Molar Incisor Hypomineralization: A Clinical Guide to Diagnosis and Treatment

Preface
Contents
Contributors
Part I: Background
	1: MIH: An Introduction
		1.1	 “The Beginning”
		1.2	 Pioneer Work
		1.3	 MIH and Fluoride Intake
		1.4	 The Future
		References
	2: Structural, Mechanical, and Chemical Evaluation of Molar Incisor Hypomineralization-Affected Enamel
		2.1	 Enamel Defects
		2.2	 Enamel Formation
		2.3	 MIH-Affected Enamel
			2.3.1	 Microstructural Changes
			2.3.2	 Mechanical Properties
			2.3.3	 Mineral Density
			2.3.4	 Chemical Properties
		2.4	 Heterogeneity in Current Research Findings
		2.5	 Clinical Considerations
		2.6	 Conclusions
		References
	3: Prevalence, Incidence, and Burden of Molar Incisor Hypomineralization
		3.1	 The Need for Epidemiologic Estimates on MIH
		3.2	 Estimating the Global Prevalence, Incidence, and Burden
		3.3	 The Global Prevalence, Incidence, and Burden of MIH
		3.4	 Interpretation
		References
	4: The Pathogenesis and Aetiology of MIH: More Questions Than Answers
		4.1	 Introduction
		4.2	 Amelogenesis
			4.2.1	 Secretion
			4.2.2	 Maturation
		4.3	 Aberrations During Amelogenesis
		4.4	 Genetic Influences
		4.5	 Potential Aetiological Factors
			4.5.1	 Environmental Contaminants
			4.5.2	 Birth “Complications”
			4.5.3	 Early Childhood
			4.5.4	 Medication
		4.6	 Overview of MIH Aetiology
		References
Part II: Considerations in Clinical Practice
	5: Diagnosis, Classifications and Treatment Strategies of MIH-Affected Teeth
		5.1	 Introduction
		5.2	 Clinical Presentation
		5.3	 Diagnostic Terms
		5.4	 Differential Diagnosis
			5.4.1	 Amelogenesis Imperfecta
			5.4.2	 Enamel Hypoplasia
			5.4.3	 Fluorosis
			5.4.4	 White Spot Lesions
		5.5	 Classifications
		5.6	 Treatment Approaches
		5.7	 Summary
		References
	6: Association Between Molar Incisor Hypomineralization and Dental Caries
		6.1	 Caries Experience in Children with MIH
		6.2	 Does DMF Index Represent Restorative Treatment Need or Dental Caries Experience in Children with MIH?
			6.2.1	 Children with MIH and Restorative Treatment Need
			6.2.2	 Children with MIH and Dental Caries Susceptibility
		6.3	 MIH as Caries Risk Factor
		6.4	 How to Deal with MIH Children in Relation to Dental Caries?
		References
	7: Hypomineralized Second Primary Molars
		7.1	 Introduction
		7.2	 Clinical Appearance
			7.2.1	 Early Clinical Sign
				7.2.1.1	 Demarcated Opacity
			7.2.2	 Late Clinical Signs
				7.2.2.1	 Posteruptive Enamel Breakdown
				7.2.2.2	 Atypical Restauration
				7.2.2.3	 Atypical Caries
				7.2.2.4	 Atypical Extraction
		7.3	 Mineral Content
		7.4	 Prevalence
		7.5	 Relation of HSPM–MIH
		7.6	 Relation HSPM—Caries
		7.7	 Aetiology
		7.8	 Treatment
		7.9	 Conclusion
		References
	8: Knowledge, Experience and Perception Regarding Molar Incisor Hypomineralization
		8.1	 Introduction
		8.2	 Dental Community Awareness
			8.2.1	 Knowledge Regarding Treatment
			8.2.2	 Knowledge Regarding Prevalence and Aetiologies
			8.2.3	 Training Aspects
		8.3	 Conclusions
		References
Part III: Treatment Approaches
	9: Treatment of Children with MIH: A Challenge in Pain Control and Behaviour Management
		9.1	 Introduction
		9.2	 Pain and Children
			9.2.1	 Definition of Pain and Fear
			9.2.2	 Peculiarities of the Child’s Perception of Pain
			9.2.3	 MIH-Induced Pain
		9.3	 Basics of Child Treatment
			9.3.1	 Behaviour Management Control and Treatment Protocols for Children with MIH
			9.3.2	 Key Moments for a Painless Clinical Examination and Treatment of Hypersensitive MIH Teeth
			9.3.3	 Everything Starts with a Painless Examination
			9.3.4	 Local Anaesthesia, Special Technics and Optimized Equipment
				9.3.4.1	 Local Anaesthesia in Children
				9.3.4.2	 Optimized Clinical Anaesthesia Technique
				9.3.4.3	 Optimized Technical Equipment
		9.4	 Premedication
		9.5	 Postoperative Pain Control, Medication After the Treatment
		9.6	 Sedation
		9.7	 General Anaesthesia
		9.8	 Conclusions
		References
	10: Prophylaxis and Desensitizing of MIH Teeth
		10.1	 Introduction
		10.2	 Conservative Management of MIH-Affected Teeth
		10.3	 Preventive Treatment Approaches
		10.4	 Existing Evidence from Clinical Studies
		10.5	 Concluding Remarks
		References
	11: The Use of Fissure Sealants in MIH-Affected Posterior Teeth
		11.1	 Introduction
		11.2	 Clinical Procedure
			11.2.1	 Isolation
			11.2.2	 Pretreatment
				11.2.2.1	 Mechanical Cleaning and Etching
				11.2.2.2	 Deproteinization
				11.2.2.3	 Adhesion/Bonding
			11.2.3	 Sealant Application
		11.3	 Success Rates
		11.4	 Conclusions
		References
	12: Direct Restorations of MIH-Affected Teeth
		12.1	 Introduction
		12.2	 Special Requirements
		12.3	 Micromorphological Features: Is Adhesion Actually Possible?
		12.4	 Different Enamel Microstructure
		12.5	 Bonding Strategies
		12.6	 Temporary Restoration
		12.7	 Adhesive Restoration
		12.8	 Repair
		12.9	 Chances and Limitations of Direct Restorations
		References
	13: Indirect Restoration Approaches for MIH-Affected Teeth
		13.1	 Introduction
		13.2	 Restorative Management of Hypomineralized First Permanent Molars
		13.3	 Preformed Metal Crowns
			13.3.1	 Indications
			13.3.2	 Placement Procedures
			13.3.3	 Clinical Outcomes
		13.4	 Indirect Restorations
			13.4.1	 Indications
			13.4.2	 Metal Alloys
			13.4.3	 Composites
				13.4.3.1	 Case
			13.4.4	 CAD/CAM
				13.4.4.1	 Case
		13.5	 Conclusions
		References
	14: Aesthetic Management of Molar Incisor Hypomineralization: Staged Strategies for Affected Incisors
		14.1	 Introduction
		14.2	 Biomechanical Considerations
		14.3	 Strategies for Optimizing Adhesive Strength
		14.4	 Restorative Considerations
		14.5	 Modalities of Treatment in Order of Staging
			14.5.1	 Remineralization Strategies
			14.5.2	 External Vital Bleaching
				14.5.2.1	 Case 1
			14.5.3	 Surface Microabrasion
				14.5.3.1	 Case 2
			14.5.4	 Resin Infiltration
				14.5.4.1	 Case 3
				14.5.4.2	 Case 4
			14.5.5	 Macroreduction and Aesthetic Layering
				14.5.5.1	 Case 5
				14.5.5.2	 Case 6
		14.6	 Conclusion and Remarks
		References
	15: Extraction of MIH-Affected Molars and Orthodontic Space Closure
		15.1	 Introduction
		15.2	 General Considerations for Extraction of Permanent Teeth in Orthodontics
			15.2.1	 Indications for the Extraction of MIH-Affected Molars
		15.3	 Extraction Timing of MIH-Affected Molars in Absence of Dental Crowding
		15.4	 Extraction Timing of MIH-Affected Molars in the Presence of Dental Crowding
		15.5	 Consequences of Late Extraction of MIH-Affected Molars
		15.6	 Consequences of Premature Extraction of MIH-Affected Molars
		15.7	 Importance of Choosing the Correct Timing of Orthodontic Extraction Therapy
		15.8	 Balancing and Compensatory Extraction Therapy
		15.9	 Prognosis for Orthodontic Space Closure After Extraction of MIH-Affected Molars
		15.10	 Advantages of Orthodontic Extraction Therapy of MIH-Affected Molars
		15.11	 Prognosis for Eruption of Third Molars After Extraction of MIH-Affected Molars
		15.12	 Summary
		References
	16: Health Economic Evaluation of Management Strategies for MIH
		16.1	 The Need for and Types of Health Economic Evaluations
		16.2	 Health Economic Analyses
		16.3	 Assessing the Cost-Effectiveness of Severe MIH
		16.4	 Cost-Effectiveness of Different Strategies for Managing Severe MIH
		16.5	 Interpretation and Critique
		16.6	 Conclusions
		References