1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
Card Set
MIH paedo