早産低体重児における乳歯の低灰化とその大臼歯切歯低灰化との関連性-3年間の前向き研究

Hypomineralized Primary Teeth in Preterm Low Birth Weight Children and Its Association with Molar Incisor Hypomineralization-A 3-Year-Prospective Study.

抄録

本研究は，早産低体重児（PT-LBW）の乳歯列におけるエナメル質の低石灰化（EH）の有病率と，同コホートにおける臼歯切歯の低石灰化（MIH）の発生率を評価し，PT-LBW，第二大臼歯の低石灰化，およびMIHの関連性を明らかにすることを目的とした。PT-LBWの研究対象者287名と対照の正常出生体重の正期産の被験者290名を対象に，36ヵ月間の追跡調査を行った。エナメル質の欠陥はベースラインで記録された。同じコホートで，3年後にEuropean Academy of Paediatric Dentistry（EAPD）の基準を用いてMIHの検査を行った。多変数ロジスティック回帰モデルを作成した。合計279名（48.4％）の小児が乳歯列期にEHを呈し，207名（35.9％）の小児がMIHを呈した。第二大臼歯が低石灰化していた小児は，MIHの頻度が2.13（R = 0.19, 95% CI = 0.98-4.19, = 0.005）倍であった．PT-LBWの子供は，小児感染症，出生前歴，第二大臼歯の低石灰化の有無を調整した後，MIHの発生頻度が3.02倍（R = 0.31，95％CI = 1.01-5.94，= 0.005）高かった。結論として，本研究では，PT-LVW，第二小臼歯の低石灰化，およびMIHの発生率に有意な関連性が認められた。

The present prospective study was conducted to assess the prevalence of enamel hypomineralization (EH) in primary dentition among preterm low birth weight (PT-LBW) children, incidence of molar incisor hypomineralization (MIH) in the same cohorts, and to determine associations between PT-LBW, hypomineralization in primary second molars, and MIH. A total of 287 PTLBW study subjects and 290 control full-term normal birth weight subjects were followed up for 36 months. Enamel defects were recorded at baseline. The same cohorts were examined after 3 years for MIH using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple variable logistic regression models were developed. A total of 279 children (48.4%) presented with EH in primary dentition and 207 (35.9%) children presented with MIH. Children with primary second molar hypomineralization had 2.13 (R = 0.19, 95% CI = 0.98-4.19, = 0.005) times higher frequency of MIH. Children with PT-LBW had 3.02 times (R = 0.31, 95% CI = 1.01-5.94, = 0.005) higher frequency of MIH incidence after adjusting for childhood infection, prenatal history, and presence of hypomineralized primary second molars. To conclude, the present study showed significant association between PT-LBW, hypomineralized second primary molars, and incidence of MIH.