Abstract
Hypocalcification of the enamel is the most common developmental disorder observed in teeth. The prevalence of this kind of hypomineralisation is about 10-19%. These molars are often referred to as cheese molars, because the lesions clinically resemble cheese in color and consistency. Other descriptions are: idiopathic enamel hypomineralisation in the permanent first molars, idiopathic enamel opacities in the permanent first molars, non fluoride enamel hypomineralisation in the permanent first molars, non-endemic mottling of enamel in the permanent first molars. Molar-Incisor Hypomineralisation is today the proposed expression for this disease. Occlusal surfaces of the first permanent molar are most commonly affected. The lesions are more frequent in the upper jaw than in the lower jaw. The incisors are affected to a lesser degree than the molars. Several aetiological factors can cause these defects. Some studies show a relation between intake of dioxins via mother's milk after prolonged breast feeding and developmental defects of the child's teeth. Because the ameloblasts are very sensitive to oxygen supply, complications involving oxygen shortages during birth or respiratory diseases such as asthma or bronchitis and pneumonia are discussed as further aetiological factors. Renal insufficiency, hypoparothyroidism, diarrhoea, malabsorption and malnutrition and high-fever diseases can be other reasons for the occurrence of these defects. Defective enamel can be a locus of lowered resistance for caries. Histologically there are areas of porosity of varying degrees. The affected teeth can be very sensitive to air, cold, warm and mechanical stimuli. Toothbrushing may create toothache in these teeth. We therefore suggest that these patients receive intensified prevention with fluoride varnish, a fissure sealing, GIZ, composits, stainless steel crowns or implants. In some cases an interdisciplinary approach with an orthodontist can result in the extraction of the molars in the age of 8 to 10 years.
Highlights
Dental development and mineralization in humans starts before birth and continues to adolescence when the permanent molars complete their mineralization
In all specimens a porous zone of hypomineralized enamel was seen, extending from the cuspal part down to the cervical third of the enamel
Teeth diagnosed with Molar Incisor Hypomineralization (MIH) have significantly lower hardness values (HV) in hypomineralized enamel as compared with normal enamel and display differences in chemical composition
Summary
Dental development and mineralization in humans starts before birth and continues to adolescence when the permanent molars complete their mineralization. The first sign of tooth mineralization is seen in the primary lower incisors in the beginning of the second trimester of pregnancy and is finished around three months post partum. The first permanent molar is the first tooth in the permanent dentition to mineralize, a process that starts around birth and is completed at approximately three years of age (Reid & Dean 2006). Enamel and dentin are formed by secretory cells and the enamel forming cells, the ameloblasts, are highly specialized cells of ectodermal origin (Simmer 2010; Mahoney 2011). After mineralization neither enamel nor dentin is remodeled. Due to the high proportion of mineral, only minor changes are found post-mortem in the teeth, even for many hundred years after burial
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
