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Relationship between caries experience and demarcated hypomineralised lesions (including MIH) in the permanent dentition of 15-year-olds

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Abstract

Objective

This cross-sectional study compared the caries experience in 15-year-olds with and without demarcated hypomineralised lesions (DHL) in permanent teeth.

Material and methods

One thousand three hundred and two 15-year-old adolescents from two ongoing birth cohorts (GINIplus15 and LISAplus15) were examined to determine non-cavitated carious lesions (NCCL) and the DMF index. Furthermore, DHL was scored on all permanent teeth/surfaces according to the molar-incisor hypomineralisation criteria of the European Academy of Paediatric Dentistry (MIH/EAPD). Adolescents with DHL were categorised into those with a minimum of one DHL in the permanent dentition (DHL ≥ 1), with DHL on at least one first permanent molar (MIH/EAPD) and with DHL on at least one first permanent molar and permanent incisor (MIH/Severe). The study was conducted in the metropolitan area of Munich.

Results

The proportion of children without caries amounted to 63.7% (DMF > 0) and 26.0% (D1-4MF > 0); the caries experience was mean = 4.0(SD = 5.2) NCCL/T and 0.9(1.7) DMF/T. Existence of DHL ≥ 1, MIH/EAPD and MIH/Severe was detected in 40.2, 17.2 and 9.8% of all adolescents, respectively. The corresponding DMF/T values were: no DHL 0.9(1.7); DHL ≥ 1 1.0(1.7); MIH/EAPD 1.1(1.6); MIH/Severe 1.1(1.7). The group of adolescents with MIH/EAPD and MIH/Severe were found to have statistically higher caries rates in comparison to those with no DHL.

Conclusions

Caries and DHL are prevalent and influenced the dental health of 15-year-old adolescents. A significant positive association existed between the presence of caries and DHL.

Clinical relevance

Children with MIH/EAPD or MIH/Severe had a higher probability to develop carious lesions in the permanent dentition.

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References

  1. Kühnisch J, Heitmüller D, Thiering E, Brockow I, Hoffmann U, Neumann C, Heinrich-Weltzien R, Bauer CP, von Berg A, Koletzko S, Garcia-Godoy F, Hickel R, Heinrich J (2014) Prevalence and extent of manifestation of molar-incisor-hypomineralisations according to different phenotypes. J Public Health Dent 74(1):42–49. https://doi.org/10.1111/j.1752-7325.2012.00365.x

    Article  PubMed  Google Scholar 

  2. Jälevik B (2010) Prevalence and diagnosis of molar-incisor-hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 11(2):59–64. https://doi.org/10.1007/BF03262714

    Article  PubMed  Google Scholar 

  3. Ellwood RP, O'Mullane DM (1994) Association between dental enamel opacities and dental caries in a north Wales population. Caries Res 28(5):383–387. https://doi.org/10.1159/000262006

    Article  PubMed  Google Scholar 

  4. Leppaniemi A, Lukinmaa PL, Alaluusua S (2001) Nonfluoride hypomineralizations in the permanent first molars and their impact on the treatment need. Caries Res 35(1):36–40. https://doi.org/10.1159/000047428

    Article  PubMed  Google Scholar 

  5. Cho SY, Ki Y, Chu V (2008) Molar incisor hypomineralization in Hong Kong Chinese children. Int J Paediatr Dent 18(5):348–352. https://doi.org/10.1111/j.1365-263X.2008.00927.x

    Article  PubMed  Google Scholar 

  6. da Costa-Silva CM, Jeremias F, de Souza JF, Cordeiro RC, Santos-Pinto L, Zuanon AC (2010) Molar incisor hypomineralization: prevalence, severity and clinical consequences in Brazilian children. Int J Paediatr Dent 20(6):426–434. https://doi.org/10.1111/j.1365-263X.2010.01097.x

    Article  PubMed  Google Scholar 

  7. Ghanim AM, Manton DJ, Morgan MV, Marino RJ, Bailey DL (2012) Trends of oral health care and dental treatment needs in relation to molar incisor hypomineralisation defects: a study amongst a group of Iraqi schoolchildren. Eur Arch Paediatr Dent 13(4):171–178. https://doi.org/10.1007/BF03262866

    Article  PubMed  Google Scholar 

  8. Garcia-Margarit M, Catala-Pizarro M, Montiel-Company JM, Almerich-Silla JM (2014) Epidemiologic study of molar-incisor hypomineralization in 8-year-old Spanish children. Int J Paediatr Dent 24(1):14–22. https://doi.org/10.1111/ipd.12020

    Article  PubMed  Google Scholar 

  9. Jeremias F, de Souza JF, Silva CM, Cordeiro Rde C, Zuanon AC, Santos-Pinto L (2013) Dental caries experience and molar-incisor hypomineralization. Acta Odontol Scand 71(3-4):870–876. https://doi.org/10.3109/00016357.2012.734412

    Article  PubMed  Google Scholar 

  10. Petrou MA, Giraki M, Bissar AR, Basner R, Wempe C, Altarabulsi MB, Schäfer M, Schiffner U, Beikler T, Schulte AG, Splieth C (2014) Prevalence of molar-incisor-hypomineralisation among school children in four German cities. Int J Paediatr Dent 24(6):434–440. https://doi.org/10.1111/ipd.12089

    Article  PubMed  Google Scholar 

  11. Ulusoy AT, Sen Tunc E, Bayrak S, Onder HA (2016) Comparative study of oral health parameters in molar incisor hypomineralization and high-caries-risk children aged 8–11 years. Med Princ Pract 25(1):85–89. https://doi.org/10.1159/000440999

    Article  PubMed  Google Scholar 

  12. Heitmüller D, Thiering E, Hoffmann U, Heinrich J, Manton D, Kühnisch J, Neumann C, Bauer CP, Heinrich-Weltzien R, Hickel R (2013) GINIplus study group. Is there a positive relationship between molar incisor hypomineralisations and the presence of dental caries? Int J Paediatr Dent 23(2):116–124. https://doi.org/10.1111/j.1365-263X.2012.01233.x

    Article  PubMed  Google Scholar 

  13. Brogardh-Roth S, Matsson L, Klingberg G (2011) Molar-incisor hypomineralization and oral hygiene in 10- to-12-yr-old Swedish children born preterm. Eur J Oral Sci 119(1):33–39. https://doi.org/10.1111/j.1600-0722.2011.00792.x

    Article  PubMed  Google Scholar 

  14. Americano GC, Jacobsen PE, Soviero VM, Haubek D (2017) A systematic review on the association between molar incisor hypomineralization and dental caries. Int J Paediatr Dent 27(1):11–21. https://doi.org/10.1111/ipd.12233

    Article  PubMed  Google Scholar 

  15. Schmalfuss A, Stenhagen KR, Tveit AB, Crossner CG, Espelid I (2016) Canines are affected in 16-year-olds with molar-incisor hypomineralisation (MIH): an epidemiological study based on the Tromso study: “Fit Futures”. Eur Arch Paediatr Dent 17(2):107–113. https://doi.org/10.1007/s40368-015-0216-6

    Article  PubMed  Google Scholar 

  16. Kevrekidou A, Kosma I, Arapostathis K, Kotsanos N (2015) Molar incisor hypomineralization of eight- and 14-year-old children: prevalence, severity, and defect characteristics. Pediatr Dent 37(5):455–461

    PubMed  Google Scholar 

  17. Bhaskar SA, Hegde S (2014) Molar-incisor hypomineralization: prevalence, severity and clinical characteristics in 8- to 13-year-old children of Udaipur, India. J Indian Soc Pedod Prev Dent 32(4):322–329. https://doi.org/10.4103/0970-4388.140960

    Article  PubMed  Google Scholar 

  18. Krishnan R, Ramesh M, Chalakkal P (2015) Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: an epidemiological study. Eur Arch Paediatr Dent 16(6):455–460. https://doi.org/10.1007/s40368-015-0194-8

    Article  PubMed  Google Scholar 

  19. Wuollet E, Laisi S, Salmela E, Ess A, Alaluusua S (2016) Molar-incisor hypomineralization and the association with childhood illnesses and antibiotics in a group of Finnish children. Acta Odontol Scand 74(5):416–422. https://doi.org/10.3109/00016357.2016.1172342

    Article  PubMed  Google Scholar 

  20. Martinez Gomez TP, Guinot Jimeno F, Bellet Dalmau LJ, Giner Tarrida L (2012) Prevalence of molar-incisor hypomineralisation observed using transillumination in a group of children from Barcelona (Spain). Int J Paediatr Dent 22(2):100–109. https://doi.org/10.1111/j.1365-263X.2011.01172.x

    Article  PubMed  Google Scholar 

  21. Lygidakis NA (2010) Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 11(2):65–74. https://doi.org/10.1007/BF03262715

    Article  PubMed  Google Scholar 

  22. Zutavern A, Brockow I, Schaaf B, Bolte G, von Berg A, Diez U, Borte M, Herbarth O, Wichmann HE, Heinrich J, LISA Study Group (2006) Timing of solid food introduction in relation to atopic dermatitis and atopic sensitization: results from a prospective birth cohort study. Pediatrics 117(2):401–411. https://doi.org/10.1542/peds.2004-2521

    Article  PubMed  Google Scholar 

  23. Heinrich J, Bolte G, Hölscher B, Douwes J, Lehmann I, Fahlbusch B, Bischof W, Weiss M, Borte M, Wichmann HE, LISA Study Group (2002) Allergens and endotoxin on mothers’ mattresses and total immunoglobulin E in cord blood of neonates. Eur Respir J 20(3):617–623. https://doi.org/10.1183/09031936.02.02322001

    Article  PubMed  Google Scholar 

  24. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008

    Article  Google Scholar 

  25. World Health Organization Oral health surveys: basic methods. 4th edition Geneva: World Health Organization, 1997

  26. Pitts NB (2009) How the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management. Monogr Oral Sci 21:1–14. https://doi.org/10.1159/000224208

    Article  PubMed  Google Scholar 

  27. Kühnisch J, Bücher K, Henschel V, Albrecht A, Garcia-Godoy F, Mansmann U, Hickel R, Heinrich-Weltzien R (2011) Diagnostic performance of the universal visual scoring system (UniViSS) on occlusal surfaces. Clin Oral Investig 15(2):215–223. https://doi.org/10.1007/s00784-010-0390-1

    Article  PubMed  Google Scholar 

  28. Lygidakis NA, Wong F, Jalevik B, Vierrou AM, Alaluusua S, Espelid I (2010) Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an EAPD policy document. Eur Arch Paediatr Dent 11(2):75–81. https://doi.org/10.1007/BF03262716

    Article  PubMed  Google Scholar 

  29. Marthaler TM (2004) Changes in dental caries 1953–2003. Caries Res 38(3):173–181. https://doi.org/10.1159/000077752

    Article  PubMed  Google Scholar 

  30. Pieper K (2010) Epidemiologische Begleituntersuchungen zur Gruppenprophylaxe 2009 - Gutachten. Deutsche Arbeitsgemeinschaft für Jugendzahnpflege (DAJ), Bonn

    Google Scholar 

  31. Jälevik B, Klingberg G, Barregard L, Noren JG (2001) The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand 59(5):255–260. https://doi.org/10.1080/000163501750541093

    Article  PubMed  Google Scholar 

  32. Dietrich G, Sperling S, Hetzer G (2003) Molar incisor hypomineralisation in a group of children and adolescents living in Dresden (Germany). Eur J Paediatr Dent 4(3):133–137

    PubMed  Google Scholar 

  33. Preusser SE, Ferring V, Wleklinski C, Wetzel WE (2007) Prevalence and severity of molar incisor hypomineralization in a region of Germany—a brief communication. J Public Health Dent 67(3):148–150. https://doi.org/10.1111/j.1752-7325.2007.00040.x

    Article  PubMed  Google Scholar 

  34. Jordan RA, Micheelis W (2016) Fünfte deutsche Mundgesundheitsstudie. Deutscher Zahnärzteverlag (DÄV), Köln

    Google Scholar 

  35. Crombie FA, Manton DJ, Palamara JE, Zalizniak I, Cochrane NJ, Reynolds EC (2013) Characterisation of developmentally hypomineralised human enamel. J Dent 41(7):611–618. https://doi.org/10.1016/j.jdent.2013.05.002

    Article  PubMed  Google Scholar 

  36. Pitts N (2009) Detection, assessment, diagnosis and monitoring of caries. Karger, Basel, New York. https://doi.org/10.1159/isbn.978-3-8055-9185-0

    Book  Google Scholar 

  37. Elfrink ME, Ghanim A, Manton DJ, Weerheijm KL (2015) Standardised studies on molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM): a need. Eur Arch Paediatr Dent 16(3):247–255. https://doi.org/10.1007/s40368-015-0179-7

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank all adolescents and their families who participated in the in the 15-year follow-up of the GINIplus and LISAplus studies. Furthermore, we thank all members of both the GINIplus and the LISAplus study groups for their excellent work and ongoing support.

Funding

The GINIplus study was mainly supported for the first 3 years of the Federal Ministry for Education, Science, Research and Technology (interventional arm) and Helmholtz Zentrum Munich (former GSF) (observational arm). The 4-, 6-, 10- and 15-year follow-up examinations of the GINIplus study were covered from the respective budgets of the five study centres (Helmholtz Zentrum Munich (former GSF), Research Institute at Marien-Hospital Wesel, LMU Munich, TU Munich and from 6 years onwards also from IUF - Leibniz Research-Institute for Environmental Medicine at the University of Düsseldorf) and a grant from the Federal Ministry for Environment (IUF Düsseldorf, FKZ 20462296). The LISAplus study was mainly supported by grants from the Federal Ministry for Education, Science, Research and Technology and in addition from Helmholtz Zentrum Munich (former GSF), Helmholtz Centre for Environmental Research - UFZ, Leipzig, Research Institute at Marien-Hospital Wesel, Pediatric Practice, Bad Honnef for the first 2 years. The 4-, 6-, 10- and 15-year follow-up examinations of the LISAplus study were covered from the respective budgets of the involved partners (Helmholtz Zentrum Munich (former GSF), Helmholtz Centre for Environmental Research - UFZ, Leipzig, Research Institute at Marien-Hospital Wesel, Pediatric Practice, Bad Honnef, IUF – Leibniz-Research Institute for Environmental Medicine at the University of Düsseldorf) and in addition by a grant from the Federal Ministry for Environment (IUF Düsseldorf, FKZ 20462296). Further, the 15-year follow-up examination of the GINIplus and LISAplus studies was supported by the Commission of the European Communities, the 7th Framework Program: MeDALL project. The 15-year follow-up examination of the GINIplus study was additionally supported by the Mead Johnson and Nestlé companies. The dental investigation was funded by grants obtained from the German Research Foundation (Deutsche Forschungsgemeinschaft, FKZ KU-2518/1-1, KU-2518/1-2, HE-3294/7-1 and HE-3294/7-2). The GABA GmbH, Lörrach, Germany, supported this study by providing oral health care packages for all of the participating children as incentives.

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Authors and Affiliations

  1. Department of Operative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany

    Jan Kühnisch, Lamiaa Kabary, Yuri Malyk, Katrin Rothmaier, Isabel Metz & Reinhard Hickel

  2. Klinik für Zahnerhaltung und Parodontologie, Klinikum der Ludwig-Maximilians-Universität München, Goethestraße 70, 80336, Munich, Germany

    Jan Kühnisch

  3. Helmholtz Zentrum Munich - German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany

    Joachim Heinrich & Marie Standl

  4. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich (LMU), Munich, Germany

    Joachim Heinrich

  5. Elsdon Storey Chair of Child Dental Health, Oral Health CRC, Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia

    David Manton

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  1. Jan Kühnisch
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  2. Lamiaa Kabary
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Correspondence to Jan Kühnisch.

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Conflict of interest

The authors declare that they have no conflict of interest with respect to the authorship or publication of this article.

Ethical approval

All procedures performed in these studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present study protocol was approved by the ethics committee of the Bavarian Board of Physicians (No. 10090 for GINIplus and No. 12067 for LISAplus).

Informed consent

Prior to all examinations, the adolescents and parents/caregivers of each patient were informed and gave their written consent.

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Kühnisch, J., Kabary, L., Malyk, Y. et al. Relationship between caries experience and demarcated hypomineralised lesions (including MIH) in the permanent dentition of 15-year-olds. Clin Oral Invest 22, 2013–2019 (2018). https://doi.org/10.1007/s00784-017-2299-4

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