浙江省温州市鹿城区6～11岁儿童磨牙-切牙釉质矿化不全调查

目的:了解浙江省温州市鹿城区6～11岁儿童磨牙-切牙釉质矿化不全(molar-incisor hypomineralization,MIH)的患病情况 方法:选取4个第一恒磨牙都已完全萌出的6～1 1岁儿童988名,按年龄分为6组,依据欧洲儿童牙科协会制定的标准对其进行诊断,详细记录MIH患牙的牙位及严重程度.采用SPSS13.0软件包对数据进行统计学分析,各年龄组间MIH严重程度比较及上、下颌第一恒磨牙及恒切牙MIH患病率的比较均采用Kruskal-Wallis检验,MIH严重程度与年龄的相关关系采用Spearman相关分析结果:MIH患病率为25.5％,轻症MIH为最主要病损各年龄组间MIH严重程度有显著差异(P＜0.05),MIH严重程度与年龄之间呈正相关关系,相关关系密切(rp=0.534)各MIH患牙在上、下颌的分布无显著差异(P＞0.05).结论:浙江省温州市鹿城区6～11岁儿童具有较高的MIH患病率,但以轻症病损为主.MIH的严重程度有随着年龄增加而加重的趋势.     

Is there a positive relationship between molar incisor hypomineralisations and the presence of dental caries?

International Journal of Paediatric Dentistry 2013; 23: 116–124 Objective This epidemiological study aimed to compare the caries experience in 10‐year‐olds with and without molar incisor hypomineralisation (MIH). Methods About 693 children from an ongoing birth cohort study (GINIplus10) were examined for caries lesions to determine the DMF index. Furthermore, enamel hypomineralisation (EH) was scored on all permanent teeth/surfaces, according to the criteria of the European Academy of Paediatric Dentistry. Children with EH were categorised into those with a minimum of one EH in the permanent dentition (MIH/1), with EH on at least one‐first permanent molar (MIH/1A), on at least one‐first permanent molar and permanent incisor (MIH/1B), and on other permanent teeth (MIH/1C). Results The mean caries experience was 0.4 (SD 0.9) DMFT. Existence of MIH/1, MIH/1A, MIH/1B, and MIH/1C was determined in 36.5%, 14.7%, 9.4%, and 21.8% of all children. The corresponding DMFT values were the following: no MIH: 0.3 (SD 0.8); MIH/1: 0.5 (SD 0.9); MIH/1A: 0.5 (SD 0.9); MIH/1B: 0.4 (SD 0.9); and MIH/1C: 0.4 (SD 0.9) DMFT. No significant differences were found between all groups. Conclusions There was no relationship between the presence of EH/MIH and caries in 10‐year‐olds. A ratio of one EH‐associated defect to two caries lesions indicates that both conditions are prevalent and influence the oral health status of 10‐year‐old children from Munich, Germany.     

Dental caries experience and Molar-Incisor Hypomineralization

Abstract

Objective. This cross-sectional study assessed the prevalence and severity of the enamel defects, known as Molar-Incisor Hypomineralization (MIH) and its relationship to dental caries. Materials and methods. A sample of 1157 schoolchildren (population based), aged 6–12 years, of the Araraquara city-Brazil, was evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria by two trained examiners. The dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). Data were analyzed using ANOVA and Chi-square tests (p < 0.05). The socioeconomic status was collected using a questionnaire answered by parents. Results. The prevalence of MIH was 12.3%. Mild impairment was the most frequent diagnosis. DMFT of children with MIH was 0.89 (±1.18), which are higher than those of the unaffected group (0.43 ± 1.01). An association was found between dental caries only in the permanent dentition of children with MIH (p = 0.0001). Family income was considered low in 85% of the families of children with MIH in the public system, while in private school it was 18% (p < 0.05). Conclusion. The prevalence of MIH in Araraquara was associated with greater caries experience in the permanent dentition.     

Increase in severity of molar-incisor hypomineralization and its relationship with the colour of enamel opacity: a prospective cohort study

International Journal of Paediatric Dentistry 2011 Background. Predicting risk of posteruptive enamel breakdown (PEB) of molar–incisor hypomineralization (MIH) opacity is a difficult but important clinical task. Therefore, there is a need to evaluate these aspects through longitudinal studies. Objective. The aim of this longitudinal study was to analyse the relationship between colours of MIH opacity of children aged 6–12 (baseline) and other clinical and demographic variables involved in the increase in severity of MIH. Materials and methods. A blinded prospective 18‐month follow‐up was conducted with 147 individuals presenting mild MIH. Tooth‐based incidence of increase in severity of MIH (PEB or atypical restorations) was used as dependent measurement. Enamel opacities were recorded according to colour shades of white, yellow and brown, allowing assessment of susceptibility to structural loss over time, according to colour of MIH opacity. Poisson regression models were used to adjust the results for demographic and clinical variables. Results. Brown and yellow MIH opacities were at higher risk for PEB and atypical restorations than those of white ones, even after adjustment for clinical and demographic variables. Conclusion. Teeth presenting mild MIH severity associated with yellow and brown enamel opacities were at high risk for increase in severity of MIH than lighter ones. This result could help clinicians determine a risk‐based treatment for children with MIH.     

The prevalence of molar incisor hypomineralisation in Northern England and its relationship to socioeconomic status and water fluoridation

International Journal of Paediatric Dentistry 2012; 22: 250–257 Background. Molar incisor hypomineralisation (MIH) is a condition which has significant implications for patients and service provision. Aims. The aim of this survey was to determine the prevalence of MIH in 12‐year olds in Northern England and to consider the relationship with socioeconomic status and background water fluoridation. Design. Twelve‐year‐old children were examined for the presence of MIH. Participating dentists were trained and calibrated in the use of the modified Developmental Defects of Enamel index. Children were examined at school under direct vision with the aid of a dental mirror. A diagnosis of MIH was attributed to a child if they had a demarcated defect in one or more of their first permanent molars. Results. Of 4795 children that were selected, 3233 (67.4%) were examined. Overall prevalence of MIH was 15.9% (14.5–17.1%). There was an association between prevalence of MIH and deprivation quintiles with a positive correlation in the first 4 quintiles (P < 0.05). There was no difference in prevalence between fluoridated Newcastle and other areas. Conclusion. Prevalence of MIH is equivalent to other European populations. Prevalence was related to socioeconomic status but not to background water fluoridation.     

Molar incisor hypomineralization: a survey of members of the Australian and New Zealand Society of Paediatric Dentistry

BACKGROUND: Worldwide, molar incisor hypomineralization (MIH) affects a substantial number of children and impacts greatly on treatment need and dental anxiety, yet there is little information regarding its prevalence, aetiology, presentation and management. The aims of this survey were to assess awareness and perceptions of the Australian paediatric dental community concerning MIH, and to describe current treatment strategies. METHODS: A questionnaire, based upon a previous European study, was sent to all Australian members of the Australian and New Zealand Society of Paediatric Dentistry. The questionnaire sought information on clinical experience of MIH, knowledge of prevalence, aetiology and contemporary management strategies for MIH. RESULTS: One hundred and thirty useable responses were received (58.8 per cent response rate) of which 36 were paediatric dentists, 6 paediatric dentistry postgraduate students, 59 general dentists, 14 dental therapists and 14 specialists in other fields. Most (98.5 per cent) respondents were familiar with MIH and encountered it in their practice. The majority (73.1 per cent) estimated that MIH occurred in between 5 to 25 per cent of their clinical practice and almost all (96.9 per cent) considered it to be a clinical problem. Only 16.9 per cent of respondents were aware of existing prevalence data and 96.9 per cent valued investigating the prevalence of MIH. No consensus existed regarding the aetiology of MIH or its restorative management. Paediatric dentists used preformed crowns significantly more than non-specialists, however glass ionomer cements were popular with all groups. CONCLUSIONS: MIH is a well recognized and widely encountered clinical condition. MIH presents several clinical problems and is worthy of further investigation. Currently, no consistent clinical management strategies are utilized.     

Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children

International Journal of Paediatric Dentistry 2013; 23: 48–55 Background. Demarcated hypomineralization lesions are not uncommon in second primary molars. Data on the prevalence of hypomineralized second primary molars (HSPM) are scarce. Aim. To investigate the prevalence of HSPM, assess the relationship between HSPM and first permanent molars previously diagnosed with demarcated lesions and to determine the severity of HSPM in relation to dental caries severity. Design. A cluster sample of 809, 7‐ to 9‐year‐old children was examined. The scoring criteria proposed by the European Academy of Paediatric Dentistry for hypomineralization in permanent dentition were adapted to score HSPMs. The International Caries Detection and Assessment System was used to assess caries status in the second primary molar of the children diagnosed with demarcated defects. The examination was carried out in schools by a calibrated dentist. Results. Of the children examined, 53 (6.6%) had hypomineralization defects in at least one second primary molar. Combinations of affected first permanent and second primary molars were reported in 21 (39.6%) of cases. Severe carious lesions were found mostly in teeth with enamel breakdown. Conclusions. The prevalence of HSPM was 6.6%. Over one‐third of affected second primary molars were associated with demarcated lesions in the first permanent molars. The chance of severe caries increased with the increase in the demarcated lesion severity.     

Risk factors in the occurrence of molar–incisor hypomineralization amongst a group of Iraqi children

International Journal of Paediatric Dentistry 2013; 23: 197–206 Background. Despite the worldwide increasing interest in the prevalence studies of molar–incisor hypomineralization (MIH), there is still insufficient evidence to verify the aetiological factors of this condition. Aims. To investigate risk factors involved in the development of MIH in a group of school‐aged Iraqi children. Design. Seven‐ to nine‐year‐old school children (823 of 1000 eligible, response rate of 82.3%) had their first permanent molars and incisors evaluated using the European Academy of Paediatric Dentistry evaluation criteria for MIH. Mothers completed a medical history questionnaire‐based interview performed in the schools by a trained examiner. Results. For children with MIH, 6% reported no relevant medical history; the remaining 94% reported various medical conditions putatively associated with MIH compared with 70% for the non‐affected group. Post‐natal medical conditions (33.3%) were most frequently reported. When data were split into the possible risk effect groups, maternal psychological stress (OR, 3.24), frequent exposure to ultrasonic scans during the last gestational trimester (OR, 2.51) and birth order as a fourth sibling or later (OR, 3.17 and 5.73, respectively) were previously unreported significant risk factors and postulated as contributing to, or causing the defect. Conclusions. Children with MIH had experienced a greater number of medical conditions than their unaffected peers with no single health event identified as a risk factor.     

Molar-incisor hypomineralisation: prevalence and defect characteristics in Iraqi children

BACKGROUND. Little prevalence data relating to molar incisor hypomineralisation (MIH) exist for Middle East populations. AIM. To evaluate the prevalence and the clinical features of MIH in school-aged children residing in Mosul City, Iraq. DESIGN. A cluster sample of 823 7- to 9-year-old children had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH. The examinations were conducted at schools by a calibrated examiner. RESULTS. Of the children examined, 177 (21.5%) had hypomineralisation defects in at least one index tooth, 153 (18.6%) had at least one affected first molar or first molars and incisors and were considered as having MIH. The most commonly affected teeth were maxillary molars. Demarcated creamy white opacities were the most frequent lesion type. Dental restorations and tooth extraction because of MIH were uncommon. Children with three or more affected teeth were 3.7 times more likely to have enamel breakdown when compared with those children having only one or two affected teeth. CONCLUSIONS. Molar incisor hypomineralisation was common amongst Iraqi children. Demarcated opacities were more prevalent than breakdown. The severity of the lesions increased with the number of affected teeth. The more severe the defect, the greater the involved tooth surface area.     

Perception of molar-incisor hypomineralisation (MIH) by Iraqi dental academics

International Journal of Paediatric Dentistry 2011; 21: 261–270 Background. The understanding and detection of molar‐incisor hypomineralisation (MIH) is linked to its recognition by clinicians. No study has investigated dental clinicians’ level of perception regarding MIH in the Middle East region including Iraq. Aim. To determine the perception of Iraqi academic clinicians about MIH prevalence, severity and aetiological factors. Design. A questionnaire, based on previous European and Australian/New Zealand studies was administered to the academic dental staff of Mosul University. Results. A response rate of 77.7% was reported. General dental practitioners represented 30.8% of the total respondents, whilst 65.1% were dentists with post‐graduate qualification. The majority of the respondents (81.2%) encountered MIH in their clinical activities and 37.3% of them identified that the prevalence appeared to have increased in recent years. Fewer than half of the respondents observed MIH affected teeth on a monthly basis. The condition was less commonly seen in primary second molars than the first permanent molars. A variation in views was recorded about MIH specific aetiological factor/s. Respondents advocated the need for clinical training regarding MIH‐aetiological and therapeutic fields. Conclusions. Molar‐incisor hypomineralisation is a condition commonly diagnosed by Iraqi dental academics. No apparent consensus existed between the general and specialist dentists regarding the anticipated prevalence, severity and aetiology of this condition.     

Molar incisor hypomineralization in HIV‐infected children and adolescents

The objective was to determine the prevalence of molar incisor hypomineralization (MIH) among individuals between 7 and 15 years old infected or noninfected with human immunodeficiency virus (HIV). The study was conducted with 33 HIV‐infected individuals (study group; SG) and 66 non‐HIV‐infected schoolchildren (control group; CG), paired by gender and age. Data collection was based on medical records (SG), a questionnaire for caregivers and oral examination for diagnosis of MIH (European Academy of Pediatric Dentistry criteria) and caries (DMFT index and ICDAS). Data were analyzed with Mann‐Whitney, chi‐square, and Fisher's exact tests and logistic regression. In SG, MIH (45.5%) and caries (87.9%) had higher prevalence. MIH was associated with use of protease inhibitors in SG (OR: 2.14; 95% CI: 1.21 to 3.77) and incubator need in CG (OR: 2.80; 95% CI: 1.71 to 9.10). HIV‐infected patients had a higher prevalence of MIH and dental caries in the permanent dentition.     

Factors associated with molar incisor hypomineralization in Thai children

Molar incisor hypomineralization (MIH) is a qualitative developmental enamel defect that affects one to four permanent first molars, with or without involvement of permanent incisors. Its etiology is of systemic origin, but is not well understood. Therefore, we conducted this cross‐sectional study to examine pre‐, peri‐, and postnatal risk factors for MIH among children, 7–8 yr of age, in urban areas of Khon Kaen, Thailand. Molar incisor hypomineralization defects were diagnosed using the European Academy of Pediatric Dentistry criteria. Mothers or primary caregivers were interviewed on maternal medical history and habits during pregnancy, pregnancy and delivery complications, and the child's medical history. Molar incisor hypomineralization defects were observed in 78 (27.7%) of 282 children. Multiple logistic regression analysis showed a statistically significant association between the development of MIH and Cesarean section (adjusted OR = 2.0, 95% CI = 1.1–3.7), complications during vaginal delivery (adjusted OR = 4.5, 95% CI = 1.9–11.0), and severe/chronic illness when under 3 yr of age (adjusted OR = 2.9, 95% CI = 1.6–5.0). There was no association of preterm birth and low birth weight with MIH. The results suggest that Cesarean section, complications during vaginal delivery, and poor health during the first 3 yr of life are independent risk factors for MIH.     

Molar incisor hypomineralization: a study of aetiological factors in a group of UK children

Objectives. The objectives were to investigate the aetiology of molar incisor hypomineralization (MIH), and to discuss previously published studies. Subjects and methods. One hundred and nine children attending the Department of Paediatric Dentistry at the Royal London Hospital were included in the study: 57 children with MIH and 52 controls. Their mothers completed a medical history interview. Results. No significant associations were found with MIH and delivery and birth complications, breastfeeding, immunization history, other illnesses and allergies, general anaesthetics, fluoride history, and trauma or abscesses affecting the primary predecessors. A family history of enamel defects was more commonly reported for MIH children, but the association was not statistically significant. However, MIH was significantly more common among those whose mothers had experienced problems during pregnancy (P = 0.025), those who had chickenpox between the ages of 3 and 3.99 (P = 0.047), and those for whom amoxycillin was the only antibiotic they had received (P = 0.028). Conclusions. The aetiology of MIH remains unclear, and this study questions whether it is because of a lone aetiological insult. This study recommends further research looking at the links with chickenpox occurring around the third year of life and amoxycillin.     

Molar incisor hypomineralization in Hong Kong Chinese children

Background.   Most prevalence studies on molar incisor hypomineralization (MIH) were carried out in European countries, and data from the East-Asian populations were lacking.
Aim.   This study aimed to investigate the prevalence of MIH in Hong Kong Chinese children.
Design.   Since 2006, charting of teeth with MIH was included into the routine dental examination in a school dental clinic. The dental records of grade 6 primary school children who attended annual check-up in this clinic in 2006 were subsequently reviewed retrospectively. The records were selected for this study if the charting indicated that the children were affected by MIH.
Results.   A total of 2635 records were reviewed and 73 cases of MIH were identified. The prevalence of MIH in this group of children was 2.8%. Their mean age was 12, and the male-to-female ratio was 1 : 1.2. The mean decayed, missing, or filled permanent teeth value of those affected was 1.5, which was higher than that of the general Hong Kong Chinese children aged 12 years old (0.8). A total of 192 teeth were affected. The most commonly affected teeth were permanent maxillary first molars, followed by mandibular first molars and maxillary central incisors. Dental fillings and fissure sealants were found in 52 (38%) and 65 (47%) permanent first molars with hypomineralization, respectively. Medical histories were unremarkable in 60 children, whereas early childhood diseases were reported in 13 cases.
Conclusions.   The prevalence of MIH in the permanent dentition of Hong Kong Chinese children was 2.8%. Children with MIH showed higher caries experience in the permanent dentition than the general population of similar age.     

Proportion and extent of manifestation of molar‐incisor‐hypomineralizations according to different phenotypes

Objective: This epidemiological study aimed to assess the proportion and extent of manifestation of enamel hypomineralization, including molar‐incisor‐hypomineralization (MIH), in the permanent and primary dentition. Methods: A total of 693 children enrolled in an ongoing birth cohort study (GINIplus‐10) were examined at their 10‐year follow‐up. Enamel hypomineralization was scored in the primary and permanent dentition on a tooth‐ and surface‐related level based on the criteria of the European Academy of Paediatric Dentistry (EAPD). Children were grouped according to their distribution pattern of enamel hypomineralization: children with a minimum of one hypomineralized tooth in the primary dentition (ht ≥ 1) and permanent dentition (HT ≥ 1); with a minimum of one hypomineralization on at least one first permanent molar (MIH); and with hypomineralization on at least one first permanent molar and permanent incisor (M + IH). For each group, the mean values of hypomineralized primary teeth (ht), permanent teeth (HT), and permanent surfaces (HS) were calculated. Results: The proportion of affected children was 36.5 percent (HT ≥ 1), 14.7 percent (MIH), and 9.4 percent (M + IH); 6.9 percent of the subjects had a minimum of one affected primary tooth (ht ≥ 1). The mean number of hypomineralized permanent teeth and surfaces were 2.3HT/2.9HS (HT ≥ 1), 3.4HT/4.8HS (MIH), and 4.2HT/5.9HS (M + IH). The mean number of hypomineralized primary teeth amounted to 0.1ht in the entire study population. Conclusions: Enamel hypomineralization can be detected frequently in this study sample. Children with M + IH showed the highest number of affected teeth and surfaces followed by those with MIH.     

Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls - a longitudinal study

International Journal of Paediatric Dentistry 2012; 22: 85–91 Background. In a previous study, 9‐year‐old children with severe Molar Incisor Hypomineralization (MIH) had undergone dental treatment of their first molars nearly ten times as often as children in a control group. They also showed more management problems (BMP) and fear and anxiety (DFA). Aim. To assess the long‐term outcomes of dental treatments, dental anxiety, and patients’ satisfaction in adolescents with MIH. Design. Sixty‐seven patients, identical with those in the baseline study, were studied at age 18‐years. The participants answered the Children’s Fear Survey Schedule – Dental Subscale the Dental Visit Satisfaction Scale (DVSS). Data were compiled from the dental records concerning dental health, number of restorative treatments and BMP. Results. Molar Incisor Hypomineralization group had a significantly higher DMFT, and had undergone treatment of their permanent first molars 4.2 times as often as the controls. BMP was still significantly more common in the MIH group. However, DFS was reduced in MIH group and increased in the control groups. The DVSS scores did not differ between the groups. Conclusions. Patients with severe MIH had a poorer dental health and were still more treatment consuming at age 18‐years. However, their dental fear was now at the same level as the controls.     

Genome-wide association study (GWAS) for molar–incisor hypomineralization (MIH)

Objectives

This genome-wide association study (GWAS) investigated the relationship between molar–incisor hypomineralization (MIH) and possible genetic loci. Clinical and genetic data from the 10-year follow-up of 668 children from the Munich GINI-plus and LISA-plus birth cohort studies were analyzed.

Material and methods

The dental examinations included the diagnosis of MIH according to the criteria of the European Academy of Paediatric Dentistry (EAPD). Children with MIH were categorized as those with a minimum of one hypomineralized first permanent molar. A GWAS was implemented following a quality-control step and an additive genetic effect was assumed.

Results

A total of 2,013,491 single-nucleotide polymorphisms (SNPs) were available for analysis. Rs13058467, which is located near the SCUBE1 gene on chromosome 22 (p?<?3.72E-7), was identified as a possible locus linked to MIH when using a threshold of p value <1E-6.

Conclusions

After considering the limitations of the present study (e.g., limited sample size and lack of an independent replication sample), it can be concluded that (1) replication analyses in an independent cohort study are strongly recommended and (2) large-scale and well-powered studies are needed to investigate a possible genetic link to MIH.     

Linking the clinical presentation of molar‐incisor hypomineralisation to its mineral density

International Journal of Paediatric Dentistry 2010; 20: 353–360 Background. The in vitro methods used for the assessment of the severity of molar‐incisor hypomineralisation (MIH) are not available for clinicians faced with questions regarding the severity in clinical cases, and the best management approach. Aim. To assess whether there is a relation between the severity of the defects in MIH enamel (represented by reduction in the mineral density) and the clinical presentation (represented by the colour of the defect and its laser fluorescence). Design. The colour of enamel was recorded (normal, white, yellow or brown) in specific areas for ten extracted first permanent molars with MIH defects and ten extracted sound teeth. Laser fluorescence (LF) and mineral density (MD) were measured for the same areas. A mixed model, using sample/tooth as a random effect, was used to estimate the relationship between the MD and the colour‐coding, and between the MD and LF readings. Results. The between‐samples correlation coefficient for the colour coding and the MD was 0.99 (P < 0.001), and 0.83 (P < 0.001) for the LF and MD. Conclusions. The degree of staining of MIH enamel, as assessed visually or by LF, may be used clinically to reflect the severity of the defect.     

Diagnosis and treatment of molar incisor hypomineralization

Molar incisor hypomineralization (MIH) is a relatively common condition that varies in clinical severity and can result in early loss of the permanent 6-year molars. The etiology of MIH remains unclear, and the diagnosis can be confused with more generalized enamel defects such as those that occur in amelogenesis imperfecta. The management of MIH depends largely on the severity of the enamel defect. Degrees of hypomineralization can range from mild enamel opacities to enamel that readily abrades from the tooth as it emerges into the oral cavity. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The purpose of this article is to review approaches to diagnosing and treating MIH.