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

Aetiological factors of molar incisor hypomineralization

Introduction. Teeth hypomineralization that involves molars only, or molars and incisors is known as disease Molar Incisor Hypomineralization (MIH). Aetiology of MIH is not known, however, factors responsible for this disease are present in the first year of life. The aim of this research was to identify possible aetiological factors responsible for the occurrence of this disease. Material and Methods. The study included eight years old children from the municipality of Foca. Parents who gave their consent for the participation of children in the study completed a questionnaire in which they listed aetiological factors described in the literature to be responsible for the emergence of hypomineralization. Modified DDE index (Modified DDE Index for Use in Epidemiological Surveys) was used to estimate hypomineralization on all teeth; however, MIH changes were classified separately. Results. More than ninety different factors may be responsible for enamel defects. Possible aetiological factors listed in the literature are: premature birth, low weight of newborns, hypoxia, metabolic disorder of calcium and phosphate, fever, genetic factors, etc. Results did not confirm statistical significance for any of examined aetiological factors. Conclusion. In this study a retrospective analysis of data was performed. Etiological factors of MIH were identified but the most responsible for MIH were not determined.

Cárie precoce na infância: prevalência e fatores de risco em pré-escolares, aos 48 meses, na cidade de João Pessoa, Paraíba, Brasil

O objetivo deste estudo foi verificar a prevalência de cárie precoce na infância em crianças de nível sócio-econômico baixo da grande João Pessoa, Paraíba, Brasil, aos 48 meses de idade, pertencentes a uma coorte. Foram analisados os hábitos alimentares, higiene, exposição ao flúor e presença de defeitos de esmalte. Examinaram-se 224 crianças em domicílio, sob luz natural, utilizando-se a técnica joelho-a-joelho. Cada dente foi limpo com gaze estéril, sendo registrados cárie (OMS) e defeitos de esmalte (DDE Index). Durante o exame foi aplicado um questionário para obtenção de dados sobre dieta, higiene, uso de flúor e presença de amamentação natural e/ou artificial. Para análise estatística, utilizou-se o programa SAS com teste não paramétrico Mantel-Haenszel. Observou-se que 10,7% e 33,0% da amostra apresentaram cárie precoce e cárie severa, respectivamente. Dentre as crianças examinadas, 79,9% tinham ao menos um dente com defeito de esmalte, sendo este o único fator estatisticamente significante (p < 0,001) associado à etiologia da cárie precoce na infância. Sabendo da associação significativa entre cárie precoce e defeitos do esmalte, pode-se concluir que alterações superficiais no esmalte podem facilitar a propagação da doença.

Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children

Developmental defects of the enamel (D.D.E.) are changes in the deciduous dentition that have been little studied in Brazil, although they lead to aesthetic problems, dental sensitivity and may be predictors of dental caries. The objective of this study was to estimate the prevalence and distribution of D.D.E. in the deciduous dentition of pre-school children in the municipality of Itajaí, Santa Catarina, in 2003. A cross-sectional study was carried out with a sample of 431 children aged 3 to 5 enrolled in public day care centres. All of the teeth were examined and the enamel defects were assessed according to the Modified DDE Index (FDI, 1992). The prevalence of D.D.E. was 24.4% (CI 95% 20.3-28.5). Diffuse opacities were the most common defects found (17.9%), followed by hypoplasia (11.1%) and demarcated opacities (6.1%). The most affected teeth were the second molars (44.4%), followed by the first molars (23.5%). Defects were observed more frequently in the upper arch (58.2%). Assessing enamel hypoplasia separately, a prevalence of 15.1% (CI 95% 11.7-18.5) was observed, with the most affected teeth being the canines (33.6%) and second molars (33.6%). One quarter of the pre-school children presented enamel defects, with diffuse opacities being the most prevalent ones.

Review of Terminology, Classifications, and Indices of Developmental Defects of Enamel

A wide variety of terms and definitions are used to describe various developmental defects of enamel. Some are simple descriptive clinical terms, and others are linked with the causative agent or the histopathology of the defect. Some confusion exists as to the most appropriate type of index to use to measure defects of enamel due to fluoride ingestion (dental fluorosis). This is primarily due to difficulties some researchers have in distinguishing between defects of fluoride and non-fluoride origin. This problem has resulted in the development of specific fluorosis indices and purely descriptive indices. The main fluorosis indices are those of Dean, Thylstrup and Fejerskov, and the TSIF Index. Dean's Index does not provide adequate information on the distribution of fluorosis within the dentition and is not sensitive at high fluorosis levels. The Thylstrup and Fejerskov Index is related to the histology of fluorosis; however, the initial minute changes observed on dry enamel surfaces are of little esthetic importance. The TSIF Index does overcome some of the limitations of Dean's Index. The DDE Index has replaced the Al-Alousi Index as the main descriptive index. The DDE Index is time-consuming, and the analyses of data are complicated. Modifications have now been proposed to make it simpler to use and the data more meaningful. Further research needs to be carried out into both the validity of the fluorosis indices and making the DDE Index more universally acceptable.

Developmental Defects of Enamel in Chinese Girls and Boys in Hong Kong

The FDI (DDE) Index-with some modifications and a re-designed recording sheet-was used to determine the prevalence of the different types of developmental defects of enamel. The public water supply contained 1.0 ppm when the children were born and 0.7 ppm at the time of the examinations. All surfaces of the teeth of 460 female and 484 male, 12-year-old, Chinese children were examined after the teeth had been cleaned and dried. Mouth prevalences for all types of opacities, hypoplasia, and discoloration were 99.6%, 82.8%, and 16.6%, respectively. There was no apparent statistically significant difference between girls and boys. However, a statistically significant difference was seen between the sexes for white patches (p < 0.05), missing enamel (p<0.05), and horizontal grooves (p<0.01). There were 811 (85.7%) children with more than 13 teeth affected by opacities, and 417 (44.2%) children had more than four teeth affected by hypoplasia. The most common defect was the diffuse white patch, and the least common was the vertical groove. There were 189 (39.0%) boys with between four and 12 teeth affected by more than two types of defect per tooth. White lines were the most difficult defect to diagnose reproducibly. Intra-examiner reproducibility for all other defects achieved levels of "almost perfect" and "substantial" by calculation of the Kappa coefficient.