Molar Incisor Hypomineralization Research Articles

Oral health-related quality of life in Egyptian children with Molar Incisor Hypomineralisation. An observational study

AimThe aim of this study was to study the effect of Molar Incisor Hypomineralisation (MIH) on Oral Health-Related Quality of Life (OHRQoL) in children at the mixed dentition stage and correlate it with their caries experience.Subjects and methodsOne hundred two children aged from 8 to 10 years were recruited, 51 with MIH and 51 as control. Caries experience was recorded using DMFT/deft and ICDAS II. MIH-TNI index was used for classifying MIH severity. CPQ8–10 with its Arabic version was used to evaluate OHRQoL. Mann–Whitney U test and Kruskal–Wallis test were used for comparisons (p ≤ 0.05).ResultsThe mean value for CPQ8–10 in MIH group was 24.67 (±11.84; median 23; range 6–55) in comparison to 21.04 (±12.3; median 18; range 2–54) for the control group, with no significant difference between groups (p = 0.109). A significantly higher value (p = 0.011) was recorded in patients with MIH-TNI 4 mean 32.16 (±13.9; median 35; range from 7 to 55) in comparison to other categories of MIH.ConclusionChildren with and without MIH, with similar caries experience showed no difference in OHRQoL. However, the presence of the severe form of MIH including hypersensitivity and enamel disintegration negatively impacted those children’s OHRQoL.

Non-Invasive Strategies for Remineralization and Hypersensitivity Management in Molar–Incisor Hypomineralization—A Systematic Review and Meta-Analysis

Background: Molar–incisor hypomineralization (MIH) is an enamel defect affecting molars and incisors, often leading to hypersensitivity, enamel breakdown, and increased caries risk. Non-invasive treatments, such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and fluoride varnish, show potential in remineralizing affected enamel and reducing sensitivity, but their efficacy is still debated. This study systematically reviews and analyzes the effectiveness of CPP-ACP and other non-invasive agents in improving remineralization and reducing hypersensitivity in MIH-affected teeth. Methods: A systematic search was conducted on PubMed, Embase, and Central in July 2024, including interventional and observational studies on remineralization and hypersensitivity in pediatric MIH patients (<18 years). A total of 1566 studies were found, with 15 included in the meta-analysis. A random-effects model was applied, including subgroup analysis by lesion severity. Results: CPP-ACP showed no statistically significant advantage over fluoride in remineralization (MD −3.80, 95% CI: −8.57; 0.98), but it significantly reduced hypersensitivity compared to fluoride varnish (MD −2.36, 95% CI: −3.83; −0.89). Although this reduction in hypersensitivity may be clinically relevant, the high heterogeneity (I² = 83%) and wide confidence intervals limit the reliability of these findings. Conclusions: CPP-ACP has a moderate effect in reducing hypersensitivity but does not outperform fluoride in remineralization. Other agents, such as calcium glycerophosphate and silver diamine fluoride, showed mild benefits. The current evidence base is limited and heterogeneous, highlighting the need for high-quality, long-term studies to confirm these findings and guide MIH management.

Investigation of the Etiology of Molar Incisor Hypomineralization in Children Residing in Konya Province and Surrounding Areas, Türkiye.

According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to contribute to the literature by identifying possible etiological factors. This research was conducted with children aged 8-11 years old and their parents from Konya province and surrounding provinces. While children who were diagnosed with MIH as a result of the examination constituted the study group, children with no findings of MIH during intraoral examination were included in the control group. Between February and October 2020, 104 patients for the study group and 104 patients for the control group were reached, and a survey was administered to a total of 208 parents. Asthma, pneumonia, lower respiratory tract infections, diarrhea, a fever, and febrile convulsions between the ages of 0-4 have been found to be related to MIH (p < 0.05). The association between medical diseases in children and enamel defect formation draws attention to the importance of pediatricians in the early diagnosis of MIH cases. Pediatricians can be very helpful in informing parents of children with health problems about possible dental defects and referring them to a pediatric dentist.

Molar Incisor Hypomineralization: A Survey of Dental Students from Polish Medical Universities.

Molar incisor hypomineralization (MIH) is a congenital qualitative disorder of the enamel tissue. During examinations, clinicians may observe a range of enamel opacities during examinations. The aim of this study was to assess the knowledge and awareness of dental students in Poland regarding MIH. This study was conducted among dental students who participated in scientific conferences for dental students in Poland. An electronic questionnaire was created for this purpose, accessible via a QR code. The respondents consisted of dental students from the first to the fifth year of study, including 98 fourth-year students and 76 fifth-year students. The students represented 10 medical universities in Poland. Of the 341 respondents, 256 (75.07%) stated that they were familiar with the term MIH, but only 61 (17.89%) correctly indicated the diagnostic criteria of MIH. The most frequently indicated condition resembling MIH was enamel hypoplasia, with 158 (46.33%) respondents identifying it. Dental students at Polish medical universities have basic knowledge of MIH, but it is insufficient and needs to be improved during their educational training.

Long-term Survival Rate and Clinical Quality of Individually Layered Indirect Composite Restorations in Adolescents and Young Adults.

To evaluate the survival and clinical quality of individually layered indirect composite restorations (ICRs) in the mixed and permanent dentition at two study centers. A total of 155 adhesively cemented ICRs in 34 participants (aged 6 to 50 years and treated between 2008 and 2018) were evaluated for survival and clinical quality. All were individually layered restorations fabricated from laboratory sculptable composites by a specialized dental technician. Two calibrated independent investigators examined and graded each restoration as success, survival with repair, or failure based on the FDI criteria. The marginal quality and gap width of the restorations were analyzed by scanning electron microscopy. The periodontal health of treated teeth (TT) was evaluated in comparison with that of unrestored control teeth (CT) by measuring the pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), and the modified Turesky Plaque Index (TPI). A serial t-test (p 0.05) was used for statistical analysis of periodontal parameters. Success and functional survival rates were calculated using the Kaplan-Meier method. Molar incisor hypomineralization (MIH) was the most common indication for treatment (41%). The median age at treatment was 14.9 years (68%-CI: 7.7-29.5). The median service time of the restorations was 5.7 ± 3.4 years. 132 restorations were classified as a success, 21 as survival with repair, and 1 as a failure. The success rates at 1, 5, and 10 years were 95.4%, 87.4%, and 78.8%, respectively, and the corresponding functional survival rates were 100.0%, 98.9%, and 98.9%. The clinical quality, encompassing esthetic, functional, and biological criteria, was rated as excellent or good in over 90%. Periodontal response, however, was the only criterion showing worse results since restored teeth (TPI = 1.9) had significantly more plaque than CT (TPI = 1.7; p = 0.0001). No significant differences were observed in PD, CAL, or SBI. The mean marginal gap width was 135.7 µm and 63.8% of the restorations had perfect margins. ICRs are suitable for minimally invasive restoration of large tooth structure defects in the developing dentition of children and adolescents and for long-term temporary restoration of the adult dentition.

Unilateral molar Incisor hypomineralization influences the chewing side? an observational study in children.

The aim of this observational study was to compare the chewing patterns of children with unilateral Molar Incisor Hypomineralization (MIH) to those of children without MIH and to assess how the MIH severity influences the risk of chewing deviation. The hypothesis was that children with unilateral MIH would prefer to chew on the side opposite the defect. A total of 121 children were included in this investigation and evaluated for their preferred chewing side (PCS). This study population comprised 45 children with unilateral mild MIH (G1), 42 with unilateral severe MIH (G2), and 34 children in the control group (CG) who had no MIH but presented with unilateral chewing complaints. The PCS pattern differed among the groups, with 31% of the children with MIH and 55.9% of the CG showing bilateral chewing. The chewing deviation prevalence was 24% in the CG and 52% in G2 (χ2 test; p = 0.03). Binomial logistic regression analysis revealed that both severities of MIH influenced the likelihood of chewing deviation (χ2 = 7.33, p = 0.026). Children with unilateral severe MIH were 3.57 times more likely to exhibit chewing deviation than were those without MIH. The null hypothesis was rejected, indicating that unilateral MIH affects children's masticatory patterns, increasing the risk of chewing deviation. Unilateral chewing may be associated with various health issues, such as temporomandibular disorders (TMDs), decreased hearing, and vision problems. Unilateral MIH is a potential risk factor for unilateral chewing.

To Treat or to Extract Necrotic First Permanent Molars Between 8 and 12 Years of Age: A Retrospective Cohort Study.

Background: First permanent molars (FPM) are highly susceptible to decay before the age of 15. When they are severely affected, the decision between conservation and extraction arises, particularly considering the potential for the second permanent molar (SPM) to replace the FPM. This cohort study aimed to evaluate clinical practices regarding FPM pulp necrosis treatment in children aged eight to twelve in two hospital departments in the Paris region. A second objective was to evaluate the one-year outcomes of the two therapies. Methods: A retrospective analysis was conducted using computerized billing software to identify patients aged eight to twelve who underwent either extraction or root canal treatment (RCT). Data collected included sex, age, arch involved, number of decayed surfaces, presence of Molar Incisor Hypomineralization (MIH), presence of infection, and treatment type. Results: A total of 66 patients were included, representing 61 extracted teeth and 23 RCT. Three main decision criteria were identified: presence of MIH (p < 0.005), extent of decay (p < 0.05), and SPM Nolla's stage. A total of 48% of the patients were seen at one year. A total of 16 of the 32 extractions and five of the nine RCTs had favorable evolution (p = 1). Conclusions: The question of whether to perform RCT or extraction of necrotic FPM in children aged eight to twelve is difficult to assess. It appears that five criteria need to be considered before the decision: possibility of long-term sealed coronal reconstruction, SPM Nolla's stage, follow-up possibilities, arch concerned, and presence of third permanent molar.

Enhancing pediatric comfort: a comprehensive approach to managing molar-incisor hypomineralization with preemptive analgesia and behavioral strategies.

Preemptive analgesia is an important strategy used in pediatric dentistry to intercept pain signals in neural pathways early, thus mitigating the perception of pain and enhancing overall patient comfort. Pedodontists often encounter challenges in conducting the therapy and managing uncooperative patients, when addressing enamel defects of the Molar-incisor hypomineralization (MIH) type. The aim of this study is to demonstrate the impact of preemptive analgesia on optimizing behavioral management and restorative treatment strategies for immature permanent molars exhibiting severe MIH and Treatment need index 4 (TNI), through the effective control of pain. This study comprised 27 cases with MIH level 3 Posteruptive breakdown (PEB), indicating post-eruptive enamel breakdown, with initial hypersensitivity scores exceeding 4 on the Wong-Baker Scale, was conducted over 12 months, between January 2023-January 2024. Data on pediatric patients aged between 5 years and 4 months and 7 years and 1 month with varying degrees of sensitivity in their permanent first molars before the completion of the eruption process were collected. Pain intensity was systematically evaluated at six specific time points: before and after the administration of analgesic medication as well as during restorative treatment using the Wong-Baker scale and data from the Face, Legs, Activity, Cry, Consolability index (FLACC). Statistical analysis for Wong-Baker scores and FLACC index indicated statistical significance (p < 0.05) for Mann-Whitney and Wilcoxon tests, respectively t-test. The comparison of mean scores recorded before and after preemptive analgesia during rotary instrumentation moments for the Wong-Baker index (4 > 0.29) and for the FLACC index (8.47 > 1.71) indicates the positive influence of administering ibuprofen. In conclusion, preemptive analgesia, alongside standardized anesthesia, significantly improved intraoperative pain management and behavioral outcomes.

Molar incisor hypomineralization: past, present, and future

Molar incisor hypomineralization: past, present, and future

Molar incisor hypomineralization restoration: direct vs. indirect

Molar incisor hypomineralization restoration: direct vs. indirect

Alliance of Molar Incisor Hypomineralization Investigation and Treatment

Alliance of Molar Incisor Hypomineralization Investigation and Treatment

Knowledge, and treatment of molar incisor hypomineralisation (MIH) among dentists in Jordan: a cross-sectional questionnaire based study.

The aim of this study is to assess the knowledge, and treatment of MIH among dentists in Jordan. An online questionnaire using Google Forms was sent to the dentists who were registered with the Jordan Dental Association and worked in Jordan through social media groups. The questionnaire consisted of three sections, sociodemographic characteristics, the knowledge of dentists about the aetiology, diagnosis, and prevalence of MIH, and treatment options and barriers for treating MIH. Descriptive statistics with chi-squared test was used, and level of statistical significance was set to 5%. A total of 388 dentists had responded to the questionnaire (response rate 24.25%), (80.7%) reported that they have come across MIH cases during their practice. Yellow/brown demarcations were reported as the most common presentation of MIH (45.6%). All paediatric dentists were confident in diagnosing MIH, this was statistically higher than that reported by general dentists (56.8%) and dentists of other specialities (60.2%), P = 0.000. Pre-formed metal crowns were the treatment of choice for (57.2%) of participant, followed by composite restorations (52.3%). Child behaviour (56.2%), and late acknowledgment of the defect by the parents (46.1%) were the most encountered barriers for treatment. Molar incisor hypomineralisation is a common condition that is encountered frequently by general dental practitioners as well as dental specialists, nevertheless most dentists were not aware about the prevalence of MIH in Jordan and indicated their need to improve their approach regarding MIH diagnosis and treatment.

Optimizing Resin Infiltration Procedure in Molar Incisor Hypomineralization Lesions.

This article aims to describe a new technique for predicting the results of resin infiltration procedure in molar incisor hypomineralization lesions, named Infiltration Monitoring by Transillumination. The technique involves the use of transillumination together with ethanol application during the steps of lesion body opening and resin penetration. It provides color contrast that enhances the removal of the less porous surface layer and controls the effectiveness of resin infiltration within the lesion. The clinical procedure presented illustrates the steps involved in the resin infiltration procedure for color masking of molar incisor hypomineralization lesions in anterior teeth, highlighting the use of transillumination both for monitoring the lesion body opening step and the resin infiltration process. The monitoring with transillumination during the ethanol test can assist the removal of the enamel external layer over the lesion, necessary to expose the inner porosity to be infiltrated, in a very precise and conservative way. In addition, it can effectively help to determine the moment when the infiltrant resin has fully penetrated the lesion. The Infiltration Monitoring by Transillumination technique offers the possibility to precisely control the infiltration procedure in molar incisor hypomineralization lesions, thereby improving the predictability of the esthetic outcome.

Molar Incisor Hypomineralization: Etiology, Correlation with Tooth Number Anomalies and Implications for Comprehensive Management Strategies in Children from Transylvania.

This study investigates the etiology of enamel developmental defects, specifically Molar Incisor Hypomineralization (MIH), and explores correlations between MIH and dental anomalies such as hypodontia to improve interdisciplinary restorative and orthodontic treatments. Additionally, it assesses the influence of stress factors on the development of enamel defects. Conducted from July to September 2024, this study involved 57 patients aged 6 to 11 from an urban setting, divided into two groups: 32 with MIH and 25 controls, selected based on criteria of mixed dentition without systemic pathology or chronic medication. Clinical evaluations, including intraoral photographs and panoramic radiographs, were performed alongside a detailed questionnaire addressed to the mothers covering prenatal, perinatal, and postnatal factors. The average age of children with MIH was 7.5 years, in contrast to 7.04 years in the control group (p = 0.17). Significant differences were noted in maternal age, with MIH mothers older (35.56 years) than controls (29.36, p = 0.0001). The prevalence of MIH was higher in boys (66.7%) compared to girls (38.1%, p = 0.036). Factors such as prolonged labor, medication during birth, and early postnatal medication were significantly linked to MIH. The study shows a strong correlation with hypodontia, with a significantly higher incidence of tooth number anomalies (p = 0.009) in the study group. Overall, the study emphasizes the association of MIH with various maternal and birth-related factors and with hypodontia, highlighting the need for a comprehensive, multidisciplinary approach to diagnosis and treatment. Further research is recommended to investigate the relationship between stress factors and MIH.

Factors associated with molar incisor hypomineralization: A literature review

Factors associated with molar incisor hypomineralization: A literature review

Influence of maternal health status during pregnancy and the child´s medical history on molar-incisor hypomineralization in a group of Spanish children (aged 6-14 years): a retrospective case-control study.

Molar-incisor hypomineralization (MIH) is a qualitative enamel defect that is highly prevalent in children. It has been reported that patients with MIH have higher caries occurrence with an increased need and frequency of dental treatment compared to patients without MIH. The objective of this study was to analyze the association between MIH and a series of factors related to maternal health status during pregnancy and children´s medical history in early childhood. A retrospective study of cases (patients with MIH) and controls (patients without MIH) was designed between 2023 and 2024. A total of 280 children (cases = 140; controls = 140) aged 6 to 14 years (138 boys and 142 girls) were examined according to the European Academy of Pediatric Dentistry (EAPD) criteria for MIH. A survey was carried out with mothers regarding the potential exposure of their children to etiological factors of MIH. Possible prenatal and postnatal etiological factors were obtained through a personal interview with the patients' mothers. The statistical analysis was carried out with the contrast test and the chi-square test. During pregnancy, folic acid consumption, alcohol intake, systemic viral and/or bacterial infections, and gestational diabetes were statistically significantly related to MIH, as were breastfeeding, asthma, and corticosteroid consumption during childhood. Although there are different factors that may have statistically significant relationships with MIH, they cannot be predicted. Therefore, longitudinal studies, with a large sample size, are needed to determine the influence of prenatal and postnatal factors on the prevalence and severity of MIH in children.

Hipomineralização molar-incisivo - HMI: relato de caso clínico

Molar Incisor Hypomineralization (MIH) is a qualitative defect in the dental enamel that affects one or more permanent molars, where the permanent incisors may also be involved. The objective of this work was to report a clinical case of Molar-Incisor Hypomineralization (MIH) following a choice of treatments according to the different severities present in the patient. The case report is of a patient, 12 years old, female, who attended the Pediatric Dentistry clinic of Faculdade do Amazonas - IAES accompanied by her guardian, with the following main complaint: “I want to remove these stains”. In the extra and intraoral examination, marked opacities ranging from yellow to brown in elements 26 and 17 and white to yellow in dental elements 11, 21, 23 were observed. 11, 21, and 23 and proservation with fluoride varnish after previous prophylaxis on molars 17 and 26. It is concluded that it is very important for the dental surgeon to know how to identify MIH in order to choose the best treatment for each patient with different levels of severity. And in this way, we provide satisfactory results both in the execution of the treatment of choice and in the patient's life, remedying her main complaint.

Association between molar incisor hypomineralisation and tooth agenesis: a cross-sectional study in Brazilian children and adolescents.

The aim of the present was to assess the association between MIH and tooth agenesis (TA) in orthodontic patients from the Federal University of Rio Grande do Norte, Natal, Brazil. A cross-sectional study was performed to evaluate the presence of MIH and TA in a sample of 371 pretreatment orthodontic records from patients aged 9-18years. Statistical analyses were performed using the Chi-square and Fisher's exact tests, and logistic regressions. There was a statistically significant association between the prevalence of tooth agenesis and MIH. A higher percentage of third molar agenesis, maxillary premolar agenesis, and mandibular second premolar agenesis was observed among children with MIH-affected teeth. Patients with MIH had a 2.43 times greater chance of third molar agenesis, and a 5.88 times higher likelihood of mandibular premolar agenesis. There is a weak association between MIH and TA. Furthermore, the presence of hypomineralised molars increases the risk of tooth agenesis.

Evaluation of oral and dental health parameters in children with special care needs

AIM. The aim of this study is to evaluate and raise awareness of the oral and dental health parameters in children aged 6 to 16 years with special care needs who are enrolled in special education institutions located in the central districts of Diyarbakir in Turkey. Specifically, the study examines the presence of caries, plaque, malocclusions, and molar-incisor hypomineralization.METHODS. A total of 368 children with special care needs participated in the study, with ages ranging from 6 to 16 years and an average age of 9.61 years. Of the participants, 196 have intellectual disabilities, 51 have Down syndrome, and 121 have autism spectrum disorder. The clinical findings of our study include the DMFT/dmft index, plaque index, occlusal relationships, and the presence of molar-incisor hypomineralization (MIH). The data obtained were analyzed using the SPSS v21 software package.RESULTS. The mean DMFT/dmft value was found to be 5.64, and the mean plaque index value was 1.37. The occlusal relationships of the participants were as followed: 78.26% had Class I, 11.14% had Class II, and 10.6% had Class III. Additionally, 98.64% of the participants did not have molar-incisor hypomineralization (MIH), while 1.36% did have MIH.CONCLUSION. In our study, it was found that children with special care needs generally have poor oral hygiene, their parents/caregivers lack sufficient awareness, and the prevalence of caries and plaque index is high in the examined population.

Molar Incisor Hypomineralization and Related Risk Factors among Primary School Children in Jeddah: A Cross-Sectional Study.

Molar Incisor Hypomineralization (MIH) is a prevalent multifactorial developmental dental defect with unclear etiology. This study aimed to identify potential risk factors for MIH among primary school children in Jeddah, Saudi Arabia. A cross-sectional study including children aged 7 to 10 years old, recruited from twelve randomly selected schools located in three regions of Jeddah city, was carried out. The children were examined for MIH and dental caries using the European Academy of Pediatric Dentistry Criteria (2003) and the DMFT/dmft WHO index. Parents were asked to provide medical and socio-demographic information on their children from their first two years of life. A total of 2010 children were examined, with 888 parents responding to the survey (a 44.2% response rate). Lower maternal education was found to be significantly associated with a decreased adjusted odds ratio (AOR) of MIH (Model 1: p = 0.014, AOR = 0.646, and 95% CI = 0.456 to 0.915; Model 2: p = 0.019, AOR = 0.658, and 95% CI = 0.465 to 0.933). Being an only child, a child's birth order, type of delivery, breastfeeding, and medical conditions were not associated with MIH. The significant association between MIH and maternal education suggests that further research is needed to explore the underlying mechanisms and identify other potential confounding variables.