MOLAR INCISOR HYPOMINERALIZATION IN MONOZYGOTIC TWINS : A CASE REPORT
Case Reports control of moisture is not possible , but are shown to have very poor retention rates . 8 , 13 In mild MIH-affected molars with small carious lesions involving 1 to 2 surfaces , composite resins are the restorations of choice and in carious teeth involving 2 or more surfaces with increased or spontaneous sensitivity , full coronal coverage with prefabricated stainless steel crowns is the preferred treatment option . 3 , 8 , 13 Composite restorations bonded with a self etching primer adhesive are shown to be successful in mildly affected MIH lesions . 12 In some cases of teeth with severe MIH where the teeth are non restorable and have a poor prognosis , extraction may be the only option . In such cases , an orthodontic evaluation is necessary to determine the timing of the extraction as well as future orthodontic intervention . 17 MIH-affected incisors pose an esthetic concern for the child and their parents and may respond to microabrasion and bleaching based on the color and thickness of the opacity . The yellowish brown lesions are full thickness and respond better to bleaching with carbamide peroxide . 8 In the present case , the incisors were mildly affected and posed no esthetic concern to either the children or the parents and were closely monitored at every recall visit for caries or enamel breakdown . The MIH-affected molars , in both MB and SB , were initially asymptomatic and treated with pit and fissure sealants to prevent decay formation . The patients were instructed to continue to maintain good oral hygiene practices
References
1 . Weerheijm KL , Jälevik B , Alaluusua S . Molar-incisor hypomineralisation . Caries Res . 2001 ; 35 ( 5 ): 390-391 . [ Full text links ] [ PubMed ]
2 . Sapir S , Shapira J . Clinical solutions for developmental defects of enamel and dentin in children . Pediatr Dent . 2007 ; 29 ( 4 ): 330-336 . [ Full text links ] [ PubMed ]
3 . Willmott NS , Bryan RAE , Duggal MS . Molar-incisorhypomineralisation : a literature review . Eur Arch Paediatr Dent . 2008 ; 9 ( 4 ): 172-179 . [ PubMed ]
4 . Alaluusua S . Aetiology of molar-incisor hypomineralisation : a systematic review . Eur Arch Paediatr Dent . 2010 ; 11 ( 2 ): 53- 58 . [ PubMed ]
5 . Lygidakis NA , Dimou G , Marinou D . Molar-incisorhypomineralisation ( MIH ). A retrospective clinical study in Greek children . II . Possible medical aetiological factors . Eur Arch Paediatr Dent . 2008 ; 9 ( 4 ): 207-217 . [ PubMed ]
6 . Jälevik B . Prevalence and diagnosis of molar-incisorhypomineralisation ( MIH ): A systematic review . Eur Arch Paediatr Dent . 2010 ; 11 ( 2 ): 59-64 . [ PubMed ]
7 . Lygidakis NA , Dimou G , Briseniou E . Molar-incisorhypomineralisation ( MIH ). Retrospective clinical study in Greek children . I . Prevalence and defect characteristics . Eur Arch Paediatr Dent . 2008 ; 9 ( 4 ): 200-206 . [ PubMed ]
8 . Lygidakis NA , Wong F , Jälevik B , et al . Best Clinical Practice Guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation ( MIH ). An EAPD Policy Document . Eur Arch Paediatr Dent . 2010 ; 11 ( 2 ): 75- 81 . [ PubMed ]
9 . Alaluusua S , Lukinmaa PL , Vartiainen T , et al . Polychlorinated dibenzo-p-dioxins and dibezofurans via mother ’ s milk may cause developmental defects in child ’ s teeth . Environ Toxicol Pharmacol . 1996 ; 1 ( 3 ): 193-197 . [ Full with the use of fluoridated toothpaste ( 1450ppm F ) and were also prescribed MI paste ( 900ppm F , GC ) to prevent sensitivity . When teeth 16 and 46 , in cases MB and SB respectively , developed sensitivity and showed signs of slight post eruptive breakdown , stainless steel crowns were recommended as the treatment of choice to avoid further sensitivity and protect the enamel from further post eruptive breakdown . The remaining teeth continued to remain asymptomatic with the sealants remaining intact . The patients continued to remain caries free and all the affected teeth remained asymptomatic at subsequent recall visits .
4 . Conclusion The diagnosis of MIH is largely based on the clinical appearance of the teeth and is often supported by a history of systemic illnesses during the developmental stages of the ameloblasts . Early , accurate diagnosis and long term follow-up is essential in order to avoid sequelae such as post eruptive enamel breakdown , caries formation and sensitivity of these teeth . Management options vary and are based on the extent and severity of the affected enamel .
Author Contributions Equal contribution to the paper . Acknowledgments The authors declare no conflict of interest related to this study . There are no conflicts of interest and no financial interests to be disclosed .
text links ] [ PubMed ]
10 . Lygidakis NA , Dimou G , Stamataki E . Retention of fissure sealants using two different methods of application in teeth with hypomineralised molars ( MIH ): a 4 year clinical study . Eur Arch Paediatr Dent . 2009 ; 10 ( 4 ): 223-226 . [ PubMed ]
11 . Cochrane NJ , Cai F , Huq NL , et al . New approaches to enhanced remineralization of tooth enamel . J Dent Res . 2010 ; 89 ( 11 ): 1187-1197 . doi : 10.1177 / 0022034510376046 . [ Full text links ] [ PubMed ]
12 . Borrie F , Bearn D . Early correction of anterior crossbites : a systematic review . J Orthod . 2011 ; 38 ( 3 ): 175-184 . doi : 10.1179 / 14653121141443 . [ Full text links ] [ PubMed ]
13 . Lygidakis NA . Treatment modalities in children with teeth affected by molar-incisor enamel hypomineralisation ( MIH ): a systematic review . Eur Arch Paediatr Dent . 2010 ; 11 ( 2 ): 65-74 . [ PubMed ]
14 . Weerheijm KL . Molar incisor hypomineralisation ( MIH ). Eur J Paediatr Dent . 2003 ; 4 ( 3 ): 114-120 . [ PubMed ]
15 . Weerheijm KL , Duggal M , Mejáre I , et al . Judgement criteria for molar incisor hypomineralisation ( MIH ) in epidemiologic studies : a summary of the European meeting on MIH held in Athens , 2003 . Eur J Paediatr Dent . 2003 ; 4 ( 3 ): 110-113 . [ PubMed ]
16 . Rodd HD , Boissonade FM , Day PF . Pulpal status of hypomineralized permanent molars . Pediatr Dent . 2007 ; 29 ( 6 ): 514-520 . [ Full text links ] [ PubMed ]
17 . Jälevik B , Klingberg GA . Dental treatment , dental fear and behavior management problems in children with sever enamel hypo mineralization of their permanent first
molars . Int J Paediatr Dent . 2002 ; 12 ( 1 ): 24-32 . [ Full text links ] [ PubMed ]
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