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Enamel defects in permanent incisors after trauma to primary predecessors: inter-observer agreement based on photographs.

14:44 EDT 22nd May 2013 | BioPortfolio

Summary of "Enamel defects in permanent incisors after trauma to primary predecessors: inter-observer agreement based on photographs."

Trauma to primary teeth may cause mineralization disturbances in the permanent successors.
OBJECTIVE:
To study the distribution and type of enamel defects in permanent incisors after trauma to primary teeth and to examine inter-observer agreement when registrations were based on photographs. MATERIAL AND
METHODS:
Of 266 children who suffered an oral injury to primary teeth in one county of Norway in 2003, 193 were included in a follow-up study to record enamel defects in the permanent successors 7 years later (age, 8-15 years). Clinical examination and intraoral photographs were undertaken by the principal investigator. The photographs were evaluated twice for enamel defects by three paediatric dentists. Evaluation 1: age at the time of injury, traumatized teeth and diagnoses were kept unknown to the examiners. Evaluation 2: age and trauma diagnoses were known to the examiners. Inter-observer agreement was calculated using Cohen's kappa and chi-square test.
RESULTS:
Of 338 successor teeth, 42% exhibited enamel defects. In neighbouring teeth (339) with non-injured predecessors, 30% were registered with defects. The most common enamel disturbance in successors was demarcated opacities, recorded in 18% of the teeth. Enamel defects owing to a previous trauma were registered in 37% of the children in Evaluation 1, kappa 0.88-0.93 and in 21% in Evaluation 2, kappa 0.63-0.84. The examiners disagreed on a higher proportion of the children when all information on the injury was available (P < 0.001).
CONCLUSION:
Demarcated enamel opacities were the most common defects in permanent successors. Although the inter-examiner agreement was good, the results indicated that recordings of enamel disturbances following trauma is associated with uncertainty.

Affiliation

Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.

Journal Details

This article was published in the following journal.

Name: Dental traumatology : official publication of International Association for Dental Traumatology
ISSN: 1600-9657
Pages:

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Medical and Biotech [MESH] Definitions

Enamel Organ

Epithelial cells surrounding the dental papilla and differentiated into three layers: the inner enamel epithelium, consisting of ameloblasts which eventually form the enamel, and the enamel pulp and external enamel epithelium, both of which atrophy and disappear before and upon eruption of the tooth, respectively.

Hip Contracture

Permanent fixation of the hip in primary positions, with limited passive or active motion at the hip joint. Locomotion is difficult and pain is sometimes present when the hip is in motion. It may be caused by trauma, infection, or poliomyelitis. (From Current Medical Information & Technology, 5th ed)

Enamel Microabrasion

Mechanical removal of a small amount of tooth structure (not more than a few tenths of a millimeter in depth) to eliminate superficial enamel discoloration defects not successfully removed by bleaching techniques. A common abrasive is a mixture of pumice and hydrochloric acid.

Dental Enamel Hypoplasia

An acquired or hereditary condition due to deficiency in the formation of tooth enamel (AMELOGENESIS). It is usually characterized by defective, thin, or malformed DENTAL ENAMEL. Risk factors for enamel hypoplasia include gene mutations, nutritional deficiencies, diseases, and environmental factors.

Amelogenesis

The elaboration of dental enamel by ameloblasts, beginning with its participation in the formation of the dentino-enamel junction to the production of the matrix for the enamel prisms and interprismatic substance. (Jablonski, Dictionary of Dentistry, 1992)

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