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Journal of Dentistry Dec 2016We systematically reviewed treatment modalities for MIH-affected molars and incisors. (Review)
Review
OBJECTIVES
We systematically reviewed treatment modalities for MIH-affected molars and incisors.
DATA
Trials on humans with ≥1 MIH molar/incisor reporting on various treatments were included. Two authors independently searched and extracted records. Sample-size-weighted annual failure rates were estimated where appropriate. The risk of bias was assessed using the Newcastle-Ottawa scale.
SOURCES
Electronic databases (PubMed, Embase, Cochrane CENTRAL, Google Scholar) were screened, and hand searches and cross-referencing performed.
STUDY SELECTION
Fourteen (mainly observational) studies were included. Ten trials (381 participants) investigated MIH-molars, four (139) MIH-incisors. For molars, remineralization, restorative or extraction therapies had been assessed. For restorative approaches, mean (SD) annual failure rates were highest for fissure sealants (12[6]%) and glass-ionomer restorations (12[2]%), and lowest for indirect restorations (1[3]%), preformed metal crowns (1.3 [2.1]%) and composite restorations (4[3]%). Ony study assessed extraction of molars in young patients (median age 8.2 years), the majority of them without malocclusions, but third molars in development. Spontaneous alignment of second molars was more frequent in the maxilla (55%) than the mandible (47%). For incisors, desensitizing agents successfully managed hypersensitivity. Micro-abrasion and composite veneers improved aesthetics.
CONCLUSIONS
Few, mainly moderate to high-risk-studies investigated treatment of MIH. Remineralization or sealants seem suitable for MIH-molars with limited severity and/or hypersensitivity. For severe cases, restorations with composites or indirect restorations or preformed metal crowns seem suitable. Prior to tooth extraction as last resort factors like the presence of a general malocclusion, patients' age and the status of neighboring teeth should be considered. No recommendations can be given for MIH-incisors.
CLINICAL SIGNIFICANCE
Dentists need to consider the specific condition of each tooth and the needs and expectations of patients when deciding how to manage MIH. Strong recommendations are not possible based on the current evidence.
Topics: Dental Calculus; Dental Enamel Hypoplasia; Humans; Incisor; Maxilla; Molar; Pit and Fissure Sealants
PubMed: 27693779
DOI: 10.1016/j.jdent.2016.09.012 -
Journal of Esthetic and Restorative... Jan 2019Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor...
INTRODUCTION
Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects.
OBJECTIVE
To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization.
MATERIALS AND METHODS
PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews.
RESULTS
From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements.
CONCLUSIONS
Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion).
CLINICAL SIGNIFICANCE
Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.
Topics: Dental Enamel; Dental Enamel Hypoplasia; Humans; Incisor; Molar; Pit and Fissure Sealants
PubMed: 30284749
DOI: 10.1111/jerd.12420 -
European Archives of Paediatric... Feb 2022To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the...
PURPOSE
To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?'
METHODS
An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers.
RESULTS
Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed.
CONCLUSION
The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.
Topics: Adolescent; Child; Composite Resins; Dental Enamel Hypoplasia; Humans; Incisor; Molar; Pit and Fissure Sealants
PubMed: 34110615
DOI: 10.1007/s40368-021-00635-0 -
The Neuroradiology Journal Dec 2021Sylvian fissure arteriovenous malformations are rare but important vascular lesions, whose importance lies in both haemorrhage and seizure risk. Although surgery has...
BACKGROUND
Sylvian fissure arteriovenous malformations are rare but important vascular lesions, whose importance lies in both haemorrhage and seizure risk. Although surgery has been recommended as a treatment, the overall estimation of success has not been reported to render outcomes easier to understand in comparison to other treatment modalities.
OBJECTIVES
This systematic review of the literature and two cases aims to illustrate the results of surgery as a contemporary treatment option and present a novel anatomical classification system for Sylvian fissure arteriovenous malformations.
MATERIALS AND METHODS
A systematic review was performed by searching MEDLINE (PubMed), EMBASE and Cochrane electronic bibliographic databases from conception to 2018. The following keywords were used: 'Sylvian fissure' AND 'AVM' OR 'arteriovenous malformation' OR 'intracranial arteriovenous malformation' OR 'cerebral arteriovenous malformation' OR 'brain arteriovenous malformation'. The search strategy was not limited by study design but only included keywords in the English language. In addition, two local institution Sylvian fissure arteriovenous malformations are presented and incorporated.
RESULTS
A total of nine full-text articles were included in the analysis. The results of reported cases and the literature review emphasise the role of surgery in the treatment of Sylvian fissure arteriovenous malformations, with an acceptable result in carefully selected patients. We propose a classification system which may inform the choice of surgical approach for these lesions.
CONCLUSIONS
Surgery remains the cornerstone of Sylvian fissure arteriovenous malformation treatment, which may apply to high-grade lesions in this special anatomical location.
Topics: Brain; Cerebral Cortex; Humans; Intracranial Arteriovenous Malformations; Seizures; Treatment Outcome
PubMed: 34086491
DOI: 10.1177/19714009211021776 -
Swiss Dental Journal Dec 2021The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases...
The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases PubMed, Embase, and Cochrane Library were searched. Only retrospective and prospective clinical studies dealing with sealing or restoration of MIH-affected teeth were included. The language was restricted to English or German. Thirteen of 36 potentially eligible studies were included focusing on the following subjects: extension of enamel preparation, adhesive procedures prior to restoration, application of fissure sealants as well as restoration with conventional glass ionomer cements (GIC), resin modified glass ionomer cements (RMGIC), resin composites, and indirect restorations. Seven clinical studies were controlled trials. However, only two included MIH-unaffected teeth as control. No meta-analysis was performed due to the heterogeneity of study designs (e.g. severity of MIH or the restorative materials investigated). Based on the present analysis, the annual failure rates were in average 21% for fissure sealants, 22% for GIC, 1-6% for RMGIC, 13-32% for resin composites, and 0-7% for indirect restorations. In summary, only few tendencies can be deduced from this review at a low level of evidence (number of studies): 1) preparation margins in sound enamel seem to be superior to preparations in hypomineralised enamel (1 study), 2) RMGIC seems to be superior to GIC (3 studies), 3) resin composites may be used for restoring all severities of MIH (7 studies) with self-etch and etch-and-rinse adhesive systems generally not performing differently (3 studies), and 4) in cases of severe MIH, indirect restorations showed a good clinical success (4 studies).
Topics: Dental Enamel Hypoplasia; Dental Restoration, Permanent; Humans; Incisor; Molar; Prospective Studies; Retrospective Studies
PubMed: 33764037
DOI: 10.61872/sdj-2021-12-764 -
Frontiers in Pediatrics 2023The fetal alcohol spectrum disorder is a group of developmental disorders caused by maternal alcohol consumption. Patients with fetal alcohol syndrome show abnormal... (Review)
Review
BACKGROUND
The fetal alcohol spectrum disorder is a group of developmental disorders caused by maternal alcohol consumption. Patients with fetal alcohol syndrome show abnormal orofacial features. This review presents an overview over the facial, oral, dental or orthodontic findings and diagnostic tools concerning these features.
METHODS
For this systematic review Cochrane, Medline and Embase databases were considered and the review was performed according to the PRISMA checklist. Two independent reviewers evaluated all studies and recorded results in a summary of findings table. Risk of bias was analyzed via Quadas-2 checklist.
RESULTS
61 studies were eligible for inclusion. All included studies were clinical studies. Methods and results of the studies were not comparable, guidelines or methods for the detection of FASD varied across studies. Facial features most often measured or found as distinguishing parameter were: palpebral fissure length, interpupillary or innercanthal distance, philtrum, upper lip, midfacial hypoplasia or head circumference.
CONCLUSIONS
This review shows that to date a multitude of heterogeneous guidelines exists for the diagnosis of FASD. Uniform, objective diagnostic criteria and parameters for the orofacial region in FASD diagnosis are needed. A bio database with values and parameters for different ethnicities and age groups should be made available for diagnosis.
PubMed: 37360373
DOI: 10.3389/fped.2023.1169570 -
Ophthalmic Epidemiology Aug 2023Although eye abnormalities are reported in fetal alcohol spectrum disorders (FASD), no systematic review based on Preferred Reporting Items for Systematic Reviews and... (Review)
Review
PURPOSE
Although eye abnormalities are reported in fetal alcohol spectrum disorders (FASD), no systematic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines has been undertaken. Our aim was to document the range and prevalence of eye abnormalities reported in children with prenatal alcohol exposure (PAE) and/or FASD.
METHODS
Searches of electronic databases and manual searches. Eligible articles were observational studies in children with PAE and/or FASD; peer reviewed journal articles in the English language; and studies reporting quantitative or frequency data on functional/structural eye abnormalities. Pooled prevalence, odds ratio, and mean differences were calculated.
RESULTS
Of the 1,068 retrieved articles 36 were eligible, including articles on children with diagnosed fetal alcohol syndrome/FASD (N = 31); PAE (N = 3); and FASD or PAE without FASD (N = 2). Structural and functional eye abnormalities were identified, the most prevalent being short palpebral fissure length (66.1%), visual impairment (55.5%), epicanthus (53.5%), subnormal stereoacuity (53.0%), abnormal retinal tortuosity (50.5%), impaired fixation ability (33.3%), telecanthus (31.7%), optic nerve hypoplasia (30.2%), and small optic discs (27.0%). Compared to non-exposed controls, strabismus, subnormal vision, ptosis, short palpebral fissure length, microphthalmos, smaller optic disc area, and retinal vessel tortuosity were more prevalent in children with FASD.
CONCLUSIONS
Examination of eyes and vision should be considered in children with PAE and suspected or diagnosed FASD to enable early identification and optimal management. This first comprehensive, systematic literature review demonstrates the variety and frequency of eye abnormalities reported in PAE/FASD.
Topics: Child; Humans; Female; Pregnancy; Fetal Alcohol Spectrum Disorders; Prenatal Exposure Delayed Effects; Prevalence; Eye Abnormalities; Visual Acuity
PubMed: 36102703
DOI: 10.1080/09286586.2022.2123004 -
Ophthalmic Genetics Oct 2022Nicolaides-Baraitser syndrome (NCBRS), first described in 1993, is a rare autosomal dominant disease caused by pathogenic variants in the SMARCA2 gene on chromosome...
BACKGROUND
Nicolaides-Baraitser syndrome (NCBRS), first described in 1993, is a rare autosomal dominant disease caused by pathogenic variants in the SMARCA2 gene on chromosome 9p24.3. NCBRS typically presents with dysmorphic facial features, seizures, intellectual disability, and developmental delays. Abnormal findings of the eye and ocular adnexa associated with NCBRS have not been systematically evaluated and summarized in literature. This report presents the case of a 4-year-old male with NCBRS along with a systematic review of literature of the abnormal ophthalmologic and facial features of NCBRS cases.
METHODS
A systematic review of literature of published cases of molecularly confirmed NCBRS was performed and the frequencies of eye, ocular adnexa, and facial abnormalities were calculated.
RESULTS
Our patient's abnormal eye features include myopia, down slanting palpebral fissures, sagging inferior periorbital skin, hypertelorism, and long eyelashes. From the systemic review of literature, the most common abnormal eye and ocular adnexa features include prominent/long eyelashes, thick eyebrows, sagging periorbital skin, down slanting palpebral fissures, and ptosis. The most common facial dysmorphic features include thick/everted lower lip, coarse facial features, wide/large mouth, and thin upper lip. Dental abnormalities are also commonly reported.
CONCLUSIONS
NCBRS frequently presents with well-defined ophthalmic and facial abnormalities. Prompt ophthalmologic evaluation following NCBRS diagnosis may be recommended to screen for several eye disorders. Surgical correction of ptosis may be indicated for NCBRS patients. This report may help further delineate the phenotype of this condition, which may allow for more rapid identification of those affected and provide incentive for additional studies.
Topics: Abnormalities, Multiple; Facies; Foot Deformities, Congenital; Humans; Hypotrichosis; Intellectual Disability; Male; Transcription Factors
PubMed: 35762114
DOI: 10.1080/13816810.2022.2089358 -
The Annals of Otology, Rhinology, and... Dec 2021To report a recalcitrant spontaneous cerebrospinal fluid (CSF) fistula arising from multiple, anatomically-linked lateral skull base defects, and to review the available...
OBJECTIVES
To report a recalcitrant spontaneous cerebrospinal fluid (CSF) fistula arising from multiple, anatomically-linked lateral skull base defects, and to review the available literature to determine optimal techniques for operative repair of congenital CSF fistulae.
METHODS
A patient with recurrent episodes of otologic meningitis was found to have a patent tympanomeningeal fissure, also known as a Hyrtl's fissure, and internal auditory canal (IAC) diverticulum that communicated with the jugular bulb. A systematic review of the literature characterized all reports of spontaneous congenital perilabyrinthine CSF leaks, and all cases of Hyrtl's fissures.
RESULTS
An 11-year-old female was referred for recurrent meningitis. Imaging demonstrated a fistulous connection between the middle ear and IAC diverticulum via the jugular foramen. Specifically, a Hyrtl's fissure was identified, as well as demineralized bone around the jugular bulb. Obliteration of the fissure was initially performed, and a fistula reformed 4 months later. Multifocal CSF egress in the hypotympanum was identified on re-exploration, and middle ear obliteration with external auditory canal (EAC) overclosure was performed. A systematic review of the literature demonstrated 19 cases of spontaneous congenital perilabyrinthine CSF leaks. In total, 6 cases had multiple sources of CSF leak and 2 had history suggestive of intracranial hypertension. All of these noted cases demonstrated leak recurrence. Middle ear obliteration with EAC overclosure was successful in 4 recalcitrant cases.
CONCLUSIONS
Repair of spontaneous congenital perilabyrinthine CSF leaks in cases demonstrating multiple sources of egress or signs of intracranial hypertension should be approached with caution. Middle ear obliteration with EAC overclosure may provide the most definitive management option for these patients, particularly if initial attempt at primary repair is unsuccessful.
Topics: Cerebrospinal Fluid Otorrhea; Child; Ear, Inner; Female; Fistula; Humans; Mastoidectomy; Skull Base; Tomography, X-Ray Computed; Tympanic Membrane
PubMed: 33834882
DOI: 10.1177/00034894211007242 -
Journal of Plastic, Reconstructive &... Jul 2021Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure...
Facial palsy can cause the impairment of eye closure and affect blink, ocular health, communication, and esthetics. Dynamic surgical procedures can restore eye closure in patients with decreased facial nerve function. There are no standardized measures of voluntary and spontaneous eye closure that are used to evaluate the outcomes of blink restoration procedures. The purpose of this systematic literature review was to identify the measures used to assess normal and abnormal eye closure and blinking in patients with facial palsy. A literature search of the PubMed database using the keyword "facial nerve/surgery" was conducted. Only English language articles that pertain to the use of facial paralysis assessment systems published in the past 20 years, which involve eyelid closure were included. There were 57 articles that used a facial paralysis classification system with an eyelid closure component: House-Brackmann Facial Nerve Grading Scale (n = 43, 67%); Sunnybrook Facial Grading Scale (n = 9); palpebral fissure heights (n = 4), and the electronic clinician-graded facial function tool (n = 3) and three additional measures were reported once. Although the Terzis and Bruno Scoring System, blink ratio, and electronic, clinician-graded facial function scale(eFACE) Clinician-Graded Scoring System were valid measures of eyelid closure, there was no one comprehensive eye assessment that demonstrated all aspects of eye closure in facial palsy, which include closure amplitude, spontaneity, and quality of life. For blink assessment, eFACE is the most comprehensive tool currently available and recommended to be used with a patient-reported quality of life supplement that captures the specific domains related to facial nerve dysfunction.
Topics: Blinking; Eyelids; Facial Nerve; Facial Paralysis; Humans; Neurosurgical Procedures; Recovery of Function
PubMed: 33952434
DOI: 10.1016/j.bjps.2021.03.059