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Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists

Alkadhimi, A; Cunningham, SJ; Parekh, S; Noar, JH; Travess, HC; (2021) Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists. Journal of Orthodontics 10.1177/14653125211041126. (In press). Green open access

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Abstract

OBJECTIVES: To obtain the views and opinions of specialist members of the British Orthodontic Society (BOS) and British Society of Paediatric Dentistry (BSPD) in relation to (1) the multidisciplinary management of patients affected by molar incisor hypomineralisation (MIH) and (2) the diagnosis and management of MIH-affected first permanent molars (FPMs) in four clinical scenarios, and compare the responses to those of an expert panel consensus. DESIGN: A prospective cross-sectional study. SETTING: Part 1: Eastman Dental Institute and part 2: online questionnaire. METHODS: Four clinical scenarios showing patients with differing severities of MIH affected FPMs were considered by a panel of orthodontists and paediatric dentists to agree on the severity of MIH and management. A 21-item online questionnaire sent to both specialist groups, after pilot study. The questionnaire covered demographics, access to multidisciplinary clinics, clinicians' opinions on various management aspects, and questions relating to the management of the same 4 clinical scenarios. RESULTS: The overall response was 21.9% (20% of the orthodontists and 45% of the paediatric dentists). Approximately half of the respondents from both groups felt that these patients should be managed through a multidisciplinary treatment type clinic (49.0% of the orthodontists and 47.2% of the paediatric dentists). Only 40.3% of the orthodontists and 35.0% of the paediatric dentists agreed completely with the panel consensus on all management options. When assessing overall agreement on all four FPMs for all scenarios, agreement was predicted by severity of MIH (P<0.001) and complexity of malocclusion (P<0.001) where more complex malocclusions and more severe MIH resulted in poorer agreement, but specialty was not a significant predictor (P=0.21). CONCLUSION: The majority of the respondents from both groups, felt that managing patients with MIH affected FPMs is challenging. Approximately half of the orthodontists and the paediatric dentists, felt that MIH affected patients should be managed through a multidisciplinary type clinic. Managing more severe cases on multidisciplinary clinics is indicated, to incorporate specialist input into decision making.

Type: Article
Title: Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/14653125211041126
Publisher version: https://doi.org/10.1177/14653125211041126
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: aetiology of malocclusion and growth, consensus, interdisciplinary treatment, occlusal development, questionnaire
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > EDI Craniofacial and Development Sci
URI: https://discovery.ucl.ac.uk/id/eprint/10136895
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