Hubbard Michael J, Mangum Jonathan E, Perez Vidal A, Nervo Garry J, Hall Roger K
Department of Paediatrics, University of MelbourneMelbourne, VIC, Australia.
Department of Pharmacology and Therapeutics, University of MelbourneMelbourne, VIC, Australia.
Front Physiol. 2017 Aug 3;8:546. doi: 10.3389/fphys.2017.00546. eCollection 2017.
Developmental dental defects (DDDs, hereafter "D3s") hold significance for scientists and practitioners from both medicine and dentistry. Although, attention has classically dwelt on three other D3s (amelogenesis imperfecta, dental fluorosis, and enamel hypoplasia), dental interest has recently swung toward Molar Hypomineralisation (MH), a prevalent condition characterised by well-delineated ("demarcated") opacities in enamel. MH imposes a significant burden on global health and has potential to become medically preventable, being linked to infantile illness. Yet even in medico-dental research communities there is only narrow awareness of this childhood problem and its link to tooth decay, and of allied research opportunities. Major knowledge gaps exist at population, case and tooth levels and salient information from enamel researchers has sometimes been omitted from clinically-oriented conclusions. From our perspective, a cross-sector translational approach is required to address these complex inadequacies effectively, with the ultimate aim of prevention. Drawing on experience with a translational research network spanning Australia and New Zealand (The D3 Group; ), we firstly depict MH as a silent public health problem that is generally more concerning than the three classical D3s. Second, we argue that diverse research inputs are needed to undertake a multi-faceted attack on this problem, and outline demarcated opacities as the central research target. Third, we suggest that, given past victories studying other dental conditions, enamel researchers stand to make crucial contributions to the understanding and prevention of MH. Finally, to focus geographically diverse research interests onto this nascent field, further internationalisation of The D3 Group is warranted.
发育性牙病损(以下简称“D3s”)对医学和牙科领域的科学家及从业者都具有重要意义。尽管传统上人们关注的是其他三种D3s(牙釉质发育不全、氟斑牙和釉质发育不良),但近期牙科领域的关注点已转向磨牙矿化不足(MH),这是一种普遍存在的病症,其特征是牙釉质中出现界限清晰的(“分界明显的”)不透明区域。MH给全球健康带来了重大负担,并且由于与婴儿疾病相关,有可能通过医学手段预防。然而,即使在医学牙科研究界,对这个儿童问题及其与龋齿的关联以及相关研究机会的认识也很有限。在人群、病例和牙齿层面都存在重大知识空白,而且牙釉质研究人员的重要信息有时在以临床为导向的结论中被忽略。从我们的角度来看,需要一种跨部门的转化方法来有效解决这些复杂的不足,最终目标是预防。借鉴澳大利亚和新西兰的一个转化研究网络(D3集团)的经验,我们首先将MH描述为一个无声的公共卫生问题,通常比三种经典的D3s更令人担忧。其次,我们认为需要多种研究投入来对这个问题进行多方面的攻克,并将分界明显的不透明区域作为核心研究目标。第三,鉴于过去在研究其他牙齿病症方面取得的成功,牙釉质研究人员有望为理解和预防MH做出关键贡献。最后,为了将地理上不同的研究兴趣聚焦到这个新兴领域,D3集团有必要进一步国际化。