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A study of the development of the permanent dentition in very low birthweight children
1Department of Dentistry, University of Queensland, Brisbane, Australia.
Insights
Very low birthweight (VLBW) children show delayed dental maturation and increased enamel defects. Catch-up growth occurs by age 9, but early VLBW infants experience the most significant delays.
Area of Science:
- Pediatric Dentistry
- Neonatology
- Developmental Biology
Background:
- Dental maturation and enamel development are critical indicators of child health.
- Premature birth and very low birthweight (VLBW) can impact numerous developmental processes.
- No prior studies have specifically examined dental maturation in VLBW Caucasian children.
Purpose of the Study:
- To investigate dental development and enamel defect prevalence in VLBW children.
- To compare dental maturity between VLBW and normal birthweight (NBW) children.
- To identify factors influencing dental maturation delays in VLBW infants.
Main Methods:
- A cohort of 55 VLBW children and 55 matched NBW controls were studied.
- Dental maturity was assessed using panoramic radiographs.
- Clinical examinations identified enamel defects in permanent teeth.
Main Results:
- VLBW children exhibited a significant delay in dental maturation (0.29 years) compared to NBW controls.
- Children younger than 6 years showed the most pronounced delay (0.31 years).
- VLBW children had a higher prevalence of enamel defects in permanent first molars (21% vs. 11%) and lateral incisors (12% vs. 0%).
Conclusions:
- VLBW children experience delayed dental maturation, with catch-up growth observed by age 9.
- Infants born with extremely low birthweight (<1000g) and prematurity (<30 weeks gestation) face the greatest dental maturation lags.
- Postnatal systemic derangements likely affect enamel formation in VLBW infants, leading to increased defects.
Abstract:
There have been no previous studies on dental maturation of prematurely born, very low birthweight (< 1500 g, VLBW) Caucasian children. This study investigated dental development and prevalence of enamel defects in a group of 55 VLBW children (mean age at dental examination 7.7 +/- 2.2 years, mean birthweight 1203 +/- 240 g, and mean gestational age 29.8 +/- 2.4 weeks) compared to 55 normal birthweight (NBW) children matched for race, sex, and age. Dental maturity was determined from panoramic radiographs. Overall, VLBW children experienced a delay in dental maturation of approximately 0.29 +/- 0.54 years compared with NBW children (P < 0.02). The VLBW children younger than 6 years of age showed the greatest delay of 0.31 +/- 0.68 years (P < 0.001). In contrast, children aged 9 years and older had no difference in their dental ages compared to controls (P > 0.01), showing that "catch-up" growth had occurred by age 9 years. Children of birthweight < 1000 g with gestational ages < 30 weeks showed the greatest lag period in dental maturation. Clinical examination also showed that VLBW children had a higher percentage of enamel defects in the permanent first molars (21% versus 11%, P < 0.02) and lateral incisors (12% versus 0%, P < 0.01). As the permanent teeth commence their mineralization of few mouths after premature birth, it is hypothesized that there is persistent systemic derangement sufficient to affect enamel formation postnatally for some time in VLBW children.