MIH

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What is MIH
- term to describe clinical appearance of enamel hypomineralisation of systemic origin
- affecting one or more permanent molars and associated with affected incisors
Characteristics of hypomineralised enamel (MIH)
- decreased calcium:phosphorous ratios
- decreased hardnessincreased porositemineral gradient decreases from DEJ to enamel (reverse of normal)
- even zones of sound enamel have lower mineral concentration ~5%
- interference with enamel maturation and crystal growth - dysfunction in resorptive potential of ameloblasts and proteolytic enzyme inhibition -> results in retention of protein (amelogenin)
- changes in pulpal innervation, vascularity, immune cell accumulation are indicative of an inflammatory response
Issues with restoring hypomineralised 6s
- difficulties to achieve LA
- behaviour management issues - painful/tender/sensitive
- determining how much enamel to remove
- selecting a suitable restorative material
- poor bond strength to composite and GIC
Moderate-to-severe post eruptive enamel breakdown - restoration of choice? why?
- SSC:
- prevent further tooth deterioration
- control tooth sensitivity
- establish correct interproximal contacts and proper occlusal relationships
- not technique sensitive/costly
- requires little time to prepare and insert
Severe hypomineralisation - tx of choice?
- consider extraction - WITH seeking orthodontic opinion
- may extract ideally between 8.5-9.5yo when calcificatino of bifurcation of 7 occurs
- if unrestorable --> extraction
- caution with Class II malocclusion and hypodivergent profile
Aetiology of MIH
- prenatal/perinatal complications:
- respiratory tract infections
- prematurity of birth/low birth weights
- hypoxia
- Ca and Phosphate metabolism disorders
- frequent childhood illnesses
- dioxins and environmental pollutants
- ??maybe vaccines/antibiotics

Author

linnyc

72853

Card Set

MIH

Description

MIH paedo

Updated

2011-03-14T18:10:36Z

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