Molar-Incisor Hypomineralization in Schoolchildren of Manaus, Brazil

Sa Hanan,Acc Zuanon,L Santos-Pinto,Po Medina,Ao Alves Filho,Rcl Cordeiro

doi:10.4034/pboci.2015.151.33

Abstract

Objective: To analyze the prevalence and severity of Molar Incisor Hypomineralization (MIH) and its relationship with dental caries in public school children in Manaus/AM. Material and Methods: Overall, 2,062 primary school children aged 6-10 years were examined to obtain MIH, DMFT, dmft and DDE indexes. The participation of five schools in each district of the city of Manaus was randomly determined, totaling 40 schools, and in each of them, two classes of each grade of elementary school in two shifts were selected, totaling 10 classes. Clinical examinations were conducted by two previously calibrated examiners in school environment under natural lighting. Data collected were submitted to descriptive statistical analysis by Chi-square, Fisher's Exact and Mann-Whitney tests at 5% significance level. Results: The prevalence of MIH in Manaus was 9.12% and no significant association with gender and age of schoolchildren was found. The mandibular arch was the most affected, with greater number of teeth being affected on the left side. The most frequently affected teeth were the mandibular permanent first molars, followed by maxillary counterparts and maxillary/mandibular central incisors. The most frequent diagnosis was mild MIH. The DMFT of children with MIH was 1.58 and dmft was 2.47, higher than those of the unaffected group. A correlation was found between DDE and MIH. Conclusion: Early diagnosis of MIH is imperative, since children affected show high risk for the development of dental caries.

Highlights

Despite having been identified clinically in Sweden in the late 1970s [1], the expression of molar-incisor hypomineralization (MIH) was first suggested in 2001 to describe a qualitative alteration of enamel of systemic origin that affects 1 to 4 permanent first molars, frequently affecting permanent incisors [2].Clinically, it is characterized by demarcated white, cream, yellow or brown opacities, smooth surface, and normal enamel thickness and, in the most severe cases, the hypomineralized enamel may become porous and break shortly after eruption, mainly under the influence of masticatory forces, leaving dentin unprotected [3]
The parents and/or guardians of children were informed about the purpose of the study and methodology, and signed the informed consent form (ICF), authorizing their children to participate in the study
The reason for the exclusion of 738 children was one of the following: not returning the signed informed consent form (n = 309); presence of syndromes associated with tooth enamel malformation (n = 12); amelogenesis imperfecta (n = 3); absence of at least one permanent molar erupted in the oral cavity (n = 176); use of fixed appliances (n = 6); refusal to be examined due to dental fear (n = 7); missing on the day of examination (n = 225)

Summary

Introduction

Despite having been identified clinically in Sweden in the late 1970s [1], the expression of molar-incisor hypomineralization (MIH) was first suggested in 2001 to describe a qualitative alteration of enamel of systemic origin that affects 1 to 4 permanent first molars, frequently affecting permanent incisors [2]. It is characterized by demarcated white, cream, yellow or brown opacities, smooth surface, and normal enamel thickness and, in the most severe cases, the hypomineralized enamel may become porous and break shortly after eruption, mainly under the influence of masticatory forces, leaving dentin unprotected [3]. It is not easy to restore a tooth affected by MIH and treatment is ten times longer than dental caries treatment [11,12]

Methods

Results

Conclusion