Molar Incisor Hypomineralization: A Clinical Guide to Diagnosis and Treatment

Description

This book is a wide-ranging reference on current clinical and scientific knowledge regarding the various aspects of molar incisor hypomineralization (MIH). Background information is first presented on the structural properties of hypomineralized enamel, the prevalence of MIH, and potential etiological factors. Subsequent chapters focus on key considerations in clinical practice. Diagnostic criteria, classifications, and treatment strategies are discussed and detailed attention is devoted to potential associations between MIH and caries, the occurrence of hypomineralized primary teeth, and the knowledge and experience of dentists concerning MIH. In the last part of the book, the different treatment options are systematically presented and reviewed, covering pain control, prophylaxis and desensitization, fissure sealing, direct and indirect restorations, and extraction therapy. The cost-effectiveness of the available procedures is also considered. The book is written by acknowledged international experts in the field and will be an ideal source of up-to-date information and guidance for both dental professionals and postgraduate students. Preface Contents Contributors Part I: Background 1: MIH: An Introduction 1.1 “The Beginning” 1.2 Pioneer Work 1.3 MIH and Fluoride Intake 1.4 The Future References 2: Structural, Mechanical, and Chemical Evaluation of Molar Incisor Hypomineralization-Affected Enamel 2.1 Enamel Defects 2.2 Enamel Formation 2.3 MIH-Affected Enamel 2.3.1 Microstructural Changes 2.3.2 Mechanical Properties 2.3.3 Mineral Density 2.3.4 Chemical Properties 2.4 Heterogeneity in Current Research Findings 2.5 Clinical Considerations 2.6 Conclusions References 3: Prevalence, Incidence, and Burden of Molar Incisor Hypomineralization 3.1 The Need for Epidemiologic Estimates on MIH 3.2 Estimating the Global Prevalence, Incidence, and Burden 3.3 The Global Prevalence, Incidence, and Burden of MIH 3.4 Interpretation References 4: The Pathogenesis and Aetiology of MIH: More Questions Than Answers 4.1 Introduction 4.2 Amelogenesis 4.2.1 Secretion 4.2.2 Maturation 4.3 Aberrations During Amelogenesis 4.4 Genetic Influences 4.5 Potential Aetiological Factors 4.5.1 Environmental Contaminants 4.5.2 Birth “Complications” 4.5.3 Early Childhood 4.5.4 Medication 4.6 Overview of MIH Aetiology References Part II: Considerations in Clinical Practice 5: Diagnosis, Classifications and Treatment Strategies of MIH-Affected Teeth 5.1 Introduction 5.2 Clinical Presentation 5.3 Diagnostic Terms 5.4 Differential Diagnosis 5.4.1 Amelogenesis Imperfecta 5.4.2 Enamel Hypoplasia 5.4.3 Fluorosis 5.4.4 White Spot Lesions 5.5 Classifications 5.6 Treatment Approaches 5.7 Summary References 6: Association Between Molar Incisor Hypomineralization and Dental Caries 6.1 Caries Experience in Children with MIH 6.2 Does DMF Index Represent Restorative Treatment Need or Dental Caries Experience in Children with MIH? 6.2.1 Children with MIH and Restorative Treatment Need 6.2.2 Children with MIH and Dental Caries Susceptibility 6.3 MIH as Caries Risk Factor 6.4 How to Deal with MIH Children in Relation to Dental Caries? References 7: Hypomineralized Second Primary Molars 7.1 Introduction 7.2 Clinical Appearance 7.2.1 Early Clinical Sign 7.2.1.1 Demarcated Opacity 7.2.2 Late Clinical Signs 7.2.2.1 Posteruptive Enamel Breakdown 7.2.2.2 Atypical Restauration 7.2.2.3 Atypical Caries 7.2.2.4 Atypical Extraction 7.3 Mineral Content 7.4 Prevalence 7.5 Relation of HSPM–MIH 7.6 Relation HSPM—Caries 7.7 Aetiology 7.8 Treatment 7.9 Conclusion References 8: Knowledge, Experience and Perception Regarding Molar Incisor Hypomineralization 8.1 Introduction 8.2 Dental Community Awareness 8.2.1 Knowledge Regarding Treatment 8.2.2 Knowledge Regarding Prevalence and Aetiologies 8.2.3 Training Aspects 8.3 Conclusions References Part III: Treatment Approaches 9: Treatment of Children with MIH: A Challenge in Pain Control and Behaviour Management 9.1 Introduction 9.2 Pain and Children 9.2.1 Definition of Pain and Fear 9.2.2 Peculiarities of the Child’s Perception of Pain 9.2.3 MIH-Induced Pain 9.3 Basics of Child Treatment 9.3.1 Behaviour Management Control and Treatment Protocols for Children with MIH 9.3.2 Key Moments for a Painless Clinical Examination and Treatment of Hypersensitive MIH Teeth 9.3.3 Everything Starts with a Painless Examination 9.3.4 Local Anaesthesia, Special Technics and Optimized Equipment 9.3.4.1 Local Anaesthesia in Children 9.3.4.2 Optimized Clinical Anaesthesia Technique 9.3.4.3 Optimized Technical Equipment 9.4 Premedication 9.5 Postoperative Pain Control, Medication After the Treatment 9.6 Sedation 9.7 General Anaesthesia 9.8 Conclusions References 10: Prophylaxis and Desensitizing of MIH Teeth 10.1 Introduction 10.2 Conservative Management of MIH-Affected Teeth 10.3 Preventive Treatment Approaches 10.4 Existing Evidence from Clinical Studies 10.5 Concluding Remarks References 11: The Use of Fissure Sealants in MIH-Affected Posterior Teeth 11.1 Introduction 11.2 Clinical Procedure 11.2.1 Isolation 11.2.2 Pretreatment 11.2.2.1 Mechanical Cleaning and Etching 11.2.2.2 Deproteinization 11.2.2.3 Adhesion/Bonding 11.2.3 Sealant Application 11.3 Success Rates 11.4 Conclusions References 12: Direct Restorations of MIH-Affected Teeth 12.1 Introduction 12.2 Special Requirements 12.3 Micromorphological Features: Is Adhesion Actually Possible? 12.4 Different Enamel Microstructure 12.5 Bonding Strategies 12.6 Temporary Restoration 12.7 Adhesive Restoration 12.8 Repair 12.9 Chances and Limitations of Direct Restorations References 13: Indirect Restoration Approaches for MIH-Affected Teeth 13.1 Introduction 13.2 Restorative Management of Hypomineralized First Permanent Molars 13.3 Preformed Metal Crowns 13.3.1 Indications 13.3.2 Placement Procedures 13.3.3 Clinical Outcomes 13.4 Indirect Restorations 13.4.1 Indications 13.4.2 Metal Alloys 13.4.3 Composites 13.4.3.1 Case 13.4.4 CAD/CAM 13.4.4.1 Case 13.5 Conclusions References 14: Aesthetic Management of Molar Incisor Hypomineralization: Staged Strategies for Affected Incisors 14.1 Introduction 14.2 Biomechanical Considerations 14.3 Strategies for Optimizing Adhesive Strength 14.4 Restorative Considerations 14.5 Modalities of Treatment in Order of Staging 14.5.1 Remineralization Strategies 14.5.2 External Vital Bleaching 14.5.2.1 Case 1 14.5.3 Surface Microabrasion 14.5.3.1 Case 2 14.5.4 Resin Infiltration 14.5.4.1 Case 3 14.5.4.2 Case 4 14.5.5 Macroreduction and Aesthetic Layering 14.5.5.1 Case 5 14.5.5.2 Case 6 14.6 Conclusion and Remarks References 15: Extraction of MIH-Affected Molars and Orthodontic Space Closure 15.1 Introduction 15.2 General Considerations for Extraction of Permanent Teeth in Orthodontics 15.2.1 Indications for the Extraction of MIH-Affected Molars 15.3 Extraction Timing of MIH-Affected Molars in Absence of Dental Crowding 15.4 Extraction Timing of MIH-Affected Molars in the Presence of Dental Crowding 15.5 Consequences of Late Extraction of MIH-Affected Molars 15.6 Consequences of Premature Extraction of MIH-Affected Molars 15.7 Importance of Choosing the Correct Timing of Orthodontic Extraction Therapy 15.8 Balancing and Compensatory Extraction Therapy 15.9 Prognosis for Orthodontic Space Closure After Extraction of MIH-Affected Molars 15.10 Advantages of Orthodontic Extraction Therapy of MIH-Affected Molars 15.11 Prognosis for Eruption of Third Molars After Extraction of MIH-Affected Molars 15.12 Summary References 16: Health Economic Evaluation of Management Strategies for MIH 16.1 The Need for and Types of Health Economic Evaluations 16.2 Health Economic Analyses 16.3 Assessing the Cost-Effectiveness of Severe MIH 16.4 Cost-Effectiveness of Different Strategies for Managing Severe MIH 16.5 Interpretation and Critique 16.6 Conclusions References