Therapeutic Approach to Molar – Incisal Hipomineralization. Narrative Review

Alvarez Ochoa, Daniela; Robles Contreras, Isabel; Díaz Meléndez, Jaime; Sandoval Vidal, Paulo

Summary

Molar Incisor Hypomineralization (MIH) is a tooth development disorder, which is associated with systemic factors, produced by incomplete enamel mineralization and maturation below the enamel surface that is intact at the time of eruption. In literature, the prevalence in children worldwide varies between 2.4 % and 40.2 %. This disorder which involves at least one first permanent molar, and depending on duration, the child’s susceptibility as well as the severity of prenatal, perinatal or postnatal insult may also compromise incisors. The defect reveals a variable degree of alteration in the translucency of the enamel, that has initially normal thickness and can be white, yellow or brown. Enamel surface may breakdown after eruption, due to masticatory forces, leaving sharp borders. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The complex care involved must address the child’s behavior and anxiety, aiming to provide pain free treatment and durable restorations. Intensive individually prescribed preventive programs may postpone the onset of restorative treatment and reduce patient discomfort in the long term. Early identification of such children will allow monitoring and implementation of preventive measures as soon as affected surfaces are accessible. Although treatment approaches for MIH have become more clear, and advances in dental materials have provided clinical solutions in cases that in the past were regarded as unrestorable, long-term clinical trials should be realized to further facilitate clinical management of this dental defect.

KEY WORDS: molar-incisal hipomineralization, enamel structural defects, preventive measures.

How to cite this article

ALVAREZ, O. D.; ROBLES, C. I.; DÍAZ, M. J. & SANDOVAL, V. P. Therapeutic approach to molar - incisal hipomineralization. Narrative review. Int. J. Odontostomat., 11(3):247-251, 2017.