Incidência da hipomineralização molar-incisivo em Araraquara e análise de fatores associados
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2017-03-21
Autores
Lago, Jéssica Damares [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Não existem dados da incidência da Hipomineralização Molar-Incisivo (HMI) reportados na literatura; o que se observa no contexto epidemiológico são apenas dados de prevalência, que são variáveis no Brasil e no mundo. O objetivo deste estudo foi avaliar a incidência e severidade da Hipomineralização Molar-Incisivo após 5 anos do estudo de prevalência da condição em escolares de 6 a 12 anos da rede pública e privada de Araraquara/SP. Além disso, ao defeito de esmalte foram correlacionados os seguintes fatores: experiência de cárie, defeitos de esmalte na dentição decidua (DDE), fluorose dentária (FD) e perfil socioeconômico. Neste sentido, buscou-se obter um panorama atual da HMI ao longo dos anos, reconhecendo se a mesma regrediu ou se acentuou. No estudo foi realizado levantamento de prevalência da HMI em 545 escolares, por 2 examinadores calibrados. Por meio de exame clínico também foram avaliados outros índices (CPO-D, ceo-d, DDE, FD). Durante o levantamento, um questionário semiestruturado foi enviado aos pais/responsáveis dos escolares, a fim de identificar o perfil socioeconômico. A prevalência de HMI em Araraquara/SP em 2016 foi de 14,3% (n=78). A incidência foi de 2%. O grau de comprometimento leve foi o diagnóstico mais prevalente nos dentes afetados (82%). A média de dentes afetados entre as crianças com HMI foi 2,78 (sem diferença entre os gêneros). Do número total de crianças examinadas com HMI, 32,0% (n=25) apresentaram alterações tanto em primeiros molares, quanto em incisivos permanentes. Cerca de 24,4% das crianças com HMI (n=19) apresentaram experiência de cárie na dentição permanente (CPOD>0), enquanto na dentição decídua este percentual foi de 44,9% (n=35) (p>0.05). Com respeito a relação entre HMI e FD, a maioria das crianças com HMI não apresentavam FD (n=68; 79,5%), demonstrando um fator protetor [p=0.02; OR=2,11 (IC=1,08-4,35)]. Nenhuma associação foi observada para DDE [p=0,36; OR=0,54 (IC=0,14-2,03)], para fatores socioeconômicos (p=0,664; OR=0,88; IC=0,51-1,52) e para renda salarial mensal (p=0,595). Conclui-se que os números de casos de HMI têm aumentado, revelando a maior necessidade de se estabelecer um correto diagnóstico para que seja possível uma intervenção precoce.
There are no data on the incidence of Molar-Incisor Hypomineralization (MIH) reported in the literature; which are variable in Brazil and in the world. The aim of this study was to evaluate the incidence and severity of MIH after 5 years of prevalence study of the condition in schoolchildren aged 6 to 12 years of Araraquara/SP. In addition, the following factors were correlated with the enamel defect: caries experience, enamel defects in the primary dentition (DDE), dental fluorosis (DF) and socioeconomic profile. In this sense, it was sought to obtain a current panorama of the MIH over the years, recognizing if it has regressed or accentuated. In the study, a prevalence of MIH was surveyed in 545 students, by 2 calibrated examiners. Clinical examination also evaluated other indexes (DMFT, dmft, DDE, DF). During the survey, a semi-structured questionnaire was sent to the parents/guardians of the students in order to identify the socioeconomic profile. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n=78). The incidence was 2%. The mild impairment degree was the most prevalent diagnosis in affected teeth (82%). The mean number of teeth affected among children with MIH was 2.78 (with no difference between genders). Of the total number of children examined with MIH, 32.0% (n=25) presented alterations in both first permanent molars and permanent incisors. About 24.4% of children with MIH (n=19) presented caries experience in the permanent dentition (DMFT>0), while in the primary dentition this percentage was 44.9% (n=35) (p>0.05). Regarding the relationship between MIH and FD, the majority of children with MIH had no DF (n=68; 79.5%), showing a protective factor [p=0.02; OR=2.11 (CI=1.08-4.35)]. No association was observed for DDE [p=0.36; OR=0.54 (CI=0.14-2.03)], for socioeconomic factors (p=0.664, OR=0.88, CI=0.51-1.52) and for monthly wage income (p=0.595). It is concluded that the numbers of cases of MIH have increased, revealing the greater need to establish a correct diagnosis so that an early intervention is possible.
There are no data on the incidence of Molar-Incisor Hypomineralization (MIH) reported in the literature; which are variable in Brazil and in the world. The aim of this study was to evaluate the incidence and severity of MIH after 5 years of prevalence study of the condition in schoolchildren aged 6 to 12 years of Araraquara/SP. In addition, the following factors were correlated with the enamel defect: caries experience, enamel defects in the primary dentition (DDE), dental fluorosis (DF) and socioeconomic profile. In this sense, it was sought to obtain a current panorama of the MIH over the years, recognizing if it has regressed or accentuated. In the study, a prevalence of MIH was surveyed in 545 students, by 2 calibrated examiners. Clinical examination also evaluated other indexes (DMFT, dmft, DDE, DF). During the survey, a semi-structured questionnaire was sent to the parents/guardians of the students in order to identify the socioeconomic profile. The MIH prevalence in Araraquara/SP in 2016 was 14.3% (n=78). The incidence was 2%. The mild impairment degree was the most prevalent diagnosis in affected teeth (82%). The mean number of teeth affected among children with MIH was 2.78 (with no difference between genders). Of the total number of children examined with MIH, 32.0% (n=25) presented alterations in both first permanent molars and permanent incisors. About 24.4% of children with MIH (n=19) presented caries experience in the permanent dentition (DMFT>0), while in the primary dentition this percentage was 44.9% (n=35) (p>0.05). Regarding the relationship between MIH and FD, the majority of children with MIH had no DF (n=68; 79.5%), showing a protective factor [p=0.02; OR=2.11 (CI=1.08-4.35)]. No association was observed for DDE [p=0.36; OR=0.54 (CI=0.14-2.03)], for socioeconomic factors (p=0.664, OR=0.88, CI=0.51-1.52) and for monthly wage income (p=0.595). It is concluded that the numbers of cases of MIH have increased, revealing the greater need to establish a correct diagnosis so that an early intervention is possible.
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Palavras-chave
Esmalte dentário-anormalidades, Criança, Epidemiologia, Incidência