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Aim: The objective of this study was to investigate whether dental hypersensitivity and dental fear were linked to the presence and severity of MIH., Methods: For this cross-sectional study, 1830 students between the ages of 6 and 12 years were recruited from four randomly selected schools. The Children's Fear Survey Schedule-Dental Subscale questionnaire was used to assess dental anxiety and fear. The children's self-reported dental hypersensitivity resulting from MIH was evaluated using the Wong-Baker Facial Scale and the Visual Analog Scale (VAS)., Results: MIH was correlated with tooth hypersensitivity, particularly in severe cases. Dental fear was present in 17.4% of the children with MIH, but it was not associated with dental hypersensitivity, gender, or age., Conclusion: No association was found between dental fear and dental hypersensitivity in children with MIH., (© 2023. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Purpose: Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc ® Blue and MTwo ® ) with manual stainless-steel instrumentation in primary molars using micro-CT analysis., Methods: Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three divergent roots were divided randomly (n = 15) according to instrument type (K file, MTwo®, and Reciproc® Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded., Results: No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p < 0.001) roots. The root segment had a significant effect on IA (p < 0.001) and the highest mean IA was observed in the apical third. Manual instrumentation had fewer procedural complications compared with rotary systems., Conclusion: No differences were determined in the cleaning and shaping effectiveness of all systems in non-fused teeth. Uninstrumented areas (> 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation., (© 2021. European Academy of Paediatric Dentistry.)

Aim: Successful endodontic treatment of primary teeth requires comprehensive knowledge and understanding of root canal morphology. The purpose of this study was to investigate the root canal configurations of primary maxillary second molars using micro-computed tomography., Methods: Extracted human primary maxillary second molars (n = 57) were scanned using micro-computed tomography and reconstructed to produce three-dimensional models. Each root canal system was analysed qualitatively according to Vertucci's classification., Results: 22.8% (n = 13) of the sample presented with the fusion of the disto-buccal and palatal roots; of these, Type V was the most prevalent classification. For teeth with three separate roots (n = 44), the most common root canal type was Type 1 for the palatal canal (100%) and disto-buccal canal (77.3%) and Type V for the mesio-buccal canal (36.4%). Overall, 7% (n = 4) of mesio-buccal canals were 'unclassifiable'., Conclusion: The root canal systems of primary maxillary second molars were not only complex but had a range of configurations that may contribute to unfavourable clinical outcomes after endodontic treatment.

Objectives: Decamarcated hypomineralised lesions of enamel include those developmental defects that are related to MIH, HSPM or any other demarcated opacities of systemic origin. The present study's aims are to determine MIH/HSPM prevalence, caries lesion severity and their association in a sample of 6-12-year-old schoolchildren from Talca, Chile., Methods: The sample (N = 577) was derived from selected primary schools in urban Talca. A full dental examination was performed at the school by one calibrated examiner. Socio-demographic data and caries experience (DMFT/dmft/merged ICDAS II and PUFA/pufa) were measured in primary and permanent dentitions. MIH/HSPM was assessed using a modified EAPD protocol. Binary and multilevel binary regression analyses were calculated., Results: The prevalence of MIH/HSPM or other demarcated hypomineralised lesions was 24.4%. MIH and HSPM was 15.8% and 5%, respectively. The presence of HSPM predicted MIH (OR 3.7; 95% CI 1.65-8.15) when corrected by demographic factors. Of the children examined, 35% had no teeth with a score greater than ICDASII Code 0 and 26% had one or more severe carious lesions (Code C). Toothwise multilevel binary regression analyses demonstrated that teeth with MIH/HSPM (OR 3.70) from low-SES children (OR 1.93) had higher odds for carious lesions compared with defect-free teeth from high-SES participants., Conclusions: MIH/HSPM lesions were associated with carious lesion occurrence and increased disease severity. The prevalence of MIH and HSPM was similar to other reports. Increased awareness of MIH/HSPM in schools and primary health settings may help to identify children at risk early.

Background: Despite clear assessment criteria, studies of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) are marked by inconsistency in outcome measurements. This has detracted from meaningful comparisons between studies and limited interpretation., Aim: To provide a comprehensive manual as a companion to assist researchers in planning epidemiological studies of MIH and HSPM, with particular reference to outcome measurement., Methods: This manual begins with a succinct review of the clinical problems and evidence for management of the conditions. The subsequent sections guide researchers through diagnosis of MIH and HSPM and implementation of both the long and short forms of a recently proposed grading system. MIH and HSPM can often be confused with fluorosis, enamel hypoplasia, amelogenesis imperfecta, and white spot lesions but can be distinguished by a number of unique clinical features. Based on the grading system, a standardised protocol is proposed for clinical examinations. Intra and inter-examiner reliability is of key importance when outcome measurement is subjective and should be reported in all epidemiological studies of MIH. The manual concludes with an exercise forum aimed to train examiners in the use of the grading system, with answers provided., Conclusion: The use of a standardised protocol, diagnostic and grading criteria will greatly enhance the quality of epidemiological studies of MIH.

Aim: This was to investigate the perception of general dental practitioners (GDPs), specialist dentists and dental students regarding the prevalence, severity and aetiological factors of molar incisor hypomineralisation (MIH)., Methods: Questionnaires were distributed to 407 general and specialist dentists who were members of the Saudi Dental Association and 222 fourth and fifth year dental students at College of Dentistry, King Saud University, Riyadh. The questionnaires investigated the perception and knowledge of MIH, including clinical experience, treatment, views on aetiology and need for further training in management of MIH., Results: A total of 230 (56.5 %) dental practitioners and 149 (67.1 %) dental students completed the questionnaire. The majority of GDPs (76.9 %) and specialists (86.3 %) had encountered MIH in their practice. The majority of specialist dentists (56.1 %) and GDPs (60.4 %) reported that MIH could come second to dental caries as a public health concern. A range of possible aetiological factors were identified by both students and dentists with genetics the most common. The majority of GDPs (90.5 %) and specialists (72.4 %) reported a need for further training in MIH, in particular, regarding treatment. The majority of dental students (64 %) had not heard of MIH and most were in favour of including MIH-associated cases in the undergraduate curriculum of paediatric dentistry. Students were more likely to request training in diagnosis than treatment., Conclusion: MIH is a condition encountered by Saudi dentists who advocated the need for clinical training regarding MIH-aetiological and therapeutic fields. Students have little exposure to MIH and are likely to have similar concerns upon commencement of dental practice.

In November 2014, a review of literature concerning prevalence data of Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM) was performed. A search of PubMed online databases was conducted for relevant articles published until November 2014. The reference lists of all retrieved articles were hand-searched. Studies were included after assessing the eligibility of the full-text article. Out of 1078 manuscripts, a total of 157 English written publications were selected based on title and abstract. Of these 157, 60 were included in the study and allocated as 52 MIH and 5 HSPM, and 3 for both MIH and HSPM. These studies utilised the European Academy of Paediatric Dentistry judgment criteria, the modified index of developmental defects of enamel (mDDE) and self-devised criteria, and demonstrated a wide variation in the reported prevalence (MIH 2.9-44 %; HSPM 0-21.8 %). Most values mentioned were representative for specific areas. More studies were performed in cities compared with rural areas. A great variation was found in calibration methods, number of participants, number of examiners and research protocols between the studies. The majority of the prevalence studies also investigated possible aetiological factors. To compare MIH and HSPM prevalence and or aetiological data around the world, standardisation of such studies seems essential. Standardisation of the research protocol should include a clearly described sample of children (minimum number of 300 for prevalence and 1000 for aetiology studies) and use of the same calibration sets and methods whereas aetiological studies need to be prospective in nature. A standardised protocol for future MIH and HSPM prevalence and aetiology studies is recommended.

Background: Molar-incisor hypomineralisation (MIH) is a global dental problem, yet little is known about the knowledge of the general dental practitioners (GDPs) and dental nurses (DNs) regarding this defect in South East Asia., Aims: To assess and compare the knowledge of the GDPs and DNs in Malaysia regarding the frequency of occurrence of MIH within their practice, its diagnosis, putative aetiological factors and management., Study Design and Methods: A questionnaire was distributed to GDPs and DNs during a nationwide dental conference in Melaka, Malaysia and who were asked to answer questions about demographic variables, knowledge, attitudes and practices in the management of MIH., Statistics: Descriptive statistics and bivariate analysis were performed. A 5% level of statistical significance was applied for the analyses., Results: A response rate of 58.2% (131/225) was obtained. Most respondents were aware of MIH and encountered it in their practice (GDPs = 82.5%, DNs = 82.4%). The condition was observed by respondents less in primary molars compared to first permanent molars. Full agreement between GDPs and DNs did not exist concerning the aetiological factors and management of MIH. Glass ionomer cements were the most popular material used in treating MIH. Most respondents (GDPs = 93%, DNs = 76.5%) indicated that they had not received sufficient information about MIH and were willing to have clinical training in the diagnosis and therapeutic modalities of MIH., Conclusions: MIH is identified and encountered by most respondents. Agreement did not exist between GDPs and DNs concerning MIH frequency of occurrence within their practice, its diagnosis, aetiological factors and management.

Background: The dynamic properties of molar-incisor-hypomineralisation lesions (MIH) may impact negatively on personal daily oral care resulting in increased treatment needs., Aims: To describe and compare individual oral health care practices between MIH-affected and non-affected children, to evaluate and compare dental treatment needs between hypomineralised and non-hypomineralised first permanent molars, and to explore the role of reported fluoride exposure in the development of MIH., Study Design: A cluster sample of 7-9 year-old Iraqi schoolchildren (823 of 1000 eligible, response rate 82.3%) had their first permanent molars and incisors evaluated using the European Academy of Paediatric Dentistry evaluation criteria for MIH. Of these 153 were diagnosed with the defect and were referred to as MIH-affected children., Methods: Mothers of the participating children were asked to complete an oral health-questionnaire administered at schools. This included questions regarding child's history of dental visits, fluoride intake and the pattern of oral hygiene practices. Assessment of the dental treatment requirements for the first permanent molars was performed in a sample subset drawn from a larger data set of affected children (n=100) having their teeth assessed previously for dental caries status following the International Caries Detection and Assessment System. The sample subset consisted of 130 hypomineralised molars and 270 non-hypomineralised molars., Results: Of the total sample, approximately 71% of parents had taken their children to the dentist at some stage. For the total sample, tooth restoration or extraction was the most likely causes for seeking dental care at the first dental appointment (57.9%). Tap water was the main source of water consumed at home by the majority of children (77.8%). The prevalence of dental caries and tooth restorations was higher in hypomineralised affected molars (78.5%) than in the defect-free molars (33.7%)., Statistics: MIH-affected children reported significantly higher frequency of seeking dental care than their non-affected counterparts (82.4%, 68.2%; respectively). They were over three times (OR = 3.18) more likely to visit the dentist complaining of pain and were over six times (OR = 6.37) more likely to seek dental care due to tooth sensitivity than their non-affected peers. No significant differences were found between the study groups in terms of tooth brushing and toothpaste history with brushing frequency "once-a-day" was commonly reported in both groups (75.5%). Early exposure to fluoridated water appeared to have a protective effect for MIH (OR=0.38). Affected molars required more than twice the amount of restorative care than unaffected molars., Conclusions: MIH did not seem to have an impact on the personal daily oral hygiene practices; however, MIH patients were commonly seeking dental consultation and needed care more often to improve their oral health.

Aim: To investigate risk factor/s involved in the development of hypomineralised second primary molars and to relate the location of the affected tooth in the dental arches with the timing of the illness/condition incidence., Study Design: A cluster sample of 1,000, Iraqi 7-9 year-old children were invited to have their second primary molars examined for demarcated hypomineralised lesions., Methods: Mothers of 823 children completed a questionnaire-based interview regarding pregnancy and childhood systemic health history. In the clinical examination, the buccal, occlusal and lingual/palatal surfaces of the second primary molar were evaluated for demarcated hypomineralisation lesions by visual examination., Results: A response rate of 82.3% was obtained. Of the children examined, 53 (6.6%) had hypomineralisation defects in at least one second primary molar and were considered as the hypomineralised second primary molar-affected group. Of the total affected teeth (n=83), maxillary molars were the teeth most frequently affected by hypomineralisation throughout all developmental stages (69.9%). Demarcated opacities were the most prevalent lesion type (71.0%). Ninety-four percent of subjects diagnosed with demarcated defects reported various medical conditions possibly associated with hypomineralisation compared with 44% for their non-affected counterparts. Peri-natal medical conditions (45.3%) were the most frequently reported followed by pre-natal and post-natal conditions (24.5%, 9.4%; respectively)., Statistics: Ill health during pregnancy, delivery complications, neonatal complications, acute childhood illness, birth weight and duration of breast feeding were significant potential risk factors (p<0.05). The greater the number of health events reported, the higher was the chance of developing the defect. Children who experienced neonatal complications and whose mothers reported pregnancy and birth problems were approximately six times more likely to have the defect than those whose mothers had delivery complications only (80% vs 14.6%) (p<0.001). Also of those children whose mothers did not report delivery complications, but were breastfed for less than six months, of low birth weight and had history of upper respiratory tract infection, the chance of hypomineralised defects was over four times more likely to happen than in those who did not suffer any of these problems (25.8% vs 6.7%) (p<0.01). No statistically significant association was revealed between the time of the illness/condition occurrence and the location of the tooth in the dental arches., Conclusions: Children with hypomineralised second primary molars had experienced more medical conditions than their unaffected peers particularly during the peri-natal period. No single factor was identified as a potential cause, leaving the aetiology of the defect unclear.

Background: Odontogenic cysts are often encountered in the paediatric and adolescent population, dentigerous cyst being the most common. The current report aims to raise the awareness of paediatric dentists about the management of this condition., Case Report: The current report presents a case of a healthy 14 year-old boy with an odontogenic cyst involving two displaced mandibular premolars., Treatment: The cyst was enucleated surgically and the two premolars were preserved. The diagnosis was a dentigerous cyst., Follow-Up: At 4, 12 and 20 months there was substantial bone healing and non-assisted eruption of the premolars., Conclusion: A less invasive approach when treating odontogenic cysts in children and adolescents is recommended when possible to preserve the permanent teeth involved.

Aims: To compare, in vitro, the effect of placing opaque (OPS) and clear fluorescing (CFS) pit and fissure sealants (PFS) on the detection of occlusal caries (OCD)., Study Design: Occlusal surfaces of 67 extracted molars were examined under standardised conditions by 6 final year undergraduate dental students, using visual, bitewing radiography, transillumination (FOTI), laser fluorescence (LF) and tactile methods of caries detection. The teeth were then assigned randomly to two groups for PFS placement: OPS and CFS; then the OCD methods were repeated. Caries presence/absence was determined histologically on serial sections examined under stereo-microscopy (10x)., Results: Before PFS placement the sensitivity and specificity for the OCD methods were: visual: 68%, 71%; radiographic: 15%, 95%; FOTI: 36%, 93%; LF: 49%, 83% and tactile: 39%, 67%, respectively. After placement of OPS, the sensitivity of LF (20%) and visual (13%) methods decreased and specificity increased (93%, 98% respectively). Placement of CFS resulted in minor changes in sensitivity and specificity. Correlation (Spearman's Rho coefficients) between OCD methods and histological intra-dentinal caries for pre- PFS, OPS, and CFS were: visual: 0.38, 0.34, 0.33; FOTI: 0.42, 0.35, 0.43; and LF: 0.41, 0.30, and 0.45 respectively., Conclusions: The sensitivity of all OCD methods was low, as well as their correlation to the histological gold standard. Placing OPS further decreased the sensitivity of LF and visual methods, whereas placing CFS had little effect on all OCD methods. It is recommended that tactile detection of occlusal caries should be discontinued, and the probe used only to clean the pits and fissures gently for more accurate visual detection, or prior to pit and fissure sealant placement. Further research into the development of an affordable, robust, accurate and easy to use method for OCD is required.