Knowledge, attitude, and practice regarding molar incisor hypomineralization among general dental practitioners in Saudi Arabia

Background: Molar Incisor hypomineralizationis an enamel defect caused by a systemic disturbance that could have occurred during child development. It affects one or more permanent molars with or without incisors involvement. Many factors could contribute in presence of MIH, for instance, chronic illnesses during pregnancy or during the first three of childhood. However, the actual etiological factor has not been determined yet. The study aim is to evaluate the knowledge and the perception on MIH among GDPs in KSA.Methods: This is a descriptive cross sectional study, web-based survey conducted on 500 participants. An online questionnaire was distributed to all GDPs working in KSA. The data analysis done using SPSS version 23 (IBM Crop USA).Results: We found that the majority of GDPs perceptions were found that 64.7% had the thought that MIH is a public problem next to dental caries. When we assessed the perceptions about diagnosis MIH, it was found that 35.7% not confident and 58.3% showed some confidence in diagnosing the same. The dentists’ confidence about treating MIH showed that 49.5% were confident.Conclusions: We found that the majority of GDPs have a good knowledge. The perception was found that 64.7% had the thought that MIH is a public problem next to dental caries. When we assessed the perceptions about diagnosis MIH, it was found that 58.3% showed some confidence in diagnosing the same. The dentists’ confidence about treating MIH showed that 49.5% were confident.

Molar Incisor Hypomineralization (MIH) in a Child with Congenital Chronic Intestinal Pseudoobstruction (CIPO)

Molar incisor hypomineralization (MIH) is a qualitative enamel defect of systemic origin affecting 1–4 permanent first molars (PFMs) frequently in association with affected permanent incisors (PIs). The exact etiology of MIH is still unclear but considered to be multifactorial. This present case report to the best of our knowledge is the first case reported which acknowledges MIH in a patient with chronic intestinal pseudoobstruction (CIPO) with underlying neurological disease due to somatic mitochondrial disorder. It also elicits the availability of various contemporary treatment options and their proper selection and early intervention to manage the functional and aesthetic problems caused by enamel defects and to improve the quality of life in the patients.

MOLAR INCISOR HYPOMINERALIZATION AND CELIAC DISEASE

ABSTRACT BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental enamel defect with multifactorial etiology. Although the relationship between celiac disease (CD) and developmental enamel defect was demonstrated, the association between CD and MIH is uncertain. OBJECTIVE: The objective of this study was to analyze the occurrence of MIH in CD patients. METHODS: Forty CD patients and a control group with 40 healthy individuals were selected. A calibrated examiner (k≥0.889) according to the European Academy of Pediatric Dentistry criteria performed the diagnosis of MIH. Data were analyzed by descriptive statistics and Fischer’s exact test (α=0.05). RESULTS: Of the 80 participants, ten presented MIH with eight individuals with CD. Celiac patients presented 4.75 times the chance of occurrence of MIH than the control group (95% CI: 2.22-10.18; P=0.044). In all the evaluated teeth (n=978), 22 had MIH: 20 teeth in individuals with CD and two in those without the disease. All CD participants with MIH presented the classic form of the disease. CD participants showed 17 teeth (85.0%) with demarcated opacities, two (10.0%) post-eruptive collapses and one (5.0%) atypical restoration. The control group presented only demarcated opacities. CONCLUSION: CD increased the chance of MIH and associated with its clinical manifestations can assist in the diagnosis of CD.

Odontogenic fibroma-like lesions associated with amelogenesis imperfecta: short case

Observation: We present a case of a 21-year-old Pakistani female with hypoplastic amelogenesis imperfecta (AI), microdontia, and multiple gingival swellings overlying impacted teeth. The gingival swellings were diagnosed as AI-associated odontogenic fibroma (OF)-like lesions on histology. Commentary: AI is an inherited enamel defect that may present in association with microdontia, root abnormalities, taurodontism, pulp stones, gingival hyperplasia, and rarely, gingival tumors. These gingival tumors share histologic features with odontogenic fibroma (OF), a benign odontogenic neoplasm, and are referred to as AI-associated OF-like lesions in the literature. Conclusion: AI-associated OF-like lesions are rare, this case will inform oral surgeons and other dental practitioners about this process and its management.

Long-Term Survival of Enamel-Defect-Affected Teeth

There has been considerable research focussed on the occurrence and aetiology of developmental defects of enamel, but less is known about the extent to which enamel-defect-affected teeth may be at greater risk for dental caries. The Dunedin Multidisciplinary Health and Development Study is a prospective cohort study of 1,037 children born in Dunedin, New Zealand, between April 1, 1972, and March 31, 1973. Participants were examined for the presence of developmental defects of enamel at the age of 9 years and then repeatedly for the occurrence of dental caries through to the age of 45 years. After controlling for confounding variables, incisor teeth affected by demarcated opacities at the age of 9 were 3.4 times more likely to be restored than teeth unaffected by defects. Incisors with diffuse opacities and hypoplasia or combinations of defects were 2.8 times more likely to be restored. Molars with enamel defects of any type did not have any significantly different risk for being subsequently restored or lost due to caries than unaffected molars, except those affected by diffuse opacities, which were at 0.4 times the risk of being lost due to caries. Dental clinicians should be aware that enamel-defect-affected teeth are not necessarily at greater risk for tooth loss due to caries in the long term, but permanent incisors affected by enamel defects are at higher risk of receiving restorative intervention.

Amelogenesis Imperfecta: Longevity of Clinical Treatment in Pediatric Dentistry

Amelogenesis Imperfecta (AI) is a rare, hereditary disorder that causes a defect in enamel mineralization in the primary and permanent dentitions. Amelogenesis imperfecta is generally categorized as hypoplastic, hypocalcified, or hypomaturation form based on the primary enamel defect. However, distinctive clinical features may be seen in each variant. Moreover, compromised esthetic appearances, tooth sensitivity and loss of occlusal vertical dimension are the common clinical problems observed in these variants. The objective of this review was to discuss the management strategies for patients with amelogenesis imperfecta. Definite diagnosis and adequate treatment planning are ensured for patients clinically presented with different forms of AI. Clinicians should provide preventive care and establish an early permanent therapy plan for these patients. Nevertheless, an interdisciplinary approach is required to improve both esthetic and functions. Moreover, there is a need for long-lasting restorative solutions for AI patients.

Prevalence of Molar Incisors Hypomineralisation (MIH) in primary school children

Introduction: Molar Incisor Hypomineralisation (MIH) is an enamel defect with white, yellow or black colour due to minerals insufficient during tooth development. The abnormality of prismatic enamel structures and tooth hypersensitivity on patients with MIH may disturb the success rate of restoration. The objective of this research was to determine the prevalence of MIH in primary school children. Methods: A cross-sectional study with purposive sampling on 619 primary school children at Pasteur Urban Village of Bandung City, Indonesia. All dentition were scored using the European Association of Paediatric Dentist (EAPD) MIH scoring sheet, and oral hygiene status assessment with simplified OHI. All data were descriptively described using distribution table. Results: Distribution of MIH on total of 619 children were scored as follows: 0,1,1a, 2, 2a, 3, 4, 5, 6, 7, 8, 9,10 (0 = free enamel defect; 6, 7, and 8 = alteration to non MIH; 1 -5 and 9 -10 = MIH) with frequencies 417(67.36%), 39(6.30%), 60(.65%), 13(2.10%), 0(0.00%), 7(1.13%), 0(0.00%), 4(0.65%), 0(0.00%), 26(4.20%), 58(9.36%), 0(0.00%), and 49(7.91%) respectively. Conclusion: Prevalence of children with MIH in primary school is quite high (19% (118 out of 619 participants)). The highest prevalence is found at the 11 years old group with 49 participants (36.84%), while the prevalence in boys (83 (62.4%)) is found to be higher than girls (50 (37.59%)).Keywords: Prevalence, Molar Incisor Hypomineralisation (MIH), primary school children

Treatment options for deciduous molar hypomineralization: a report of three cases

Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour. CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.