Butera Andrea, Maiorani Carolina, Morandini Annalaura, Simonini Manuela, Morittu Stefania, Barbieri Stefania, Bruni Ambra, Sinesi Antonia, Ricci Maria, Trombini Julia, Aina Elisa, Piloni Daniela, Fusaro Barbara, Colnaghi Arianna, Pepe Elisa, Cimarossa Roberta, Scribante Andrea
Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Member Association: " Mamme & Igieniste", 24125 Bergamo, Italy.
Children (Basel). 2021 May 21;8(6):432. doi: 10.3390/children8060432.
Analyze defects in the state of maturation of the enamel result in an adequate volume of enamel, but in an insufficient mineralization, which can affect both deciduous teeth and permanent teeth. Among the most common defects, we recognize Deciduous Molar Hypominerlization (DMH), Hypomineralized Second Primary Molar (HSPM), and Molar Incisor Hypomineralization (MIH). These, in fact, affect the first deciduous molars, the second deciduous molars and molars, and permanent incisors, respectively, but their etiology remains unclear. The objective of the paper is to review studies that focus on investigating possible associations between genetic factors or prenatal, perinatal, and postnatal causes and these enamel defects.
A comprehensive and bibliometric search for publications until January 2021 was conducted. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. Case-control, cross-sectional, cohort studies, and clinical trials investigating genetic and environmental etiological factors of enamel defects were included.
Twenty-five articles are included. For genetic factors, there is a statistical relevance for SNPs expressed in the secretion or maturation stage of amelogenesis (16% of studies and 80% of studies that investigated these factors). For prenatal, perinatal, and postnatal causes, there is a statistical relevance for postnatal factors, such as the breastfeeding period (2%), asthma (16%), high fever episodes (20%), infections/illnesses (20%), chickenpox (12%), antibiotic intake (8%), diarrhea (4%), and pneumonia (4%).
The results are in agreement with the multifactorial idea of the dental enamel defects etiology, but to prove this, further studies enrolling larger, well-diagnosed, and different ethnic populations are necessary to expand the investigation of the genetic and environmental factors that might influence the occurrence of DMH, HPSM, and MIH.
分析牙釉质成熟状态的缺陷,这种缺陷会导致牙釉质体积足够,但矿化不足,这可能会影响乳牙和恒牙。在最常见的缺陷中,我们认识到乳牙磨牙矿化不全(DMH)、第二乳磨牙矿化不全(HSPM)和磨牙切牙矿化不全(MIH)。事实上,它们分别影响第一乳磨牙、第二乳磨牙和磨牙以及恒牙切牙,但其病因仍不清楚。本文的目的是回顾那些专注于研究遗传因素或产前、围产期和产后原因与这些牙釉质缺陷之间可能关联的研究。
对截至2021年1月的出版物进行了全面的文献计量检索。研究问题按照人群、干预、对照、结局策略制定。纳入了调查牙釉质缺陷的遗传和环境病因因素的病例对照研究、横断面研究、队列研究和临床试验。
纳入了25篇文章。对于遗传因素,在釉质形成的分泌或成熟阶段表达的单核苷酸多态性(SNP)具有统计学相关性(在研究这些因素的研究中,分别为16%和80%)。对于产前、围产期和产后原因,产后因素具有统计学相关性,如母乳喂养期(2%)、哮喘(16%)、高热发作(20%)、感染/疾病(20%)、水痘(12%)、抗生素摄入(8%)、腹泻(4%)和肺炎(4%)。
结果与牙釉质缺陷病因的多因素观点一致,但要证明这一点,需要进一步开展研究,纳入更大规模、诊断明确且种族不同的人群,以扩大对可能影响DMH、HPSM和MIH发生的遗传和环境因素的调查。