L112. Molar Incisor Hypomineralisation Flashcards
(21 cards)
L112: What is molar incisor hypomineralisation?
Hypomineralisation of systemic origin of 1-4 permanent molars, frequently associated with affected incisors
L112: In the seventies, where was there an increased number of idiopathic cases of hypomineralised teeth?
Sweden
L112: What does ‘hypomineralised’ mean?
Disturbance of enamel formation resulting in a reduced mineral content
L112: What does ‘hypoplastic’ mean?
Reduced bulk or thickness of enamel
L112: What does ‘true’ hypoplasia mean?
Enamel never formed
L112: What does ‘acquired’ hypoplasia mean?
Post-eruptive loss of enamel bulk
L112: Why is the aetiology of MIH unclear?
- Unclear diagnostic criteria;
- Parents cannot recall details from 8-10 years ago;
- Variation in quality of medical records;
- Study populations small.
L112: When is the enamel matrix of crowns usually complete?
First year of life
L112: When diagnosing the cause of MIH, what’re the three periods for clinical enquiry?
- Pre-natal;
- Natal;
- Post-natal.
L112: In which pregnancy trimester can problems cause MIH?
Third
L112: Provide examples of prenatal problems that can result in MIH in the foetus/ baby?
- Pre-eclampsia;
- Gestational diabetes.
L112: Provide examples of perinatal problems that can result in MIH in the foetus/ baby?
- Birth trauma/ anoxia;
- Hypocalcaemia;
- Pre-term birth.
L112: Provide examples of post natal problems that can result in MIH in the foetus/ baby?
- Certain childhood infections (chicken pox, measles, rubella);
- Fever and medication;
- Socioeconomic status (nutrition);
- Breast feeding (dioxins in breast milk or prolonged feeding).
L112: Histologically, what changes can be seen with the chemical composition of hypomineralised teeth?
- Higher carbon content;
- Lower calcium and phosphate content.
L112: What research suggests a presence of underlying pulpal inflammation with hypomineralised teeth?
- Increased neural density;
- Increased accumulation of immune cells;
- Increased vascularity.
L112: Why are hypomineralised teeth often more sensitive?
- Dentine hypersensitivity (porous enamel or exposed dentine facilitates fluid flow within dentine tubules - activates Ad fibres);
- Peripheral sensitisation (underlying pulpal inflammation - c fibres);
- Central sensitisation (from cont. nociceptive input).
L112: Alongside sensitivity, what other clinical problems are associated with MIH?
- Loss of tooth substance (wear/ secondary caries);
- Appearance.
L112: What treatment options are there for treating MIH?
- Composite/ GIC restorations;
- Stainless steel crowns;
- Adhesively retained copings;
- Extraction (8.5-9.5 y/o).
L112: What treatment options are there for treating affected molars?
- Composite/ GIC restorations;
- Stainless steel crowns;
- Adhesively retained copings;
- Extraction (8.5-9.5 y/o).
L112: What should you consider before extracting a affected molars in children?
- Age;
- Skeletal pattern;
- Future orthodontic needs;
- Quality of teeth e.g. caries.
L112: What treatment options are there for treating affected incisors?
- Acid pumice micro abrasion;
- External bleaching;
- Localised composite placement;
- Full composite or porcelain veneers.
