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5th ACS - Dental Anomalies > MIH > Flashcards

MIH Flashcards

1
Q

What is MIH?

A

Molar incisor hypomineralisation

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2
Q

MIH definition?

A

Hypo-mineralisation of systemic orgin affecting 1 to 4 first permanent molars, frequently associated w/ affected incisors

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3
Q

What is hypomineralisation?

A

Qualitative defect in enamel formation - amount of mineral and content disturbed

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4
Q

What is hypoplasia?

A

Quantitative defect in enamel formation - less enamel formed, mineralisation phase normal

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5
Q

How do molars appear in MIH?

A

Well-demaracted white/yellow or brown/yellow opacities

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6
Q

What see severe cases MIH

A

Defective enamel lost soon after erupting exposing underlying dentine = post eruptive breakdown

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7
Q

How do incisors appear in MIH?

A

Well-demaracted white/yellow or yellow/brown opacities

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8
Q

Do see PEB in incisors?

A

No

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9
Q

Prevelance MIH?

A

13%

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10
Q

How can aetiological factors be divided?

A

Pre, peri and post natal

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11
Q

What are some pre-natal factors affecting MIH?

A

Maternal pyrexia
Anitbitoics
Maternal diabtetes
Prolonged vomitting

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12
Q

What are some peri-natal issue increase risk MIH?

A 
Caserean
Prlonged/ complicated delivery
Premature
Low birth weight
Twins
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13
Q

What are some post-natal risks of MIH?

A

ENT infection
Pyrexia
UTI
Antibitocis

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14
Q

Who see increased prevelance of MIH?

A

Twins

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15
Q

How does enamel appear in MIH?

A

Porous
Weak
High protein contnet
Low calcium: phosphate

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16
Q

How does dentine appear MIH?

A

Sparse reparative dentine

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17
Q

Clinical challenges of MIH - pt factors?

A

sensitivity
aesthetics
need long term tx - financial burden

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18
Q

Clinical challenges of MIH?

A

High failure rate adhesive restorations
TSL
High caries rate

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19
Q

What would generic holistic tx plan look like?

A
  1. Prevention, remin, alleviate symptoms
  2. Tx plan first molars
  3. Improve aesthetic incisiors
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20
Q

What is tooth mousse?

A

Topical cream containing CPP-ACP
Casein phosphopeptide - amorphous calcium phosphate
Improve re-min enamel and improve symptoms

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21
Q

Issue w/ FS on MIH?

A

Recommended but have high failure rate - hard w/ sensitivity of air/water

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22
Q

How to provide FS for teeth with MIH?

A

Light cured GIC

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23
Q

Preventative tx for MIH?

A 
OHI
Diet advice 
Topical F-
Tooth mousse
FS
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24
Q

Restorative options for MIH?

A

Adhesive
PMCS
Lab formed crowns

25
What to consider if need XLA poor prognosis tooth?
Do need to compensate? | Ortho consideration?
26
When best time to XLA poor prognosis 6s?
9-11 yrs produce acceptable occlusal situation Furcation developing 7s 8s developing
27
Would change plan for XLA if class II or class III?
Class II - maintain upper 6s until 7s erupted | Class III - try restore
28
What happen if leave XLA of 6s too late?
Mesial tipping of lower 7s
29
What happens if XLA 6s too early?
Space between lower premolars
30
When seek ortho opinon regarding timing XLA?
If malocclusion - class II/III/ hypodontia and severe crowidng cases
31
What material can't be used in MIH in children?
Amalgam - can't be used in under 15yrs | Materials also need to be adhesive
32
When is GIC useful in MIH?
Short-term restorations prior to providing definitive restorations
33
When are composites indiciated in MIH?
Mildly affected teeth w/ no cuspal involvement
34
Adv PMC?
``` Prevent further deterioration/caries Control sensitivity Establish correct interproximal contact Quick Cost effective ```
35
Disadv PMC
reaction pt w/ nickel allergy AOB if not fitted correctly Gingival inflammation
36
Restoration of choice for mod-severe hypomin?
Indirect gold onlay
37
When should gold onlay be placed?
Late mixed or early permanent dentition
38
Tx options for hypomin of incisiors?
Whitening Resin infil - ICON Micro-abrasion Direct/indirect comp
39
What is psychological impact of enamel opacities?
Self-esteem Peer and adult social judgement Social interaction
40
What asses prior tx anterior teeth?
Colour, TSL and sensitivity | Is child bothered?
41
What products can be used for teeth whitening?
Hydrogen peroxide | Carbamide peroxide
42
How does teeth whitening work?
Free radicals diffuse into tissue and react w/ organic pigments to create less pigemneted molecules whcih reflect less colour
43
Main issue with whitening?
Post-op sensitivity
44
What stage of development before whitneing?
Full dentition
45
Can whiten single tooth?
Yes include reservoir
46
Can tooth whitening be prescribed under 18s?
Products containing between 0/1-6% hydrogen peroxide can't be used under 18s except when for purpose of treating or preventing disease
47
What is microabrasion?
Chemical and mechnical removal of intrinsic and superficial enamel staining
48
Benefit microabrasion?
Safe, effective, simple, economical and conservative
49
What should microabrasion not be used on?
DI | Tetracycline staining
50
Common prep for microabrasion?
6.6% hydrochloric acid | w/ silicon carbide microparticles
51
What must do if using microabrasion?
Protect teeth w/ dam and oraseal
52
How use microabrasion?
Apply etch and scrub surface then wash | up to 10 cycles
53
What opacities does microabrasion work well on?
brown e/g fluoriosis White striations Diffuse opacities
54
What warning must give pt post micro-abrasion?
Severe extrinsic staining post micro-abrasion - avoid all food that could stain - beige diet few days after
55
Disadv of ICON?
Expesnive
56
What is ICON?
Low viscosity resin that can flow into porosity
57
How use ICON?
``` Isolate Etch - wash and dry Apply ICON dry Repeat etch/ icon dry until opacity fades Accon ICON, remove excess and cure ```
58
What are composite restorations beneficial?
Camoflague residual discolouration/ replace missing enamel

5th ACS - Dental Anomalies (4 decks)

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