factors, which is characterized by demarcated opacities. These opacities are liable to result in brittle hypomineralized enamel breakdown, which expediting the eventual development of cavities, even tooth loss. Early diagnosis and prompt intervention are essential. The MIH scoring system based on the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD) is internationally recognized. This system is particularly helpful to diagnose and evaluate the MIH, as well as conductive to the performance of epidemiological investigations. This paper gives a presentation on the EAPD judgment criteria and scoring system as well as their applications, based on the current situation of MIH studies and our findings of MIH epidemiological investigation.

Fluoride prophylaxis - poison or simple way to get rid of early childhood caries (ECC) – review

Introduction: As a prevention, fluoride is used systemically as well as topically in the oral cavity. Thanks to fluoride prophylaxis, one of the most common bacterial disease in the world can be significantly reduced. This disease is dental caries. As such, it constitutes a huge problem in current stomatology, especially the type that affects small children - early childhood caries (ECC). Fluoride has beneficial effects not only in caries prevention but also in arresting and inhibiting the active decay process. Nevertheless, in recent years the use of fluoride is claimed to be controversial due to its toxic properties. Aim: The aim of this study is to summarize the current knowledge on the effect that fluoride has on caries diseases affecting children and the safety of its use based on the available research. Materials and methods: Review of the current literature based on data available in: Pubmed, Ncbi, NIH, AAPD (American Academy of Pediatric Dentistry) and EAPD (European Academy of Pediatric Dentistry) websites using the following phrases: fluoride, fluoride in caries prevention, fluoride in caries, fluoride mechanism, fluoride toxicity, fluoride safety, caries, early childhood caries (ECC). Conclusions: The use of fluoride is debatable, due to its toxic properties when used in excessive doses. The analysis of the studies proved that fluoride concentrations used in dentistry for the prevention and treatment of early childhood caries (ECC) are safe for the children's organism. The benefits resulting from its use in modern dentistry, which should be based on prophylaxis, are indisputable.

Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren.

Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9,and with low SES.

Prenatal, perinatal and postnatal risk factors associated with hypomineralised second primary molars – A cross-sectional study

ObjectiveTo evaluate the prenatal, perinatal, and postnatal risk factors associated with hypomineralised second primary molars (HSPM) in four to seven-year-old children. MethodsThis cross-sectional study comprised 300 children (100 with HSPM and 200 controls). Four-to-seven-year-old children were selected after examining for the presence of demarcated hypomineralised lesions in second primary molars using an adapted version of the European Academy of Pediatric Dentistry (EAPD) criteria 2003. Children who exhibited signs of HSPM were selected as the subjects HSPM group), and those children without HSPM were taken as controls. Only patients with documented medical records were included to evaluate the possible risk factors. Information regarding the children's maternal health during pregnancy and postnatal health was recorded using a structured proforma. ResultsMothers suffering from systemic illnesses during pregnancy were significantly more in the HSPM group than controls (61% vs. 13.5%; p < 0.001). Presence of early childhood illnesses (80% vs. 19.0%; p < 0.001), hospital admission more than once in three months (45% vs. 4.5%; p < 0.001), and frequent intake of antibiotics (42% vs. 4.0%; p < 0.001) were significantly more in children with HSPM than the controls. ConclusionA significant association between maternal illnesses during pregnancy and HSPM was observed. Children with HSPM experienced more medical conditions than their unaffected counterparts, particularly during the post-natal period.

Prevalence and clinical characteristics of molar-incisor hypomineralization in Syrian children: a cross-sectional study

This study was undertaken to determine the prevalence of molar incisor hypomineralization (MIH) in Syrian children and to provide information about clinical patterns and severity of MIH lesions. A sample of 1138 children aged 8–11 years was recruited for this cross-sectional study. The diagnosis of MIH was made using the criteria of the European Academy of Paediatric Dentistry (EAPD) and the MIH/HPSMs short charting form was used to score the index teeth. The results showed that the prevalence of MIH in Syrian children was 39.9%. Demarcated opacities were the most prevalent pattern of MIH defects on Permanent first molars (PFMs) and permanent incisors (PIs). Spearman rank correlation showed that the mean number of PIs and HPSMs with MIH increased when the number of affected PFMs was increased (P < 0.001). Chi-square test resulted that girls showed a higher number of severe PFMs than boys did with a statistically significant difference (x2 = 133.1, P < 0.05). Moreover, Chi-square test showed that the number of severe PFMs is higher than the number of severe PIs with a statistically significant difference (x2 = 54.9, P < 0.05). In addition, the mean dmft/DMFT index in children with MIH was found to be significantly higher than children without MIH (P < 0.05). The findings emphasize the need for early identification and management of MIH in children to prevent adverse effects on their oral health.

Türkiye’deki Çocuk Diş Hekimlerinin Dental Radyografi Bilgi ve Tutumlarının Değerlendirilmesi

Aim: The aim of this study is to evaluate the knowledge levels and attitudes of pediatric dentists regarding the use of dental radiography through an online survey. Materials and Method: A data collection form consisting of a total of 17 questions and 2 basic parts, which was prepared in accordance with the current guidelines of the European Academy of Pediatric Dentistry regarding the use of radiography in 2020, was used. The first part of the form was prepared to evaluate the sociodemographic characteristics of the participants and the second part of the form was for the evaluation of the participants’ level of knowledge about the use of radiography in pediatric dentistry. In the analysis of the data, descriptive statistics, mean values, frequencies and proportions were calculated. The chisquare test was used to determine the association between categorical variables. Results: 131 pediatric dentists participated in the study. In accordance with the Guideline recommendation, 40.5% of dentists stated that they preferred bite-wing radiographs as the first choice for the detection and diagnosis of dental caries and 77% stated that they preferred periapical radiographs as the first choice for dental trauma. Conclusion: Even though pediatric dentists in Türkiye usually choose the most appropriate radiographic technique for most clinical situations; knowledge levels need to be increased for more precise diagnosis and treatment planning and radiation protection.

Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study.

Molar incisor hypomineralization (MIH) is an emerging clinical problem as the affected tooth is prone to dental caries with the lapse of time. To assess the prevalence, severity, and associated risk indicators of MIH amongst 8-13 years of children of Vadodara District, Gujarat, India. A cross-sectional study with a sample size of 3,000 government schoolchildren. A total of 1,500 children each from urban and rural areas were randomly selected and examined. Only permanent incisors and first molars were examined. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Paediatric Dentistry (EAPD), 2003. To check the relation between the two variables-Pearson's chi-squared test was applied. Fisher's exact test was applied when less than five expected values were found. A total of 286 children (9.6 %) had MIH, with 189 (rural) and 97 (urban) children. MIH was significantly higher in the rural population as compared to the urban. In the rural area, the cause was found to be a child suffering from an illness (>15 days) which was 35.98%, and in the urban area was due to prolonged use of antibiotics before 4 years of age, which was 28.87%. The overall prevalence rate of MIH among the screened children between the age-group 8 and 13 was found to be 9.6%. Males were more affected. The severity of MIH was more in molars compared to incisors and more in children of rural areas. Protocol for early diagnosis and follow-up to access the squeal of breakdown should be undertaken along with parents and health workers. Shah VU, Dave BH, Chari DN, et al. Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):280-286.

Study on machine learning of molar incisor hypomineralization in an endemic fluorosis region in central China.

Objectives: The aim of the present study was to develop a machine learning model to predict the risk of molar incisor hypomineralization (MIH) and to identify factors associated with MIH in an endemic fluorosis region in central China. Methods: A cross-sectional study was conducted with 1,568 schoolchildren from selected regions. The clinical examination included an investigation of MIH based on the European Academy of Paediatric Dentistry (EAPD) criteria. In this study, supervised machine learning (e.g., logistic regression) and correlation analysis (e.g., Spearman correlation analysis) were used for classification and prediction. Results: The overall prevalence of MIH was 13.7%. The nomograph showed that non-dental fluorosis (DF) had a considerable influence on the early occurrence of MIH and that this influence became weaker as DF severity increased. We examined the association between MIH and DF and found that DF had a protective correlation with MIH; the protective effect became stronger as DF severity increased. Furthermore, children with defective enamel were more likely to experience caries, and dental caries were positively correlated with MIH (OR = 1.843; 95% CI: 1.260-2.694). However, gender, oral hygiene, and exposure to poor-quality shallow underground water did not increase the likelihood of developing MIH. Conclusions: DF should be considered a protective factor within the multifactorial etiology of MIH.

Awareness and practice of dentomaxillofacial imaging among paediatric dentists: a questionnaire survey of members of the European Academy of Paediatric Dentistry.

Assess knowledge, attitudes and practices of paediatric dentists towards dentomaxillofacial imaging and correlate findings with practitioner and practice-specific characteristics. An online questionnaire was sent to all paediatric dentists who attended a scientific seminar organized by the European Academy of Paediatric Dentistry (EAPD) regarding dental radiology. Data regarding available equipment, number, type and reason for performing radiographs, frequency and reasoning for retakes were collected. Data analysis was performed according to practitioner- and practice-specific characteristics and factors directly associated with the type and frequency of radiographs taken, and reason and frequency of repeats were determined. Significant differences were tested using Chi-square and Fisher's exact test. Statistical significance was set at p < 0.05. More than half of the participants (58%) reported having digital radiographic equipment and almost 1/4 (23%) conventional. A panoramic equipment was available in 39% working places and a CBCT scanner in 41%. Two thirds of the participants reported taking up to 10 intra-oral radiographs per week, mainly for trauma (75%) and caries diagnosis (47%). Extra-oral radiographs were prescribed to monitor development (75%) and for orthodontic evaluation, (63%) with a frequency of less than 5 weekly (45%). Participants reported that they repeat radiographs in a frequency of < 5 per week (70%) mainly due to patient's movement (55%). The majority of paediatric dentists within Europe use digital imaging equipment for both intra- and extra-oral radiographs. Nevertheless, great variation in practices exists and, therefore, continuous education in oral imaging is crucial to maintain high quality standards for the radiographic examination of patients.

Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization.

The etiology of molar incisor hypomineralization (MIH) has been extensively explored. Recently, the effect of drugs used in aerosol therapy in childhood has been implicated as a possible factor in the development of MIH. A case-control study was conducted in children aged 6-13 years to determine the association between aerosol therapy and other factors in the development of MIH. A total of 200 children were examined for the presence of MIH according to the European Academy of Paediatric Dentistry (EAPD) criteria (2003). Their mothers or primary caregivers were interviewed regarding the preterm history and perinatal, and postnatal history of the child up to 3 years of life. The collected data were subjected to statistical analysis using descriptive and inferential analyses. The p-value ≤ 0.05 was considered statistically significant. Statistically significant association was observed between the development of MIH and exposure to aerosol therapy in childhood and the use of antibiotics before 1 year of life. Exposure to aerosol therapy and antibiotics before 1 year of age are risk factors in MIH. Children who had aerosol therapy and antibiotics are 2.01 times and 1.61 times more prone to MIH. Shinde MR, Winnier JJ. Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2022;15(5):554-557.