molar incisor hypomineralisation Flashcards
what is MIH?
hypomineralisation of systemic origin of 1-4 permanent molars, frequently associated with affected incisors
describe typical presentation of MIH
enamel not formed
yellow in colour
likely caries
post-eruption breakdown
what is the prevalence if MIH?
10-20%
what does hypomineralised mean?
disturbance of enamel formation resulting in a reduced mineral content
what does hypoplastic mean?
reduced bulk/thickness of enamel, either:
true- enamel never formed
acquired - post-eruptive loss of enamel bulk
enamel good quality
what effect does MIH have of number of immune cells?
MIH teeth have increased numbers of immune cells
what else is increased due to MIH?
innervation- nervous tissue neural material in pulp, blood vessels
what are the MIH pain mechanisms?
dentine hypersensitivity
-porous/exposed dentine facilitates fluid flow w/i dentine tubules activating A delta fibres
peripheral sensitisation
-underlying pulpal inflammation sensitisation of C-fibres
central sensitisation
what are the possible causes of MIH?
prolonged breast feeding dioxins in breast milk fever & medications measles rubella chicken pox
what are the clinical problems associated with MIH?
loss of tooth substance -breakdown of enamel -tooth wear -secondary caries sensitivity appearance
what are the tx options for molars?
composite/GIC restorations
stainless steel crowns
adhesively retained copings
extraction
what should you consider before extraction ?
age
skeletal pattern
future ortho needs
quality of teeth eg caries
what are the tx options for affected incisors?
acid pumice micro abrasion resin infiltration external bleaching localised composite placement combo of above full comp veneers (or porcelain)
