Severity Of Molar Incisor Hypomineralization Research Articles

Prevalence and severity of molar-incisor hypomineralization, is there an association with socioeconomic status? A cross-sectional study in Chilean schoolchildren.

Data about molar-incisor hypomineralization (MIH) prevalence and its severity remains limited for some Latin American countries. Furthermore, its association with socioeconomic status (SES) is still unclear. Thus, this study aims to determine the prevalence and severity of MIH in Santiago, Chile and explore its association with SES. A cross-sectional study with schoolchildren between 6 and 12 years was conducted. Children were evaluated using the European Academy of Paediatric Dentistry to diagnose MIH, and the Mathu-Muju and Wright criteria to determine its severity. A total of 1,270 children were included. The MIH prevalence was 12.8% without association with gender (p = 0.609). Prevalence was higher among schoolchildren ages 8 and 9 (p = 0.002), and in lower SES (p = 0.007). MIH mild cases were the most prevalent (63%), and severity was not related to gender (p = 0.656), age (p = 0.060), or SES (p = 0.174). The prevalence of MIH in the province of Santiago, Chile is 12.8% and was found to have a higher incidence in 8-9-year-old students and among those categorized by low SES. Furthermore, MIH prevalence was associated with low SES. Public health policies to address MIH in Chile should start with schoolchildren aged 8 to 9,and with low SES.

Association of dental hypersensitivity and anxiety in children with molar-incisor hypomineralisation (MIH).

The objective of this study was to investigate whether dental hypersensitivity and dental fear were linked to the presence and severity of MIH. For this cross-sectional study, 1830 students between the ages of 6 and 12years were recruited from four randomly selected schools. The Children's Fear Survey Schedule-Dental Subscale questionnaire was used to assess dental anxiety and fear. The children's self-reported dental hypersensitivity resulting from MIH was evaluated using the Wong-Baker Facial Scale and the Visual Analog Scale (VAS). MIH was correlated with tooth hypersensitivity, particularly in severe cases. Dental fear was present in 17.4% of the children with MIH, but it was not associated with dental hypersensitivity, gender, or age. No association was found between dental fear and dental hypersensitivity in children with MIH.

Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study.

Molar incisor hypomineralization (MIH) is an emerging clinical problem as the affected tooth is prone to dental caries with the lapse of time. To assess the prevalence, severity, and associated risk indicators of MIH amongst 8-13 years of children of Vadodara District, Gujarat, India. A cross-sectional study with a sample size of 3,000 government schoolchildren. A total of 1,500 children each from urban and rural areas were randomly selected and examined. Only permanent incisors and first molars were examined. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Paediatric Dentistry (EAPD), 2003. To check the relation between the two variables-Pearson's chi-squared test was applied. Fisher's exact test was applied when less than five expected values were found. A total of 286 children (9.6 %) had MIH, with 189 (rural) and 97 (urban) children. MIH was significantly higher in the rural population as compared to the urban. In the rural area, the cause was found to be a child suffering from an illness (>15 days) which was 35.98%, and in the urban area was due to prolonged use of antibiotics before 4 years of age, which was 28.87%. The overall prevalence rate of MIH among the screened children between the age-group 8 and 13 was found to be 9.6%. Males were more affected. The severity of MIH was more in molars compared to incisors and more in children of rural areas. Protocol for early diagnosis and follow-up to access the squeal of breakdown should be undertaken along with parents and health workers. Shah VU, Dave BH, Chari DN, et al. Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):280-286.

An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol

Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental anomalies in different populations. Investigators were trained and calibrated for the assessment of MIH and dental anomalies and ethical approvals obtained in each participating country. The study aimed to recruit 584 children with MIH and 584 children without MIH. Patients aged 7-16 years who attend specialist clinics will be invited to participate. Children will undergo a clinical examination to determine the presence and severity of MIH, using an established index. The presence of any other anomalies, affecting tooth number, morphology, or position, will be documented. Panoramic radiographs will be assessed for dental anomalies and the presence of third permanent molars. Statistical analysis, using a chi squared test and regression analysis, will be performed to determine any differences in dental anomaly prevalence between the MIH and non-MIH group and to determine any association between dental anomalies and patient characteristics. This large-scale study has the potential to improve understanding about MIH with benefits for patient management.

Prevalence and severity of Molar-Incisor Hypomineralisation in children in Fujairah, United Arab Emirates.

This study aims to find the prevalence of MIH in children in the city of Fujairah, United Arab Emirates, utilising the current standardised guidelines for diagnosis and calibration. Molar-Incisor Hypomineralization (MIH) prevalence in paediatric patients has been widely studied. However, most of the available studies have utilised criteria that did not offer consistent diagnostic and calibration tools, which resulted in incomparable results. Cross-sectional study. One hundred sixty-two school children aged 7-9 years in the city of Fujairah, UAE have been randomly selected and orally examined for the presence of MIH lesions. This was conducted following Ghanim et al. [2015] guidelines and after calibrating examiners following Ghanim et al. [2017] training manual. MIH prevalence was high in the city of Fujairah, UAE. More studies utilising the standardised criteria are required for valid comparisons. Further research on the aetiology of MIH is also needed.

Assessment of oral manifestations in pediatric patients with celiac disease in relation to marsh types

To investigate the presence of molar-incisor hypoplasia and recurrent aphthous ulcers, the level of caries experience, and oral hygiene status, and to measure salivary flow rate, salivary buffer capacity, and salivary cariogenic microflora with Marsh types. A single-blind, prospective clinical study with 62 pediatric patients diagnosed with celiac disease with 64 controls. Clinical identification of molar-incisor hypomineralization (MIH) was followed according to the European Academy of Pediatric Dentistry criteria. DMFS and dfs index were used for the caries experience of each child. The clinical diagnosis of RAU was present or not. Oral hygiene was surveyed by recording the OHI-S and the CRT® Bacteria and Buffer Test was used to examine the cariogenic microflora of each child. The prevalence of MIH was 61% and the number of recurrent aphthous ulcers were significantly higher in children with celiac disease. There was no statistically significant difference in the CD group, when DMFS, dfs, and MIH parameters were investigated according to dietary compliance. Higher dietary compliance resulted in better oral hygiene status. There was an inverse relationship between the duration of celiac diagnosis and the presence of MIH. A positive relation was found between the duration of the disease and the severity of MIH. In addition to the higher S. mutans counts, the salivary flow rate was very low in children with celiac disease, indicating a positive correlation between poor dietary compliance and poorer oral hygiene. In children, enamel defects and recurrent mucosal lesions may be a sign of celiac disease. Higher numbers of dental caries in permanent teeth of children with celiac disease may be related to Marsh 2 type. The pediatricians and/or pediatric gastroenterologists should refer the chin with celiac disease to the pediatric dentist for the accurate treatment of intraoral manifestations of the disease itself.

Restauração de molares afetados pela Hipomineralização Molar-Incisivo utilizando a técnica da réplica oclusal

ABSTRACT The aim of this study was to report the clinical case of an 8-year-old male patient seen at the Pediatric Dentistry outpatient clinic at the Universidade Federal do Paraná, Brazil, diagnosed with molar-incisor hypomineralization (MIH) after presenting with pain in teeth 16, 36, and 46, which had extensive atypical cavities and opacities on the adjacent enamel. A diagnostic wax-up of affected teeth was performed for manufacture of silicone occlusal matrix. Encapsulated high-viscosity glass ionomer cement was handled and inserted into the occlusal matrix which was fitted onto the teeth by slight finger pressure. After setting time, excess of material was removed, and occlusion was checked. A flowable resin coating material was applied, and the restorations were finished. Six months later, the restorations performed for treatment of the severe MIH lesions proved to be efficient, lowering the sensitivity reported by the patient, reshaping the teeth, improving their function, and refining dental esthetics.

Determination of dental caries, molar-incisor hypomineralization, and oral health-related quality of life in schoolchildren: A structural equation modeling approach.

Some oral conditions can have psychosocial consequences that affect children's daily life and well-being. To create a structural model for the determination of dental caries, molar-incisor hypomineralization (MIH), and the impact of these conditions and socioeconomic status on schoolchildren's oral health-related quality of life (OHRQoL). A representative cross-sectional study was conducted in Lavras, Brazil, with 1181 female and male schoolchildren 8-9 years of age. OHRQoL was measured using the Brazilian version of the CPQ8-10. Clinical examinations were performed by a calibrated dentist for the diagnosis of dental caries (WHO) and MIH (EAPD). Parents/caregivers answered questionnaires addressing the child's medical history and socioeconomic status. Data were analyzed using structural equation modeling. The model revealed that greater MIH severity (β=.874; p < .001) and worse socioeconomic status (β=-.060; p=.001) were associated with a greater number of teeth with caries experience. The higher the number of teeth with caries experience (β=.160; p=.007) and worse socioeconomic status (β=-.164; p < .001), the greater the negative impact on OHRQoL. The model created showed that dental caries and socioeconomic status had a direct negative impact on the OHRQoL of schoolchildren and MIH had an indirect impact mediated by the occurrence of caries experience.

Conservative Management of Molar Incisor Hypomineralization Using Biomimetic Material in a 9-Year-Old Boy

Comprehensive management of severe molar incisor hypomineralization with dental caries in a 9-year-old boy is reported. After the consultation, diagnosis and treatment planning; upon obtaining the consent from parents, and behavior modification of the child over a preparatory visit, three of the four permanent first molars (PFMs) were treated: two with indirect pulp therapy and one with direct pulp capping using tricalcium silicate cement. After observation of 1 month for each tooth, preformed stainless steel crowns (SSCs) were placed on all three PFMs in a diagonal manner for minimizing occlusal discomfort. The remaining PFM (36), restored earlier by another dentist, developed a dentoalveolar abscess during the course; the same was treated endodontically and a coronal seal was established with an SSC. A quadrant approach was adopted to complete extractions of all carious primary teeth along with the treatments of PFMs during the same appointments to minimize the number of visits. Local anesthesia with 4% articaine with adrenaline infiltrations was used for all quadrants except for the third where an inferior alveolar nerve block with 2% lignocaine with adrenaline was given. Follow-up of all PFMs, over a period of over 9 months, was uneventful. The endodontically treated PFM, too, showed satisfactory recovery, posttreatment.

Association between hypomineralization of deciduous and molar incisor hypomineralization and dental caries

This study aimed to evaluate the association between the severity of hypomineralized second primary molars (HSPM), molar-incisor hypomineralization (MIH) and dental caries in children. 450 children between the ages of 6 and 7 years were included in this cross-sectional study. A calibrated examiner classified the enamel hypomineralizations and dental caries lesions using the MIH and HSPM and the Nyvad criteria, respectively. The primary outcome was the severity of MIH according to the severity of HSPM. Statistical analysis was performed using the generalized linear model and ordinal logistic regression. The prevalence of concomitant MIH and HSPM was 26% sex and age adjusted. Mild enamel defects were more frequent than severe enamel defects. An association was found between the severity of MIH and HSPM, both for mild defects (OR=87.54; 95%CI: 55.87, 137.17) and severe defects (OR=82.15; 95%CI: 45.72, 147.61). The severity of hypomineralization in permanent molars was associated with the activity of dental caries lesions (OR=29.85; 95%CI: 12.95, 68.83). To conclude, there is a strong association between the severity of HSPM and MIH, which is more significant in the presence of active dental caries lesions.

Changes in oral health-related quality of life after treatment of molar incisor hypomineralisation using Glass Hybrid Restorations.

To assess the changes in children's oral health-related quality of life following the treatment of severely affected molar-incisor hypomineralisation with Glass Hybrid Restorative System (GH) after selective caries removal. The observational cross-sectional study was conducted at the Marmara University, School of Dentistry, Department of Pediatric Dentistry, Istanbul, Turkey.. Children aged 11-14 years (n = 55) who were diagnosed with MIH and had finished their dental treatment from November 2018 to December 2019, were included. The children's MIH-affected teeth were treated with GH after SCR. Participants answered the Child Perceptions Questionnaire (CPQ11?14) prior to their dental treatment and 6 months after the treatment. Of the fifty-five patients, 40 patients (24 girls-16 boys) completed baseline and follow-up data. The mean age of the children was 11.85 ±1.02 years. The overall CPQ score ranged from 3-83 (average 33.27 ± 16.46) at baseline and 0-61 (average 11.67 ± 11.21) at follow up. The emotional well-being among children was the highest score at baseline. A significant decrease (p < 0.001) in the mean values was observed for both the overall CPQ scores and for the scores of the oral symptoms, functional limitations, and social-emotional well-being limitation. All subdomains showed large effect sizes and oral symptom limitation domain presented the greatest effect. Wilcoxon Rank test was used to determine the statistical significance of the changes and the magnitude of change was determined by calculating and classifying the effect size. Restorative treatment with GH following selective caries removal positively influenced the oral health-related quality of life of children with severe molar-incisor hypomineralisation.

Prevalence, Pattern, and Severity of Molar Incisor Hypomineralization in 8-12-year-old Schoolchildren of Moradabad City.

Recently, molar incisor hypomineralization (MIH) has become more evident and one of the most common reasons for loss of teeth in children after dental caries. Being a country with a diverse ethnic population, the prevalence of MIH in different regions of India may differ. Hence, the present study was undertaken to determine the prevalence, pattern, and severity of MIH in 8-12-year-old Schoolchildren in Moradabad city. This study was conducted in various schools of Moradabad city to target a sample of 2,300 children aged between 8 and 12 years. The examination was done in their respective schools by a calibrated examiner in natural daylight using European Academy of Pediatric Dentistry diagnostic criteria for MIH 2015. The results, thus obtained, were statistically analyzed using Pearson's Chi-square test. A prevalence of 3.96% (91/2300) for MIH was reported without any gender predilection. Molar hypomineralization showed a prevalence of 1.3% (29/2300) whereas the prevalence for hypomineralization of second primary molars was 1.4% (22/1620). The most common type of defect was type 2 and most of the affected teeth were of grade I. Mandibular molars were more commonly affected compared to the maxillary molars. A prevalence of 3.96% (91/2300) was observed for MIH. Frequent dental screening camps should be organized in schools at the community level for the enhancement of early diagnosis of MIH and designing appropriate management strategies. Khan A, Garg N, Mayall SS, et al. Prevalence, Pattern, and Severity of Molar Incisor Hypomineralization in 8-12-year-old Schoolchildren of Moradabad City. Int J Clin Pediatr Dent 2022;15(2):168-174.

Correlation between the Prevalence and Severity of Molar Incisor Hypomineralization and Age and Sex among a Group of Egyptian Children: A Cross Sectional Study

Correlation between the Prevalence and Severity of Molar Incisor Hypomineralization and Age and Sex among a Group of Egyptian Children: A Cross Sectional Study

Treatment of Severe Caries and Molar Incisor Hypomineralization and Its Influence on Oral Health-Related Quality of Life in Children: A Comparative Study

Background: Treatment of oral diseases can have a long-lasting impact on a child’s life well beyond its childhood years. The purpose of this study was to compare the impact of treatment on the oral-health-related quality of life (OHRQoL) of children with severe caries and severe molar incisor hypomineralization (MIH). Methods: A total of 210 children (mean age 9 years; 49% female) with severe caries (inner third of dentin) and severe MIH (post-eruptive breakdown, crown destruction) were included in the study. Both groups were matched according to age, gender, and social status. The German version of the Child Perception Questionnaire for 8–10-year-olds (CPQ-G8–10) was used before and after treatment to analyze the impact on OHRQoL. Results: Patients with severe MIH showed a significantly higher total CPQ score (17.8 (±10.6)) before treatment compared to the caries group (13.8 (±14.3)). The mean CPQ score in all subdomains decreased significantly after therapy in the MIH group. Children with severe carious lesions had similar results except in the domain “functional limitations”, as treatment led to only minor changes (2.9 (±3.6) to 2.2 (±2.6)). Conclusions: Despite a narrower treatment spectrum, patients with severe MIH experienced a greater overall improvement in OHRQoL compared to the caries group.

Impact of molar incisor hypomineralization on oral hygiene and gingival health in 8-15-years-old children.

This study aimed to evaluate the impact of molar incisor hypomineralization (MIH) on oral hygiene and gingival health, and to investigate the relationship between these factors and the severity of MIH. A total of 72 children (48 with MIH and 24 healthy controls) were included in the study. MIH severity was categorized into three groups:mild (n = 16), moderate (n = 16) and severe (n = 16).The modified-Quigley Hein plaque index (m-QHPI) was used to determine oral hygiene, and the gingival index (GI) and bleeding on probe (BOP) were used to determine the gingival status of each subject. The Mann-Whitney U test was used for binary comparisons and the Kruskal-Wallis test was used for multiple comparisons. The m-QHPI,GI and BOP were significantly higher in all individuals with MIH compared with the control group. The m-QHPI increased with the severity of MIH (P &lt; 0.001).The GI of the MIH-affected teeth had highly significant increases according to MIH severity (P &lt; 0.05). The mean BOP score for the entire mouth was significantly higher in patients with severe and moderate MIH than mild MIH (P &lt; 0.001). The mean BOP for affected teeth with moderate and severe MIH was significantly higher than the mean BOP of mildly affected teeth (P &lt; 0.05). The presence and severity of MIH might be associated with increased plaque accumulation and gingival inflammation. © 2022 Australian Dental Association.

The association between molar incisor hypomineralization and oral health-related quality of life: a cross-sectional study.

ObjectivesWe aimed to assess the association between molar incisor hypomineralization (MIH) and the oral health-related quality of life (OHRQoL) in a group of 7- to 14-year-old children in Berlin, Germany.Materials and methodsThe cross-sectional study consisted of a consecutive sample of 317 children, aged 7–14 years (49% girls, 51% boys; mean age, 8.71). Data were collected between June 2018 and December 2019. MIH was diagnosed using the criteria of the European Academy of Paediatric Dentistry. OHRQoL was assessed using the German 19-item version of the Child Oral Health Impact Profile (COHIP-G19). Differences in COHIP-19 summary scores between controls without MIH and MIH patients and with regards to MIH severity were tested for statistical significance using t test and analysis of variance (ANOVA), respectively.ResultsData were obtained for 217 untreated MIH patients and 100 controls. OHRQoL of MIH patients was significantly more impaired than of controls indicated by COHIP-19 mean scores (60.9 ± 10.7 vs. 67.9 ± 7.8; p < 0.001). Patients with severe MIH (59.6 ± 11.0) reported significantly worse OHRQoL than patients with mild MIH (63.6 ± 9.1; p = 0.013).ConclusionsMIH has a significant negative impact on the children’s OHRQoL. Patients with severe MIH experience a greater negative impact on OHRQoL than those diagnosed with mild MIH.Clinical significanceMIH is one of the major dental problems of our time; pediatric dentists should be aware of its impact on the OHRQoL of the patient.

Tips for private practice on molar-incisor hypomineralisation therapy

The treatment of severe molar-incisor hypomineralisation (MIH) is often a challenge for both the patient and the practitioner. Factors such as hypersensitivity, pulpitis, partially erupted molars, and reduced adhesive bond strength make dental work more difficult and reduce long-term success. It is particularly important for everyday practice that there is a wide range of temporary restoration options even for teeth that are difficult to restore. The present paper deals with the practical recommendations for the therapy of MIH. Therapy recommendations from the European Academy of Pediatric Dentistry (EAPD) and the Würzburg MIH Concept are considered. In addition, established therapy methods from the Universities of Bern and Zurich will be discussed.

Association Between Frequency and Severity of Dental Fluorosis and Molar Incisor Hypomineralization.

To assess the association between the frequency and severity of dental fluorosis (DF) and molar incisor hypomineralization (MIH) in a fluoridated salt region. In this retrospective cross-sectional study, we evaluated the buccal, occlusal/incisal, and palatal/lingual surfaces of first permanent molars and permanent incisors of 453 patients aged 13-16 years through intraoral standardized photographs. Two standardized examiners evaluated DF and MIH independently, utilizing the Thylstrup-Fejerskov (TF) index and the MIH index. The statistical analysis was performed using a generalized linear model and logistic regression adjusted for age, sex, and dental caries experience. The MIH frequency at the surface level was lower in the presence of DF (PR= 0.03; P= 0.00, 95% CI: 0.01-0.08). At the surface level, MIH severity was lower among those presenting mild DF (aOR= 0.02; 95% IC: 0.01-0.07). Regarding severe DF, we found no significant difference in MIH severity (P= 0.174). MIH frequency and severity tend to be lower in the presence of DF.

Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial

Molar incisor hypomineralization (MIH) is often accompanied by dental hypersensitivity and difficulty in achieving effective analgesia.Objective:This study evaluated the effectiveness of preemptive analgesia in children with severe MIH, post-eruptive enamel breakdown, and hypersensitivity.Methodology:Ibuprofen (10 mg/kg child weight) or placebo was administered, followed by infiltrative anesthesia and restoration with resin composite. Hypersensitivity was evaluated in five moments. The data were analyzed using the chi-square test, Fisher’s exact test, and t-test.Results:Preemptive analgesia provided benefits for the treatment of severe cases of MIH, with an increase in the effectiveness of infiltrative anesthesia and improved patient comfort during the restorative procedure.Conclusion:Preemptive analgesia has shown efficacy in reducing hypersensitivity during restorative dental procedures, evidencing the significance of this study for patients with MIH and hypersensitivity.

Restoration of teeth affected by molar-incisor hypomineralisation: a systematic review.

The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases PubMed, Embase, and Cochrane Library were searched. Only retrospective and prospective clinical studies dealing with sealing or restoration of MIH-affected teeth were included. The language was restricted to English or German. Thirteen of 36 potentially eligible studies were included focusing on the following subjects: extension of enamel preparation, adhesive procedures prior to restoration, application of fissure sealants as well as restoration with conventional glass ionomer cements (GIC), resin modified glass ionomer cements (RMGIC), resin composites, and indirect restorations. Seven clinical studies were controlled trials. However, only two included MIH-unaffected teeth as control. No meta-analysis was performed due to the heterogeneity of study designs (e.g. severity of MIH or the restorative materials investigated). Based on the present analysis, the annual failure rates were in average 21% for fissure sealants, 22% for GIC, 1-6% for RMGIC, 13-32% for resin composites, and 0-7% for indirect restorations. In summary, only few tendencies can be deduced from this review at a low level of evidence (number of studies): 1) preparation margins in sound enamel seem to be superior to preparations in hypomineralised enamel (1 study), 2) RMGIC seems to be superior to GIC (3 studies), 3) resin composites may be used for restoring all severities of MIH (7 studies) with self-etch and etch-and-rinse adhesive systems generally not performing differently (3 studies), and 4) in cases of severe MIH, indirect restorations showed a good clinical success (4 studies).