Prevalence Of Molar Incisor Hypomineralization Research Articles

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.

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.

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.

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.

"Ethnic disparities in the prevalence of Molar-Incisor-Hypomineralisation (MIH) and caries among 6-12-year-old children in Catalonia, Spain".

To study the prevalence of MIH and caries in 6- and 12-year-old schoolchildren and their association with ethnic disparities and other relevant factors. In recent years, there has been uneven improvement in school children's oral health, highlighting inequalities in access to dental care and health outcomes, particularly among ethnic minorities. The most prevalent oral disease in childhood, caries, is preventable, as its risk factors are well known. However, MIH, a common condition affecting the enamel of permanent incisors and/or molars, has no established aetiology or preventive measures. A cross-sectional study among schoolchildren was conducted in 725 children from Masnou (Barcelona, 2013) and in 577 children from Sant Andreu de Llavaneres (Barcelona, 2018-2020). Data collection was carried out by means of clinical examination and a selfreferenced questionnaire. Oral health outcomes included: presence of dental caries, presence of MIH, hypomineralised second primary molars (HSPM). All variables were analysed according to ethnic disparities and other variables such as socioeconomics, diet, hygiene habits, plaque and access to dental services. We performed multivariate Poisson regression models with robust variance to examine ethnic disparities in MIH and caries. This cross-sectional study based in Catalonia, Spain showed that there are ethnic disparities in caries as observed with other child's diseases; however, they do not seem to follow the same pattern for MIH. More studies are needed (i) to explore how MIH behaves among populations in terms of inequality; (ii) to study the aetiological factors of MIH; and (iii) to identify potential factors associated with MIH and caries that have not been studied and that may contribute to the observed ethnic disparities.

Association between molar-incisor hypomineralisation and dental anomalies.

Common etiological factors have been reported in the development of molar-incisor hypomineralisation (MIH) and dental anomalies (DA). To assess the association between MIH and DAs. A cross-sectional study was performed to evaluate the presence of MIH and other six DAs in a sample of 415 pretreatment records from patients aged 9-18 years. Statistical analyses were performed using the chi-squared and Fisher's exact tests, and logistic regressions. There was statistically significant association between the prevalence of DAs and MIH (CI: 1.43-2.43, φ-coefficient: 0.204, PR: 1.87). Higher percentage of tooth agenesis (CI: 1.37-1.68, φ-coefficient: 0.271, PR: 1.50), maxillary premolar agenesis (CI: 1.70-3.65, φ-coefficient: 0.125, PR: 2.49), mandibular second premolar agenesis (CI: 1.68-3.16, φ-coefficient: 0.172, PR: 2.30) and distoangulation of the mandibular second premolars (CI: 1.31-3.47, φ-coefficient: 0.103, PR: 2.13) was observed among children who had MIH-affected teeth. Individuals with MIH had a 2.95 times greater chance of having DAs (R2 = .153). The number of patients with DAs was higher when the first molar showed severe defects (OR = 4.47; R2 = .149). There is a weak association between MIH and DAs. Patients with severe MIH lesions have a slightly higher risk of presenting DAs.

Revalence of Molar Incisor Hypomineralization among Primary School Children in Baquba City

Background: Molar incisor hypomineralization is a clinical symptom of general hypomineralization affecting a single or multiple first permanent molars, which is generally accompanied with incisors. Objective: To determine the prevalence of molar incisor hypomineralization among 12 years students in Baquba city. Patients and Methods: This study was conducted from middle of January 2022 till the end of May 2022 in Baqubah city/Diyalla Governorate/Iraq. The sample excluded all students who had other enamel defects (fluorosis or hypoplasia, uncooperative students and students who refuse to participate. Results: Out of 700 participants, 52.43% of them were females and the rest were males. About 13% of the total sample showed a molar incisor hypomineralization, with significant association between gender, in which male were significantly more affected than females. The data showed 13% of the total sample had a demarcated opacities . Also the results showed that the upper centrals were more affected by hypominrlization than other teeth. Conclusion: However, the study revealed that demarcated opacity was the most common form of defect with a significant correlation, with a frequency of 13%. The upper central tooth was always the most commonly impacted by molar incisor hypomineralization.

Revalence of Molar Incisor Hypomineralization among Primary School Children in Baquba City

Background: Molar incisor hypomineralization is a clinical symptom of general hypomineralization affecting a single or multiple first permanent molars, which is generally accompanied with incisors. Objective: To determine the prevalence of molar incisor hypomineralization among 12 years students in Baquba city. Patients and Methods: This study was conducted from middle of January 2022 till the end of May 2022 in Baqubah city/Diyalla Governorate/Iraq. The sample excluded all students who had other enamel defects (fluorosis or hypoplasia, uncooperative students and students who refuse to participate. Results: Out of 700 participants, 52.43% of them were females and the rest were males. About 13% of the total sample showed a molar incisor hypomineralization, with significant association between gender, in which male were significantly more affected than females. The data showed 13% of the total sample had a demarcated opacities . Also the results showed that the upper centrals were more affected by hypominrlization than other teeth. Conclusion: However, the study revealed that demarcated opacity was the most common form of defect with a significant correlation, with a frequency of 13%. The upper central tooth was always the most commonly impacted by molar incisor hypomineralization. Keywords: MIH, hypomineralization, Demarcated opacity.

Incidence and treatment for hypomineralization of incisor and molar among school going Indian children.

The presence of molar incisor hypomineralization (MIH) raises the likelihood of enamel degradation, which in turn raises the risk of plaque buildup and dental caries. Individuals impacted by this illness frequently incur large long-term costs. Therefore, it is of interest to evaluate prevalence and treatment need of MIH in school going children. Hence, 3030 school going students were included in this study. Considering the WHO 1997 guidelines for caries severity and the requirement of therapy for the damaged teeth and criteria for MIH, a full mouth visual assessment of moist teeth was conducted for every student. The overall prevalence of MIH was 174 (7.9%). Preventive caries restricting therapy was needed in 42(6.2%) maxillary right first molar,30(4.5%) maxillary left first molar, 30 (4.5%) mandibular right first molar, 36 (5.4%) in mandibular left first molar. Data shows that an incidence rate of 7.4 percent was noted, with a larger propensity among male children and a predominant impact on mandibular molars.

Worldwide prevalence of molar-incisor hypomineralization: A literature review

Molar-incisor hypomineralization (MIH) is a qualitative enamel defect with a multifactorial etiology, affecting at least one permanent first molar and often associated with permanent incisors and other teeth. MIH is prevalent worldwide, particularly among children under 10 years of age. However, its prevalence rates vary significantly even within the same country. This study aimed to determine the global prevalence of MIH from 1987 to 2023, focusing on children aged 3 to 18 years, using the 2003 EAPD classification. A comprehensive literature review was conducted using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS, and Google Scholar, covering studies from 1987 to July 2023 that included sample sizes of more than 1,000 children. A total of 80 studies met the inclusion criteria, with most participants aged between 6 and 12 years. Of these studies, 69 (86.2%) utilized the 2003 EAPD classification. Globally, 17,980 children out of 179,800 examined presented MIH, resulting in a prevalence of 9.4%. Regional prevalence varied: in Asia, 8,812 out of 81,954 children (10.7%) had MIH; in Africa, 344 out of 6,904 children (4.9%); in America, 2,193 out of 12,324 children (17.7%); and in Europe, 6,631 out of 90,042 children (7.3%). The American region reported the highest prevalence of MIH at 17.7%, while Europe and Asia showed similar rates close to the global prevalence (7.3% and 10.7%, respectively). Africa reported the lowest prevalence at 4.9%, but the number of studies conducted there was limited. Overall, MIH has a moderate global incidence with significant regional variations.

Prevalence and clinical presentation of molar incisor hypomineralisation among a population of children in the community of Madrid

ObjectiveThe main objective of this study was to estimate the prevalence of molar incisor hypomineralisation (MIH), an alteration of tooth enamel with an estimated worldwide prevalence rate of 14%, among children using primary care services in the Community of Madrid, Spain.Materials and methodsThis was a descriptive, cross-sectional and multicentre study. After calibrating all researchers and following the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD), children aged between 8 and 16 years who were users of the dental services at 8 primary oral health units of the Madrid Health Service (SERMAS) were included. The children underwent a dental examination, and the parents were asked to complete a questionnaire.ResultsThe prevalence of MIH was 28.63% (CI: 24.61–32.65%). The age cohorts most affected by MIH were 8 years (21.4%) and 11 years (20.7%). The presence of MIH was greater among girls (85; 60.71%) than among boys (55; 39.28%). The mean number of affected teeth per patient was 4.46 ± 2.8. The most frequently affected molar was the upper right first molar (74.3%), and the upper left central incisor was the most affected incisor (37.85%). Opacities were the defects most frequently recorded (63.57%).ConclusionsThe prevalence of MIH in this study is the highest of all relevant studies conducted in Spain.

Does information about MIH on dental homepages in Germany offer high quality? A systematic search and analysis

PurposeThe internet is increasingly used to seek health information. A dental condition of increasing concern and public interest is molar incisor hypomineralisation (MIH), why we evaluated the information quality of German dentists ‘websites on the topic of MIH.MethodsA systematic search was performed by two independent investigators using three search engines. The information content of websites on MIH and technical, functional aspects, overall quality, and risk of bias were assessed using validated instruments (LIDA, DISCERN). Practice-related characteristics (practice type, specialization, setting, number and mean age of dentists) were recorded, and associations of these characteristics with websites’ overall quality were explored using multivariable linear regression modelling.Results70 sites were included. 52% were multipractices in urban areas (49%). The most common age group was middle-aged individuals (41–50 years). The average number of dentists/practice was 2.5. The majority met more than 50% of the DISCERN and LIDA criteria (90%, 91%). The MIH definition was frequently used (67%), MIH symptoms were described (64%), and 58% mentioned therapies. The prevalence of MIH was mentioned less frequently (48%). MIH example photographs were rarely shown (14%). In multivariable analysis, most practice-related factors were not significant for overall site quality. Only chain practices had slightly higher quality in this regard (2.2; 95% CI of 0.3–4.1).ConclusionsMIH is mentioned on a large proportion of dentists’ websites. Overall technical, functional, and generic quality was high. Risk of bias is limited. While most websites provided a basic definition of MIH and its symptoms, important information for patients was missing.

The prevalence and characteristics of molar-incisor hypomineralisation in Natal, Brazil

ObjectivesTo determine the prevalence and presentation patterns of molar-incisor hypomineralisation (MIH) in Brazilian children. MethodsA cross-sectional study was carried out with 715 individuals aged 8–17 years. MIH was diagnosed according to European Academy of Paediatric Dentistry (EAPD) criteria, using intraoral photographs. Data were analysed using Chi Square and Pearson's Correlation tests at α = 0.05. ResultsThe prevalence of MIH was 15.66 %. Mild defects represented by demarcated yellow and brown opacities comprised 83.5 % of the total MIH lesions and the severity of MIH lesions increased significantly as age increased. The average number of first molars affected by MIH per child was 2.26, and 36 children (32.14 %) had at least one affected incisor. With the increase of affected molars, the number of incisors with opacities showed an obvious increasing. The maxillary left first molar was the most affected tooth, and the maxillary central incisors were the anterior teeth most frequently affected by MIH. ConclusionThe prevalence of MIH was within the range of published studies and the severity of the defects was mostly mild.

Caries prevalence and molar incisor hypomineralisation (MIH) in children. Is there an association? A systematic review.

Molar incisor hypomeralisation (MIH) is a dental condition clinically characterised by the presence of morphological and qualitative enamel defects involving the occlusal and/or incisal third of one or more permanent molars or incisors. Its worldwide prevalence ranges between 2.4 and 40%. Several harmful conditions, such as genetic or medical problems during pregnancy, may act together and increase the risk of MIH. The main objective of this systematic review is to assess whether there is a correlation between MIH and dental caries in mixed or permanent dentition. An electronic search was performed on PubMed (Medline), Scopus and Cochrane Library for articles published from August 2022 to April 2023. Cohort, cross-sectional, retrospective and prospective studies were included. In vitro and animal studies, as well as clinical cases and systematic reviews, were excluded. Studies not differentiating between mixed and permanent dentition were excluded. The observed variables were DMFT (Decayed Missed Filled Teeth) score, DMFS (Decayed Missed Filled Surface) and DMF scores related to FPM (First Permanent Molar) and the clinical prevalence of MIH. DMFT, DMFS and DMFT on FPM scores are significantly different between the group of patients with MIH and the control group. The available evidence supports a correlation between MIH lesions and caries. Caries indexes scores increase proportionally to the severity of MIH.

Association between psychological factors and molar-incisor hypomineralization: A cross-sectional study.

Molar-incisor hypomineralization (MIH) is a developmental enamel defect characterized by opacities from white to brownish color. A suspected multifactorial etiology has been suggested, whereas psychological factors during pregnancy have only been limitedly analyzed. We assessed the association between stress, depression, and anxiety in pregnancy and the presence of MIH in children at a later age. Using a cross-sectional Web-based questionnaire, we included 384 mothers who had children aged 6 and 12 years from Pasto, Colombia. Data were collected between October 2021 and March 2022. Sociodemographic variables; maternal and child factors related to prenatal, natal, or postnatal problems; and psychological factors such as stress and symptoms of anxiety and depression in pregnancy were inquired. Utilizing photographs depicting MIH lesions, mothers assessed their child's MIH status. A directed acyclic graph (DAG) analysis was performed to create causal assumptions, and logistic regression models were estimated to evaluate these assumptions. p-value was set at p < .05. The prevalence of MIH was 33.3%; 12.8% of the participants exhibited hypomineralization in both molars and incisors. DAG analysis and logistic regression models determined that MIH (present or not) was associated with symptoms of maternal depression (ORadj = 3.26, 95% CI: 1.92-5.52, p < .001), and MIH (both molars and incisors) was associated with symptoms of maternal anxiety (ORadj = 3.49, 95% CI: 1.80-6.76, p < .001). Psychological factors, among others, were significantly associated with the presence of MIH.

Comparison between two molar incisor hypomineralization detection criteria in epidemiological surveys.

There is no consensus on which molar incisor hypomineralization (MIH) indices are more suitable for epidemiological surveys. To compare the operational aspects and diagnostic ability of the MIH index (simplified/MIH_s and extended/MIH_e) with the MIH-Severity Scoring System (MIH-SSS) in classifying and diagnosing MIH. This cross-sectional study assessed the indices in a homogeneous group of 680 6- to 10-year-old schoolchildren in Bauru, Brazil, who had at least one first permanent molar, ensuring consistent conditions. Followed by toothbrushing, the children seated on school chairs were examined by the two calibrated researchers under artificial lighting, using mouth mirror and WHO probe, and chronometer recording the duration of examinations. The prevalence of MIH was 24.7%. The most common characteristic of MIH was demarcated opacity, with a prevalence of 81.7% and 85.45% according to the MIH_s and the MIH-SSS, respectively. A positive association was observed among the MIH_s, the MIH_e, and the MIH-SSS (chi-squared test; p < .01). The MIH-SSS demonstrated a shorter average application time than both versions of the MIH index (ANOVA/Tukey; p < .05). Additionally, fluorosis was found to be the most prevalent among other developmental defects of enamel, with a prevalence of 38.38%. All systems effectively diagnosed MIH and its characteristics.

Real-World Evidence on the Prevalence of Molar Incisor Hypomineralization in School Children from Bucharest, Romania.

Molar incisor hypomineralization (MIH) is an understudied and underrecognized clinical entity occurring in children. We performed a cross-sectional study to determine the real-world prevalence of MIH among school children undergoing routine dental checkups at one primary and middle school in Bucharest, Romania. Our study cohort consisted of 266 children with evaluable data, of which 143 (53.8%) were males, with a median age of 10 years old (interquartile range: 8-11 years). In this study cohort, we have identified a prevalence of 14.3% (n = 38 cases) of MIH. Among patients diagnosed with MIH, hypomineralizations were present in 47.4% of children on the maxillary first molar, 92.1% on the mandibular first molar, 94.7% on the maxillary incisor, 36.8% on the mandibular incisor, and 5.3% on the deciduous second molar. We identified the maxillary incisor and the mandibular first molar as the most important examined sites significantly associated with the presence of MIH (p < 0.0001 each), highlighting the importance of paying focused attention to these sites during routine dental care in children. In order to establish the diagnosis of MIH, findings of hypomineralization should be present on at least one permanent first molar, according to the case definition currently in use; this definition does not include findings on the incisors. Thus, our finding that hypomineralization of the maxillary incisors is significantly associated with MIH is particularly important. While incisor hypomineralization is not diagnostic of MIH, based on our results, we conclude that it should raise the suspicion of MIH and lead to an attentive examination of the permanent molars in order to establish timely diagnosis.

Investigation on the effects of long-term antibiotic therapy in sickle cell disease associated with molar-incisor hypomineralisation-a pilot study.

The term Molar-Incisor Hypomineralisation (MIH) is used to describe hypomineralised defects of systemic origin that affect at least one of the first permanent molars and often involves the permanent incisors. Antibiotic therapy during amelogenesis may be associated with enamel hypomineralisation. By examining children with Sickle Cell Disease (SCD), who take prophylactic antibiotics daily from birth until age five, it may be possible to determine if there is an increased prevalence of MIH in this population. The aim of this study was to determine the effect of long-term antibiotic use on the prevalence and severity of MIH in children with SCD. In a prospective cohort pilot study over a period of seven months, children aged 7-17 years, with SCD at Boston Children's Hospital (n = 18) were examined for MIH. Information regarding peri-natal concerns, incidence of illness and antibiotic use were also collected. The results were compared to a group of control patients (n = 63) for prevalence and severity of MIH using Fisher's exact test. The patients with SCD, 4/18 (22%) taking daily antibiotics did not show a statistically significant greater prevalence of MIH compared to the control group, 24/63 (38%). There was no correlation between MIH and pneumonia, asthma, fever, flu, otitis media, breastfeeding, gender and birth weight. However, an association was noted between premature birth and MIH (p ≤ 0.05). No correlation was found between long-term antibiotic use and higher prevalence of MIH in the SCD group compared to the control group. However, MIH may be more severe in those with a history of long-term antibiotics.

MIH and compromised permanent first molars. When and which teeth to extract: guidelines

The prevalence of molar incisor hypomineralisation (MIH), the degree of severity of experienced molars, their medium-term survival rate are factors that have reintroduced the decision to extract first permanent molars, forced extractions or chosen therapeutic option. The author summarizes pedodontic and orthodontic clinical studies in the management of patients with compromised first permanent molars in order to analyze the consequences of single or multiple extractions of these teeth. Firstly, the consequences of extractions of the first permanent molars in the absence of malocclusion are studied. The goal is the establishment of all the teeth without orthodontic treatment. The impact of the age at which the extraction is practiced is a key factor. In a second step, extractions of first permanent molars in the presence of orthodontic anomalies are analyzed to define the optimal therapeutic strategies, the precautions during these treatments, the contraindications. Consultation and good coordination between the generalist dentist / pediatric dentist and orthodontist are the key factors for stable and functional end-of-treatment results and optimized treatment duration. Clinical experience and knowledge make it possible to properly select patients qualified for these therapies who obtain multidisciplinary planning and good biomechanical control. By bringing together optimal decision-making conditions, extraction is a therapeutic option that often proves to be superior to a restorative option in providing our patients with the greatest long-term service.

A clinical and statistical study on enamel hypomineralization of the first permanent molar in the period of mixed dentition.

The first permanent molar (FPM) is the first tooth in the permanent dentition that emerges in the oral cavity, at around the age of six and behind the deciduous teeth, thus converting the primary dentition into a mixed dentition. Its early formation represents a risk factor for the onset of hard dental tissues disorders, the most common being the molar incisor hypomineralization (MIH). The aim of the study was to assess the hypomineralization type of developmental defects of enamel at FPM level during the mixed dentition stage, in a group of Romanian children. The research was conducted on 87 patients, 44 females and 43 males, divided into the following age groups: 5-6 years, 6-7 years, 7-8 years, 8-9 years, 9-10 years, 10-11 years, 11-12 years and older than 12 years. All children were examined in the dental office by a pediatric dentist. Of the subjects, 40.2% presented hypomineralization lesions on the FPM. Among the affected children, 62.9% were girls and 37.1% were boys. Mild forms were the most prevalent, being found in 71.4% of the affected subjects. Moderate forms were present in 22.9% and severe forms in 5.7% of the affected children. MIH prevalence significantly decreased with increasing age. Only two children belonging to the group 8-9 years and 10-11 years, respectively, showed severe MIH lesions. Statistically significant differences were determined in what regards the distribution of MIH children according to the severity of the lesions in relation to age (p=0.007). Children 6- to 7-year-old have been the most affected by FPM hypomineralization, which indicates the need for early management of the disease, through a thorough diagnosis, and preventive and interceptive therapeutic approaches.