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4th Yr- CCD2-Clinical > Molar Incisor Hypomineralisation > Flashcards

Molar Incisor Hypomineralisation Flashcards

1
Q

Name the cells that form enamel

A

Ameloblasts

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2
Q

What is the stimulus that causes ameloblasts to start making enamel

A

Dentine deposition which causes ameloblasts to retreat from the ADJ

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3
Q

What do Amelobalsts do

A

They secrete matrix protein that calcify immediately

This forms enamel

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4
Q

Apart from matrix secretion what else do ameloblasts of

A

They secrete enzymes that remove the organic component and allow full mineralisation of the matrix proteins

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5
Q

What problems can occur with enamel deposition

A
  1. Hypoplastic enamel

2. hypomineralsition

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6
Q

What causes Hypoplastic enamel

A

Physical disruption during the laying down of the enamel matrix

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7
Q

What causes hypomineralsition

A

Can occur either int eh calcification stage or in the maturation stage

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8
Q

How can the classification of enamel defects be split

A
  1. Systemic

2. local

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9
Q

What can cause localised enamel defects

A
  1. Trauma

2. Infection

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10
Q

What can cause systemic enamel defects

A
  1. Genetic

2. Environmental cause

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11
Q

What is the only genetic condition that can lead to enamel defects

A

Amelogenisis imperfecta

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12
Q

What can environmental systemic enamel defects be split into

A
  1. Chronological defect

2. Generalised defect

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13
Q

Give an example of a generalised environmental enamel defect

A

Fluorosis

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14
Q

Give an example of a chronological environmental enamel defect

A

Molar incisial hypomineralisation

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15
Q

What terms can we use to describe enamel defects

A
  1. Demarcated
  2. Diffused
  3. Hypoplastic
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16
Q

What does demarcated mean when referring to enamel

A
  1. Distinct, clear boundaries

2. Yellow, white or brown in colour

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17
Q

What does diffused mean when referring to enamel

A
  1. No clear boundaries

2. Lines, patchy or confluent areas

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18
Q

What does hypoplastic mean in terms of enamel

A

Loss of enamel

Pits or grooved present

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19
Q

How do we describe enamel suffering from molar incisor hypomineralisation

A

Demarcated

20
Q

How do we describe enamel suffering from fluorisis

A

Diffused

21
Q

How do we describe enamel suffering from localised enamel defects

A

Hypoplastic

22
Q

How do we describe enamel suffering from amelogensis imperfect

A

Demarcated, Diffused and hypoplastic

23
Q

What is molar incisor hypomineralisation

A

hypomineralisation of systemic origin of one or more first permanent molars as well as any associated and affected incisors

24
Q

What are other terms used to describe MIH

A
  1. Molar hypomineralisation
  2. Incisor hypomineralisation
  3. Deciduous molar hypomineralisation
25
Q

What does the term hypomineralised mean

A

A disturbance of enamel formation resulting in a reduced mineral content

26
Q

What does the term hypoplastic mean

A

Reduced bulk or thickness of enamel

Enamel NEVER formed

27
Q

If enamel is a brownish/ yellow colour what does that indicate

A

It is most porous

28
Q

If enamel is a whitish/ yellow colour what does that indicate

A

It is less porous

29
Q

What problems can hypomineralsed molars cause

A
  1. Post eruptive breakdown
  2. Can be sensitive
  3. Teeth are more susceptible to caries
  4. Teeth decay faster
  5. Teeth are more difficult to restore
30
Q

How common is MIH?

A

5-25%

31
Q

How do we treat MIH

A
  1. Start with molars and think about prognosis
32
Q

What do we think about when forming long term diagnosis for MIH molars

A
  1. Multi surface defects
  2. Brown/yellow defects
  3. Is there evidence of post eruptive breakdown
  4. Is there pain/ sensitivity
  5. Is the defect extending across cusps or marginal ridges
  6. Caries
33
Q

What considerations do we need to take before extraction permanent molars

A

Orthodontic considerations

34
Q

Describe the ideal orthodontic situation when considering the removal of a permanent molar

A
  1. Class I occlusion
  2. Normal/ reduced overbite
  3. Mild to moderate crowding
  4. Minimal anterior crowding
  5. All permanent teeth present
35
Q

At what age is ti best to carry out lower permanent molar extraction

A

8-9

36
Q

At what age is ti best to carry out upper permanent molar extraction

A

Timing less critical but the space is likely to close if the molar is extracted before 11/12 yrs

37
Q

When extracting permanent molars we also need to what

A

Compensate for iver eruption

38
Q

How do we compensate for overruption when extracting a lower 6

A

Extract the upper 6 as well as it will most lilt over erupt and cause unfavourable occlusion

39
Q

How do we compensate for overruption when extracting an upper 6

A

We don’t need to compensate

40
Q

Do we extract every MIH affected permanent molar

A

NO we can restore/ conserve

41
Q

How can we restore/ conserve an MIH affected molar

A
  1. Tooth mousse
  2. Fissure sealant
  3. Amalgam
  4. GIC
  5. Composite
  6. SSC
  7. Onlays
42
Q

Why might we use tooth mousse

A

If the patient has sensitivity

43
Q

What conditions must be fulfilled before we place fissure sealants

A
  1. Enamel is intact ad of good hardness
  2. No sensitivity
  3. Bitewings demonstrate no caries
44
Q

Do we regularly place amalgam on primary teeth

A

no

45
Q

what options do we have to restore incisors

A
  1. Microabrasion
  2. Bleaching
  3. Resin infiltration
  4. Composite veneers
  5. Porcelain veneers

4th Yr- CCD2-Clinical (6 decks)

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