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Background: The purpose of this study was to assess the awareness of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPMs) among dental practitioners in Northern Italy, and to gather data on the occurrence of these conditions in their paediatric patients. Methods: A cross-sectional study was conducted using a structured online questionnaire administered through Google Forms. The survey comprised 10 single-choice questions addressing the occurrence of MIH and HSPM in caries-free patients aged 6–9 years. Results: A total of 315 dentists participated in the survey, yielding a response rate of 31.5%. The majority of respondents reported that 1–25% of their paediatric patients exhibited HSPMs. Among this group, 43.62% of respondents observed MIH in 1–25% of cases. Conclusion: The findings from this survey suggest a consistent perception of MIH and HSPMs among dental practitioners, aligning with known prevalence data and indicating recognition of these conditions within the dental community in Northern Italy. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralisation is a qualitative defect of enamel. The diagnosis of molar incisor hypomineralisation is clinical and it can be challenging to manage. Objective: To determine the prevalence of molar incisor hypomineralisation among public school children aged 12 – 15 years in a south-eastern Nigerian rural community. Methodology: A cross sectional descriptive study of 12-15 year old school children was done in a rural public technical college and three public secondary schools selected in Nkanu–West and Udi local Government Area of Enugu State respectively. Socio-demographic data was obtained using semi--structured questionnaire. Tests of association between dependent variables and independent variables were conducted using Fisher’s exact test. Inferential analysis to determine predictors of molar incisor hypomineralisation was done using logistic regression analysis (binary). Statistical analysis was done using SPSS Version 25. P values ≤ 0.05 were accepted as being statistically significant. Results: One hundred and forty (47.3%) males and one hundred and fifty six (52.7%) females were seen and examined. The mean age of the children was 13.56 ± 1.1. The prevalence of molar incisor hypomineralisation was 2.4%. Molar incisor hypomineralisation was seen more in males than females. There was no significant association between MIH, sex (p = 0.71) and age (p = 0.59). There was significant association between MIH and socioeconomic status (p= 0.05). Socio-economic status was a predictor for molar incisor hypomineralisation (P = 0.04, OR = 0.20, 95% CI = 0.043- 0.944) Conclusion: Molar incisor hypomineralisation can affect the quality of life of children. Visit to dental clinic is recommended.

Background: The purpose of this study was to assess the awareness of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPMs) among dental practitioners in Northern Italy, and to gather data on the occurrence of these conditions in their paediatric patients. Methods: A cross-sectional study was conducted using a structured online questionnaire administered through Google Forms. The survey comprised 10 single-choice questions addressing the occurrence of MIH and HSPM in caries-free patients aged 6–9 years. Results: A total of 315 dentists participated in the survey, yielding a response rate of 31.5%. The majority of respondents reported that 1–25% of their paediatric patients exhibited HSPMs. Among this group, 43.62% of respondents observed MIH in 1–25% of cases. Conclusion: The findings from this survey suggest a consistent perception of MIH and HSPMs among dental practitioners, aligning with known prevalence data and indicating recognition of these conditions within the dental community in Northern Italy.

Dental fluorosis is characterized by the presence of irregularities on the surface of the teeth. It is caused by the excessive intake of fluoride during the first year of life. This can lead to a significant impact on the esthetics. The pooled estimate of worldwide date on dental fluorosis reported a prevalence rate of around 13%. The fluoride content in ground water and other fluoridated dental products are the two major sources of fluoride that can lead to dental fluorosis. Different treatment options are available that can be used alone or in combination, depending on the severity and the needs of the patient. Diagnosis of this condition is made by considering the factors that contributed to excessive fluoride exposure during early years of age. The aim of this paper is to provide a comprehensive literature review on the various factors that can influence the exposure of fluoride leading to dental fluorosis. The data from Bahrain is used as an example to arrive at the diagnosis. The paper also presents a decision tree for the dentist in order to diagnose and treat these conditions. The differential diagnoses of this condition are also presented. A case report that applies the discussed literature is also presented as an example. The key to prevent the development of dental fluorosis is to prevent the exposure as early in life as possible. Government entities should bring about strategies that can prevent early high concentration fluoride exposures to reduce the incidence of this disease. [ABSTRACT FROM AUTHOR]

The endodontic management of enamel mineralisation defects, such as amelogenesis imperfecta, may be challenging because the root canal configuration of affected teeth is often abnormal. This report of two cases illustrates the difficulties of cleaning, shaping and obturating the root canal system of teeth with amelogenesis imperfecta. [ABSTRACT FROM AUTHOR]

Aim: To investigate the use of optical coherence tomography (OCT) as a tool to assess general and localised hypomineralisation defects in the enamel. Design and Materials: Ten extracted permanent teeth (four teeth with localised hypomineralisation, four teeth with general hypomineralisation, and two healthy controls) were used in this study. In addition, four participants who underwent OCT served as living controls for the extracted teeth. Methods: The OCT results were compared with clinical photographs, digital radiographs, and polarising microscopy images of tooth sections (considered the gold standard) to determine the method with the most accurate information regarding the extent of enamel disturbances: 1) visibility of enamel disturbance (visible yes/no); if yes, 2) extent of the disturbance in the enamel; and 3) determination of the plausible involvement of the underlying dentin. Results: OCT was more accurate than digital radiography and visual assessment. OCT could provide information about the extent of localised hypomineralised disturbances in the enamel that was comparable to that with polarisation microscopy of the tooth sections. Conclusion: Within the limitations of this pilot study, it can be concluded that OCT is suitable for investigating and evaluating localised hypomineralisation disturbances; however, it is less useful in cases with generalised hypomineralisation of the enamel. In addition, OCT complements radiographic examination of enamel; however, more studies are necessary to elucidate the full extent of the use of OCT in case of hypomineralisation.

Objectives: Autosomal‐dominant hypocalcified amelogenesis imperfecta (ADHCAI) shows phenotypic heterogeneity. Our aim was to characterise the ADHCAI phenotypes, tooth properties and genotypes. Methods: Three unrelated ADHCAI probands and seven additional affected members of the three families were recruited. Mutations were identified by exome and Sanger sequencing, and haplotypes by SNP array. Tooth colour, roughness, density, nanohardness, minerals and ultrastructure were investigated. Results: Ten participants were heterozygous for the FAM83H mutation c.1387C>T (p.Gln463*). All shared a 3.43 Mbp region on chromosome 8q24.3 encompassing the FAM83H variant, indicating a common ancestry. The c.1387C>T was estimated to be 23.8 generations or 600 years. The FAM83H enamel had higher roughness and lower lightness, density, nanohardness, and calcium and phosphorus levels than controls. Blunted enamel rods, wide interrod spaces and disorganised dentinoenamel junctions were observed. Evaluating the patients with the same mutation and reviewing others with different mutations in FAM83H revealed that the FAM83H heterogeneous phenotypes are age‐influenced. Tooth colour and surface texture change with ageing. Conclusions: FAM83H enamel demonstrated decreased lightness, density, hardness, calcium, phosphorus and defective ultrastructure. We have identified that the phenotypic variation in FAM83H‐associated ADHCAI is age‐related. Awareness of the correlation between age and clinical features of FAM83H‐ADHCAI can help dentists make an accurate diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review the aetiological factors associated with molar incisor hypomineralisation (MIH). To this day, the aetiology remains unknown. Determining risk factors would allow risk assessment and enhance early diagnosis of MIH in young patients. The aim was to assess, evaluate and summarise the relationship between MIH and reported aetiological hypotheses. Methods: Electronic database searches of MEDLINE, EMBASE, EBSCO, LILACS and Cochrane Library were conducted. Authors conformed to PRISMA guidelines. Studies were screened, data extracted, assessment of risk of bias and calibration was completed by two independent reviewers. Meta-analyses with heterogeneity calculations were performed. Results: Of the potential 8949 studies, 64 studies were included in the qualitative analysis whilst 45 were included in the quantitative analysis. Prenatal factors: results are inconclusive as only unspecified maternal illnesses appear to be linked to MIH. Perinatal factors: prematurity (OR 1.45; 95% CI 1.24–1.70; p = 0.0002) and caesarean delivery (OR 1.45; 95% CI 1.09, 1.93; p < 0.00001) are associated with an increased risk of developing MIH. Birth complications are also highlighted. These three factors can lead to hypoxia, and children with perinatal hypoxia are more likely to develop MIH (OR 2.76; 95% CI 2.09–3.64; p < 0.0001). Postnatal factors: measles, urinary tract infection, otitis media, gastric disorders, bronchitis, kidney diseases, pneumonia and asthma are associated with MIH. Fever and antibiotic use, which may be considered as consequences of childhood illnesses, are also associated with MIH. Genetic factors: an increasing number of studies highlight the genetic and epigenetic influences in the development of MIH. Conclusion: Several systemic and genetic and/or epigenetic factors acting synergistically or additively are associated with MIH, revealing a multifactorial aetiology model. Peri- and postnatal aetiological factors are more likely to increase the odds of causing MIH than prenatal factors. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions., Methods: 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis., Results: The caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations., Conclusions: During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss., Clinical Significance: Both SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants., Clinicaltrials Registration Number: NCT03862014., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: The aim of this study is to gather baseline information on knowledge, perceptions, clinical experience and treatment options regarding MIH among dental care providers in Oslo, Norway, before a larger epidemiological study. Methods: An electronic questionnaire was distributed to dentists (n = 88) and dental hygienists (n = 47) working in the Public Dental Service (PDS) in Oslo. The questionnaire consisted of five sections related to sociodemographic, clinical experience, perceptions, clinical management and preferences for further training. Descriptive statistics with chi-squared test was used, and level of statistical significance was set to 5%. Results: Replies were obtained from 74.1% (n = 100) after two reminders. All respondents encountered MIH in their practice. The respondents' perception of the prevalence of MIH in Oslo varied. The majority felt confident when diagnosing MIH (86%). The clinicians qualified in the last 10 years felt more confident than those who had qualified earlier (p = 0.016). Most were self-confident when treating these patients (68.3%), however, nearly all (88%) agreed that MIH was a clinical problem. The clinician's treatment of MIH varied. Difficulties achieving adequate local anaesthetic (71.4%) and the child's behavioural problems (84.1%) were treatment barriers for the dentists. Approximately two thirds (69%) would like further training, in particular on the aetiology (70%), diagnosis (57%) and treatment (77%) of the developmental disorder. Conclusion: All clinicians were familiar with the diagnosis of MIH and experienced the condition to be a clinical problem. Continuing education on aetiology, diagnosis and treatment of MIH is requested by dental health personnel. [ABSTRACT FROM AUTHOR]

Abstract Background Current knowledge on treatment strategies and choice of restorative materials when treating deep caries or severe dental developmental defects (DDDs) in young individuals is scarce. Therefore, the aim was to investigate Norwegian dentists´ treatment decisions and reasons for treatment choice when treating deep caries in primary teeth and severe DDDs in permanent teeth in children. Methods A pre-coded questionnaire was sent electronically to all dentists employed in the Public Dental Service (PDS) in Norway (n = 1294). The clinicians were asked about their background characteristics and how often they registered DDDs. Three clinical cases were presented to the dentists and asked to prioritize treatment options and reasons for their choice. Results After three reminders, 45.8% of the dentists answered. Most clinicians were general practitioners (96.3%), females (77.9%), under 41 year-olds (59.4%), graduated in 2001 or later (61.1%), and representing all regions of Norway. The respondents registered molar incisor hypomineralisation (MIH), other DDDs and dental fluorosis (DF) frequently, 523 (91.1%), 257 (44.8%) and 158 (27.5%), respectively. In case 1a with severe dental caries in a primary molar, the preferred treatment was resin-modified glass ionomer cement (RMGIC) (58.3%), followed by glass ionomer cement (GIC) (17.9%) and zinc oxide-eugenol (ZOE) (13.2%). Extraction, compomer or stainless steel crowns (SSC) were preferred by 0.9, 0.7 and 0.4%, respectively. In case 1b, which was identical to case 1a, but treated under general anaesthesia, the preferred treatment alternatives were RMGIC (37.1%), resin composite (RC) (17.6%) and GIC (17.2%). Extraction and SSC were chosen by 15.1 and 7.2%, respectively. In case 2, showing a severely hypomineralised and symptomatic first permanent molar, the dentists preferred RC (38.4%), followed by RMGIC (26.6%) and GIC (19.0%). Extraction and SSC were chosen by 8.7 and 5.4%, respectively. The treatment choices were not significantly affected by the dentists’ background characteristics. The reasons for dentists’ treatment decisions varied for each patient case; patient cooperation, prognosis of the tooth and own experience were the dominant reasons. Conclusions A notable disparity in treatment choices was shown indicating that Norwegian dentists evaluate each case individually and base their decisions on what they consider best for the individual patient.

Purpose: The purpose of this study was to investigate defect distribution and morphology in hypomineralised second primary molars (HSPM), presence of similar defects in other primary teeth and clinical similarities with molar-incisor hypomineralisation (MIH). Methods: This clinical descriptive study involved children who attended a postgraduate paediatric dental clinic in a 20-month period and were diagnosed with HSPM. The updated MIH/HSPM index of Ghanim et al. (Eur Arch Paediatr Dent 16(3):235–46, 2015) was used to record defects on primary molars and canines. Results: 54 children (23 boys) aged 4 to 12 years comprised the study sample. The mean number of affected second primary molars per child was 2.65 with no statistically significant difference between maxilla and mandible or between right and left side with defects more frequently located on buccal surfaces. 66.7% of the children were mildly affected (opacities only) with 29 out of 54 having defects occupying less than 1/3 of the surface. Severity increased with increasing number of affected teeth and extent of the defects per child. Similar defects were recorded in the first primary molars and canines in 55.5% of the children who had those teeth present. Conclusion: The distribution and morphology pattern of HSPM defects was similar to that in MIH, supporting the notion of a common hypomineralisation entity. [ABSTRACT FROM AUTHOR]

Aim: The objective of this research was to determine the incidence and severity of HSPM and its association with caries in 4–5 year-old children in Latakia, Syria. Methods: A cross-sectional study was carried out with 600 preschool children. The European Academy of Pediatric Dentistry (EAPD) criteria were used for scoring HSPM. The decayed, missing and filled teeth (dmft) index was used to evaluate caries status. Results: The prevalence of HSPM was 41%. The difference in HSPM prevalence between males and females was not statistically significant (p > 0.05). Children with HSPM are more likely to have dental caries (OR 6.69; CI 4.5_10; p < 0.001). Conclusions: The prevalence of HSPM was relatively high in Syrian children. HSPM increases the incidence of caries. [ABSTRACT FROM AUTHOR]

Abstract Background Developmental defects of the enamel (DDE) increase the risk for diseases that impact negatively on the quality of life. The objective of this study was to compare the oral health quality of life of children with molar-incisor-hypomineralisation (MIH) and enamel hypoplasia; and assess if caries worsened the impact of these lesions on the quality of life. Methods This study recruited 853 6 to 16-years-old school children. They filled the Child-OIDP questionnaire. The MIH, enamel hypoplasia, caries and oral hygiene status was assessed. Poisson regression was used to determine the impact of MIH and enamel hypoplasia on the oral health quality of life, after adjusting for the effect of sex, age, socioeconomic class, oral hygiene and caries status. Results The prevalence of MIH and enamel hypoplasia was 2.9% and 7.6% respectively. There was no significant difference in the mean child-OIDP scores of children with or without MIH (p = 0.57), children with or without enamel hypoplasia (p = 0.48), and children with enamel hypoplasia with and without caries (p = 0.30). Children with enamel hypoplasia and caries had worse outcomes for speaking (p = 0.01). Children with middle (AOR: 2.74; 95% CI: 1.60–4.67; P

Purpose: The purpose of the study was to determine the prevalence and presentation patterns of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) in the Division of Paediatric Dentistry at The Hospital for Sick Children (SickKids) in Toronto, Canada. Methods: A cross-sectional study of 429 eligible participants was carried out by nine trained and calibrated examiners. The European Academy of Paediatric Dentists (EAPD) criteria for diagnosis and documentation of MIH and HSPM defects were used. Results: Molar incisor hypomineralisation and HSPM prevalence was 12.4% and 5.2%, respectively. Regarding MIH, the affected molars and incisors attributed to 5.6% of the total prevalence, the remaining having only molars affected. Demarcated white opacities were most common in MIH (60%) and HSPM (67%), followed by yellow/brown opacities (MIH 22%, HSPM 9%), post-eruptive breakdown (MIH 8%, HSPM 24%), atypical caries (MIH 6%, HSPM 0%), and atypical restorations (MIH 4%, HSPM 0%). In both MIH and HSPM, single surface hypomineralised lesions were significantly more common than multi-surface lesions (p < 0.0001). Most lesions affected buccal enamel (MIH 55%, HSPM 47%). Lesion extension was most frequently less than 1/3 of a tooth surface (MIH 58%, HSPM 67%) and this was significantly more common in teeth affected by HSPM than MIH (p = 0.03). Individuals with HSPM were more likely to present with two affected molars than individuals with MIH (p = 0.03). Hypomineralised second primary molars were not predictive for MIH. Conclusions: The prevalence of MIH and HSPM was within the range of published studies. The most common MIH and HSPM lesions affected single surface of a tooth, mostly on the buccal surface and were less than 1/3 of the surface area size. [ABSTRACT FROM AUTHOR]

Aim: To investigate the root canal morphology of hypomineralised first permanent molars (FPMs) using micro-CT (μCT). Methodology: Twenty-four hypomineralised FPMs and five clinically sound FPMs were scanned using μCT and assessed using the following parameters: (i) root canal configuration, (ii) connecting canal frequency, (iii) enamel, dentin, and pulp volumes, (iv) cusp tip to pulp horn distance, root canal length, root canal width, and dentin thickness, and (v) the influence of the root canal system landmarks on access cavity outline forms and canal curvature. A two-way repeated-measures analysis of variance was employed with the statistical significance set at p < 0.05. Results: The frequency of accessory and connecting canals was higher in hypomineralised FPMs. Mesio-buccal cusp horn was found to be the closest to its corresponding cusp tip in both groups. There was no significant difference between the root lengths, dentine widths, and pulp space measurements of hypomineralised FPMs compared to clinically sound FPMs. The best angulation to access FPMs was straight-line radicular, along the pulp horn. Conclusions: This study illustrates some variations in the root canal morphology in hypomineralised FPMs compared to clinically sound FPMs. Future studies should focus on assessing these parameters in larger samples. [ABSTRACT FROM AUTHOR]

Objectives: Decamarcated hypomineralised lesions of enamel include those developmental defects that are related to MIH, HSPM or any other demarcated opacities of systemic origin. The present study's aims are to determine MIH/HSPM prevalence, caries lesion severity and their association in a sample of 6–12-year-old schoolchildren from Talca, Chile. Methods: The sample (N = 577) was derived from selected primary schools in urban Talca. A full dental examination was performed at the school by one calibrated examiner. Socio-demographic data and caries experience (DMFT/dmft/merged ICDAS II and PUFA/pufa) were measured in primary and permanent dentitions. MIH/HSPM was assessed using a modified EAPD protocol. Binary and multilevel binary regression analyses were calculated. Results: The prevalence of MIH/HSPM or other demarcated hypomineralised lesions was 24.4%. MIH and HSPM was 15.8% and 5%, respectively. The presence of HSPM predicted MIH (OR 3.7; 95% CI 1.65–8.15) when corrected by demographic factors. Of the children examined, 35% had no teeth with a score greater than ICDASII Code 0 and 26% had one or more severe carious lesions (Code C). Toothwise multilevel binary regression analyses demonstrated that teeth with MIH/HSPM (OR 3.70) from low-SES children (OR 1.93) had higher odds for carious lesions compared with defect-free teeth from high-SES participants. Conclusions: MIH/HSPM lesions were associated with carious lesion occurrence and increased disease severity. The prevalence of MIH and HSPM was similar to other reports. Increased awareness of MIH/HSPM in schools and primary health settings may help to identify children at risk early. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the ability to recognise different types of developmental defects of enamel (DDE) by a group of general dental staff, trained prior to the comprehensive prevalence study (the BITA study), and to compare their skills to that of an untrained group. To evaluate the validity and reliability of the DDE registrations and MIH diagnoses, 3 years after the BITA study ended. To evaluate the reliability of an MIH diagnose, 3 years after the study ended. Materials and methods: The dental staff from five clinics (n = 43) was given instructions in identifying different types of DDE, according to the mDDE index (FDI in Int Dent J 42:411–426 1992). A test protocol with 24 digital photos of teeth with different DDE was filled out. The dental staff from five other clinics (n = 60), without preceding instructions, also filled out the protocol. Ninety-one patients with reported DDE were clinically re-examined 3 years later by two dentists with certified experience of DDE. Results: When untrained dental staff filled out the test protocol, only 42% of the affected surfaces were correctly assessed, whereas 85% of the dental staff instructed in recognizing DDE made a correct assessment (p < 0.000). The specialists confirmed 73% of the teeth diagnosed with DDE in the BITA study as affected. The agreement in judging the opacities as diffuse or demarcated was 76%. One-fourth of those being judged to be affected by MIH in the BITA-study also showed to be affected by other enamel disturbances. Conclusions: The ability of the untrained dental staff to recognize DDE was insufficient. Instructions, using digital photos, raised the ability considerably. To ensure a correct MIH diagnosis, the patients should be followed until all the permanent teeth have erupted. [ABSTRACT FROM AUTHOR]

Developmental enamel defects (DDE) are often used as indicators of general health in past archaeological populations. DDE include three common types of lesions: hypoplasia, diffuse, and demarcated opacities. Molar incisor hypomineralisation (MIH) was defined in 2001 as a qualitative enamel defect affecting first permanent molars and often permanent incisors. The European Academy of Paediatric Dentistry established criteria to diagnose MIH in current populations as demarcated white or yellow‐brown opacities of enamel with or without posteruptive breakdown. MIH is prevalent in current populations (average 14.2%) and may cause important damage to first permanent molars. Aetiological factors are uncertain. The discovery of MIH in archaeological skeletal collections based on macroscopic examination has been reported previously, in particular by Ogden and colleagues (2008). If MIH exists in past populations, there are profound implications regarding current aetiological hypotheses. Aims of the present study were to (a) reassess the London postmedieval archaeological collection from which the first cases of MIH were reported and evaluate the reliability of MIH diagnosis criteria in past populations and (b) differentially diagnose developmental defects of enamel and post mortem discoloration in the teeth. Contrary to the reported prevalence in the original study (93.2%), among 47 subadult (>18 years) individuals, a low MIH prevalence was determined (27%). Reliability of MIH diagnosis was tested with three MIH experts who were also physical anthropologists. Our study highlighted that the reliability of a macroscopic diagnosis of MIH in past populations is fair (Cohen's kappa = 0.35 ± 0.11; Fleiss's kappa = 0.3). It could explain the large differential in prevalence values in studies performed in archaeological collections. Pathological and taphonomic agents can produce enamel modifications indistinguishable from one another, even to an "experienced eye." Here, we examined the literature to highlight potential differential diagnoses of MIH (taphonomic discoloration, amelogenesis imperfecta, fluorosis, rachitic teeth, etc.). Employing nondestructive analyses to characterise and diagnose tooth discoloration in past populations is highly recommended. [ABSTRACT FROM AUTHOR]

Aim: This study sought to evaluate the tooth mineral density (TMD) for the different lesion types in hypomineralised first permanent molars (FPMs) and compare them to unaffected enamel in clinically sound FPMs. Design: Eighteen FPMs with varying degrees of hypomineralised enamel were grouped into brown, yellow/creamy and white lesion types. Micro-CT was used to determine the TMD for each lesion type, and for unaffected enamel at different locations in the outer, middle, and inner-third of the enamel. Results: The average TMD for brown, yellow/creamy, white and unaffected enamel was 1.79, 2.21, 2.43 and 2.46 g/cm, respectively. Brown and yellow/creamy lesions exhibited a statistically significant difference when compared to white lesions and unaffected enamel. However, no statistical difference was evident in TMD between white lesions and unaffected enamel. The TMD increased from the outer-third to inner-third for brown and yellow/creamy lesions (p < 0.05), while in white lesions and unaffected enamel, the TMD decreased from the outer-third to inner-third (p < 0.05). Conclusion: TMD was lowest for brown lesions followed by yellow/creamy lesions while the TMD for white lesions was similar to unaffected enamel. [ABSTRACT FROM AUTHOR]

Objective Molar Incisor Hypomineralisation (MIH) is a structural anomaly that affects the quality of tooth enamel and has important consequences for oral health. The developmentally hypomineralised enamel has normal thickness and can range in colour from white to yellow or brown with or without surface breakdown. The possibility of finding MIH in ‘ancient populations' could downplay several current aetiological hypotheses (e.g., dioxin derivatives, bisphenols, antibiotics) without excluding the possible multifactorial aspect of the anomaly. In an archaeological context, chemical elements contained in the burial ground can stain teeth yellow or brown and therefore might create a taphonomic bias. The purpose of the present study is to test a proposed diagnostic guide enabling determination of the pathological or taphonomic cause of enamel discolouration and defects that resemble MIH present on ‘ancient teeth'. Design Two sample groups including MIH discoloration (n = 12 teeth) from living patients, taphonomic discoloration (n = 9 teeth) and unknown discoloration (n = 2 teeth) from medieval specimens were tested. Three non-destructive methods—Raman spectroscopy, X-ray micro-computed tomography and X-ray fluorescence were utilised. Results Hypomineralised enamel has decreased mineral density (p < 0.0001) and increased phosphate/β-carbonate ratio (p < 0.01) compared to normal enamel whereas relative concentrations of manganese, copper, iron and lead are similar. In taphonomic discoloration, relative concentrations of these elements are significantly different (p < 0.05) to normal enamel whereas mineral density and Raman spectra profile are comparable. Conclusions Enamel hypomineralisation can be distinguished from taphonomic staining in archaeological teeth. [ABSTRACT FROM AUTHOR]

Objective: Molar Incisor Hypomineralisation (MIH) is systemic in origin, and affects one to four permanent first molars. It frequently affects the incisors also. Its aetiology remains unknown, with some evidence suggesting association with childhood diseases during the first four years of life, the use of antibiotics (amoxicillin, a macrolide), and exposure to dioxins. This report is documented to highlight the possible risk factors for MIH in four sets of monozygotic twins. Methods: A case series consisting of four related case reports. Results: In each of the four cases described, precipitating environmental factors could be identified. This ranged from prolonged use of antibiotics, to early childhood illnesses, prenatal maternal ill health, and long duration of breast feeding. The possibility of genes in the aetiology of MIH is further strengthened by the observation in this study, that all the monozygotic twin pairs identified with MIH during public oral health screening exercises, had the lesion. Conclusion: The aetiology of MIH may be due to early childhood illnesses and the use of amoxicillin. Also, the possible role of genetic disposition needs to be further investigated.

Objectives Molar incisor hypomineralization ( MIH) is a common developmental dental defect of permanent teeth, which can increase the risk of dental caries, infection and hospitalization. The etiology is currently unclear although prenatal or early childhood health factors are suspected. The aim of this systematic review was to assess the strength of evidence linking etiological factors with MIH. Methods A systematic search was conducted using the Medline and Embase electronic databases for studies investigating environmental etiological factors of MIH. Two reviewers assessed the eligibility of studies. The level of evidence and bias was determined for all eligible studies according to Australian National Health and Medical Research Council guidelines for systematic reviews of etiology and the Newcastle-Ottawa Scale. Results From a total of 2254 studies identified through electronic and hand searching, 28 were eligible for inclusion. Twenty-five of these investigated MIH and three investigated a related condition in primary teeth, hypomineralized second primary molars ( HSPM), and these were analysed separately. A limited number of studies reported significant associations between MIH and pre- and perinatal factors such as maternal illness and medication use in pregnancy, prematurity and birth complications. Early childhood illness was implicated as an etiological factor in MIH in several studies, in particular fever, asthma and pneumonia. The studies investigating HSPM revealed an association with maternal alcohol consumption, infantile fever and ethnicity. However, the validity of these findings is impaired by study design, lack of adjustment for confounders, lack of detail and consistency of exposures investigated and poor reporting. Conclusions Childhood illness is likely to be associated with MIH. Further prospective studies of the etiology of MIH/ HSPM are needed. [ABSTRACT FROM AUTHOR]

Aim: To investigate the use of optical coherence tomography (OCT) as a tool to assess general and localised hypomineralisation defects in the enamel., Design and Materials: Ten extracted permanent teeth (four teeth with localised hypomineralisation, four teeth with general hypomineralisation, and two healthy controls) were used in this study. In addition, four participants who underwent OCT served as living controls for the extracted teeth., Methods: The OCT results were compared with clinical photographs, digital radiographs, and polarising microscopy images of tooth sections (considered the gold standard) to determine the method with the most accurate information regarding the extent of enamel disturbances: 1) visibility of enamel disturbance (visible yes/no); if yes, 2) extent of the disturbance in the enamel; and 3) determination of the plausible involvement of the underlying dentin., Results: OCT was more accurate than digital radiography and visual assessment. OCT could provide information about the extent of localised hypomineralised disturbances in the enamel that was comparable to that with polarisation microscopy of the tooth sections., Conclusion: Within the limitations of this pilot study, it can be concluded that OCT is suitable for investigating and evaluating localised hypomineralisation disturbances; however, it is less useful in cases with generalised hypomineralisation of the enamel. In addition, OCT complements radiographic examination of enamel; however, more studies are necessary to elucidate the full extent of the use of OCT in case of hypomineralisation., Competing Interests: The authors declare no competing interests., (© 2023 The Authors.)

Raman spectroscopy was used to investigate how the effect of pre-treatment protocols, with combinations of hydrochloric acid (HCl), sodium hypochlorite (NaOCl) and hydrogen peroxide (HO), for molar-incisor hypo-mineralisation (MIH) altered the penetration depth of polymer infiltrants (ICON, DMG, Hamburg, Germany). Furthermore, the effect on the structure of the MIH portions of the teeth with treatment is examined using multivariate analysis of spectra. It was found that pre-treatment protocols improved penetration depths. The structure of the MIH portion post-treatment appeared much closer to that of normal enamel suggesting a diminution of protein in the MIH region with treatment. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the prevalence, pattern and severity of MIH in school children resident in a suburban population in Nigeria. Methods: This was a cross-sectional study involving pupils aged 8-10 years resident in suburban Nigeria. Details of each pupil's socio-demographic variables were collected. Intra-oral examination was conducted to determine the presence of MIH, the affected tooth and the severity of the lesion. The association between the prevalence of MIH and socio-demographic variables of each child was determined. The predictors of MIH were also determined using a binomial regression analysis. Result: Eighty-three of the 469 children examined (17.7 %) had MIH. There was no significant association between sex ( p = 0.58), socio-economic status ( p = 0.09), age ( p = 0.26) and MIH. There was also no significant difference in the number of teeth affected by MIH in the maxilla and mandible, and on the right and left side of the face. The most commonly affected teeth were the left mandibular molars. The occlusal surfaces of the first molars were mostly affected by MIH and the severity of MIH on the teeth examined varied from mild (80.8 %), moderate (14.0 %) to severe (5.2 %). Conclusion: The prevalence of MIH in this study population is consistent with previous reports. The non-association between sex and MIH prevalence, the varied severity of the lesion and association between MIH affectation of the first permanent molars and central incisors give more weight to the possible role of environmental factors in the aetiology of the lesion. The non-association between MIH and socio-economic status may serve as a distinctive feature of MIH and chronological enamel hypoplasia. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify the prevalence of oral co-morbidities in 8 to 16 years old children with Molar Incisor Hypomineralisation (MIH) and compare this with the prevalence of same oral lesions in children without MIH. Method: Study participants were selected through a multi-staged sampling technique. The children were asked if they had dentine hypersensitivity or any concerns about their aesthetics. Children were examined for MIH, caries, traumatic dental injury and their oral hygiene status. The association between MIH and each of the independent variables was determined. Results: Only children with MIH had aesthetic related concerns and dentine hypersensitivity. The differences in the oral hygiene status (p < 0.001) and caries prevalence (p < 0.001) of children with and without MIH were statistically significant. The prevalence of traumatic dental injury did not differ statistically between children with MIH and those without MIH (p = 0.24). Conclusion: Children with MIH had more oral pathologies than children without MIH. These co-morbidities (dentine hypersensitivity, aesthetic concerns, caries and oral hygiene) are capable of impacting negatively on the quality of life of the children. Screening for children with MIH may help facilitate prompt access to treatment. [ABSTRACT FROM AUTHOR]

Objectives: We report the mineral (hydroxyapatite) density of sound and opaque areas in DMH molars with sound parts of (carious) deciduous teeth serving as controls. Methods: Twenty-nine extracted second primary molars obtained from 15 children were studied. Thirteen of these molars were DMH molars with yellow opacities, seven were DMH molars with white opacities, three DMH molars with brown opacities and eleven were molars without DMH. Prior to microCT scanning, the teeth were mounted in impression material (Impregum®) and stored in water with a thymol crystal. Spot analysis and line scans were performed in areas with opacities and in sound areas. An ANOVA test and t-tests were used to test if there were significant differences between the groups. Results: The average densities of the hydroxyapatite in yellow and brown opacities (1368 mg HA/cm² and 1407 mg HA/cm², respectively) were significantly lower than in clinically unaffected enamel (1747 mg HA/cm²) of DMH molars or of sound molars (1758 mg HA/ cm²). The mineral density in white opacities (1737 mg HA/cm²) was not different from that in the enamel of sound molars. The mineral density values in yellow and brown enamel opacities were in between those of dentine (1018 mg HA/cm²) and enamel. Conclusions: DMH molars with yellow or brown opacities had a 20-22% lower mineral density in the hypomineralised enamel compared with sound molars. White opacities do not show a lower mineral content. The reduction in enamel mineral content in DMH molars stressed the need for a preventive approach in DMH. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Swedish Dental Journal is the property of Swedish Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: Autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED) causes multiple endocrine deficiencies, oral candidiasis and different forms of ectodermal dystrophy including enamel hypoplasia, documented in permanent teeth. Our purpose was to examine dental aberrations associated with APECED, including possible manifestations in primary teeth. Design: We studied clinically, radiographically, and by scanning electron microscopy (SEM) teeth of children belonging to two APECED families with different mutations in the AIRE gene. Results: In addition to enamel defects in the permanent teeth we observed hypoplastic pits and hypomaturated patches in the deciduous teeth with underlying changes in the prismatic ultrastructure. The enamel of the permanent molars exhibited a layered arrangement with included whirl-like formations. Conclusions: Our findings confirm that APECED causes enamel defects that are individually but chronologically distributed, and can alter enamel development early enough to affect deciduous teeth. [Copyright &y& Elsevier]

Abstract: Tooth enamel is the stiffest tissue in the human body with a well-organized microstructure. Developmental diseases, such as enamel hypomineralisation, have been reported to cause marked reduction in the elastic modulus of enamel and consequently impair dental function. We produce evidence, using site-specific transmission electron microscopy (TEM), of difference in microstructure between sound and hypomineralised enamel. Built upon that, we develop a mechanical model to explore the relationship of the elastic modulus of the mineral–protein composite structure of enamel with the thickness of protein layers and the direction of mechanical loading. We conclude that when subject to complex mechanical loading conditions, sound enamel exhibits consistently high stiffness, which is essential for dental function. A marked decrease in stiffness of hypomineralised enamel is caused primarily by an increase in the thickness of protein layers between apatite crystals and to a lesser extent by an increase in the effective crystal orientation angle. [Copyright &y& Elsevier]

Aims: This was to determine the prevalence of Molar-Incisor- Hypomineralisation (MIH) among children participating in the Dutch National Epidemiological Survey of 2003 and to compare the prevalence data with that found in the previous survey of 1999 when MIH was found in 9.7% of 11-year-old Dutch children. Methods: The survey took place in the same four cities as the previous survey in 1999. In 442 9-year-old children born in 1994, first permanent molars and all permanent incisors were examined for demarcated opacities, post-eruptive enamel breakdown, atypical restorations and extractions due to MIH. Children were considered as having MIH, when at least one molar was affected, with or without involvement of the incisors. Results: Of the children examined 63 or 14.3% had at least one affected molar with hypomineralisation defects. Of those children with MIH only demarcated opacities were present in 35 (55.6%), while 13 (20.6 %) had at least one tooth with occlusal breakdown in addition to opacities, and in 15 (23.8%) atypical restorations were found. No teeth had been extracted due to MIH. Of the children with MIH there were 36 (57.1%) who had both molars and incisors affected. Conclusions: A significantly higher prevalence of MIH has been found in Dutch 9 year-old children in the last National Epidemiological Survey of 2003 as compared with to the Survey of 1999. [ABSTRACT FROM AUTHOR]

After a synthesis on some recent data on the biology of bone tissues senso lato, this paper focuses on the limits of known variability of bone regarding its amount of mineralisation (maximal and minimal) and on the underlying control mechanisms. Two models of hypermineralised bones are reviewed among cetaceans: the rostrum of the ‘beaked whale’ Mesoplodon and the tympanic bulla of the dolphin Delphinus. In the first case, hypermineralisation is reached lately through an ultrastructural specialization of the secondary osteons. In the second case, hypermineralisation starts at once, during foetal life, through a specialization of the primary osteons. In both cases, ultrastructural peculiarities of collagen fibrillogenesis are demonstrated. Diameter and spacing of the fibrils leave an exceptional empty space available for mineral deposition. Conversely, hypomineralisation is observed on the model of the Teleost scale. The basal plate of the scale is made of a regular ‘biological plywood’ of densely packed collageneous fibres. The mineral is laid down mostly in the interfibrillary spaces. All such tissue modulations seem to be rigorously controlled by details of the osteoblast biosynthetic activities. In a given situation, osteoblasts may express only a subset of molecules from their potential complete biosynthetic repertoire. The debate now centres on how osteoblasts acquire positional information to express this subset. To cite this article: L. Zylberberg, C. R. Palevol 3 (2004). [Copyright &y& Elsevier]