MIH

Question 1

What is MIH

Answer 1

Hypomineralisation of systemic origin of 1-4 perm. molars frequently assoc. with affected incisors

Question 2

What does hypomineralised mean

Answer 2

Disturbance of enamel formation resulting in reduced mineral content

Question 3

What does hypoplastic mean and what are the 2 types

Answer 3

Reduced bulk or thickness of enamel

True- Enamel never formed

Aquired- Post eruptive loss of enamel bulk

Question 4

Why is dentine sensitivity a problem in MIH

Answer 4

Dentine hypersentivity
-Porous enamel or exposed dentine facilitates fluid flow within dentine tubules to activate A(delta) nerve fibres (hydrodynamic theroy)

peripheral senitisation
-Underlying pulpal inflam. leads to sensitisation of Cfibres

Central sensitisation
-From continued nociceptive input

Question 5

What is te cause of MIH

Answer 5

The critical period of MIH forming is the first year of life as the enamel matrix of crown of FPM’s done by 1 year

Cause not entirely known but as pt mum about pre-natal, peri-natal and post-natal health

Question 6

What question to ask about pre-natal

Answer 6

Health in 3rd trimester (as FPM only tooth to calcify before birth)
-Preclampsia?

Question 7

What question do you ask about peri-natal

Answer 7

Birth trauma?

Pre-term birth?

Question 8

What question do you ask about post natal

Answer 8

Any childood inf, fevers, medications

Socioeconomic factors to

Question 9

What are the clinical problems of MIH

Answer 9

Loss of tooth substance= breakdown of enamel, tooth wear, 2ndary caries

Sensitivity

Aesthetics

Question 10

What is the Tx for MIH molars

Answer 10

COMP/GI restoration

SSC

Adhesive retained copings

Extract (if pt 8.5-9.5)

Question 11

What s the Tx for incisors

Answer 11

Acid pumice abrasion

Resin infil, ICON

Ex. bleaching

Localised COMP placement

COMP veneers