Pediatric Dentistry, Department of Pediatric Dentistry and Public Health, Faculty of Dentistry, Delta University, International Coastal Rd, Al Hafir WA Al Amal, Al Satamoni, Dakahlia Governorate, 7730103, Egypt.
Pediatric Dentistry, Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
BMC Oral Health. 2024 Oct 4;24(1):1182. doi: 10.1186/s12903-024-04860-z.
Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up.
Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient.
There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups.
Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year.
The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).
修复受磨牙牙釉质不全（MIH）影响的第一恒磨牙具有挑战性。本研究旨在比较微创改良银蚀技术（SMART）与常规修复和氟化物涂料应用对中重度矿化不全磨牙的效果，重点在于提高受 MIH 影响儿童的生活质量，至少在第一恒磨牙完全萌出并接受全面覆盖之前，减轻其敏感性并能够进行适当的口腔卫生措施。本研究在一年随访后比较了保留率、敏感性和数字表面面积变化。
选择 28 名儿童（20 名女孩和 8 名男孩），至少有 2 颗具有相同缺陷严重程度的 MIH 磨牙。该研究包括 2 个组：MOD 组（中度矿化不全磨牙严重程度）和 SEV 组（重度矿化不全磨牙严重程度）（n=28 颗牙）。每个组根据修复技术进一步分为 2 个亚组：SMART 亚组和 CONV 亚组（高粘度玻璃离子水门汀修复和氟化物涂料应用）（每组=14 颗牙）。评估包括修复体的保留率（6 个月和 12 个月）、1 周、6 个月和 12 个月时的敏感性以及 12 个月时的咬合面面积变化。每位患儿均接受专业氟化物涂料应用和 MI 糊剂家庭预防措施。
在 6 个月和 12 个月时，4 个亚组的牙齿修复体完整性没有显著差异。然而，在 12 个月时，4 个亚组的牙齿修复体完整性有统计学显著差异（P=0.049）。此外，在 4 个时间间隔之间，敏感性评分有统计学显著差异（P<0.001），在 4 个亚组之间，表面面积变化也有统计学显著差异。
选择性去除龋坏组织和 SMART 修复，结合每 3 个月的口腔家庭和专业预防措施，可在 1 年内保持严重和中度受影响的恒磨牙修复体的完整性。
研究方案已在临床试验中进行回顾性注册（NCT05931822-05/07/2023）。
