Molar Incisor Hypomineralization Research Articles

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.

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.

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

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

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.

"Evaluation of Silver Diamine Fluoride Modified Atraumatic Restorative Treatment (SMART) on hypomineralized first permanent molar"- a randomized controlled clinical study.

Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P = .049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P < .001) and a statistically significant difference in surface area changes between the 4 subgroups. Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. The study protocol was retrospectively registered on Clinical Trials (NCT05931822-05/ 07/2023).

Factors related to spontaneous space closure following early first permanent molar extraction: A systematic review.

Dental caries and molar-incisor hypomineralization (MIH) are primary reasons for the extraction of first permanent molars (M1) in children, which can lead to significant dental and facial development issues such as a midline shift and temporomandibular joint disorder. This systematic review aimed to identify key factors influencing spontaneous space closure following the early extraction of first permanent molars (M1) in children aged 5-15. We conducted a comprehensive search across Scopus, PubMed, Dimensions, Web of Science, and Cochrane databases, including the literature from 1960 to 2024. The inclusion criteria focused on clinical trials, case-control, cross-sectional, cohort studies, and case series that evaluated the impact of various factors on the spontaneous closure after M1 extraction. The analysis highlights that chronological age and the developmental stage of the second permanent molars (M2) at the time of extraction are significant predictors of successful spontaneous space closure. Additionally, the presence and angle of M2, along with the presence of third permanent molars (M3), play crucial roles but require further investigation. Early assessment of M2's developmental stage and inclination, and the presence of M3 are essential for enhancing the likelihood of successful spontaneous space closure following M1 extraction in children.

Rebuilding the Strength of Hypomineralized Enamel – An In-Depth Systematic Literature Review

Molar Incisor Hypomineralization (MIH) is a prevalent developmental enamel defect characterized by qualitative changes in the enamel of one or more first permanent molars, often accompanied by similar defects in the incisors. This condition leads to significant dental challenges, including soft, porous enamel, which is more susceptible to damage and caries than non-MIH teeth. The affected teeth exhibit lower mineral concentration, higher porosity, and altered mechanical properties, contributing to their increased vulnerability to decay and restoration failures. Research indicates that MIH-affected teeth often require more extensive dental treatments due to compromised structural integrity. The enamel defects associated with MIH manifest as well-demarcated opacities, which can lead to hypersensitivity and aesthetic concerns for patients, particularly children. However, there is hope in the form of various remineralization strategies that have been explored to address MIH's challenges. These strategies, including recent clinical trials, have demonstrated the efficacy of remineralization agents in restoring some of the lost enamel properties, which is crucial for managing MIH effectively. This potential for restoration through remineralization strategies offers a hopeful outlook for improving patient outcomes with MIH.

Developmental dental anomalies in children with molar incisor hypomineralization

Developmental dental anomalies in children with molar incisor hypomineralization

Treatment approaches for molar incisor hypomineralization: CAD-CAM or Adhesive?

Treatment approaches for molar incisor hypomineralization: CAD-CAM or Adhesive?

Diagnosing celiac disease in children using oral manifestations

PurposeCeliac disease (CD) may be frequently undiagnosed due to the absence of characteristic gastroenterologic symptoms in many CD patients. Our objective was to diagnose CD by utilizing documented oral manifestations such as Recurrent Aphthous Stomatitis (RAS) and Molar-Incisor Hypomineralization (MIH).MethodsThe study comprised sixty children who presented with complaints of RAS lesions. The MIH group consisted of 40 children, while the control group comprised 20 children without MIH lesions, ranging in age from 7 to 13 years. After the dental examination, all children were given a questionnaire to assess whether they had any previous history of general symptoms related to CD. Following that, diagnostic testing for celiac disease were conducted, including serological tests such as Tissue transglutaminase IgA (tTG-IgA), Endomysium Antibody (EMA), and Total IgA, as well as genetic tests for HLA-DQ2 and HLA-DQ8.ResultsThe statistical analysis, conducted using Fisher’s Exact, Yates’ Continuity Correction, Fisher Freeman Halton, and Student’s t tests, revealed no significant differences between the groups (p < 0.05). Within the MIH group, 3 children exhibited border tTG-IgA values, while another 3 had positive tTG-IgA results. Two of these 6 children had also positive EMA and HLA results. Following a biopsy procedure, these two children were ultimately diagnosed with celiac disease (CD).ConclusionsIn this study, while children initially presented to the clinic with complaints of recurrent aphthous stomatitis (RAS), 2 children (5% of the MIH group) were diagnosed with CD shortly after the onset of MIH lesions. CD enhanced the likelihood of observing some oral manifestations particularly recurrent aphtous stomatitis and developmental enamel defects. We recommend that dentists be cautious about diagnosing CD when RAS lesions and DEDs and/or MIH lesions are present, whether or not other indications of this systemic disease exist.

An inverse relationship between dental fluorosis and Molar Incisor Hypomineralization in Mexican schoolchildren in an area with a high concentration of fluoride in drinking water: A cross-sectional study.

To evaluate the association between the frequency and severity of dental fluorosis and Molar Incisor Hypomineralization (MIH) in 8-12-year-old schoolchildren living in an area with a high concentration of fluoride in the drinking water. The present cross‑sectional study was conducted on Mexican children (n = 573) selected from one community presenting a drinking water fluoride concentration of 1.39 ppm/F. The prevalence of dental fluorosis was ascertained using the Thylstrup and Fejerskov Index (TFI). The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using the severity of MIH as the result. The prevalence of MIH was 37.7% and, by severity, was 16.1% mild, 14.3% moderate, and 7.3% severe. The prevalence of dental fluorosis in permanent dentition was 70.9% (TFI ≥1) and, by severity, was 29.2% (TFI = 0), 45.6% (TFI 1-3) and 25.3% (TFI ≥4), while 54.5% of subjects were found to have poor oral hygiene. Schoolchildren with fluorosis (TFI ≥4) were 49% less likely [OR = 0.51; p = 0.025] to present mild MIH than children with fluorosis (TFI <4). Similarly, children with fluorosis (TFI ≥4) were 53% [OR = 0.47; p = 0.019] and 62% [OR = 0.38; p = 0.036] less likely to present moderate and severe MIH than children with fluorosis (TFI <4). An inverse relationship between the presence of fluorosis and MIH was found. The results obtained by the present study may contribute to both the early identification of disorders affecting the enamel and the creation and implementation of long-term oral health prevention, promotion, and intervention programs in the affected population.

Assessment of the salivary level of glutathione and the feeding pattern in molar incisor hypomineralization among 7-9 years of age: an analytical cross-sectional study

Background: The study aimed to assess salivary glutathione levels and the pattern of feeding on molar incisor hypomineralization among healthy children aged 7-9 years. Materials and Methods: The study was a cross-sectional study. A total of 90 children sample was further sub classified into two groups: the study group, including 60 children with molar incisor hypomineralization, classified into two subgroups, 30 children with mild type and 30 children with severe type of molar incisor hypomineralization. In addition to the control group involving 30 children without incisor hypomineralization and free of caries. Examination and diagnostic criteria for hypominerlization of the molar incisor and assessment of severity were according to European Academy of Pediatric Dentistry (EAPD) guidelines in 2003. The salivary glutathione ELISA kit was used to assess the amount of glutathione in unstimulated saliva samples. After an oral examination, the parents of each child completed a self-administered questionnaire that included information on the child's feeding pattern during the first year of life. The questionnaires were returned to the researcher the following day. The child who received a mixed feeding pattern was excluded from the study. Results: The ordinal logistic regression model (Overall model test: p &lt; 0.001) presented that salivary glutathione (p &lt; 0.001), saliva pH (p = 0.014) and saliva flow rate (p = 0.009) were significant predictors of hypomineralization of the molar incisor. The feeding pattern (p = 0.625) and gender (p = 0.394) were not significant predicators for hypomineralization of the molar incisor hypomineralization. Conclusion: In children aged 7 to 9 years, salivary glutathione level is a negative predicator for the degree of hypomineralization of the molar incisor. Moreover, child feeding pattern, and gender, are not significant predicators of hypomineralization of the incisor hypomineralization.

Perceptions, attitudes, and clinical experiences of Brazilian dental practitioners towards molar incisor hypomineralisation: a cross-sectional study.

To evaluate perceptions, attitudes, and clinical experience of Brazilian dental practitioners regarding molar incisor hypomineralisation (MIH). An online survey with 27 questions, covering professional profile data, perceptions, and knowledge on clinical management of MIH, was employed. Descriptive analyses, chi-square, Fisher's exact, and Cramer's V tests were used. Sample comprised 100 participants, equally distributed between those working in private or public sectors. Most private sector practitioners had 21-30years of clinical experience (28%) and master's degree (50%), while most public sector practitioners had 11-20years of clinical experience (32%) and a PhD degree (32%). Most participants (86%) recognized MIH in their practice. Statistically significant differences were observed in frequency (p = 0.001), incidence (p = 0.039), and lesion type (p = 0.043) between practitioners from both sectors. Uncertainly in management was reported by 49%, mainly in public sector. For mild MIH in incisors, no treatment was chosen (43%), and the treatment longevity was the only significant factor reported (p = 0.012). In cases of mild MIH in first permanent molars (FPMs), 51% of respondents opted to keep the affected tissue and apply fissure sealant. Glass ionomer (GI) restoration was commonly indicated for FPMs with severe MIH with moderate loss of structure and sensitivity (38%). In cases with substantial structural loss and pulpal involvement, the most chosen treatment was endodontic intervention combined with preformed crowns. Brazilian dental practitioners face MIH in clinical practice. Although, public sector professionals are less confident in diagnosis and treatment, no significant differences in treatment preferences between public and private sector dental practitioners were identified.

Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City.

Molar incisor hypomineralization (MIH) is one of the most common developmental disturbances that dental practitioners encounter, which may influence the child's quality of life and can impact their future dental health. To determine prevalence and treatment needs of MIH in children of Lucknow. A total of 800 children aged 7 to 9 years were clinically screened for the presence of MIH. All demographic details were filled in by the examiner in communication with the parents, and examination was performed using the Würzburg MIH concept. The overall prevalence of MIH in the children examined was 5.12%. A higher prevalence was found in males (7%) than in females (3.25%). The distribution of MIH was higher in the mandibular arch than in the maxillary arch. Mandibular molars were the most affected teeth, followed by maxillary incisors, and the least affected teeth were maxillary molars. On the basis of severity, 55.14% of teeth with MIH had no breakdown or hypersensitivity followed by 30.14% of teeth with hypersensitivity but no breakdown, and 7.35% of teeth had both hypersensitivity and breakdown. Based on severity, in 39.70% of teeth, the intervention suggested was fluoridated toothpaste, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) remineralizing agent, and varnish application. This was followed by the application of sealants and low-viscosity glass ionomer cement (GIC) in 38.97% of teeth, and in 7.35% of teeth, short- and long-term restorations, including stainless steel crown (SSC), were recommended. Prevalence of 5.12% was observed in children of Lucknow city. The characteristics of MIH defects were predictive of the treatment of the affected first permanent molars and incisors and can guide their management. Chowdhury AR, Singh N, Rathore M. Molar Incisor Hypomineralization: Prevalence and Treatment Needs in 7- to 9-year-old Children of Lucknow City. Int J Clin Pediatr Dent 2024;17(7):790-795.

Prevalence and Association of Caries and Enamel Hypomineralisation/Molar-Incisor Hypomineralisation in 8- to 10-Year-Old Children from Bavaria, Germany

Introduction: The aim of this cross-sectional epidemiological study was to record caries and enamel hypomineralisation (EH), including molar-incisor hypomineralisation (MIH), and assess associations between both entities in 8- to 10-year-olds from Bavaria, Germany. Methods: A total of 5,418 children (mean age 9.8 years; 2,726 females, 2,692 males) were examined using the dmft/DMFT index with additional inclusion of initial or non-cavitated carious lesions (it/IT). EHs were recorded in the primary (eh) and permanent dentition (EH), and individuals with different EH phenotypes were determined as follows: at least one EH, at least one hypomineralised second primary molar (HSPM), at least one hypomineralised first permanent molar (MIH), and at least one hypomineralised first permanent molar and incisor (M+IH). Multiple logistic regression models were constructed to assess association between caries and EH. Results: The percentage of children without caries in the permanent dentition (DMF = 0) was 88.9%. When data regarding initial carious lesions were included (IDMF = 0), the prevalence decreased to 75.7%. The caries experience was idmf/t = 1.6 and the IDMF/T = 0.6. The mean number of carious teeth in subjects with no eh/EH was higher than that in subjects with HSPM, MIH, or M+IH. The presence of HSPM, MIH, and M+IH was associated with a significantly lower probability of caries in the permanent dentition; the corresponding adjusted odds ratios were 0.55 (95% CI: 0.41−0.75), 0.67 (95% CI: 0.56−0.81), and 0.54 (95% CI: 0.41−0.72), respectively. Conclusions: Caries and EH are prevalent conditions in 8- to 10-year-old Bavarian schoolchildren; both dental diseases were negatively associated with each other.