Amelogenesis imperfecta (AI) is a genetic disorder that presents as an abnormal formation of enamel. AI can have a range of inheritance patterns and the exact incidence is uncertain with estimates ranging from 1:700 to 1:12-14,000. Clinically, AI can be classified into four categories: hypoplastic (type I), hypomaturation (type II), hypocalcified (type III), and hypomature hypoplastic enamel with taurodontism (type IV).
The aim of this review was to compare the success rates of different restorative materials and techniques used for the restoration of anterior and posterior teeth with AI in terms of patient satisfaction (aesthetics and sensitivity) and function.
Searches were conducted in the Cochrane Oral Health Group’s Trials Register the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via EMBASE, CINAHL ,Abstracts of the Conference Proceedings of the International Association for Dental Research and reference lists of relevant articles. There were no language restrictions.
The plan was to include randomised controlled trials where children and adolescents with AI who required restoration of teeth were allocated to different restoration techniques. The outcomes patient satisfaction, aesthetics, masticatory function and longevity of restorations would have been evaluated.
- No studies met the inclusion criteria. One ongoing study was identified (ISRCTN70438627)
The authors concluded
We found no randomised controlled trials of restorative treatments for children and adolescents with AI, and therefore there is no evidence as to which is the best restoration. Well defined randomised controlled trials which recruit children and adolescents and focus on the type and severity of the disorder should be undertaken to determine the best intervention for restoring teeth affected by AI.
Comment
In the discussion the authors highlight that a number of studies and reviews have been published on molar-incisor hypomineralisation (MIH) and that MIH and AI present similar clinical management problems. They highlight the six-step management approach proposed for MIH (William 2006) and suggest that,
Well designed trials supported by laboratory studies should be undertaken to determine the clinical approach and set guidelines for treating AI.
Links
Dashash M, Yeung CA, Jamous I, Blinkhorn A. Interventions for the restorative care of amelogenesis imperfecta in children and adolescents. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD007157. DOI: 10.1002/14651858.CD007157.pub2.
William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006 May-Jun;28(3):224-32. Review. PubMed PMID: 16805354.
