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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
Q

What to consider if need XLA poor prognosis tooth?

A

Do need to compensate?

Ortho consideration?

26
Q

When best time to XLA poor prognosis 6s?

A

9-11 yrs produce acceptable occlusal situation

Furcation developing 7s
8s developing

27
Q

Would change plan for XLA if class II or class III?

A

Class II - maintain upper 6s until 7s erupted

Class III - try restore

28
Q

What happen if leave XLA of 6s too late?

A

Mesial tipping of lower 7s

29
Q

What happens if XLA 6s too early?

A

Space between lower premolars

30
Q

When seek ortho opinon regarding timing XLA?

A

If malocclusion - class II/III/ hypodontia and severe crowidng cases

31
Q

What material can’t be used in MIH in children?

A

Amalgam - can’t be used in under 15yrs

Materials also need to be adhesive

32
Q

When is GIC useful in MIH?

A

Short-term restorations prior to providing definitive restorations

33
Q

When are composites indiciated in MIH?

A

Mildly affected teeth w/ no cuspal involvement

34
Q

Adv PMC?

A 
Prevent further deterioration/caries
Control sensitivity 
Establish correct interproximal contact 
Quick
Cost effective
35
Q

Disadv PMC

A

reaction pt w/ nickel allergy
AOB if not fitted correctly
Gingival inflammation

36
Q

Restoration of choice for mod-severe hypomin?

A

Indirect gold onlay

37
Q

When should gold onlay be placed?

A

Late mixed or early permanent dentition

38
Q

Tx options for hypomin of incisiors?

A

Whitening
Resin infil - ICON
Micro-abrasion
Direct/indirect comp

39
Q

What is psychological impact of enamel opacities?

A

Self-esteem
Peer and adult social judgement
Social interaction

40
Q

What asses prior tx anterior teeth?

A

Colour, TSL and sensitivity

Is child bothered?

41
Q

What products can be used for teeth whitening?

A

Hydrogen peroxide

Carbamide peroxide

42
Q

How does teeth whitening work?

A

Free radicals diffuse into tissue and react w/ organic pigments to create less pigemneted molecules whcih reflect less colour

43
Q

Main issue with whitening?

A

Post-op sensitivity

44
Q

What stage of development before whitneing?

A

Full dentition

45
Q

Can whiten single tooth?

A

Yes include reservoir

46
Q

Can tooth whitening be prescribed under 18s?

A

Products containing between 0/1-6% hydrogen peroxide can’t be used under 18s except when for purpose of treating or preventing disease

47
Q

What is microabrasion?

A

Chemical and mechnical removal of intrinsic and superficial enamel staining

48
Q

Benefit microabrasion?

A

Safe, effective, simple, economical and conservative

49
Q

What should microabrasion not be used on?

A

DI

Tetracycline staining

50
Q

Common prep for microabrasion?

A

6.6% hydrochloric acid

w/ silicon carbide microparticles

51
Q

What must do if using microabrasion?

A

Protect teeth w/ dam and oraseal

52
Q

How use microabrasion?

A

Apply etch and scrub surface then wash

up to 10 cycles

53
Q

What opacities does microabrasion work well on?

A

brown e/g fluoriosis
White striations
Diffuse opacities

54
Q

What warning must give pt post micro-abrasion?

A

Severe extrinsic staining post micro-abrasion - avoid all food that could stain - beige diet few days after

55
Q

Disadv of ICON?

A

Expesnive

56
Q

What is ICON?

A

Low viscosity resin that can flow into porosity

57
Q

How use ICON?

A 
Isolate
Etch - wash and dry
Apply ICON dry
Repeat etch/ icon dry until opacity fades
Accon ICON, remove excess and cure
58
Q

What are composite restorations beneficial?

A

Camoflague residual discolouration/ replace missing enamel

5th ACS - Dental Anomalies (4 decks)

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