| 1. |
- Fagrell, Tobias G, et al.
(author)
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Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars.
- 2010
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In: Acta odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 68:4, s. 215-22
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Journal article (peer-reviewed)abstract
- The microstructure of hypomineralized enamel in permanent teeth has been described in several studies as less distinct prism sheaths and disorganized enamel with lack of organization of the enamel crystals. The mechanical properties, hardness and modulus of elasticity of the hypomineralized enamel have lower values compared with normal. The aim of this study was to examine normal and hypomineralized enamel using scanning electron microscopy (SEM), hardness measurements and X-ray microanalysis (XRMA).
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| 2. |
- Hajdarevic, Adnan, 1994, et al.
(author)
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Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7-8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists
- 2024
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In: EUROPEAN ARCHIVES OF PAEDIATRIC DENTISTRY. - 1818-6300 .- 1996-9805.
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Journal article (peer-reviewed)abstract
- PurposeThe aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH).MethodsAn online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Vastra Gotaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%.ResultsA response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. "When root furcation is under development of the second permanent molar on radiographs" was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist.ConclusionExtraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.
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| 3. |
- Heijs, Suzanne C B, et al.
(author)
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Morphology and chemical composition of dentin in permanent first molars with the diagnose MIH.
- 2007
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In: Swedish dental journal. - 0347-9994. ; 31:4, s. 155-64
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Journal article (peer-reviewed)abstract
- The purpose of this investigation was to study the morphology and distribution of some inorganic elements in dentin in first permanent molars from children with Molar-Incisor Hypomineralization (MIH). Sixty four tooth sections from thirty two children were examined in polarized light. Fifteen representative sections were selected for SEM/XRMA analysis; 5 were used for SEM analysis and 10 for XRMA analysis. No morphological changes in the dentin were revealed in polarized light microscopy (PLM). However, in all but two sections interglobular dentin was found. The SEM analyzes confirmed the findings of the PLM with no structural changes to be found in the dentin. The XRMA results showed a difference in the concentration of elements between dentin below normal and dentin below carious or hypomineralized enamel. Elements related to organic matter appeared with higher values in dentin below hypomineralized and carious enamel. The morphological and chemical findings in dentin below hypomineralized enamel imply that the odontoblasts are not affected in cases of MIH, but may be affected by hypocalcemia, reflected by the presence of interglobular dentin.
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| 4. |
- Jälevik, Birgitta, et al.
(author)
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Can molar incisor hypomineralization cause dental fear and anxiety or influence the oral health-related quality of life in children and adolescents?-a systematic review
- 2022
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In: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805. ; 23, s. 65-78
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Journal article (peer-reviewed)abstract
- Purpose Molar Incisor Hypomineralization (MIH) are first molars with developmental enamel defects and are common findings in many child populations. The porous nature of MIH enamel and the presence of post-eruptive enamel breakdown leads to the presence of hypersensitivity and pain, which is often the patient's main complaint and can result in dental fear and affect the quality of life. The present review aims to summarise the evidence for the ability of MIH to cause problems, such as dental fear and anxiety (DFA) and to summarise the evidence for a possibly negative impact on the oral health-related quality of life (OHRQoL) of MIH affected children and adolescents, in a systematic review. Method Two searches, (1) MIH AND dental anxiety and (2) MIH AND Quality of life, were performed in MEDLINE/PubMed and Scopus. Selection demands were fulfilling the MIH diagnosis criteria using validated instruments and questionnaires for assessing DFA and OHRQoL, respectively. Results After removing duplicates and articles not fulfilling the selection demands, 6 studies concerning MIH and DFA and 8 studies concerning MIH and OHRQoL remained. Conclusion Children and adolescents with diagnosed MIH did not seem to suffer from increased dental fear and anxiety, but indicated an impaired oral health-related quality of life.
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| 5. |
- Jälevik, Birgitta, et al.
(author)
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Difficulties in identifying developmental defects of the enamel: a BITA study
- 2019
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In: European Archives of Paediatric Dentistry. - : Springer Science and Business Media LLC. - 1818-6300 .- 1996-9805. ; 20:5, s. 481-488
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Journal article (peer-reviewed)abstract
- Aim: To evaluate the ability to recognise different types of developmental defects of enamel (DDE) by a group of general dental staff, trained prior to the comprehensive prevalence study (the BITA study), and to compare their skills to that of an untrained group. To evaluate the validity and reliability of the DDE registrations and MIH diagnoses, 3 years after the BITA study ended. To evaluate the reliability of an MIH diagnose, 3 years after the study ended. Materials and methods: The dental staff from five clinics (n = 43) was given instructions in identifying different types of DDE, according to the mDDE index (FDI in Int Dent J 42:411–426 1992). A test protocol with 24 digital photos of teeth with different DDE was filled out. The dental staff from five other clinics (n = 60), without preceding instructions, also filled out the protocol. Ninety-one patients with reported DDE were clinically re-examined 3 years later by two dentists with certified experience of DDE. Results: When untrained dental staff filled out the test protocol, only 42% of the affected surfaces were correctly assessed, whereas 85% of the dental staff instructed in recognizing DDE made a correct assessment (p < 0.000). The specialists confirmed 73% of the teeth diagnosed with DDE in the BITA study as affected. The agreement in judging the opacities as diffuse or demarcated was 76%. One-fourth of those being judged to be affected by MIH in the BITA-study also showed to be affected by other enamel disturbances. Conclusions: The ability of the untrained dental staff to recognize DDE was insufficient. Instructions, using digital photos, raised the ability considerably. To ensure a correct MIH diagnosis, the patients should be followed until all the permanent teeth have erupted. © 2019, The Author(s).
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| 6. |
- Jälevik, Birgitta
(author)
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Enamel hypomineralization in permanent first molars. A clinical, histo-morphological and biochemical study.
- 2001
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Doctoral thesis (other academic/artistic)abstract
- Hypomineralization in the permanent first molars was common in a group of 516 Swedish 8-year-old children. Ninety-five children (18.4%) had at least one molar with demarcated opacity. The incisors frequently displayed opacities concomitantly. The mean number of hypomineralized teeth of the affected children was 3.2 (SD 1.8), of which 2.4 were first molars. Six and a half percent of the children had severe defects, 5% had moderate defects, while 7% had only mildly hypomineralized teeth. Fifteen percent had more than one tooth affected, indicating systemic causation. The affected children, especially the boys, were reported to have had more health problems, asthma in particular (but only 4 cases), during the first year of life. Breast feeding history was similar in children with and without enamel defects. The children with severely defected enamel had undergone dental treatment of their first molars nearly ten times as often as the children in the healthy control group at the age of nine. Behavior management problems and dental fear and anxiety were common compared to the controls. Undemineralized sections from 73 permanent first molars, extracted due to severe hypomineralization of the enamel, were examined in polarized light. The hypomineralized areas extended from the cusps cervically comprising about half of the buccal and lingual sides. The cervical border to normal enamel was well defined and mainly followed the lines of Hunter-Schreger. The hypomineralized zones were covered by thin well-mineralized enamel. The concentration gradients for F, Cl, Na, Mg, K and Sr in hypomineralized enamel were analyzed by means of Secondary Ion Mass Spectrometry (SIMS), and completed with an analysis of the main matrix elements O, P and Ca by means of X-ray microanalysis (XRMA). Hypomineralized enamel had a higher content of C. Ca and P concentration were lower compared with normal enamel. The mean Ca/P ratio in hypomineralized areas was significantly lower (1.4) than the mean Ca/P ratio in the adjacent normal enamel (1.8).
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| 7. |
- Jälevik, Birgitta, et al.
(author)
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Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors.
- 2000
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In: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 10:4, s. 278-89
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of this study was to investigate the morphological appearance of severe hypomineralized enamel of permanent first molars by means of polarized light microscopy, and to estimate the possible time, severity and longevity of the insult. Furthermore, the aim was to survey some commonly implicated aetiological factors in order to gain knowledge about possible pathogenesis of the enamel disturbances which could be compared with future epidemiological studies. SAMPLE AND METHODS: Seventy-three teeth, which had been extracted due to severe hypomineralizations of the enamel, were collected and serially cut longitudinally in a bucco-lingual direction. The sections were examined in polarized light, dry and embedded in water. The children were also examined with respect to the demarcated opacities of other permanent teeth than those that were extracted. The parents were asked about their health during the mother's pregnancy, the time of gestation, birth weight and any complications. They were also asked about the child's health during the first 2 years of its life, the length of time of breast-feeding and also about fluoride supplements. RESULTS: The hypomineralized areas extended cervically from the cusps, comprising about half of the buccal and lingual sides. The cervical borders to normal enamel were well defined and mainly followed the lines of Hunter-Schreger. The hypomineralized zones were covered by thin well-mineralized enamel. The majority of the children had demarcated opacities of all their first molars and also of some permanent incisors. No obvious correlation to the anamnestic data could be found. CONCLUSIONS: The hypomineralized enamel in the investigated teeth demonstrated areas of porosity of varying degrees. The yellow/brown defects were more porous than the white-cream and extended through the whole enamel layer, while the white-cream opacities were situated in the inner parts of the enamel. There had probably been an interacting disturbance of short duration of systemic origin of the activity of the ameloblast during the first 2 years of the child's life, resulting in chronological dispersed hypomineralized demarcated opacities in the developing teeth.
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| 8. |
- Jälevik, Birgitta, et al.
(author)
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Etiologic factors influencing the prevalence of demarcated opacities in permanent first molars in a group of Swedish children.
- 2001
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In: European journal of oral sciences. - 0909-8836. ; 109:4, s. 230-4
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Journal article (peer-reviewed)abstract
- The aim of this study was to determine possible etiological factors for a developmental enamel defect, i.e. demarcated opacities, affecting the permanent first molars. A questionnaire about possible etiological factors of enamel developmental defects was filled in by the parents of 8-yr-old children (n=516) prior to a dental examination of permanent teeth. Demarcated opacities of permanent first molars had been found in 18.4% of the children in a previous study of these children. Fifteen % had more than one tooth affected indicating systemic causation. Questions were asked about mother's health and medication during pregnancy, birth complications, health and medication of the child during the first 3 yr of life, breast-feeding, heredity, and fluoride supplements. The affected children, especially the boys, were reported to have had more health problems, in particular asthma (but only 4 cases), during the first year of life. Use of antibiotics was also more common among the affected children, but owing to a strong co-variance with health problems these factors could not be separated. Breast-feeding history was similar in children with and without enamel defects. The etiology of hypomineralized first molars is not yet fully understood, but based on the results of this retrospective study, health problems in infancy, especially respiratory diseases, seem to be involved.
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| 9. |
- Jälevik, Birgitta, et al.
(author)
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Evaluation of three years of dental care of adolescents in the Public Dental Service in west Sweden.
- 1999
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In: Swedish dental journal. - 0347-9994. ; 23:4, s. 141-8
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Journal article (peer-reviewed)abstract
- 107 individuals, randomly selected from the County of Göteborg and Bohuslän, all born in 1970 were followed regarding the dental care received 1987-1989. The records of each individual from the actual time were collected and information on diagnosis and treatment measures was gathered. Radiographs from the actual time were studied by one of the authors. Sixty-two per cent of the adolescents had been examined and treated all 3 years. Six percent had not been seen at all. The sample was divided into three groups depending on the patient's DFSa value at the examination the first year. This classification appeared to correlate well with caries development in the following years. One-fourth of the sample was responsible for the major part of the non-attendance and late cancellations. The dental health of these subjects was below average, and non-attendance seemed to be a further risk factor. The preventive measures undertaken during the study appeared to correlate poorly with the actual situation of the patient and the presence or absence of potential risk factors.
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| 10. |
- Jälevik, Birgitta, et al.
(author)
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Pain sensation and injection techniques in maxillary dento-alveolar surgery procedures in children - a comparison between conventional and computerized injection techniques (The Wand (R))
- 2014
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:2
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Journal article (peer-reviewed)abstract
- Local anesthesia, especially palatal injection, is often associated with fear and anxiety. The aim was to compare the sensation of pain when using palatal block technique with computerized injection technique (CIT), to conventional infiltration technique with traditional syringe in surgical procedures involving the palate. Patients referred for bilateral minor maxillary surgical treatments were randomized for traditional infiltration anesthesia on one side and palatal block anesthesia with CIT on the other side. AMSA and P-ASA approaches were used with CIT. The sensation of pain was scored by the VAS scale. Twenty-eight patients were included in the study, whereof 17 (61%) were girls. The median age was 14.8 yrs. (12.6 - 17.8). Bilateral exposure of palatal impacted canines was the most common treatment. The injection pain was significantly lower, (p = 0.009), when using the CIT injection compared to conventional injection. However, with time-consuming surgery, additional CIT analgesic solution had to be injected in the buccal gingiva when suturing, in one fourth of the cases. Patients sedated with nitrous oxide seemed to benefit less from CIT. Computerized injection techniques, including P-ASA and AMSA approaches, reduces the sensation of pain when carrying out less time-consuming palatal dental surgery, especially in non-sedated teenagers.
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