Treatment Of Molar Incisor Hypomineralization Research Articles

Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review.

Molar incisor hypomineralization (MIH) is a significant health problem that can affect the child's quality of life by negatively affecting their esthetics and function. This review aimed to summarize the etiology and pathogenesis of MIH. It also aimed to summarize the recent studies on MIH in children and adolescents, focusing on diagnosis, prevention, and clinical management. An electronic search on the PubMed, Cochrane Database of Systematic Reviews, MEDLINE, MedlinePlus, WHO reports, and Google Scholar databases was performed. The volume of research on the etiology, presentation, and clinical management of MIH is still expanding. The creation and validation of indices for the diagnosis and management of MIH, as well as any potential genetic aspects appear to be the main areas of current research. Notably, MIH was linked to childhood illnesses, the use of antibiotics, and early childhood fever. Although many studies discuss the different options for managing MIH lesions, evidence-based studies that address the long-term outcomes of MIH are still lacking. Indeed, future clinical studies should be directed to evaluate the impact of each systemic etiological factor and its different types of management on normal amelogenesis. Regarding the diagnosis, future research should focus on the pre-eruption diagnosis and early approaches to prevent the post-eruption breakdown and caries. Regarding the treatment of MIH, future investigations should emphasize further improvements in adhesion and the use of new materials and techniques, such as digital dentistry.

Management of Teeth Affected by Molar Incisor Hypomineralization Using a Resin Infiltration Technique—A Systematic Review

In recent years, an increase in children diagnosed with molar incisor hypomineralization (MIH) has been observed. Children with MIH show a high failure rate with conservative treatment. The ICON® system (DMG, Hamburg, Germany), which is an infiltration of decalcified lesions with resin, may strengthen the tooth structure, improve its aesthetics, and cure hypersensitivity. The following article is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Scientific articles in the PubMed and Google Scholar databases describing the use of the ICON system in the treatment of MIH published in the years 2012–2022 were analyzed. Two independent study authors selected publications that show that the ICON system can be used during the treatment of children with MIH. So far, in the literature, there are no standardized protocols for the dental treatment of patients with hypomineralization of the incisors using the ICON system. Therefore, clinicians rarely use this method of treatment. The ICON system may be successfully used to infiltrate tooth decalcification in children with MIH. However, the depth of infiltration and the achievement of enamel hardness after such therapy are not precisely defined.

How is the quality of the available evidence on molar-incisor hypomineralization treatment? An overview of systematic reviews.

This overview analyzed the quality of the systematic reviews (SRs) available on treatments for molar-incisor hypomineralization (MIH). Six electronic databases were searched (PubMed/MEDLINE, Scopus, Web of Science, LILACS, Brazilian Bibliography of Dentistry and Cochrane Library) until March 2022. Two reviewers independently performed the selection, the quality assessment (Assessment of Multiple Systematic Reviews 2 - AMSTAR-2), and the risk of bias assessment of the SR (Risk of Bias in Systematic Reviews - ROBIS). Two hundred nine records were retrieved; after removing duplicates and applying the inclusion/exclusion criteria, 5 SRs remained. Three SRs were rated as showing critically low methodological quality and high risk of bias, and two were rated as moderate methodological quality and low risk of bias. The identified treatments that may be suitable for MIH were classified as (1) non-invasive - casein incorporated into toothpaste and sugar-free chewing gum, toothpaste containing arginine, 0.4% stannous fluoride gel; fluoride varnish; (2) micro-invasive - resin sealants for pits and fissures, microabrasion, dental whitening, resin infiltration; (3) invasive - ART restorations, indirect restorations (metal, composite, or ceramic); and (4) mixed intervention - stainless steel crowns. Despite the considerable number of published papers included in this set of systematic reviews, the evidence supporting the effectiveness of treatments for treating MIH is limited due to the methodological quality and risk of bias of the systematic reviews, as well as the quality of the primary studies (PROSPERO: CRD42020144831). Different treatments have been purposed for MIH treatment, but there is still not enough scientific evidence of good quality for the establishment of a definitive clinical protocol for the treatment of MIH.

Etiological Factors Involved in Molar-Incisor Hypomineralization in 7 to 12-Year-Old Children in Tehran.

Objectives: Molar-incisor hypomineralization (MIH) lesions are common in children. The prevalence of MIH is variable in different communities. However, information regarding the prevalence of MIH in the Iranian population is limited. This study sought to assess the prevalence and etiological factors of MIH in 7-12-year-old children in Tehran. Materials and Methods: This descriptive, cross-sectional study evaluated 1028 elementary students between 7-12 years, selected from different districts of Tehran in 2017. The frequency of MIH in the maxillary and mandibular molars and incisors was determined by clinical examination. In order to assess the role of different factors in the development of MIH, a questionnaire was filled out by the mothers regarding problems during their pregnancy, medical history of children, and age of occurrence of systemic conditions (if any). The effect of different factors on the development of MIH was analyzed by the logistic regression test. Results: The prevalence of MIH was found to be 25.6%. The delivery condition of the mother (P<0.001), history of urinary tract infection (P<0.011), history of chickenpox (P<0.018), and frequent use of amoxicillin during childhood (P<0.041) significantly affected the occurrence of MIH. The most commonly involved teeth were the mandibular left first molars. Conclusion: The prevalence of MIH in our study population was within the range reported in the literature. Considering the relatively high prevalence of MIH in 7-12-year-old children, pediatric dentists should pay special attention to treatment of MIH.

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.

Management of molar–incisor hypomineralization and hypodontia in monozygotic twins: a case report

Molar–incisor hypomineralization (MIH) is the hypomineralization of permanent first molars and is often associated with similarly affected incisors. This can lead to caries development and post-eruptive enamel breakdown. Early diagnosis and management are of prime importance to prevent premature loss of these molars at a young age, and to mitigate against negative changes on the patient's quality of life. This is particularly true when the patients also present with hypodontia. Wherever possible, conservative management in primary care should be undertaken. This case report explores the presentation and on-going treatment of MIH, and hypodontia, illustrated in monozygotic twin males. CPD/Clinical Relevance: It is important to consider factors involved in the early identification of MIH and hypodontia and to develop strategies to treat the patient.

Hipomineralização Molar-Incisivo em dentes permanentes: revisão de literatura

A Hipomineralização Molar-Incisivo (HMI) é uma terminologia descrita para determinar os Defeitos de Desenvolvimento do Esmalte (DDE), causados durante a etapa de maturação, caracterizando-se por defeitos qualitativos, com uma etiologia sistêmica que pode afetar apenas um molar permanente ou, também, os quatro molares. Frequentemente, está associada a alterações nos incisivos permanentes, igualmente afetados. A prevalência, etiologia e tratamento da HMI ainda não estão bem definidos. Desta forma, esse estudo teve por objetivo analisar a prevalência, etiologia e tratamento da Hipomineralização Molar-Incisivo (HMI) em dentes permanentes. Para seu desenvolvimento, foi realizado um levantamento bibliográfico nas seguintes bases de dados online, BVSalud, SCielo e Lilacs, empregando 26 estudos, que demonstraram o valor do diagnóstico precoce e da adequada terapêutica em casos de Hipomineralização Molar-Incisivo. Assim, conclui-se que a prevalência pode-se considerar relativamente alta, para um tema não muito relatado na literatura. Além disso, nota-se que há uma relação entre HMI e problemas de saúde nos primeiros anos de vida, além de fatores genéticos associados e que os principais métodos terapêuticos para HMI devem ser baseados na qualidade de vida relacionada à saúde bucal. No entanto, outras investigações devem ser realizadas.

Dental management strategies for Molar Incisor Hypomineralization

Abstract Background Molar Incisor Hypomineralization (MIH) is defined as a hypomineralization of systemic origin that can affect all permanent first molars and, in most cases it can also affect the permanent incisors. Objective The aim of this review was to describe the various options available to treat and restore MIH-affected molars. Results MIH is a developmental, qualitative enamel defect caused by reduced mineralization of the inorganic enamel components, leading to enamel discoloration and defects in the affected teeth. MIH in permanent molars is usually associated with caries and intense pain, and children often become disruptive during MIH treatment due to the challenges associated in achieving proper anesthesia of the affected teeth. Conclusion Early detection and appropriate therapy can prevent severe complications and improve both masticatory function and esthetics. The treatment of MIH varies from a simple procedure, such as a controlled clinical eruption, to extensive and recurrent treatments in more severe cases.

Prevalence, aetiology, and treatment of molar incisor hypomineralization in children living in Izmir City (Turkey).

Molar incisor hypomineralization (MIH) is frequent in children and etiology is different. The aim of this study was to determine the prevalence, severity, and risk factors of MIH and to investigate the relationship between the severity of the defect in the teeth affected by MIH and the risk factors. The study included patients at the age range of 9 and 10years, who were admitted to the clinic of paediatric dentistry in Dokuz Eylul University and had four-first molar teeth (FMT) and eight incisor teeth eruptions in the jaws. The presence of only demarcated opacities in one or several FMT and incisor teeth was defined as MIH1, and the presence of post-eruptive breakdown (PEB), atypical restorations, and extracted teeth was defined as MIH2. MIH was detected in 142 (11.5%) of 1237 children. Although there was no statistically significant difference between upper and lower FPM and the occurrence of MIH (P<0.902), there was a difference between upper and lower central and lateral teeth (P<0.001; P<0.009). A significant difference was detected between birth week, birthweight, high fever, and asthma/bronchitis and MIH1 and MIH2 (P<0.001). The prevalence of MIH was found to be 11.5%. It was observed that the patients undergoing low birthweight, preterm delivery, high fever, and asthma/bronchitis were more severely affected by MIH.

Esthetic Approach for Treatment of Molar Incisor Hypomineralization: A Case Report

Stains and irregularities on tooth surfaces are factors that often lead patients to seek dental treatments to improve their smile aesthetics. Among these lesions, one may cite Molar Incisor Hypomineralization (MIH). MIH is a lesion of hypomineralization of systemic origin, in which up to four first permanent molars may be affected, concomitantly or not with incisors. This case report aims to describe the step-by-step of a treatment of MIH on left maxillary central incisor of a young patient. Accordingly, a direct restoration was performed with conventional composite resin, allowing the reestablishment of aesthetics and function, significantly influencing the self-esteem and quality of life of the patient.

Knowledge, perceptions, and clinical experiences on molar incisor hypomineralization among dental care providers in Hong Kong

BackgroundMolar incisor hypomineralization (MIH) is an alarming problem with considerable challenges in management. This study aimed to evaluate and compare the knowledge, perceptions, and clinical experiences of molar incisor hypomineralization (MIH) between general dental practitioners (GDPs) and paediatric dentists (PDs) in Hong Kong.MethodsA cross-sectional survey of 557 randomly selected GDPs (approximately 25% of all registered dentists) and all registered PDs (n = 31) were invited. They were asked to complete a 4-section questionnaire adapted and modified from a study by Gambetta-Tessini and co-workers on sociodemographic profiles, knowledge, experience, and perceptions regarding MIH. Data were analyzed with chi-square, Fisher’s exact, and multiple factor ANCOVA tests.ResultsThe overall response rate was 43.37% (255/588). Majority (74.1%) of the respondents encountered MIH in their practices. A significantly higher mean knowledge score (46.33 ± 7.1) was observed among PDs than GDPs (43.09 ± 7.0) (P < 0.01) and among PDs who are 40 years old or younger (P < 0.001). Differences in treatment of MIH were also observed between PDs and GDPs (P < 0.05). Paediatric dentists were more confident in diagnosing and treating MIH (P < 0.001). Most respondents (87.8%) expressed a need for continuing education on MIH.ConclusionContinuing education on MIH is needed to assure that the highest quality of evidence-based care is given to patients with MIH. Dissemination of latest best evidence on MIH, especially to GDPs, will assure that the condition is accurately diagnosed and well managed.

Prevalence, Etiology, Severity and Treatment of Molar Incisor Hypomineralization for 7 to 9 Years Old Children Attending Royal Medical Services Clinics in Amman, Jordan

Prevalence, Etiology, Severity and Treatment of Molar Incisor Hypomineralization for 7 to 9 Years Old Children Attending Royal Medical Services Clinics in Amman, Jordan

Modified glass ionomer and orthodontic band: An interim alternative for the treatment of molar incisor hypomineralization. A case report.

Introduction: Molar incisor hypomineralization (MIH) is a developmental condition resulting in defects in the enamel characterized by demarcated opacities mainly affecting first permanent molars and occasionally permanent incisors in 1 of every 6 children worldwide. Affected molars have greater susceptibility to post eruptive breakdown, extensive caries and, in severe cases, are difficult to restore. When the MIH-affected molar presents severe crown destruction, it is necessary to perform an intermediate restoration to preserve the remaining dental structure in order to maintain occlusion, proper hygiene and periodontal health. The case of an 11-year-old patient with severe MIH is reported. The patient had extensive crown destruction by caries in tooth 1.6 without clinical or radiographic signs of pulp pathology. After an initial preventive intervention, enamel without dentin support and carious dentin were removed from tooth 1.6. Subsequently, crown restoration was performed with resin-modified glass ionomer, followed by the cementation of an orthodontic band. After 18 months of follow-up, the patient reported no pain or discomfort. The restoration was preserved intact, maintaining occlusal functionality, pulp and gingival health. Conclusion: The interim treatment, cementing an orthodontic band over a tooth restored with glass ionomer seems to favor retention and compressive strength, keeping the MIH-affected molar asymptomatic for at least 18 months. Further studies evaluating this treatment option in similar clinical situations are recommended.Keywords:

Current View on the Diagnosis and Treatment of Molar Incisor Hypomineralization

Molar incisor hypomineralization (MIH) is defined as the hypomineralization of one or more first permanent molars with or without the involvement of the maxillary and mandibular permanent incisors. Although the etiology of MIH remains unclear, several etiological factors, such as the genetic and environmental factors and systemic disturbance during pre-, peri-, and postnatal period, can cause enamel defects and their occurrence. The prevalence of MIH is reported to be between 2.4% and 25% in different communities. Teeth with MIH are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients, and thus, dentists may have difficulties during diagnosis, treatment planning, and managing children with MIH during treatment. Early diagnosis is essential because rapid breakdown of tooth structure may occur, resulting in acute symptoms and complicated treatment. This study aimed to review the diagnosis and etiological factors involved in the occurrence of MIH and to evaluate treatment approaches in the management of MIH.

Hipomineralização incisivo-molar: uma revisão da literatura

Molar Incisor Hypomineralization (MIH) is a hypomineralization of systemic origin affecting one to four permanent first molars and frequently associated with affected permanent incisors. Its etiology is still unclear and affected children often exhibit behavior problems, fear and anxiety, probably related to the repeated treatment needs, and also the difficulty in anesthetizing these teeth. Due to its potential negative impact on oral health of affected individuals and based on a literature search of scientific articles in English published between 1970 and 2011, the authors proposed to review the available information particularly: characteristics of the pathology, etiological factors, diagnosis and treatment of molar-incisor hypomineralization.

Surface Integrity Governs the Proteome of Hypomineralized Enamel

Growing interest in the treatment and prevention of Molar/Incisor Hypomineralization (MIH) warrants investigation into the protein composition of hypomineralized enamel. Hypothesizing abnormality akin to amelogenesis imperfecta, we profiled proteins in hypomineralized enamel from human permanent first molars using a biochemical approach. Hypomineralized enamel was found to have from 3- to 15-fold higher protein content than normal, but a near-normal level of residual amelogenins. This distinguished MIH from hypomaturation defects with high residual amelogenins (amelogenesis imperfecta, fluorosis) and so typified it as a hypocalcification defect. Second, hypomineralized enamel was found to have accumulated various proteins from oral fluid and blood, with differential incorporation depending on integrity of the enamel surface. Pathogenically, these results point to a pre-eruptive disturbance of mineralization involving albumin and, in cases with post-eruptive breakdown, subsequent protein adsorption on the exposed hydroxyapatite matrix. These insights into the pathogenesis and properties of hypomineralized enamel hold significance for prevention and treatment of MIH.