Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (UNESP). Rua Humaitá, 1680, 14801- 903, Araraquara, SP, Brazil.
J Dent. 2021 Feb;105:103570. doi: 10.1016/j.jdent.2020.103570. Epub 2020 Dec 29.
To evaluate the influence of fluoride varnish (FV) therapies or resin infiltration (RI) to maintain the structural integrity of Molar Incisor Hypomineralization (MIH) -affected teeth.
Fifty-one children aged 6-12 years with at least one incisor and one first permanent molar with yellow/brown MIH opacities were included. Patients were randomly allocated into three groups: FV - Fluoride Varnish (Duraphat); FV+etch - Fluoride Varnish (Duraphat) after enamel etching with 37% phosphoric acid; or RI - Resin Infiltration system (Icon). Opacities were monitored for 18 months. The primary outcome was the loss of integrity due to post-eruptive enamel breakdown (PEB). Covariables included sex, age, DMFT index, opacity colour, plaque index, number of MIH-affected teeth, and number of MIH-affected surfaces. Fisher's Exact was used to test the association of treatments with PEB, the Kaplan-Meyer method analysed the survival rates and Cox-regression determined which covariables would predict failure (α=0.05).
From a total of 235 teeth, the PEB rate for RI (6.1%) was significantly lower (p<0.05) than FV (17.9%; OR 3.0, 95%CI 1.07, 8.48) and FV+etch (17.3%; OR 3.1, 95%CI 1.13, 8.73). DMFT index >3, brown opacities, cusp involvement, and age between 6-8 years predicted PEB (p<0.05).
Resin infiltration positively influenced the structural integrity maintenance of MIH-affected teeth by decreasing the risk of enamel breakdown over18 months follow-up. Registry of Clinical Trials (RBR-8wwk3n).
Resin infiltration proved to be a more efficacious intervention to maintain the structural integrity of MIH-affected teeth than fluoride varnish therapies.
评估氟保护漆（FV）疗法或树脂渗透（RI）治疗对维持矿化不全磨牙（MIH）患牙结构完整性的影响。
纳入了 51 名 6-12 岁的儿童，他们至少有一颗切牙和一颗第一恒磨牙有黄色/棕色 MIH 不透明。患者被随机分配到三组：FV-氟保护漆（Duraphat）；FV-酸蚀-氟保护漆（Duraphat）用 37%磷酸酸蚀牙釉质后；或 RI-树脂渗透系统（Icon）。在 18 个月内监测不透明度。主要结局是由于萌出后牙釉质破裂（PEB）导致的完整性丧失。协变量包括性别、年龄、DMFT 指数、不透明度颜色、菌斑指数、MIH 受累牙数和 MIH 受累牙面数。Fisher 精确检验用于检验治疗与 PEB 的关联，Kaplan-Meier 法分析生存率，Cox 回归确定哪些协变量将预测失败（α=0.05）。
在总共 235 颗牙齿中，RI（6.1%）的 PEB 率明显低于 FV（17.9%；OR 3.0，95%CI 1.07，8.48）和 FV-酸蚀（17.3%；OR 3.1，95%CI 1.13，8.73）。DMFT 指数>3、棕色不透明度、牙尖受累和 6-8 岁年龄预测 PEB（p<0.05）。
树脂渗透通过降低 18 个月随访期间牙釉质破裂的风险，对 MIH 患牙结构完整性的维持产生了积极影响。临床试验注册（RBR-8wwk3n）。
与氟保护漆疗法相比，树脂渗透被证明是维持 MIH 患牙结构完整性更有效的干预措施。
