Prevalência de hipomineralização molar-incisivo associada a experiência de cárie dentária em escolares de 8 a 10 anos

Abstract

Introduction: Molar-incisor hypomineralization (MIH) is a condition resulting in enamel defects in first permanent molars and permanent incisors. Due to less mineralized enamel, the affected teeth are more prone to post-eruptive fractures and may have atypical cavities, leading to a greater deposit of bacterial biofilm and increased susceptibility to dental caries. Objective: This study aimed at identifying the prevalence of MIH in schoolchildren aged 8 to 10 years and its association with dental caries experience. Methodology: Cross-sectional study with a sample of 471 children aged 8 to 10 years enrolled in urban public schools in Campina Grande, Paraíba. Data were collected via a sociodemographic questionnaire completed by the students’ parents or legal guardians. Clinical examination was used to identify and diagnose MIH as well as dental caries. Three investigators were trained prior to data collection. The diagnosis of MIH was made based based on previously validated Index. The International Caries Detection & Assessment System (ICDAS II) was used for dental caries assessment. Sociodemographic information about the children and their parents or legal guardians, as well as students’ oral health information was obtained using the questionnaire. Data on MIH lesions, severity and location were obtained. The presence of dental caries along with their severity were identified. Data were analyzed using the IBM SPSS version 22.0 for Windows. A descriptive analysis of the data was performed (using absolute and percentage frequencies) and the Pearson's Chi-square test, Fisher's exact test, Mann-Whitney test and Poisson regression were computed. Associations were demonstrated as Prevalence Ratio (PR) and confidence intervals (95%). Statistical significance was set at p<0.05. Results: The prevalence of MIH in our participants was 9.8%, with 65.2% of the lesions being considered mild. In all, 121 affected index teeth were identified, being 67,8% permanent first molars. The enamel defect was present mainly in the occlusal faces (34.3%) of the first molars and in the buccal faces of the incisors (96.0%). The occurrence of dental caries was 88.1%, with 92.6% of the lesions being classified as moderate / severe. As to the participants’ oral health, almost half of the children complained of pain (43.4%) and tooth sensitivity (43.0%) in the last 6 months, and most of the students visited the dentist in the past semester (61.3%). Socioeconomic status information revealed that parents or legal guardians had monthly family income of up to a minimum wage (82.3%) and had completed up to 8 years of education (57.4%). We observed a significant association between dental caries and the following variables: visit the dentist (p < 0.02), parents or legal guardians’ education (p < 0.05), and presence of MIH (p < 0.01). A MIH diagnosis was also significantly associated with family income (p < 0.05). Children with IMH had more decayed first molar faces (p <0.01). Conclusion: The prevalence of MIH was found to be moderate and the presence of enamel defect was associated with dental caries. Most children had only affected first permanent molars without incisor involvement. The most prevalent faces were occlusal in the first molars and buccal in the incisors.