05), it is to be mentioned that children NVP-BEZ235 purchase with MIH had higher percentages of mothers with allergies during pregnancy, of pre-term birth and of food intolerances, upper respiratory tract infections, allergies

and antibiotic treatment during the child’s first 3–4 years of life. This cross-sectional study shows that MIH is a relatively frequent syndrome among Spanish schoolchildren. Methodologically, the size of the sample gives this study sufficient statistical power, and its cluster randomization ensures that it is appropriate to generalize the inferences from the results to the population. Along with sample representativeness, uniform diagnosis criteria and calibration of the examiners are other factors, and it is essential to discuss if the true extent of MIH in different countries is to be known. The wide range of prevalence rates obtained PLX4032 mw in the published studies

could be related to the different diagnostic criteria employed. The present study used the MIH diagnosis criteria established by EAPD in 2003, but a specific code was used to register teeth with caries lesions with demarcated opacities at the border of the cavity, which had proven to be very useful during calibration sessions, to distinguish caries from cavities not related to caries. The explorer was calibrated with an array of photographs that included numerous clinical images, with particular emphasis on the differences between opacities, hypoplasias, inherited defects and fluorosis stains, and a very high diagnostic agreement percentage was achieved. A number of authors[3, 12, 25-27] have confirmed that calibration using clinical photographs appears

to be suitable for detecting visible alterations, such as MIH, but few information exists about the way it was performed[28, 29]. The present study found 21.8% MIH prevalence, similar to the levels obtained in European countries such as Finland, where the earliest of these studies were conducted: Alaluusua et al.[5] and Leppäniemi et al.[20] found rates of up to 25% and 19.3%, respectively, although they did not use the EAPD diagnostic criteria[11]. Two previous studies from Spain[2, 3] have reported lower prevalences 12.4% and 17.8%, respectively. Sample size and age range differences, as well as retrospective nature involving evaluation of dental records may have result Gemcitabine purchase in underestimation of prevalence in the study from Comes et al.[2] Moreover, the study conducted by Martínez Gómez et al.[3] in Barcelona was carried out in dental chair with better clinical conditions, but considered to carry a crown as exclusion criteria, which could result in loss of positive diagnosis in the elderly children in a population attending a institutional dental clinic. Research that has used the same method as the present study also shows similar MIH prevalence rates, such as da Costa-Silva et al.[30] in Brazil and Ghanim et al.[31] in Iraq, with 19.8% and 18.6%, respectively.