UNICA - Caries Unit Research, Research Department, Universidad El Bosque, Bogotá, Colombia,
Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
Caries Res. 2021;55(1):1-11. doi: 10.1159/000512483. Epub 2021 Jan 13.
Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.
非龋性牙科病变，如牙釉质发育不全（DDE）和酸蚀性牙齿磨损（ETW），是当前研究的热点。本文旨在探讨 DDE（包括氟斑牙和磨牙-切牙矿化不全）和 ETW，并介绍来自美洲的流行病学数据及相关诊断要点。此外，还需要提供循证医学证据来指导临床评估过程，为临床医生为患者提供更好的口腔健康管理决策提供支持。本文讨论了全球范围内非龋性病变患病率的上升，这可能反映了人们观念的转变。尽管近年来与这些疾病相关的研究数量有所增加，但仍需要提高临床诊断和管理意识，以便在日常临床实践中纳入这些疾病。此外，还需要制定标准化的临床评估标准，以改善评估过程并提高临床医生的依从性。为此，本文讨论了每种疾病最常用的评估指数。因此，尽管有广泛的诊断指数，但建议将 BEWE 指数用于 ETW 的评估，Dean 或 Thylstrup & Fejerskov 指数用于氟斑牙，而改良的 DDE 指数或 EAPD 标准（或改良的 DDE 指数）用于 MIH。总之，非龋性病变日益受到关注，重要的是要实施预防措施来控制其严重程度和进展，并由牙科临床医生进行准确诊断。
