A case-controlled investigation of risk factors associated with molar incisor hypomineralization (MIH) in 8-12 year-old children living in Chandigarh, India.

PURPOSE: Despite mounting evidence in favour of various perinatal risk factors for occurrence of MIH, verification of these remains doubtful because of lack of documented proof. The present study was aimed at examining the putative risk factors for MIH based on hospital-maintained records assessment. METHODS: A total of 3176, 8-12 year-old children were screened for MIH using EAPD criteria (2003). Of these, risk factor analysis was carried out for 104 MIH affected and 211 non-MIH affected children with complete peri-natal medical records maintained up to 3 year post-birth. Chi-square test was used for risk factor comparison, while significance was assessed using logistic regression. RESULTS: Prevalence of MIH in study population was 11.72% (372/3176). Various pre-natal, natal and post-natal risk factors including intra-uterine growth retardation (6.7 vs. 1.4%); maternal anaemia (10.6 vs. 3.8%) and neonatal jaundice (29.8 vs. 14.2%) were significantly higher in the MIH group. Furthermore, pre-term birth (OR 3.01), low birth weight (OR 2.37), more than three pyrogenic episodes (OR 7.61) and consumption of Amoxicillin Clavulanate (OR 3.01) were significantly associated with higher risk of developing MIH. CONCLUSIONS: Pre and post-natal risk factors showed a moderate to high association for occurrence of MIH although social and nutritional factors had a lesser association.

Prevalence, defect characteristics and distribution of other phenotypes in 3- to 6-year-old children affected with Hypomineralised Second Primary Molars.

PURPOSE: To assess the prevalence, severity and defect characteristics of hypomineralised second primary molars in schoolgoing children along with distribution of other phenotypes. METHODS: A total of 3013, 3- to 6-year-old children were examined for the presence of hypomineralised second primary molars (HSPMs) using an adapted version of EAPD Criteria (2003). The molars were evaluated for the presence, location and colour of demarcated opacities along with associated post-eruptive breakdown (PEB) and atypical restorations. A thorough examination of the entire dentition was followed for evaluation of teeth other than primary second molars for the presence of similar hypomineralised defects. Data were analysed using Chi Square, Fisher exact's and Mann-Whitney U tests at α = 0.05. RESULTS: A total of 3013 out of 3200 children were included having a mean age of 4.25 ± 0.5 years and deft of 2.1 ± 0.5. Using the adapted version of EAPD 2003 criteria for MIH, the children were evaluated for the presence of hypomineralised second primary molars, the prevalence of which was found to be 7.9%. Hypomineralisation defects were more commonly observed in the maxillary arch (53.4% vs. 42.8%, p = 0.04) with creamish white opacities involving the buccal and lingual surfaces being the most common defects (43.6%). The mean number of HSPMs per child was 1.9. Other phenotypes included demarcated opacities majorly on primary canines (6.6%) followed by primary first molars (4.6%). CONCLUSIONS: Hypomineralised primary second molars are a fairly common condition affecting approximately 7.9% of the population thus warranting early recognition and management.

A clinical and radiographic investigation comparing the efficacy of cast metal and indirect resin onlays in rehabilitation of permanent first molars affected with severe molar incisor hypomineralisation (MIH): a 36-month randomised controlled clinical trial.

PURPOSE: Definitive restorative management of young permanent molars affected with severe MIH is still elusive with a dearth of conservative restorative options. The present trial compared the 36 months clinical and radiographic performance of minimally invasive cast metal and indirect resin onlays for rehabilitation of permanent first molars affected with severe MIH. METHODS: In this parallel group open label randomised trial, 42 vital molars affected with severe MIH in 30 children, aged 8-13 years were randomly allocated using stratified permuted block randomization to receive either a cast metal onlay or an indirect composite onlay (n = 21 each). Clinical and radiographic evaluations of these onlays were carried out at 9, 18 and 36 months using the USPHS criteria. Cumulative survival rate as well as the calculated clinical success rates of both types of onlays were also determined. The longevity of onlays was assessed using Kaplan-Meier survival analysis. RESULTS: At 36 months, overall retention rate was found to be 95% with complete elimination of any pre-existing sensitivity. Cumulative survival rates were found to be 95% vs. 100%, p = 0.67, while the calculated clinical success rates were 90% and 85.7% for metal and resin onlays, respectively, with no significant differences (p = 0.76). Mean survival rates based on Kaplan-Meier analysis were determined to be 85% vs. 100% for the metal and composite groups, respectively (p = 0.075). CONCLUSIONS: Irrespective of the type of material used, onlays offer a predictable and conservative restorative alternative for molars affected with severe MIH. CLINICAL TRIAL REGISTRY: The trial is registered under Clinical Trial Registry India (CTRI/2016/10/007379).