MOLAR INCISOR HYPOMINERALIZATION: CURRENT TREATMENT MODALITIES FROM PARTIAL ERUPTION TILL POST-ERUPTIVE BREAKDOWN
Ola B. Al-Batayneh, BDS, MDSc, JDB, FRACDS (PAED), is Professor in Pediatric Dentistry at the Faculty of Dentistry, Jordan University of Science and Technology (JUST) and Consultant in Pediatric Dentistry at King Abdullah University Hospital (KAUH). She holds a Master’s degree in pediatric dentistry from the University of Queensland, Australia (2005), and a Fellowship in pediatric dentistry from the Royal Australasian College of Dental Surgeons, Sydney, Australia (2008). She has been involved in several international collaborative and postgraduate research projects in pediatric dentistry with educational institutions worldwide.
Ola has authored & co-authored several books and publications in reputable international journals, and has been a keynote speaker at many local and international conferences and symposia in Turkey, Greece, India, KSA, Dubai, Australia, Munich, and Egypt on her experience in epidemiological, laboratory, and clinical trials of her research. Research interests include molar incisor hypomineralisation (MIH), early childhood caries, remineralization of primary enamel, minimum Intervention dentistry, dental anomalies and children with special needs. She has published more than 50 research papers/books/articles in peer-reviewed journals with more than 1000 citations and 54 abstracts. Ola is serving as an Associate Editor in BMC Oral Health Journal and is on the editorial and scientific boards of four journals. She is also a member of the D3G (developmental dental defects group). Details about her are available on:
ORCID ID: https://orcid.org/0000-0003-1670-497X/
Scopus Author ID: 36164877800
Research gate URL: https://www.researchgate.net/profile/Al-Batayneh_OB
Google scholar URL: https://scholar.google.com/citations?user=cx2NFl0AAAAJ&hl=en
Molar incisor hypomineralisation (MIH) is a developmental, qualitative enamel defect affecting all types of primary and permanent teeth with a worldwide prevalence of nearly 15% and no gender differences. Patients complain mainly of sensitivity and pain during eating or brushing teeth, and esthetics. Clinically, MIH manifests as hypomineralized enamel which is soft, porous, with color that may vary from white, yellow or brown. The porous, brittle enamel can easily chip under masticatory forces. Due to pain and sensitivity, children avoid tooth brushing, and with the porous, brittle enamel, this makes them more prone for dental caries. Caries on MIH teeth, if left untreated, will rapidly progress towards the pulp and can eventually lead to pulpal necrosis in which case root canal treatment or extraction would be required; both leading to loss of a vital tooth at a young age. Therefore, early examination, prevention and treatment are encouraged in light of the management difficulties of such children which include sensitivity, inability to obtain profound anesthesia, limited access and isolation, and behavior management in young patients and adolescents which may range from non-pharmacologic approaches to sedation, or need for general anesthesia.
Principles of management of MIH include preventive therapy, restorative therapy using adhesive materials or preformed crowns, pulp therapy (vital or non-vital procedures), and extraction of the first permanent molars if the timing is optimal. The purpose of this presentation will be to describe the diagnosis and clinical presentation and therefore, outline a sequential approach to management of MIH since partial eruption of molars till later stages of post-eruptive breakdown based on current literature and guidelines. Management of different cases will be presented.