United Arab Emirates dentists’ perceptions about the management of broken down first permanent molars and their enforced extraction in children: a questionnaire survey

Dastouri, M.; Kowash, Mawlood; Halabi, Manal Al; Salami, Anas; Khamis, Amar Hassan; Hussein, Iyad

doi:10.1007/s40368-019-00434-8

Cited by 6 publications

(8 citation statements)

References 42 publications

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“…A paradigm shift towards more minimally invasive approaches has been adopted in dental caries management (Banerjee 2017 ); however, such widespread change in attitudes has yet to be observed in treatment of MIH, as this approach may jeopardise the final result considering the nature of the enamel defect. Despite this, some clinicians have reported adopting minimally-invasive approaches in clinical practice for MIH-affected molars (Kopperud et al 2016 ; Taylor et al 2019 ; Dastouri et al 2020 ), suggesting this is an area where more high-quality research studies are required to provide conclusive evidence for this approach (Alkhalaf et al 2020 ). Differences in the restorative materials used across studies was observed.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, comparing results across studies is difficult and introduces high levels of bias and is reflected in the risk of bias scores for these studies. Ultimately, deciding how to manage MIH-affected molars is challenging and complex, and management has been shown in various studies to differ greatly (Kopperud et al 2016;Taylor et al 2019;Dastouri et al 2020;Wall and Leith 2020). Despite an increase, there still remains a lack of highquality studies, and as such consideration to decide which approach to adopt should be based on the age of the child, co-operative ability, pulpal diagnosis, number of affected surfaces, number of teeth affected, underlying malocclusion, ability to access and pay for treatment and the need for general anaesthetic and the impact this may have on the treatment plan (Lygidakis et al 2010).…”

Section: Management Of Posterior Teethmentioning

confidence: 99%

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An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

Somani

Garot

et al. 2021

Eur Arch Paediatr Dent

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Purpose To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, ‘What are the treatment options for teeth in children affected by molar incisor hypomineralisation?’ Methods An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. Results Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. Conclusion The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.

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Section: Discussionmentioning

confidence: 99%

Section: Management Of Posterior Teethmentioning

confidence: 99%

An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

Somani

Garot

et al. 2021

Eur Arch Paediatr Dent

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“…15 The invasiveness of this approach in the UK compared with international counterparts could be explained by a lack of perceived clear guidance on how best to restore cFPMs and judge their prognosis in children. 7,8,10 Natural physiological space closure following the cFPM extraction, however, is not always guaranteed. A meta-analysis showed that clinically satisfactory space closure was observed in 72% of maxillary molars, dropping to 48% in the mandible even when the extraction is performed at the optimal stage of dental development.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 A recent survey in the United Arab Emirates among General Dental Practitioners (GDPs) and specialists in paediatric dentistry found that almost 85% of them believed in restoring rather than extracting cFPMs. 10 Similarly, 94% of Norwegian dentists and 74% of practitioners in France would choose to retain a cFPM. 11,12 Interestingly, a recent study into the cost-effectiveness of different treatment options for hypomineralised FPMs within the German healthcare system has shown that, assuming spontaneous alignment occurs after extraction and no orthodontic intervention is needed, timed extractions of cFPMs are the best practice in the long term.…”

Section: Introductionmentioning

confidence: 99%

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Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital‐based services

Alkhalaf

Neves

Banerjee

et al. 2022

Int J Paed Dentistry

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Background There are diverse opinions among dentists about managing compromised first permanent molars (cFPMs) in children and a perceived lack of guidance to help them evaluate prognosis. Aim To evaluate the current management of cFPM in children referred to a UK hospital centre and to report the severity of the affected teeth. Design A service evaluation was undertaken, based on case records of medically fit children (6‐11 years) referred to for the management of cFPMs. The presence of hypomineralisation, post‐eruptive breakdown and the proposed care plans were recorded. Radiographic signs of severity were scored using the ICDAS index (intra/inter‐rater kappa 0.96/0.82). Results From 349 records screened over a 4‐month period, 249 met the selection criteria. Almost 81% were planned to have extraction of at least one cFPM, whereas 19.3% were managed without extraction. More than half of the extraction cases (n = 105) had radiographic radiolucencies not exceeding the middle third of dentine in the worst‐affected FPM. At the time of extraction, the mean age of the patients was 9.8 years (±0.9). GA was used in 196 (97.5%) cases, and 40.8% had not received previous treatment in any of their cFPMs. Conclusion Potentially restorable cFPMs in children is, most of the time, in a cohort of UK patients referred for tier 3 services, being managed by timed extractions under general anasethesia.

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Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7–8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists

Hajdarević,

Čirgić,

Robertson

et al. 2024

Eur Arch Paediatr Dent

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Purpose The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). Methods An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. Results A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. “When root furcation is under development of the second permanent molar on radiographs” was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. Conclusion Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.

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United Arab Emirates dentists’ perceptions about the management of broken down first permanent molars and their enforced extraction in children: a questionnaire survey

Cited by 6 publications

References 42 publications

An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital‐based services

Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7–8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists

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