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Enamel Hypomineralization in Children With Clefts and the Relationship to Treatment: A Cross-sectional Retrospective Study

Allam, Eman, PhD*†; Ghoneima, Ahmed, PhD*‡; Tholpady, Sunil S., MD§; Kula, Katherine, MS*

doi: 10.1097/SAP.0000000000001538
Head and Neck Surgery

Objective The aim of this study was to determine whether molar incisor hypomineralization (MIH) is greater in patients with cleft lip and palate (CLP) who underwent primary alveolar grafting (PAG) as compared with CLP waiting for secondary alveolar grafting (SAG) and with controls.

Design A retrospective analysis of intraoral photographs of 13 CLP patients who underwent a PAG, 28 CLP prior to SAG, and 60 controls without CLP was performed. Mantel-Haenszel χ2 tests were used to compare the 3 groups for differences in MIH scores, and Wilcoxon rank sum tests were used to compare the groups for differences in average MIH scores. A 5% significance level was used for all tests.

Results Molar incisor hypomineralization scores were significantly higher for the PAG and SAG groups compared with the control group (P < 0.001). The PAG group had significantly higher incisor MIH (P = 0.016) compared with the SAG group. Molar incisor hypomineralization average scores were significantly higher for the 2 graft groups compared with the controls (P < 0.0001). The PAG group had significantly higher average MIH score and average MIH score for incisors compared with the SAG group (P = 0.03).

Conclusions Cleft lip and palate patients have significantly greater MIH compared with controls, and CLP patients with PAGs have significantly greater MIH in the incisor region compared with CLP patients with SAGs, indicating that subjects with PAGs have more severely affected dentition.

From the *Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN;

Oral and Dental Research Division, National Research Centre, Cairo, Egypt;

Hamdan Bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates; and

§Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.

Received March 9, 2018, and accepted for publication, after revision April 29, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Katherine Kula, MS, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, 1121 W Michigan St, Indianapolis, IN 46202. E-mail: kkula@iu.edu.

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