Clinical studies on Molar-Incisor-Hypomineralisation (MIH) and on Molar-hypomineralisation (MH)

Development of the severity index(HSI)

Author: Orbán TimeaCo-authors: Cristina Bică, Crișan Mihaela Laura

Lecturer: Cristina Bică PHD

Definition

Clinical appearance, symptoms and signs In MIH and MH we can see white-cream opacities or

yellow-brown discoloration with or without post-eruptive breakdown

MH: one or more affected FPM MIH: one or more affected FPM asociated with

hypomineralised permanent incisors

Objective To examine 261

children with or without hypomineralisation in order to develop the hypomineralisation severity index(HSI)

To clarify aetiological factors

Aetiology

Materials and methods Data collection

There were examinated 261 children between 9-11 years

63 of them showed signs of hypomineralisation (prevalence of 24,1%)

The parents completed a questionnaire describing their perinatal and medical histories

Questionnare Did you had any illnesses during

pregnancy? Did you take any antibiotics during

pregnancy? Birth prematurity? Illnesses of the child: pneumonia?

upper respiratory infections? fevers? otitis media?

Classification 1

Classification of Alaluusa (1996) Mild- color change: white, yellow or

brown Moderate- loss of enamel only Severe- loss of enamel in association

with affected dentine

Classification 2

Classification of Leppaniemi (2001) Mild- white-cream opacities Moderate- yellow-brown coloration Severe- PEB

HSI An index of hypomineralisation severity

was computed, based on the extension of the affection on dental surfaces HSI=0: no signs of hypomineralisation HSI=1: one surface is affected HSI=2: two surfaces HSI=3: three surfaces HSI=4: four surfaces HSI=5: five surfaces

Results 63 of the 261

children showed signs of hypomineralisation (prevalence 24,1%)

no signs ofhypomineralisation =198

MH =27

MIH =36

Results Some medical

conditions affect the mineralisation of the first permanent molars and permanent incisors

One or more conditions were collated with hypomineralisation (57 of 63 children, 90,47%)

Results of the questionnaire

9,52%-no illnesses 23,80%-fevers 14,28%-birth prematurity 9,52%-pneumonia 33,33%-upper respiratory

infections 23,80%-tonsillitis

Results of the clinical examination

In MH in 77,77% there were only one affected first permanent molars

In MIH in 75% there were affected all four first permanent molars.

HSI-MIH>HSI-MH

MH with onlyone affectedFPM = 21

MH with morethan oneaffected FPM=6

MIH with allfour FPM withhypomineralisation =27

MIH with threeor less FPMwithhypomineralisation =9

Discussion

Melbourne Dental School, Australia: dentitions MIH had higher severity indices than those with MH

Medical histories showed that most of the children had one or more relevant conditions in the first three years of life

Conclusions The severity index of the MH is always

lower than the severity index of the MIH MIH is more severe form of the

hypomineralisation than MH In most of the cases of MH there is only

one FPM with hypomineralisation In most of the cases of MIH there are

affected all four FPMs Some medical and perinatal conditions

can affect the mineralisation of the enamel

Bibliografy N.S.Willmott, R.A.E. Bryan, M.S. Duggal: Molar-

Incisor-Hypomineralisation, A literature review N.Chawla, L.B. Messer, M. Silva: Clinical

studies on Molar-Incisor-Hypomineralisation M. Pereira Alves dos Santos, L. Cople Maia:

MIH:Morphological, Aetiological, Epidemiological and Clinical Considerations

Weerheijm: MIH A.J. Munoz, J.D. Melendez, C.V. Gonzalez, C. Z.

Sanchez: Frecvency and severity of Molar Incisor Hypomineralisation in Patients treated at the Dental Clinic of the Universidad de la Frontera, Chile

“MH is a sort of birth defect, where the tooth isn’t made

properly before it’s born into your mouth”