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Clinical studies on Molar-Incisor-Hypomineralisation (MIH) and on Molar-hypomineralisation (MH)
Development of the severity index(HSI)
Author: Orbán TimeaCo-authors: Cristina Bică, Crișan Mihaela Laura
Lecturer: Cristina Bică PHD
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Definition
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Clinical appearance, symptoms and signs In MIH and MH we can see white-cream opacities or
yellow-brown discoloration with or without post-eruptive breakdown
MH: one or more affected FPM MIH: one or more affected FPM asociated with
hypomineralised permanent incisors
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Objective To examine 261
children with or without hypomineralisation in order to develop the hypomineralisation severity index(HSI)
To clarify aetiological factors
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Aetiology
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Materials and methods Data collection
There were examinated 261 children between 9-11 years
63 of them showed signs of hypomineralisation (prevalence of 24,1%)
The parents completed a questionnaire describing their perinatal and medical histories
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Questionnare Did you had any illnesses during
pregnancy? Did you take any antibiotics during
pregnancy? Birth prematurity? Illnesses of the child: pneumonia?
upper respiratory infections? fevers? otitis media?
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Classification 1
Classification of Alaluusa (1996) Mild- color change: white, yellow or
brown Moderate- loss of enamel only Severe- loss of enamel in association
with affected dentine
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Classification 2
Classification of Leppaniemi (2001) Mild- white-cream opacities Moderate- yellow-brown coloration Severe- PEB
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HSI An index of hypomineralisation severity
was computed, based on the extension of the affection on dental surfaces HSI=0: no signs of hypomineralisation HSI=1: one surface is affected HSI=2: two surfaces HSI=3: three surfaces HSI=4: four surfaces HSI=5: five surfaces
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Results 63 of the 261
children showed signs of hypomineralisation (prevalence 24,1%)
no signs ofhypomineralisation =198
MH =27
MIH =36
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Results Some medical
conditions affect the mineralisation of the first permanent molars and permanent incisors
One or more conditions were collated with hypomineralisation (57 of 63 children, 90,47%)
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Results of the questionnaire
9,52%-no illnesses 23,80%-fevers 14,28%-birth prematurity 9,52%-pneumonia 33,33%-upper respiratory
infections 23,80%-tonsillitis
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Results of the clinical examination
In MH in 77,77% there were only one affected first permanent molars
In MIH in 75% there were affected all four first permanent molars.
HSI-MIH>HSI-MH
MH with onlyone affectedFPM = 21
MH with morethan oneaffected FPM=6
MIH with allfour FPM withhypomineralisation =27
MIH with threeor less FPMwithhypomineralisation =9
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Discussion
Melbourne Dental School, Australia: dentitions MIH had higher severity indices than those with MH
Medical histories showed that most of the children had one or more relevant conditions in the first three years of life
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Conclusions The severity index of the MH is always
lower than the severity index of the MIH MIH is more severe form of the
hypomineralisation than MH In most of the cases of MH there is only
one FPM with hypomineralisation In most of the cases of MIH there are
affected all four FPMs Some medical and perinatal conditions
can affect the mineralisation of the enamel
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Bibliografy N.S.Willmott, R.A.E. Bryan, M.S. Duggal: Molar-
Incisor-Hypomineralisation, A literature review N.Chawla, L.B. Messer, M. Silva: Clinical
studies on Molar-Incisor-Hypomineralisation M. Pereira Alves dos Santos, L. Cople Maia:
MIH:Morphological, Aetiological, Epidemiological and Clinical Considerations
Weerheijm: MIH A.J. Munoz, J.D. Melendez, C.V. Gonzalez, C. Z.
Sanchez: Frecvency and severity of Molar Incisor Hypomineralisation in Patients treated at the Dental Clinic of the Universidad de la Frontera, Chile
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“MH is a sort of birth defect, where the tooth isn’t made
properly before it’s born into your mouth”