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ORIGINAL ARTICLE  
Year : 2014  |  Volume : 7  |  Issue : 1  |  Page : 34-40
 

Prevalence of dental attrition in in vitro fertilization children of West Bengal


Department of Pedodontics and Preventive Dentistry, Guru Nanak Institute of Dental Science and Research, Kolkata, West Bengal, India

Date of Submission16-Dec-2013
Date of Decision21-Jan-2014
Date of Acceptance30-Jan-2014
Date of Web Publication19-Apr-2014

Correspondence Address:
Sudipta Kar
21F, Charakdanga Road, Uttarpara, Hooghly - 712 258, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.130820

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   Abstract 

Context: Dental attrition is one of the problems affecting the tooth structure. It may affect both in vitro fertilization (IVF) and spontaneously conceived children. Aims: This study was aimed to evaluate and to compare the prevalence of dental attrition in deciduous dentition of IVF and spontaneously conceived children. Settings and Design: In a cross-sectional case control study dental attrition status of 3-5 years old children were assessed. The case group consisted of term, singleton babies who were the outcome of IVF in the studied area in 2009. Subjects and Methods: The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children who were also resident of the studied area. A sample of 153 IVF and 153 spontaneously conceived children was examined according to Hansson and Nilner classification. Statistical Analysis Used: Statistical analysis was carried out using Chi-square tests (χ2 ) or Z test. Results: No statistically significant difference found in studied (IVF children) and control group (spontaneously conceived children). Conclusions: IVF children are considered same as spontaneously conceived children when studied in relation to dental attrition status.


Keywords: Deciduous dentition, dental attrition, in vitro fertilization children, prevalence


How to cite this article:
Kar S, Sarkar S, Mukherjee A. Prevalence of dental attrition in in vitro fertilization children of West Bengal. J Hum Reprod Sci 2014;7:34-40

How to cite this URL:
Kar S, Sarkar S, Mukherjee A. Prevalence of dental attrition in in vitro fertilization children of West Bengal. J Hum Reprod Sci [serial online] 2014 [cited 2020 Jul 13];7:34-40. Available from: http://www.jhrsonline.org/text.asp?2014/7/1/34/130820



   Introduction Top


The history of in vitro fertilization (IVF) and embryo transfer dates back as early as the 1890s when Walter Heape, a professor and physician at the University of Cambridge, England, who had been conducting research on reproduction in a number of animal species, reported the first known case of embryo transplantation in rabbits.

The first ever IVF birth occurred in Oldham, England on July 25, 1978. This birth was the result of the collaborative work of Dr. Patrick Steptoe and Dr. Robert Edwards. [1] On 3 rd October the birth of world's 2 nd test tube baby named Durga was born as a result of team work done by Dr. Subhas Mukherjee and Dr. Saroj Bhattacharya [2] in Kolkata, West Bengal.

Dental attrition is the loss of tooth structure by mechanical forces from opposing teeth. Attrition initially affects the enamel and may proceed to the underlying dentin also. As dentin is softer in consistency attrition quickly affects the underlying dentin. Attrition usually starts on the incisal or occlusal surfaces. Salient characteristic feature of dental attrition is the development of a facet - flat surface with circumscribed and well-defined border. Facets of the opposing tooth will match perfectly in occlusion.

Since, there has been no study on attrition status of the deciduous dentition in IVF children of the studied area it was decided to conduct a cross-sectional study in that area to investigate the prevalence and severity of incisal and occlusal tooth wear among IVF children of the studied area, in order to evaluate the changes in the oral health due to IVF and compare the data with spontaneously conceived children of the same age group to provide a baseline data aids for future studies.


   Materials and Methods Top


This was a descriptive, analytic, cross sectional study approved by the Ethical Committee of Guru Nanak Institute of Dental Science and Research. Dental attrition status of 3-5 years old children were evaluated. The children in both case and control groups based on the route of pregnancy were enrolled for the entire course of study. The case group consisted of term (gestational age = 37-42 weeks), singleton babies whom were outcomes of IVF of the studied area and were chosen by a computer generated random number list. The control group consisted of term, first child, singleton and spontaneously conceived 3-5 years old children whom were referred to the department of pedodontics and preventive dentistry for the primary dental health check-up. Case and control matched for the year of birth, area of residence, parity, gestational age, maternal weight, maternal age and socio-economic status. Neonatal medical records of the case and control groups were reviewed and variables such sex, gestational age, birth weight and length, route of delivery, maternal age and parity were recorded. Multiple pregnancies, severe asphyxia, children with major congenital malformations, chromosomal abnormalities genetic syndromes and children with heavily caries teeth were excluded from the sample. To obviate error due to inter observer variations all measurements were made by a trained single examiner who was not informed about the birth status of the children.

The study was conducted after informed consent was obtained from the concerned authorities and guardians of children. A total of 734 parents of studied samples were approached to participate in the present study. Out of the above total sample, the parents of 153 IVF and 153 spontaneously agreed to participate in the present study. After informed consents were collected from the parents, all children were examined for dental attrition using a sterile mouth mirror and probe under adequate illumination. The severity of attrition was determined according to Hansson and Nilner [3] and Nilner and Lassing classification: [4]

  • 0 = No wear
  • 1 = wear of enamel only
  • 2 = one or more teeth worn into dentine
  • 3 = one or more teeth worn up to 1/3 of the crown
  • 4 = extensive wear of one or more teeth more than 1/3 of the crown.


Prior to starting the procedure, the armamentarium was sterilized with the help of autoclaving unit. Obtained data was statically analyzed. For comparison of proportions Z test was used.


   Results Top


Totally 153 IVF children and 153 spontaneously conceived children were studied. Among 153 IVF children 81 (52.94%) were male and 72 (47.05%) were female. Among spontaneously conceived children 85 (55.55%) were male and 68 (44.44%) were female [Table 1]. IVF children and spontaneously conceived children were again divided into three sub groups of 3 years, 4 years and 5 years. In each subgroup 51 children were selected for the study [Table 2] and [Table 3].
Table 1 : Sex-wise distribution of in vitro fertilization children and spontaneously conceived children

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Table 2: Distribution of in vitro fertilization children according to age and sex

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Table 3: Distribution of spontaneously conceived children according to age and sex

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When comparing [Table 4] and [Table 5], Score 0 - The Z-Score is − 0.1189. The P = 0.90448. The result is not significant at P < 0.05. Score 1 - The Z-Score is 0.1148. The P = 0.9124. The result is not significant at P < 0.05. Score 2 - The Z-Score is 0. The P = 1. The result is not significant at P < 0.05. Score 3 - The Z-Score is 0.2496. The P = 0.80258. The result is not significant at P < 0.05. Score 4 - The Z-Score is − 0.3071. The P = 0.75656. The result is not significant at P < 0.05.
Table 4: Distribution of attrition of maxillary incisors of in vitro fertilization children of West Bengal

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Table 5: Distribution of attrition of maxillary incisors of spontaneously conceived children of West Bengal

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When comparing [Table 6] and [Table 7], Score 0 - The Z-Score is −0.8323. The P = 0.40654. The result is not significant at P < 0.05. Score 1 - The Z-Score is 0.1147. The P = 0.9124. The result is not significant at P < 0.05. Score 2 - The Z-Score is 1.0435. The P = 0.29834. The result is not significant at P < 0.05. Score 3 - The Z-Score is 0.2369. The P = 0.81034. The result is not significant at P < 0.05. Score 4 - The Z-Score is 0. The P = 1. The result is not significant at P < 0.05.
Table 6: Distribution of attrition of mandibular incisors in vitro fertilization children of West Bengal

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Table 7: Distribution of attrition of mandibular incisors of spontaneously conceived children of West Bengal

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When comparing [Table 8] and [Table 9], Score 0 - The Z-Score is −0.851. The P = 0.39532. The result is not significant at P < 0.05. Score 1 - The Z-Score is − 0.2293. The P = 0.8181. The result is not significant at P < 0.05. Score 2 - The Z-Score is 1.4577. The P = 0.1443. The result is not significant at P < 0.05. Score 3 - The Z-Score is 0.5472. The P = 0.58232. The result is not significant at P < 0.05. Score 4 - The Z-Score is 0.3383. The P = 0.72786. The result is not significant at P < 0.05.
Table 8: Distribution of attrition of maxillary canine in vitro fertilization children of West Bengal

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Table 9: Distribution of attrition of maxillary canine of spontaneously conceived children of West Bengal

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When comparing [Table 10] and [Table 11], Score 0 - The Z-Score is − 0.4713. The P = 0.63836. The result is not significant at P < 0.05. Score 1 - The Z-Score is 0.1153. The P = 0.90448. The result is not significant at P < 0.05. Score 2 - The Z-Score is 0.2834. The P = 0.77948. The result is not significant at P < 0.05. Score 3 - The Z-Score is 0.5802. The P = 0.56192. The result is not significant at P < 0.05. Score 4 - The Z-Score is 1.0016. The P = 0.31732. The result is not significant at P < 0.05.
Table 10: Distribution of attrition of mandibular canine in vitro fertilization children of West Bengal

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Table 11: Distribution of attrition of mandibular canine of spontaneously conceived children of West Bengal

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When comparing [Table 12] and [Table 13], Score 0 - The Z-Score is −0.2261. The P = 0.8181. The result is not significant at P < 0.05. Score 1 - The Z-Score is 0.4859. The P = 0.62414. The result is not significant at P < 0.05. Score 2 - The Z-Score is −0.5802. The P = 0.56192. The result is not significant at P < 0.05. Score 3 and 4 - The Z-Score is NaN. The P = 0.
Table 12: Distribution of attrition of maxillary molars in vitro fertilization children of West Bengal

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Table 13: Distribution of attrition of the maxillary molar of spontaneously conceived children of West Bengal

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When comparing [Table 14] and [Table 15], Score 0 - The Z-Score is 0.8505. The P = 0.39532. The result is not significant at P < 0.05. Score 1 - The Z-Score is − 0.9252. The P = 0.35238. The result is not significant at P < 0.05. Score 2 - The Z-Score is 0. The P = 1. The result is not significant at P < 0.05. Score 3 and 4 - The Z-Score is NaN. The P = 0.
Table 14: Distribution of attrition of mandibular molars in vitro fertilization children of West Bengal

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Table 15: Distribution of attrition of mandibular molar of spontaneously conceived children of West Bengal

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   Discussion Top


Tooth attrition is defined as gradual and regular loss of tooth substance as a result of natural mastication. [5] Incisal and occlusal tooth wear have been studied in several epidemiologic and clinical investigations. Many factors may cause dental attrition such as masticatory habit and parafunctions. [6],[7] Dietary factors, [8] digestive disturbance and industrial environmental factors, [9] are also responsible for tooth wear. The composition of saliva may also be an important factor. [10] Researchers expressed that the higher prevalence of incisal or occlusal wear of any degree on the primary teeth observed in the 5-year-olds compared with the 3-year-old is probably related to the longer exposure time for tooth wear. [11]

Some researchers studied tooth wear on primary teeth and on the first permanent molars in primitive and urbanized Greenland natives. They found that the degree of incisal or occlusal wear decreased with increasing urbanization. When comparing-incisal wear decreased with increasing urbanization. [12] When comparing - incisal or occlusal wear of deciduous teeth in skeletal material of children, less severe tooth wear in Scottish medieval children than in a contemporary group of English children. [13]

Teeth wear patterns reported in deciduous dentition in Belgian children was 41% in the incisors and 21% in the molars. [14] In our study, 55 IVF children and 56 spontaneously conceived children had no attrition of the maxillary incisors. The percentage total is 35.94 and 36.60. There is a no significant proportion found between IVF children spontaneously conceived children in and respect to all subgroups.

Teeth wear pattern in American children was documented as 83.4%. Attrition in maxillary teeth was higher. Regarding maxillary incisors it was found that 35.94% IVF children and 36.60% spontaneously conceived children had Score 0, 45.75% and 45.09% had Score 1, 9.15% and 9.15% had Score 2 and only 5.88% and 5.22% had Score 3, 3.26% and 3.92% had Score 4. Regarding mandibular incisors it was found that 33.94% IVF children and 38.56% spontaneously conceived children had Score 0, 46.40% and 45.75% had Score 1, 9.80% and 6.53% had Score 2 and only 6.53% and 5.88% had Score 3, 3.26% had Score 4. In North American children, [14] in Swedish population [11] and in Cambridge preschool children [15] found near similar result. No previous study was found involving IVF children in this field. Hence, no comparison was possible with the previous study. More studies are required in this arena.

Coming on to, maxillary canines, it was found that 30.71% IVF children and 35.29% spontaneously conceived children had Score 0, 52.94% and 54.24% had Score 1, 7.84% and 3.92% had Score 2 and only 5.22% and 3.92% had Score 3, 3.26% and 2.61 had Score 4. No previous study was found involving IVF children in this field. So no comparison was possible with the previous study.

Coming on to, mandibular canines, it was found that 36.60% IVF children and 39.21% spontaneously conceived children had Score 0, 56.86% and 56.20% had Score 0, 4.57% and 3.92% had Score 2 and only 1.30% and 0.65% had Score 3, 0.65% and 0 had Score 4. No previous study was found involving IVF children in this field. So no comparison was possible with the previous study.

In a study on Israeli preschool children canine attrition was highly associated with straight terminal pattern molar relation. [16] Coming on to, maxillary molars it was found that 92.81% IVF children and 93.46% spontaneously conceived children had Score 0, 6.53% and 5.22% had Score 1, 0.65% and 1.30% had Score 2 and no cases had Score 3 and Score 4. No previous study was found involving IVF children in this field. So no comparison was possible with the previous study.

Coming on to, mandibular molars it was found that 93.46% IVF children and 90.84% spontaneously conceived children had Score 0, 5.22% and 7.84% had Score 1, 1.30% and 1.30% had Score 2 and no cases had Score 3 and Score 4. No previous study was found involving IVF children in this field. So no comparison was possible with the previous study.

No forward movement or physiological shift of the mandibular arch occurs during the functional period of deciduous dentition between 3 and 6 years. Researchers expressed attrition is an environmental process and not a physiological phenomenon. [17] Hence, one researcher considered forward movement of all the mandibular deciduous teeth in relation to maxillae is necessary for establishment correct jaw relation. He considered the attrition of canine cusp to be important for forward growth of the mandible. Thus, attrition was considered an essentially normal feature in the primary dentition. [18] A clear relationship was found between tooth wear in children and the consumption of fruit-based drinks, especially at bedtime. [19] So proper dietary advice may be needed.


   Conclusion Top


In this study IVF children expressing similar kind of dental attrition pattern as like spontaneously conceived children. This study invites further scope for cross sectional and longitudinal study for the researcher. Hopefully this kind of study will bring positive assurance to numerous parents of IVF children.

 
   References Top

1.Steptoe PC, Edwards RG. Birth after the reimplantation of a human embryo. Lancet 1978;2:366.  Back to cited text no. 1
    
2.Chakraborty BN. Test Tube Baby Procedures Miracles, Mysteries and Miseries. 1 st ed. Kolkata: The Standard Literature Company Pvt. Ltd; 2005. p. 1-3.  Back to cited text no. 2
    
3.Hansson T, Nilner M. A study of the occurrence of symptons of disease of the temporomandibular joint masticatory musculature and related structures. J Oral Rehabil 1975;2:313-24.  Back to cited text no. 3
    
4.Nilner M, Lassing SA. Prevalence of functional disturbances and diseases of the stomatognathic system in 7-14 year olds. Swed Dent J 1981;5:173-87.  Back to cited text no. 4
    
5.Pindborg JJ. Pathology of the Dental Hard Tissues. Philadelphia, Pa, USA: WB Saunders; 1970.  Back to cited text no. 5
    
6.Russell MD. The masticatory cycle in relation to occlusal wear and its treatment. J Dent 1982;10:69-77.  Back to cited text no. 6
    
7.Jemt T. Masticatorymandibular movements. Swed Dent J 1984;23 Suppl: 36.  Back to cited text no. 7
    
8.Linkosalo E, Markkanen H. Dental erosions in relation to lactovegetarian diet. Scand J Dent Res 1985;93:436-41.  Back to cited text no. 8
    
9.Enbom L, Magnusson T, Wall G. Occlusal wear in miners. Swed Dent J 1986;10:165-70.  Back to cited text no. 9
    
10.Carlsson GE, Johansson A, Lundqvist S. Occlusal wear. A follow-up study of 18 subjects with extensively worn dentitions. Acta Odontol Scand 1985;43:83-90.  Back to cited text no. 10
    
11.Hugoson A, Ekfeldt A, Koch G, Hallonsten AL. Incisal and occlusal tooth wear in children and adolescents in a Swedish population. Acta Odontol Scand 1996;54:263-70.  Back to cited text no. 11
    
12.Davies TG, Pedersen PO. The degree of attrition of the deciduous teeth and first permanent molars of primitive and urbanized Greenland natives. Br Dent J 1955;19:35-43.  Back to cited text no. 12
    
13.Lunt DA. The dentition in a group of mediaeval Scottish children. Br Dent J 1972;132:443-6.  Back to cited text no. 13
    
14.Warren JJ, Yonezu T, Bishara SE. Tooth wear patterns in the deciduous dentition. Am J Orthod Dentofacial Orthop 2002;122:614-8.  Back to cited text no. 14
    
15.Bernal M, Tsamtsouris A. Signs and symptoms of temporomandibular joint dysfunction in 3 to 5 year old children. J Pedod 1986;10:127-40.  Back to cited text no. 15
    
16.Kaufman A, Koyoumdjisky E. Normal occlusal patterns in the deciduous dentition in preschool children in Israel. J Dent Res 1967;46:478-82.  Back to cited text no. 16
    
17.Baume LJ. Physiological tooth migration and its significance for the development of occlusion. I. The biogenetic course of the deciduous dentition. J Dent Res 1950;29:123-32.  Back to cited text no. 17
    
18.Friel S. The development of ideal occlusion of the gum pads and the teeth. Am J Ophthalmol 1954;40:196-27.  Back to cited text no. 18
    
19.Millward A, Shaw L, Smith AJ, Rippin JW, Harrington E. The distribution and severity of tooth wear and the relationship between erosion and dietary constituents in a group of children. Int J Paediatr Dent 1994;4:151-7.  Back to cited text no. 19
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13], [Table 14], [Table 15]



 

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