Glass hybrid restorations as an alternative for restoring hypomineralized molars in the ART model

Juliana de Aguiar Grossi, Renata Nunes Cabral, Ana Paula Dias Ribeiro, Soraya Coelho Leal, Juliana de Aguiar Grossi, Renata Nunes Cabral, Ana Paula Dias Ribeiro, Soraya Coelho Leal

Abstract

Background: This study aimed to evaluate the survival rate of glass hybrid restorations placed under the atraumatic restorative treatment (ART) technique in first permanent molars affected by molar incisor hypomineralization (MIH).

Methods: Sixty teeth with severe MIH associated to carious dentin lesions without pulp involvement were included. Treatments were performed by one trained dentist using the ART approach and restored with a glass hybrid restorative system (Equia Forte, GC®) on school premises. Treatments were evaluated after 6 and 12 months by an independent examiner using the modified ART criterion. Data analysis involved descriptive statistics and actuarial success analysis.

Results: The sample comprised 24 (54.54%) girls and 20 (45.45%) boys with a mean age of 10.55 (±1.25) years. In regard to the number of surfaces involved in the restorations, 29 (48.3%) comprised one surface and 31 (51.7%) two or more surfaces. Considering cavity extent, 25 (41%) presented dentin cavitation without cusp weakness, 23 (37.7%) with large dentin cavitation with cusp weakness and 13 (21.3%) with large dentin cavitation with the breakdown of one or more cusps. Only 4 teeth required local anesthesia. A success rate of 98.3% after 6 and 12 months was observed, as only one restoration failed. The only failure occurred in a restoration involving three or more sur-faces presenting the breakdown of all cusps.

Conclusion: Restorations using a glass hybrid restorative system and performed in the field with the ART technique proved, after 12 months of evaluation, to be an effective approach to preserving first permanent molars affected by MIH.

Trial registration: REBEC-RBR-8drccq (17/06/15).

Keywords: Atraumatic restorative treatment; Cavity size; Glass ionomer; Molar incisor hypomineralization; Survival rate.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Research Ethics Committee of the University of Brasilia, Brazil (CAAE-31973413.0.0000.0030), registered as a clinical trial in the Brazilian Registry of Clinical Trials (REBEC-RBR-8drccq), and supported by the local Secretary of Education. Children were invited to join the study and objectives were explained to the parents, who then signed an informed consent form.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart with the number of children/eligible teeth, sample loss and composition of the study sample
Fig. 2
Fig. 2
12-month follow-up and restorative failure. a, d, g - initial aspect of MIH affected molars associated with carious lesions at baseline; b, e, h - clinical aspect of restorations immediately after being performed using the ART technique involving 1 surface (b), 2 surfaces (e) and all surfaces (h); c, f, i - clinical aspect of restorations after 12 months (c and d) and the only failure observed (i) which occurred after 6 months follow-up

References

    1. Soviero V, Haubek D, Trindade C, Da Matta T, Poulsen S. Prevalence and dis-tribution of demarcated opacities and their sequelae in permanent 1st molars and incisors in 7 to 13 year-old Brazilian children. Acta Odontol Scand. 2009;67:170–175. doi: 10.1080/00016350902758607.
    1. Fragelli CMB, Souza JF, Jeremias F, Cordeiro RCL, Santos-Pinto L. Molar incisor hypomineralization (MIH): conservative treatment management to restore affected teeth. Braz Oral Res. 2015;29:1–7. doi: 10.1590/1807-3107BOR-2015.vol29.0076.
    1. Zhao D, Dong B, Yu D, Ren Q, Sun Y. The prevalence of molar incisor hypomineralization: evidence from 70 studies. Int J Paediatr Dent. 2017; 10.1111/ipd.12323.
    1. Hernandez M, Boj JR, Espasa E. Do we really know the prevalence of MIH? J Clin Pediatr Dent. 2016;40:259–263. doi: 10.17796/1053-4628-40.4.259.
    1. Weerheijm KL, Jalevik B, Alaluusua S. Molar incisor hypomineralization. Caries Res. 2001;35:390–391. doi: 10.1159/000047479.
    1. Chawla N, Messer LB, Silva M. Clinical studies on molar incisor Hypomineralisation part 1: distribution and putative associations. Eur Arch Paediatr Dent. 2008;9:180–190. doi: 10.1007/BF03262634.
    1. Takahashi K, Correia ASC, Cunha RF. Molar incisor hypomineralization. J Clin Pediat Dent. 2009;33:193–198. doi: 10.17796/jcpd.33.3.c0202140n373rg42.
    1. Lygidakis NA, Wong F, Vierrou AM, Alaluusua S, Espelid I. Best clinical practice guidance for clinicians dealing with children presenting with molar incisors hypomineralisation (MIH). An EADP policy document. Eur Arch Paediatr Dent. 2010;11:75–81. doi: 10.1007/BF03262716.
    1. Grossi JA, Cabral RN, Leal SC. Caries experience in children with and without molar-incisor Hypomineralisation: a case-control study. Caries Res. 2017;51:419–424. doi: 10.1159/000477099.
    1. Americano GC, Jacobsen PE, Soviero VM. Haubek D.- a systematic review on the association between molar incisor hypomineralization and dental caries. Int J Paediatr Dent. 2017;27:11–21. doi: 10.1111/ipd.12233.
    1. Garcia-Margarit M, Catalá-Pizarro M, Montiel-Company JM, Almerich-Silla JM. Epidemiologic study of molar-incisor hypomineralization in 8-year-old Spanish children. Int J Paediatr Dent. 2014;24:14–22. doi: 10.1111/ipd.12020.
    1. Jälevik B, Norén JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Paediatr Dent. 2000;10:278–289. doi: 10.1046/j.1365-263x.2000.00210.x.
    1. Jälevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralisation of their permanent first molars. Int J Paediatr Dent. 2002;12:24–32.
    1. Lygidakis NA. Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent. 2010;11:65–74. doi: 10.1007/BF03262715.
    1. Elhennawy K, Schwendicke F. Managing molar-incisor hypomineralization: a systematic review. J Dent. 2016;55:16–24. doi: 10.1016/j.jdent.2016.09.012.
    1. Koch MJ, García-Godoy F. The clinical performance of laboratory fabricated crowns placed on first permanent molars with developmental defects. JADA. 2000;131:1285–1290.
    1. Frencken JE, Leal SC, Navarro MFL. 25 years atraumatic restorative treatment (ART) approach: a comprehensive overview. Clin Oral Invest. 2012;16:1337–1346. doi: 10.1007/s00784-012-0783-4.
    1. Luengas-Quintero E, Frencken JE, Muñúzuri-Hernández JA, Mulder J. The atraumatic restorative treatment (ART) strategy in Mexico: two-years follow up of ART sealants and restorations. BMC Oral Health. 2013;13:42. doi: 10.1186/1472-6831-13-42.
    1. Nyvad B, Machiulskiene V, Baelum V. Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res. 1999;33:252–260. doi: 10.1159/000016526.
    1. Weerheijm KL, Duggal M, Mejare I, Papagiannoulis L, Koch G, Martens LC, Hallonsten AL. Judgement criteria for molar incisor hypomineralization (MIH) in epidemiologic studies: a summary of European meeting on MIH held in Athens, 2003. Eur J Paed Dent. 2003;3:110–113.
    1. Frencken JE, Holmgren CJ. Atraumatic restorative treatment for dental caries. STI Book B.V: Nijmegen; 1999.
    1. Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Doméjean S, Fontana M, Leal S, Lo E, Ma-chiulskiene V, Schulte A, Splieth C, Zandona AF, Innes NP. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016;28:58–67. doi: 10.1177/0022034516639271.
    1. Lasfargues JJ, Kaleka R, Louis JJ. A new system of minimally invasive preparations: The Si/Sta concept. In: Roulet JF & Degrange M Adhesion: The Silent Revolution in Dentistry. Chicago: Quintessence; 2000. p. 107–151.
    1. Farag AM, Van der Sanden WJ, Abdelwahab H, Frencken JE. Survival of ART restorations assessed using selected FDI and modified ART restoration criteria. Clin Oral Investig. 2011;15:409–415. doi: 10.1007/s00784-010-0403-0.
    1. Atlas de Desenvolvimento Humano no Brasil. 2013. . Accessed 20 Sept 2016.
    1. De Amorim RG, Figueiredo MJ, Leal SC, Mulder J, Frencken JE. Caries experience in a child population in a deprived area of Brazil, using ICDAS II. Clin Oral Investig. 2012;16:513–520. doi: 10.1007/s00784-011-0528-9.
    1. Mickenautsch S, Frencken JE. Utilization of the ART approach in a group of public oral health operators in South Africa: a 5-year longitudinal study. BMC Oral Health. 2009;21:9–10.
    1. Gurgan S, Kutuk ZB, Ergin E, Oztas SS, Cakir FY. Four-year randomized clinical trial to evaluate the clinical performance of a glass ionomer restorative system. Oper Dent. 2015;40:134–143. doi: 10.2341/13-239-C.
    1. De Souza JF, Fragelli CB, Jeremias F, Paschoal MAB, Santos-Pinto L, Cordeiro RCL. Eighteen-month clinical performance of composite resin restorations with two different adhesive systems for molars affected by molar incisor hypomineralization. Clin Oral Invest. 2016; 10.1007/s00784-016-1968-z.
    1. Garg N, Jain AK, Saha S, Singh J. Essentiality of early diagnosis of molar incisor Hypomineralization in children and review of its clinical presentation, etiology and management. Int J Clin Pediatr Dent. 2012;5:190–196. doi: 10.5005/jp-journals-10005-1164.
    1. William V, Messer LB, Burrow MF. Molar incisor Hypomineralisation: review and recommendations for clinical management. Pediatr Dent. 2006;28:224–232.
    1. Fayle SA. Molar-incisor hypomineralisation: restorative management. Eur J Paediatr Dent. 2003;4:121–126.
    1. Preusser SE, Ferring WC, Wetzel WE. Prevalence and severity of molar incisor hypomineralization in a region of Germany - a brief communi-cation. J Public Health Dent. 2007;67:148–150. doi: 10.1111/j.1752-7325.2007.00040.x.

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