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Teeth as Time-Resolved Perinatal Archives: An Integrated Protocol for Reconstructing Early-Life Exposures Associated
Marta Mazur1, Artnora Ndokaj2, Livia Ottolenghi2
1Interdisciplinary Department of Wellbeing, Health and Environmental Sustainability-BeSSA Department, Sapienza University, Rieti, Italy.
Introduction/Objectives:
Molar-incisor hypomineralization (MIH) is a highly prevalent developmental enamel defect with origins during perinatal life. Despite extensive research, its aetiology remains unclear, likely reflecting the interaction of multiple exposures during critical periods of enamel development. This study aims to establish an integrated exploratory framework for reconstructing biologically plausible early-life exposure profiles associated with MIH.
Methods:
An exploratory observational case-control study will enrol 400 children aged 9-12 years, including 200 with MIH and 200 unaffected controls. Maternal, environmental, lifestyle, and early-life child health data will be integrated with dental phenotyping. Exfoliated second primary molars will be collected and a subset of 150 teeth will undergo non-demineralised dental histology and spatially resolved laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). Histological analysis will reconstruct enamel growth dynamics, developmental chronology, and markers of stress, while LA-ICP-MS will generate temporally aligned trace-element profiles. Clinical, histological, and biogeochemical findings will be integrated to reconstruct early-life exposure profiles.
Expected Results:
The study is expected to generate individual dental biochronologies spanning late prenatal and early postnatal enamel formation, with the neonatal line marking the prenatal-postnatal transition. These chronologies will enable documented mother-child events and spatially resolved trace-element profiles to be aligned with enamel developmental time. Integration of clinical, microstructural, and biogeochemical data will investigate whether recurrent developmental patterns distinguish MIH from unaffected controls and vary according to MIH phenotype.
Conclusions:
This protocol provides an integrated methodological framework for investigating early-life exposure profiles associated with MIH by combining mother-child clinical information with time-resolved biological records preserved in second primary molars.
Clinical Significance:
Second primary molars may provide a unique time-resolved biological archive of prenatal and early postnatal development. By integrating dental histology, spatially resolved LA-ICP-MS, and clinical data from mother-child dyads, this study may improve reconstruction of early-life exposures associated with MIH and provide a methodological foundation for future prospective studies targeting the mother-child dyad.
