ABSTRACT
BACKGROUND: There is no consensus on which molar incisor hypomineralization (MIH) indices are more suitable for epidemiological surveys. AIM: 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. DESIGN: 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. RESULTS: 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%. CONCLUSION: All systems effectively diagnosed MIH and its characteristics.
ABSTRACT
The restoration of teeth affected by molar-incisor hypomineralization (MIH) is challenging. To this end, preformed stainless steel crowns (SSCs) are a good option; however, their conventional use involves the removal of tooth structure. In the Hall technique, the SSC is seated over the primary teeth without caries removal or tooth preparation, aiming to seal carious lesions. This case series reports the use of SSCs in a similar way to the Hall technique for 3 pediatric patients with MIH. The high-caries-risk patient in case 1 lost hypomineralized enamel and developed a carious lesion immediately after eruption of a permanent first molar. The patient in case 2 complained of hypersensitivity associated with MIH of a first molar that had previously been restored. The patient in case 3 experienced atypical restoration failures in MIH-affected first molars. In all 3 cases, the use of SSCs without tooth preparation was an effective restorative treatment. Although this conservative treatment is a temporary solution, it provides good longevity and preserves tooth structure until the patient reaches physical and emotional/behavioral maturity for a definitive restoration.
Subject(s)
Dental Caries , Dental Enamel Hypoplasia , Child , Crowns , Dental Caries/therapy , Dental Enamel Hypoplasia/therapy , Humans , Incisor , Molar , Stainless SteelABSTRACT
BACKGROUND AND OVERVIEW: Molar-incisor hypomineralization (MIH) is a qualitative developmental defect of enamel, which has been a daily concern in clinical practice owing to its difficult treatment. CASE DESCRIPTION: An 11-year-old girl was admitted to the pediatric dental clinic with a symptom of severe hypersensitivity in the permanent molars owing to MIH. The treatment consisted of a simplified occlusal replica adapted technique with conventional glass ionomer cement in the MIH-affected molars, which involved laboratory and clinical stages. The patient was reexamined every 3 months, and after 18 months there was no additional tooth structure loss, restoration failure, or pain. This technique may be considered a feasible alternative to restore hypomineralized teeth owing to its reduced procedure time and good performance in the follow-up period of 18 months. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The technique successfully restored the function and shape of the affected teeth, decreasing the sensitivity by means of covering the demarcated MIH opacities.
