Severity Of Molar Incisor Hypomineralization Research Articles

Molar incisor hypomineralisation (MIH): correlation with dental caries and dental fear.

This cross-sectional study was to investigate correlations between molar incisor hypomineralisation (MIH), dental caries and child dental fear. The subjects in the study were representative samples of 8 and 14year old children from three Greek cities (total N=2335). Dental examinations were performed by one calibrated examiner in classrooms, after the children had brushed their teeth, using an intraoral mirror and artificial room light supplemented by a penlight. All the children completed the children's fear survey schedule-dental subscale (CFSS-DS) questionnaire. MIH scores were recorded using EAPD criteria and dental caries experience by DMFS/dmfs index. Data were analysed with the Chi-squared (χ (2)), Mann-Whitney and Spearman's rank correlation coefficient tests. The mean DMFS in children with MIH (8-year olds: 1.60±2.01, 14-year olds: 4.60±4.41) was statistically significantly higher than children without MIH (8-year olds: 1.01±1.78, 14-year olds: 3.46±4.28) (p<0.001 for both age groups). Children with severe MIH had statistically significantly higher mean DMFS scores than children with mild or no MIH (p<0.001), while the dmfs of the 8year olds were unrelated to their MIH status (p=0.332). Caries experience was associated with the MIH status of the first permanent molars in both age groups (p<0.001). The mean CFSS-DS scores did not differ significantly between the groups of children without (26.2±9.9) or with MIH (26.5±9.6) (p=0.339), regardless of MIH severity. A positive association between MIH and dental caries was confirmed and a lack of association found between MIH and dental fear in Greek children.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren.

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Prevalence of molar incisor hypomineralization in school children aged 8-12 years in Chennai.

To investigate the prevalence and severity of molar incisor hypomineralization (MIH). A sample of 2,864 students aged 8-12 years were selected from government and private schools in Chennai. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Pediatric Dentistry (EAPD) 2003. A total of 277 children (9.7%) had MIH. There was statistically significant difference in prevalence related to age but there was no statistical difference in prevalence with respect to gender. Prevalence of MIH was 9.7% in the child population residing in Chennai. Males and females were equally affected. The rate of occurrence and severity of MIH are more in the right mandibular first molar. The severity of MIH is more in molars compared to incisors (P < 0.001) and is more in government schools compared to private schools (P = 0.002).

Canines are affected in 16-year-olds with molar-incisor hypomineralisation (MIH): an epidemiological study based on the Tromsø study: "Fit Futures".

This was to determine the prevalence, distribution of affected teeth and severity of MIH in adolescents from Northern Norway. It was part of a cross-sectional health survey Fit Futures including 16-year-olds from two neighbouring municipalities, Tromsø and Balsfjord. The prevalence of MIH was 13.9% (110 of 794). The maxillary first permanent molars (FPMs) were 1.6 times more frequently affected than in the mandible (P < 0.001). The FPMs on the right side were 1.2 times more often affected than the FPMs on the left side (P = 0.038). The maxillary incisors were 2.5 times more often affected than the incisors in the mandible (P < 0.001). The proportions of participants whose canines and incisors were involved were 22.8 and 41.8%, respectively. Altogether 201 FPMs were affected; 54.0% of these had opacities only, 24.3% had posteruptive breakdown (PEB), 18.8% had atypical restorations, and 3.0% had been extracted due to MIH. The buccal surfaces were most often affected in FPMs. More severe lesions were found in the mandibular FPMs compared with the maxillary FPMs (P = 0.002). In the lower canines, only opacities were recorded, while in the upper jaw 13.0% of the affected canines showed PEBs. The distribution of MIH in the dentition was not symmetrical. The prevalence of MIH (13.9%) in the study population of 16-year-olds from Northern Norway is consistent with previous Scandinavian reports. The distribution pattern shows that one participant in four with MIH had at least one affected canine. Further studies are needed to describe the localisation of defects on the enamel surface and to relate these findings to enamel thickness and the duration of amelogenesis.

A Comparative Study of Oral Health Parameters in Molar Incisor Hypomineralization and High-Caries-Risk Children Aged 8-11 Years

Objective: To compare oral health parameters: decayed missing filled teeth (dmft, DMFT), gingival index and plaque index in high-caries-risk children and children with molar incisor hypomineralization (MIH). Subjects and Methods: A study group of 81 children affected by MIH (49 girls, 32 boys) aged 8-11 years (mean 9.4 ± 1.1) was race-, age- and sex-matched with 81 high-caries-risk children not affected by MIH (controls). The MIH and control groups were divided into four subgroups according to age. The oral health parameters of both groups were recorded under clinical conditions. Mann-Whitney U and Kruskal-Wallis tests were used to compare the differences in the number of MIH-affected teeth between the groups. Other traits were evaluated with the ANOVA test, and Duncan's multiple comparison tests were used for comparing means. Linear and ordinal regression analyses were used to model the variables. Results: The mean age of the participants was 9.4 ± 1.1 years, and the mean number of affected teeth was 7.7 (range 3-12) in the MIH group. The number of affected teeth and severity of MIH did not change significantly with age and sex (p > 0.05). A comparison of the oral health parameters of MIH-affected and control children according to groups did not show any statistically significant differences between the groups for all parameters for all groups (p > 0.05) with the exception of DMFT values at 10 years of age (p < 0.05). In a comparison of the total scores without taking age into account, the children with MIH showed a significantly higher DMFT value than the children without MIH (p < 0.05), but there were no significant differences between the dmft, GI and PI values of the study groups (p > 0.05). Conclusion: The children in the MIH group had higher DMFT than those without MIH. Hence, the presence of MIH could have a detrimental effect on oral health parameters, especially on DMFT values.

Longitudinal Evaluation of the Structural Integrity of Teeth Affected by Molar Incisor Hypomineralisation

The aim of this prospective cohort study was to evaluate the risk of posteruptive breakdown and the development of caries lesions in teeth with molar incisor hypomineralisation (MIH). A total of 367 permanent incisors and first molars, affected and not affected by MIH lesions, of 45 children with MIH from Araraquara, São Paulo, Brazil, were evaluated at intervals from 6 to 12 months by assessing the severity of MIH, the presence of tooth caries lesions and the treatment needed. During the study period, all patients received preventive care. The data were analysed using Fisher's exact test and actuarial method survival analysis. Significant associations were also found in teeth between the presence of MIH and a DMFT index >0 in all periods and also between the need for treatment and the presence of MIH. The teeth affected by MIH opacities were healthy in 99% of incisors and 93% of molars at the end of the 12-month period. Due to the high likelihood of maintaining the tooth structure in opacities, the complete or premature removal of the affected area is not justified.

Is human immunodeficiency virus (HIV) a risk factor to development of dental caries and molar incisor hypomineralization (MIH) in children?

Introduction: HIV-positive children are susceptible to various infections, and they are often placed on long-term medications to control and/or prevent these infections. It is possible that the ingestion of these medications by the children could result in some form of dental conditions, like dental caries that possibly results from the intake of sugar-containing medications and poor oral hygiene, and or molar incisor hypomineralization (MIH) ensuing from the febrile conditions, ingestion of certain medications and/or other chemicals at the time the dentition is developing. Case Series: Two cases of HIV-positive children have been described in this paper, both of which suffered from severe dental caries and MIH. The treatment included extractions and extensive dental restorative procedures to improve their masticatory function and aesthetics. Conclusion: HIV-positive children may be at a greater risk of developing dental caries and MIH.

Prevalence, pattern and severity of molar incisor hypomineralisation in 8- to 10-year-old school children in Ile-Ife, Nigeria.

This study aimed to determine the prevalence, pattern and severity of MIH in school children resident in a suburban population in Nigeria. This was a cross-sectional study involving pupils aged 8-10 years resident in suburban Nigeria. Details of each pupil's socio-demographic variables were collected. Intra-oral examination was conducted to determine the presence of MIH, the affected tooth and the severity of the lesion. The association between the prevalence of MIH and socio-demographic variables of each child was determined. The predictors of MIH were also determined using a binomial regression analysis. Eighty-three of the 469 children examined (17.7 %) had MIH. There was no significant association between sex (p = 0.58), socio-economic status (p = 0.09), age (p = 0.26) and MIH. There was also no significant difference in the number of teeth affected by MIH in the maxilla and mandible, and on the right and left side of the face. The most commonly affected teeth were the left mandibular molars. The occlusal surfaces of the first molars were mostly affected by MIH and the severity of MIH on the teeth examined varied from mild (80.8 %), moderate (14.0 %) to severe (5.2 %). The prevalence of MIH in this study population is consistent with previous reports. The non-association between sex and MIH prevalence, the varied severity of the lesion and association between MIH affectation of the first permanent molars and central incisors give more weight to the possible role of environmental factors in the aetiology of the lesion. The non-association between MIH and socio-economic status may serve as a distinctive feature of MIH and chronological enamel hypoplasia.

Molar-Incisor Hypomineralization in Schoolchildren of Manaus, Brazil

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

Prevalence and severity of molar incisor hypomineralization in children aged 11-16 years of a city in Karnataka, Davangere.

Molar incisor hypomineralization (MIH) describes the clinical picture of hypomineralization of systemic origin affecting one or more first permanent molar. There is a rarity of prevalence studies in Indian population. The main aim of this study was to investigate the prevalence of MIH in a population of South Indian children. A cross-sectional epidemiological survey, included 2000 children aged 11-16 years chosen by stratified random sampling from government and private schools of Davangere, a city in South India. Evaluation of MIH and decayed, missing and filled teeth was carried out in these children by a calibrated examiner. The severity of hypomineralization was recorded according to the Wetzel and Reckel scale. Chi-square test was used to analyze the categorical data. P ≤ 0.05 was considered for statistical significance. About 8.9% of all examined children showed at least one ill-structured first permanent molar in terms of MIH. The male and female ratio was found to be 1:1.1. The decreasing order of occurrence of MIH affected teeth were permanent maxillary molars, maxillaryincisors, mandibular molars and the mandibular incisors. The prevalence of MIH in the permanent dentition of south Indian children was 8.9%. There is a need for a proper planned preventive and restorative program with regard to the increasing prevalence of MIH.

Prevalence and Severity of Molar Incisor Hypomineralization in Students of Belém, Brazil

Objective: To measure the prevalence of Molar Incisor Hypomineralization (MIH), its severity and association with dental caries among public school children from Belem/PA, Brazil. Material and Methods: This is a cross-sectional study conducted with children enrolled in three public schools of Belem, which were selected by simple random sampling. MIH diagnosis was carried out according to criteria of the European Academy of Pediatric Dentistry. Results: Among the 260 students that met the inclusion criteria, 56.92% were male and 43.07% female. The average age was 10.22 years. Of these, 8.84% (n = 23) had MIH, but there was no statistically significant difference in this prevalence between sexes (p = 0.6244). The most affected teeth were the upper first permanent molars, followed by lower first permanent molars and upper permanent central incisors. About 43.48% of students had at least one tooth with severe defect in enamel and 30.43% of students with MIH presented dental caries in the affected teeth. Conclusion: Severe MIH was not the most prevalent among schoolchildren, but the relationship with dental caries found demonstrates the importance of knowledge about diagnosis and treatment of enamel defects, which should be part of promotion and prevention actions in oral health due to its epidemiological impact in the demographic change of dental caries.

Prevalence and severity of molar-incisor hypomineralisation with relation to its etiological factors among school children 7- 9 years of Al-Najaf governorate

Prevalence and severity of molar-incisor hypomineralisation with relation to its etiological factors among school children 7- 9 years of Al-Najaf governorate

Oral health-related quality-of-life in Swedish children before and after dental treatment under general anesthesia

Objective. This study evaluated oral health-related quality-of-life (OHRQoL) in children and families before and after dental treatment under general anesthesia because of severe caries or molar-incisor hypomineralization (MIH). Materials and methods. A consecutive sample of the parents/caregivers of children (3–14 years) in need of treatment under general anesthesia participated in the study. The children were divided into two groups: 3–6 years and 7–14 years. The 49-item questionnaire that was administered before and after general anesthesia comprised the Child Oral Health Quality of Life-components of the Parental-Caregivers Perception Questionnaire (P-CPQ), the Family Impact Scale (FIS) and two global questions concerning oral health and general well-being. The P-CPQ domains were Oral symptoms, Functional limitations, Emotional well-being and Social well-being. The FIS items assessed impact on family life. Results. In both age groups, a significant decrease (p < 0.001) occurred in overall P-CPQ and the Oral symptoms, Functional limitations and Emotional limitations domains of the P-CPQ. Mean values for the Social well-being domain decreased significantly in the older (p < 0.05) but not the younger age group. Mean values for FIS decreased significantly in the younger (p < 0.001) and the older (p < 0.05) age groups. Conclusions. Dental treatment of severe caries or MIH, performed under general anesthesia, had an immediate effect on the oral health-related quality-of-life in the children in this study and a positive impact on the family situation.

Prevalence of molar incisor hypomineralization (MIH) in Singaporean children

There is a lack of data on molar incisor hypomineralization (MIH) in Asia, but this is not an indication that MIH is rare in the Asian population. Early identification of MIH is important as affected teeth frequently display post-eruptive enamel loss which would result in rapid caries progression. This objective of this study was to assess the prevalence of MIH in Singaporean children. Patients were recruited from 30 schools across Singapore. All children were examined by a single dentist, and the judgement criteria used were based on the 2003 European Academy of Paediatric Dentistry criteria. A total of 1083 children; average age of 7.7 ± 0.3 years were examined. One hundred and thirty-five children (12.5%) had MIH. A significantly higher proportion of children of the Malay ethnicity had MIH, compared to Chinese children (P = 0.02). Post-eruptive enamel breakdown and the presence of atypical restorations were correlated with increasing number of MIH teeth/child (Rho= 0.599, P < 0.001) and the cumulative enamel opacity colour score (Rho = 0.601, P < 0.001). Our findings suggest the role of ethnicity in MIH occurrence and that MIH severity may be influenced by the number of MIH teeth/child and the cumulative enamel opacity colour score.

Distribution and characteristics of molar-incisor hypomineralization.

Developmental disorders of teeth are the problems that are becoming more present in pediatric dentistry, especially on first permanent molars and incisors. Molar Incisor Hypomineralization (MIH) is proposed term for this phenomenon. The aim of this study was to establish the MIH prevalence in children living in the Foca municipality (Bosnia and Herzegovina) as well as to assess characteristics and expression of hypomineralization within the tested population. A total of 141 children from the Foca municipality, 8 years of age, were included in this study. Criteria according to Weerhejm have been used for diagnosis of hypomineralization: demarcated opacity (DO), post-eruptive breakdown (PEB), atypical restoration (AR), extracted molars due to MIH (E-MIH) and unerupted tooth (UT). Level and the prominence of color changes have been determined for patients with DO, PEB and AR. MIH in this area was present in 12.8% of children. The prevalence of MIH changes expressed in percentages was as follows: DO was at 9.2%, PEB in 3.5%, AR in 5.6%, while E-MIH was 5.6%. A total of 9.9% of the examinees had mild, 5.6% moderate, and 7.8% severe form of MIH. White form of MIH defects was found in 9.9% of the examinees, white-yellow one in 5.6% and yellow-brown color in 3.5% of the examined children. These changes were more often present in the lower jaw (60.3%). In total, 6.4% of children had these changes present only on molars, while 6.4% of them both on molars and incisors simultaneously. A total of 12.8% of the examinees with MIH is not to be disregarded. With timely diagnosis, prevention and therapy complications could be avoided or mitigated.

Prevalence of Molar–Incisor–Hypomineralisation among school children in four German cities

A wide range for the prevalence of Molar-Incisor-Hypomineralisation (MIH) has been found in regional studies. The aim of this study was to determine the prevalence of MIH in Germany and to compare the findings with other studies. In the compulsory dental school examination, the first permanent molars, permanent incisors, and second primary molars were examined according to EAPD criteria in 2395 children (8.1 ± 0.8 years) in four regions in Germany for the presence of MIH. Examinations were performed by five calibrated examiners (κ = 0.9) on clean teeth after toothbrushing. The prevalence of MIH at the four regions differed considerably (4.3-14.6%) with a mean prevalence of 10.1%. The DMFT/dmft was generally low, but children with MIH exhibited statistically significant higher caries values. A total of 12.0% of the children with MIH also had at least one affected primary molar, which resulted in a statistically significant correlation between primary and permanent teeth. Most of the affected teeth had demarcated opacities, but more than half of the affected children showed at least one tooth with severe MIH. Molar-Incisor-Hypomineralisation is a prevalent finding in German school children. The prevalence varies highly in different regions, and the high rate of severe forms has clinically relevant implications.

Molar incisor hypomineralisation: prevalence and clinical presentation in school children of the northern region of India

There is rarity of prevalence data on molar incisor hypomineralisation (MIH) for the Indian population and the majority of data originated from European countries. To report on prevalence and defect characteristics of MIH for school children of the northern Indian region. A cross-sectional survey including 1,792, 6-9-year-old school children of Chandigarh, India was carried out using European Academy of Paediatric Dentistry (EAPD) 2003 criteria for diagnosis of MIH. In addition to descriptive analysis for distribution of various defects, comparative data analysis was carried out for inter-comparison of distribution and type of defect amongst two phenotypes, MH [first permanent molar (FPMs) involvement] and M + IH (simultaneous involvement of molars and incisors). Similar comparative analysis was performed for four subgroups on the basis of number of affected surfaces/subjects. A prevalence of 6.31% was reported. FPMs (2.83 ± 0.874/subject) were more commonly affected than permanent incisors (1.19 ± 1.614/subjects). White/creamy opacity without post-eruptive breakdown (PEB) was the most common lesion, seen in 85% of subjects. MH phenotype was seen in 44% of subjects and 56% exhibited M + IH phenotype. A trend toward greater severity was seen in M + IH phenotype when compared to MH phenotype. A greater number of surfaces presented with white/creamy opacities without PEB (p < 0.05). With an increase in the number of surfaces involved the severity of MIH also increased with more frequent presence of brown defects with PEB. With concomitant involvement of incisors, more severe presentation of MIH was seen. Also, with increase in number of affected surfaces a parallel increase in severity as well as extent of lesions was observed.

Dental development in children with severe molar-incisor hypomineralization in Samsun, Turkey

Anomalies in amelogenesis may be due to developmental defects or abnormalities in different components of developing teeth and can affect dental development. We compared dental development in a group of children with molar-incisor hypomineralization (MIH) with that in age- and sex-matched controls. Dental age was determined using panoramic radiographs of 105 children (59 girls, 46 boys) aged 7-11 years with severe MIH, and the findings were compared with those from 105 healthy age- and sex-matched controls. Although accelerated dental development was noted in the MIH group, the difference between the MIH and control groups was not statistically significant (P < 0.05). Furthermore, no relationship was found between number of affected teeth and the difference between dental and chronological age. In conclusion, children with severe MIH had slightly accelerated dental development as compared with controls.

Treatment outcomes and dental anxiety in 18‐year‐olds with MIH, comparisons with healthy controls – a longitudinal study

In a previous study, 9-year-old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). To assess the long-term outcomes of dental treatments, dental anxiety, and patients' satisfaction in adolescents with MIH. Sixty-seven patients, identical with those in the baseline study, were studied at age 18-years. The participants answered the Children's Fear Survey Schedule - Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were compiled from the dental records concerning dental health, number of restorative treatments and BMP. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. Conclusions. Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18-years. However, their dental fear was now at the same level as the controls.

Increase in severity of molar-incisor hypomineralization and its relationship with the colour of enamel opacity: a prospective cohort study

Predicting risk of posteruptive enamel breakdown (PEB) of molar-incisor hypomineralization (MIH) opacity is a difficult but important clinical task. Therefore, there is a need to evaluate these aspects through longitudinal studies. The aim of this longitudinal study was to analyse the relationship between colours of MIH opacity of children aged 6-12 (baseline) and other clinical and demographic variables involved in the increase in severity of MIH. A blinded prospective 18-month follow-up was conducted with 147 individuals presenting mild MIH. Tooth-based incidence of increase in severity of MIH (PEB or atypical restorations) was used as dependent measurement. Enamel opacities were recorded according to colour shades of white, yellow and brown, allowing assessment of susceptibility to structural loss over time, according to colour of MIH opacity. Poisson regression models were used to adjust the results for demographic and clinical variables. Brown and yellow MIH opacities were at higher risk for PEB and atypical restorations than those of white ones, even after adjustment for clinical and demographic variables. Teeth presenting mild MIH severity associated with yellow and brown enamel opacities were at high risk for increase in severity of MIH than lighter ones. This result could help clinicians determine a risk-based treatment for children with MIH.