MIH_HSPM_questions Flashcards
Define molar-incisor hypomineralization (MIH).
MIH is a qualitative enamel defect of systemic origin affecting one or more permanent first molars (PFMs) and frequently incisors.
What is hypomineralization of second primary molars (HSPM)?
HSPM is an idiopathic, multifactorial hypomineralization defect of second primary molars, associated with systemic factors similar to MIH.
List synonyms for MIH.
Hypomineralized PFMs, idiopathic enamel hypomineralization, cheese molars, and non-fluoride hypomineralization.
What systemic issue causes hypomineralization in MIH and HSPM?
Disrupted ameloblastic function during the transitional and maturational stages of amelogenesis.
What complications are associated with MIH?
Tooth structure breakdown, sensitivity, caries, tooth loss, and occlusal issues.
What is the prevalence of MIH and HSPM?
MIH: 13.5%, HSPM: 11%.
Why is MIH prevalence often underestimated?
Lack of diagnostic knowledge by dentists and late patient presentation after severe destruction.
What is the relationship between HSPM and MIH?
Children with HSPM are 10 times more likely to develop MIH.
What is the primary cause of MIH?
Gene-environmental interaction affecting amelogenesis-related genes.
Name environmental factors contributing to MIH risk.
Prenatal smoking or alcoholism, low birth weight, and postnatal illnesses like fever and antibiotic use.
At what stages does hypomineralization in HSPM occur?
During enamel formation, particularly the first year of life.
How does maternal alcohol intake affect HSPM?
It increases the risk of enamel defects during tooth development.
What are the EAPD diagnostic criteria for MIH?
Soft porous enamel, white/yellow-brown opacities, post-eruption enamel breakdown, and asymmetrical defects.
How does wet tooth examination assist MIH diagnosis?
It reveals clear demarcation between affected and sound enamel.
What are the characteristics of mild MIH?
Opacities in non-stress areas, no caries, and no sensitivity.
How is moderate MIH identified?
Enamel breakdown on 1-2 surfaces without cuspal involvement and mild hypersensitivity.
What defines severe MIH?
Crown destruction, post-eruption breakdown, and severe hypersensitivity.
How is MIH differentiated from dental caries?
MIH involves asymmetrical defects, often sparing adjacent deciduous teeth.
What distinguishes fluorosis from MIH?
Fluorosis affects multiple teeth diffusely, while MIH shows asymmetrical demarcation.
How does enamel hypoplasia differ from MIH?
Hypoplasia presents with smooth enamel edges but irregular surfaces.
What differentiates amelogenesis imperfecta from MIH?
Amelogenesis imperfecta affects both dentitions symmetrically and is often linked to consanguinity.
Why is anesthesia difficult to achieve in MIH-affected teeth?
Chronic pulp inflammation reduces local anesthetic efficacy.
What are the six steps in MIH management?
Risk identification, early diagnosis, remineralization, prevention of breakdown, restoration, and regular follow-up.
What materials are used for mild MIH restorations?
Glass ionomer cement (GIC), resin infiltration, and fissure sealants.
What treatment options are suggested for severe MIH?
SMART restorations, Hall stainless steel crowns, or molar extraction.
What is the etch-bleach-seal technique used for?
To treat anterior teeth with mild MIH by removing chromogenic material and infiltrating resin.
What is the prevalence of HSPM?
11%, though it may be underdiagnosed due to masking by dental caries.
How does HSPM increase the risk of MIH?
The more molars affected by HSPM, the higher the likelihood of developing MIH.
What are diagnostic criteria for HSPM?
Demarcated opacities, post-eruptive breakdown, and atypical caries patterns.
How is HSPM differentiated from ECC?
ECC shows a symmetrical cariogenic pattern, while HSPM is localized and asymmetric.
What management is preferred for HSPM in young children?
Hall technique with stainless steel crowns for minimal intervention.
Why is early diagnosis of HSPM critical?
It allows monitoring of FPM eruption to minimize MIH complications.
What fluoride treatments are recommended for MIH and HSPM?
2.5% NaF varnish, 38% SDF, and fluoride toothpaste (1000-1450 ppm).
What additional remineralization agents are used?
Functionalized tricalcium phosphate (f-TCP) and MI paste/MI paste plus.
How often should children with MIH or HSPM be followed up?
Every 4 months to monitor the status of affected teeth.
