Abstract
Molar incisor hypomineralization (MIH) affects the permanent incisors and molars, whose undermineralized matrix is evidenced by lesions ranging from white to yellow/brown opacities to crumbling enamel lesions incapable of withstanding normal occlusal forces and function. Diagnosing the condition involves clinical and radiographic examination of these teeth, with known limitations in determining the depth extent of the enamel defects in particular. Optical coherence tomography (OCT) is an emerging hard and soft tissue imaging technique, which was investigated as a new potential diagnostic method in dentistry. A comparison between the diagnostic potential of the conventional methods and OCT was conducted. Compared to conventional imaging methods, OCT gave more information on the structure of the enamel defects as well as the depth extent of the defects into the enamel structure. Different types of enamel defects were compared, each type presenting a unique identifiable pattern when imaged using OCT. Additionally, advanced methods of OCT image analysis including backscattered light intensity profile analysis and enface reconstruction were performed. Both methods confirmed the potential of OCT in enamel defects diagnosis. In conclusion, OCT imaging enabled the identification of the type of enamel defect and the determination of the extent of the enamel defects in MIH with the advantage of being a radiation free diagnostic technique.
Highlights
Molar incisor hypomineralization (MIH) is defined as “hypomineralization of systemic origin affecting at least one first permanent molar (FPM), which is frequently associated with affected incisors.”[1]. The prevalence of MIH was reported to range from 2.8% to 25% in pediatric patients.[2]
The main diagnostic method for MIH is clinical visual examination of the teeth. This can be performed with the aid of indices used to describe enamel defects, such as the modified developmental defects of enamel index[11] or the European Association of Pediatric Dentistry (EAPD) MIH index, the latter requiring the examination of 12 permanent teeth (8 permanent incisors and 4 FPMs) at the age of eight.[4]
There are no means to evaluate whether the MIH lesion is affecting the entire enamel thickness or whether the lesion is affected subsurface by cracks, which may lead to posteruptive breakdown (PEB)
Summary
Molar incisor hypomineralization (MIH) is defined as “hypomineralization of systemic origin affecting at least one first permanent molar (FPM), which is frequently associated with affected incisors.”[1]. The main diagnostic method for MIH is clinical visual examination of the teeth This can be performed with the aid of indices used to describe enamel defects, such as the modified developmental defects of enamel index (mDDE index)[11] or the European Association of Pediatric Dentistry (EAPD) MIH index, the latter requiring the examination of 12 permanent teeth (8 permanent incisors and 4 FPMs) at the age of eight.[4] Diagnosis at an early stage is key in the Journal of Biomedical Optics. The determination of the extent of an MIH lesion into the enamel depths is crucial to determine the prognosis and treatment plan for affected teeth This can be difficult to evaluate accurately solely from clinical examination, and as the lesions are superimposed on the bulk of the tooth structure.
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