Dental tissue fractures and their relationship with deciduous molar hypomineralization, molar incisor hypomineralization, and psychosomatic factors: a cross-sectional study

牙体组织骨折及其与乳磨牙釉质矿化不足、磨牙切牙釉质矿化不足和心身因素的关系:一项横断面研究

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Abstract

This study aimed to investigate the relationship between post-eruptive dental fractures, hypomineralization, and psychosomatic factors such as anxiety, headache, awake bruxism, and temporomandibular disorder (TMD) in children aged 7 to 12 years. A cross-sectional study involving 274 children was conducted using clinical examinations based on the European Academy of Pediatric Dentistry (EAPD) criteria for the diagnosis of hypomineralization and post-eruptive breakdown. Structured and validated questionnaires were administered through interviews to assess psychosomatic factors such as anxiety, headache, awake bruxism, and TMD. Statistical analysis included descriptive and inferential analyses using Fisher's exact test and the chi-square test. The margin of error was 5%, with a 95% confidence interval. Tissue breakdown was observed in 6.2% of children, with a higher prevalence in posterior teeth. A significant association was found between tissue breakdown and hypomineralization in deciduous (p=0.002) and permanent teeth (p < 0.001), especially when hypomineralization presented as yellow-brown (p < 0.001). Anxiety, awake bruxism, and TMD were not significantly associated with such fractures, but they were significantly associated with headache (p = 0.023). Additionally, dental caries (p = 0.003) and occlusal wear (p < 0.001) were associated with tissue breakdown. Post-eruptive breakages were found to be associated with dental enamel hypomineralization in deciduous and permanent teeth. Furthermore, dental caries and occlusal wear were identified as key contributing factors for these fractures. In conclusion, post-eruptive fractures were associated with enamel hypomineralization in both deciduous and permanent teeth, as well as with dental caries and occlusal wear. Among psychosomatic factors, only headache showed a significant association.

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