Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지
DOI QR코드

DOI QR Code

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm

조산아의 발육성 법랑질 결함의 위험 요인 평가

  • Shang-yon Park (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Jaeho Lee (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Hyung-Jun Choi (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Chung-Min Kang (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 박상연 (연세대학교 치과대학 소아치과학교실) ;
  • 이제호 (연세대학교 치과대학 소아치과학교실) ;
  • 최형준 (연세대학교 치과대학 소아치과학교실) ;
  • 강정민 (연세대학교 치과대학 소아치과학교실)
  • Received : 2023.02.23
  • Accepted : 2023.04.19
  • Published : 2023.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.

본 연구는 조산아 유치의 발육성 법랑질 결함을 정량화하는 평가 기준을 제시하고, 조산아의 재태기간, 출생 시 체중, 다양한 합병증 및 치료 이력에 따른 발육성 법랑질 결함의 심각도를 조사하고자 하였다. 조산아의 신생아집중치료실 입원 및 퇴원 기록을 후향적으로 평가하여 출생 정보, 합병증 진단 여부, 비경구 영양 및 기관내 삽관 기간을 조사하였다. 기존의 발육성 법랑질 결함 평가지표를 수정하여 Preterm Developmental Defects of Enamel (PDDE) index를 고안하였으며, 평가자는 기준에 맞추어 조산아 유치의 발육성 법랑질 결함을 법랑질 저광화와 저형성으로 구분하여 점수화하였다. 재태기간 28주 미만, 출산 시 체중 1000 g 미만인 군의 PDDE score는 유의하게 증가하였다. 기관지폐이형성증, 구루병, 뇌실내출혈, 괴사성 대장염 진단 이력이 있는 군, 기관내 삽관 일수가 50일 이상인군, 비경구영양 일수가 20일 이상인 군 역시 PDDE score를 유의하게 증가시켜 발육성 법랑질 결함의 위험인자임을 확인하였다. 본 연구는 조산아 발육성 법랑질 결함 위험인자를 파악하여 조산아의 구강 상태를 예측하고 설명하기 위한 기초 정보를 제공할 수 있을 것이다.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. NRF-2020R1G1A1100275).

References

  1. World Health Organization : International Statistical Classification of Diseases and related health problems. Available from URL: https://apps.who.int/iris/handle/10665/42980 (Accessed on April 10, 2023).
  2. Statistics Korea : Total fertility rate of south Korea. Available from URL: https://www.index.go.kr/unify/idx-info.do?idxCd=5061 (Accessed on April 10, 2023).
  3. Shim JW, Jin HS, Bae CW : Changes in survival rate for very-low-birth-weight infants in Korea: comparison with other countries. J Korean Med Sci, 30(Suppl 1):S25-S34, 2015. https://doi.org/10.3346/jkms.2015.30.S1.S25
  4. Chang YS, Park HY, Park WS : The Korean neonatal network: an overview. J Korean Med Sci, 30(Suppl 1):S3-S11, 2015. https://doi.org/10.3346/jkms.2015.30.S1.S3
  5. Randis TM : Complications associated with premature birth. Virtual Mentor, 10:647-650, 2008. https://doi.org/10.1001/virtualmentor.2008.10.10.cprl1-0810
  6. Ward RM, Beachy JC : Neonatal complications following preterm birth. BJOG, 110(Suppl 20):8-16, 2003. https://doi.org/10.1046/j.1471-0528.2003.00012.x
  7. Platt MJ : Outcomes in preterm infants. Public Health, 128:399-403, 2014. https://doi.org/10.1016/j.puhe.2014.03.010
  8. Bhutani VK, Wong RJ, Stevenson DK : Hyperbilirubinemia in preterm neonates. Clin Perinatol, 43:215-232, 2016. https://doi.org/10.1016/j.clp.2016.01.001
  9. Jain A, Agarwal R, Sankar MJ, Deorari A, Paul VK : Hypocalcemia in the newborn. Indian J Pediatr, 77:1123-1128, 2010. https://doi.org/10.1007/s12098-010-0176-0
  10. Rehman MU, Narchi H : Metabolic bone disease in the preterm infant: Current state and future directions. World J Methodol, 5:115-121, 2015. https://doi.org/10.5662/wjm.v5.i3.115
  11. Clarkson J : Review of terminology, classifications, and indices of developmental defects of enamel. Adv Dent Res, 3:104-109, 1989. https://doi.org/10.1177/08959374890030020601
  12. Salanitri S, Seow WK : Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J, 58:133-140, 2013. https://doi.org/10.1111/adj.12039
  13. Da Costa-Silva CM, Ambrosano GM, Jeremias F, De Souza JF, Mialhe FL : Increase in severity of molar-incisor hypomineralization and its relationship with the colour of enamel opacity: a prospective cohort study. Int J Paediatr Dent, 21:333-341, 2011. https://doi.org/10.1111/j.1365-263X.2011.01128.x
  14. Seow WK : Effect of preterm birth on oral growth and development. Aust Dent J, 42:85-91, 1997. https://doi.org/10.1111/j.1834-7819.1997.tb00102.x
  15. Seow WK, Humphrys C, Tudehope DI : Increased prevalence of developmental dental defects in low birth-weight, prematurely born children: a controlled study. Pediatr Dent, 9:221-225, 1987.
  16. Cortines AAO, Correa-Faria P, Paulsson L, Costa PS, Costa LR : Developmental defects of enamel in the deciduous incisors of infants born preterm: prospective cohort. Oral Dis, 25:543-549, 2019. https://doi.org/10.1111/odi.13011
  17. Halperson E, Shafir S, Fux-Noy A, Ram D, Eventov-Friedman S : Developmental defects of enamel in children born preterm. Front Pediatr, 10:1019586, 2022.
  18. Xu S, Zhao C, Jia L, Ma Z, Zhang X, Shi H : Relationship between preterm, low birth weight, and development defects of enamel in the primary dentition: A meta-analysis. Front Pediatr, 10:975340, 2022.
  19. Clarkson J : A review of the developmental defects of enamel index (DDE Index). Commission on Oral Health, Research & Epidemiology. Report of an FDI Working Group. Int Dent J, 42:411-426, 1992.
  20. Clarkson J, O'mullane D : A modified DDE Index for use in epidemiological studies of enamel defects. J Dent Res, 68:445-450, 1989. https://doi.org/10.1177/00220345890680030201
  21. Seow WK, Ford D, Kazoullis S, Newman B, Holcomben T : Comparison of enamel defects in the primary and permanent dentitions of children from a low-fluoride District in Australia. Pediatr Dent, 33:207-212, 2011.
  22. Vargas-Ferreira F, Ardenghi TM : Developmental enamel defects and their impact on child oral health-related quality of life. Braz Oral Res, 25:531-537, 2011. https://doi.org/10.1590/S1806-83242011000600010
  23. Oliveira AFB, Chaves AMB, Rosenblatt A : The influence of enamel defects on the development of early childhood caries in a population with low socioeconomic status: a longitudinal study. Caries Res, 40:296-302, 2006. https://doi.org/10.1159/000093188
  24. Hong L, Levy SM, Warren JJ, Broffitt B : Association between enamel hypoplasia and dental caries in primary second molars: a cohort study. Caries Res, 43:345-353, 2009. https://doi.org/10.1159/000231571
  25. Zhou Y, Yang JY, Lo ECM, Lin HC : The contribution of life course determinants to early childhood caries: a 2-year cohort study. Caries Res, 46:87-94, 2012. https://doi.org/10.1159/000335574
  26. Seow WK, Masel JP, Weir C, Tudehope DI : Mineral deficiency in the pathogenesis of enamel hypoplasia in prematurely born, very low birthweight children. Pediatr Dent, 11:297-302, 1989.
  27. Aine L, Backstrom MC, Maki R, Kuusela AL, Koivisto AM, Ikonen RS, Maki M : Enamel defects in primary and permanent teeth of children born prematurely. J Oral Pathol Med, 29:403-409, 2000. https://doi.org/10.1034/j.1600-0714.2000.290806.x
  28. Reed SG, Miller CS, Wagner CL, Hollis BW, Lawson AB : Toward preventing enamel hypoplasia: Modeling maternal and neonatal biomarkers of human calcium homeostasis. Caries Res, 54:55-67, 2020. https://doi.org/10.1159/000502793
  29. Trindade CE : Minerals in the nutrition of extremely low birth weight infants. J Pediatr (Rio J), 81(1 Suppl):S43-S51, 2005. https://doi.org/10.1590/S0021-75572005000200006
  30. Bancalari E, Claure N : Definitions and diagnostic criteria for bronchopulmonary dysplasia. Semin Perinatol, 30:164-170, 2006. https://doi.org/10.1053/j.semperi.2006.05.002
  31. Noren JG, Ranggard L, Klingberg G, Persson C, Nilsson K : Intubation and mineralization disturbances in the enamel of primary teeth. Acta Odontol Scand, 51:271-275, 1993. https://doi.org/10.3109/00016359309040577
  32. Lim SY, Kim SO, Lee JH, Kim IH : Developmental disturbance of primary incisors in preterm infants with endotracheal intubation: A case report. J Korean Assoc Dis Oral Health, 15:89-93, 2019.
  33. Green TP, Thompson TR, Johnson D, James EL : Furosemide use in premature infants and appearance of patent ductus arteriosus. Am J Dis Child, 135:239-243, 1981. https://doi.org/10.1001/archpedi.1981.02130270031011
  34. Ryan S, Congdon PJ, Horsman A, James JR, Truscott J, Arthur R : Bone mineral content in bronchopulmonary dysplasia. Arch Dis Child, 62:889-894, 1987. https://doi.org/10.1136/adc.62.9.889
  35. Lambert AS, Linglart A : Hypocalcaemic and hypophosphatemic rickets. Best Pract Res Clin Endocrinol Metab, 32:455-476, 2018. https://doi.org/10.1016/j.beem.2018.05.009
  36. Foster BL, Nociti FH Jr, Somerman MJ : The rachitic tooth. Endocr Rev, 35:1-34, 2014. https://doi.org/10.1210/er.2013-1009
  37. Bassan H : Intracranial hemorrhage in the preterm infant: understanding it, preventing it. Clin Perinatol, 36:737-762, 2009. https://doi.org/10.1016/j.clp.2009.07.014
  38. Bhat M, Nelson KB : Developmental enamel defects in primary teeth in children with cerebral palsy, mental retardation, or hearing defects: a review. Adv Dent Res, 3:132-142, 1989. https://doi.org/10.1177/08959374890030021101
  39. Martinez A, Cubillos P, Jimenez M, Brethauer U, Catalan P, Gonzalez U : Prevalence of developmental enamel defects in mentally retarded children. ASDC J Dent Child, 69:151-155, 2002.
  40. Korchagina VV, D'iakova SV : Dental enamel hypoplasia in children with combined congenital and hereditary defects in the development of the CNS and the locomotor system (infantile cerebral palsy, spinal cord hernias and myopathies). Stomatologiia (Mosk), 76:60-64, 1997.
  41. Stey A, Barnert ES, Tseng CH, Keeler E, Needleman J, Leng M, Kelley-Quon LI, Shew SB : Outcomes and costs of surgical treatments of necrotizing enterocolitis. Pediatrics, 135:E1190-E1197, 2015. https://doi.org/10.1542/peds.2014-1058
  42. Yu L, Tian J, Zhao X, Cheng P, Chen X, Yu Y, Ding X, Zhu X, Xiao Z : Bowel perforation in premature infants with necrotizing enterocolitis: risk factors and outcomes. Gastroenterol Res Pract, 2016:6134187, 2016.
  43. Seow WK, Shepherd RW, Ong TH : Oral changes associated with end-stage liver disease and liver transplantation: implications for dental management. ASDC J Dent Child, 58:474-480, 1991.
  44. Watanabe K, Shibata T, Kurosawa T, Morisaki I, Kinehara M, Igarashi S, Arisue M : Bilirubin pigmentation of human teeth caused by hyperbilirubinemia. J Oral Pathol Med, 28:128-130, 1999. https://doi.org/10.1111/j.1600-0714.1999.tb02010.x
  45. Carrillo A, Rezende KM, de Carrillo SR, Arana-Chavez VE, Bonecker M : Hyperbilirubinemia and intrinsic pigmentation in primary teeth: a case report and histological findings. Pediatr Dev Pathol, 14:155-156, 2011. https://doi.org/10.2350/10-10-0929-LET.1
  46. Peleg D, Kennedy CM, Hunter SK : Intrauterine growth restriction: identification and management. Am Fam Physician, 58:453-460, 466-467, 1998.
  47. Figueras F, Gratacos E : Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther, 36:86-98, 2014. https://doi.org/10.1159/000357592
  48. Pinho JR, Filho FL, Thomaz EB, Lamy ZC, Liberio SA, Ferreira EB : Are low birth weight, intrauterine growth restriction, and preterm birth associated with enamel developmental defects? Pediatr Dent, 34:244-248, 2012.
  49. Sharma D, Shastri S, Farahbakhsh N, Sharma P : Intrauterine growth restriction - part 1. J Matern Fetal Neonatal Med, 29:3977-3987, 2016. https://doi.org/10.3109/14767058.2016.1152249
  50. Olczak-Kowalczyk D, Danko M, Banas E, Gozdowski D, Popinska K, Krasuska-Slawinska E, Ksiazyk J : Parenteral nutrition in childhood and consequences for dentition and gingivae. Eur J Paediatr Dent, 18:69-76, 2017.  https://doi.org/10.1007/s40368-017-0272-1