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用于临床现场调查与实践的磨牙切牙矿化不全(MIH)培训手册

Molar incisor hypomineralisation (MIH) training manual for clinical field surveys and practice.

作者信息

Ghanim A, Silva M J, Elfrink M E C, Lygidakis N A, Mariño R J, Weerheijm K L, Manton D J

机构信息

Oral Health CRC, Melbourne Dental School, The University of Melbourne, Parkville, Melbourne, Australia.

Department of Paediatrics, Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Melbourne, Australia.

出版信息

Eur Arch Paediatr Dent. 2017 Aug;18(4):225-242. doi: 10.1007/s40368-017-0293-9. Epub 2017 Jul 18.

Abstract

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.

摘要

背景

尽管有明确的评估标准,但关于磨牙症和低矿化第二乳磨牙(HSPM)的研究在结果测量方面存在不一致性。这影响了研究之间有意义的比较,并限制了研究结果的解读。

目的

提供一份综合手册,作为研究人员计划磨牙症和HSPM流行病学研究的辅助工具,特别涉及结果测量。

方法

本手册首先简要回顾了这些病症的临床问题和治疗证据。随后的章节指导研究人员对磨牙症和HSPM进行诊断,并实施最近提出的分级系统的长版和短版。磨牙症和HSPM常与氟斑牙、釉质发育不全、牙釉质形成不全和白斑病变相混淆,但可通过一些独特的临床特征加以区分。基于该分级系统,提出了临床检查的标准化方案。当结果测量具有主观性时,检查者内部和检查者之间的可靠性至关重要,所有磨牙症的流行病学研究均应报告这一可靠性。手册最后设有一个练习论坛,旨在培训检查者使用分级系统,并提供答案。

结论

使用标准化方案、诊断和分级标准将大大提高磨牙症流行病学研究的质量。

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