SpringerLink
Log in

Molar Incisor Hypomineralization in adolescents and adults and its association with facial profile and occlusion

  • Research
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

To date, there are no data available in the scientific literature about the diagnosis of Molar Incisor Hypomineralization (MIH) in adults. We aimed to assess the MIH prevalence and clinical characteristics in adolescents and adults and its association with facial profile and occlusion.

Materials and methods

In this cross-sectional study, permanent teeth were evaluated in 275 patients between the ages of 12 and 49 at a dental clinic, using intraoral photographs. A calibrated examiner classified enamel hypomineralization using the MIH index. Statistical analyses were performed using chi-square, Fisher’s tests, and ordinal logistic regression.

Results

MIH was observed in 12.73% of all patients. The most commonly affected teeth were permanent molars, while incisors, premolars, and canines were less affected. MIH usually appears as demarcated opacities, with less than one-third of the tooth affected. There was no association between severe defects and facial profile and occlusion, but rather with the higher age of the participants.

Conclusion

Enamel hypomineralization mainly affects the first and second permanent molars, but it could also be observed in the third molars, although it is not associated with the orthodontic characteristics investigated.

Clinical relevance

This is the first study to highlight the prevalence of MIH in adults. This result showed the importance of other specialists beyond Pediatric Dentistry in the diagnosis of this defect. In addition, hypomineralization of other permanent teeth (canines, premolars, and second molars) has been described previously in other studies, but this is the first to identify MIH in third molars.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Weerheijm KL (2004) Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. Dent Update 31(1):9–12

    Article  PubMed  Google Scholar 

  2. Elfrink ME, ten Cate JM, Jaddoe VW, Hofman A, Moll HA, Veerkamp JS (2012) Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res 91(6):551–555. https://doi.org/10.1177/0022034512440450

    Article  PubMed  Google Scholar 

  3. Kevrekidou A, Kosma I, Kotsanos I et al (2020) (2020) Enamel opacities in all other than molar incisor hypomineralization index teeth of adolescents. Int J Paediatr Dent 31(2):270–277. https://doi.org/10.1111/ipd.12735

    Article  PubMed  Google Scholar 

  4. de Farias AL, Rojas-Gualdrón DF, Girotto Bussaneli D, Santos-Pinto L, Mejía JD, Restrepo M (2022) Does molar-incisor hypomineralization (MIH) affect only permanent first molars and incisors? New observations on permanent second molars. Int J Paediatr Dent 32(1):1–10. https://doi.org/10.1111/ipd.12780

    Article  PubMed  Google Scholar 

  5. Jälevik B (2010) Prevalence and diagnosis of molar-incisor- hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 11:59–64

    Article  PubMed  Google Scholar 

  6. Dantas-Neta NB, Moura LF, Cruz PF et al (2016) Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren. Braz Oral Res 30(1):e117. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0117

    Article  PubMed  Google Scholar 

  7. Lopes LB, Machado V, Mascarenhas P, Mendes JJ (2021) Botelho J (2021) The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Sci Rep 11(1):22405. https://doi.org/10.1038/s41598-021-01541-7

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ghanim A, Silva MJ, Elfrink MEC et al (2017) Molar incisor hypomineralisation (MIH) training manual for clinical field surveys and practice. Eur Arch Paediatr Dent 18(4):225–242. https://doi.org/10.1007/s40368-017-0293-9

    Article  PubMed  Google Scholar 

  9. Garot E, Manton D, Rouas P (2016) Peripartum events and molar-incisor hypomineralisation (MIH) amongst young patients in southwest France. Eur Arch Paediatr Dent 17(4):245–250. https://doi.org/10.1007/s40368-016-0235-y

    Article  PubMed  Google Scholar 

  10. Fatturi AL, Wambier LM, Chibinski AC et al (2019) A systematic review and meta-analysis of systemic exposure associated with molar incisor hypomineralization. Community Dent Oral Epidemiol 47(5):407–415. https://doi.org/10.1111/cdoe.12467

    Article  PubMed  Google Scholar 

  11. Hernandez M, Boj JR, Espasa E (2016) Do we really know the prevalence of MIH? J Clin Pediatr Dent 40(4):259–263. https://doi.org/10.17796/1053-4628-40.4.259

    Article  PubMed  Google Scholar 

  12. Dwijendra KS, Parikh V, George SS, Kukkunuru GT, Chowdary GN (2015) Association of dental anomalies with different types of malocclusions in pretreatment orthodontic patients. J Int Oral Health 7(6):61–4

    PubMed  PubMed Central  Google Scholar 

  13. Giffoni TCR, Brandt GZ, Rocha IS, Ramos AL, Provenzano MGA, Fracasso MLC (2019) Relation of dental anomalies with occlusal alterations in the pediatric patients. Pesqui Bras Odontopediatr Clín Integr 19:e4026. https://doi.org/10.4034/PBOCI.2019.191.68

    Article  Google Scholar 

  14. Hanan SA, Filho AOA, Medina PO, Cordeiro RC, Santos-Pinto L, Zuanon ÂC (2015) Molar-incisor hypomineralization in schoolchildren of Manaus. Brazil Pesqui Bras Odontopediatr Clin Integr 15(1):309–317. https://doi.org/10.4034/PBOCI.2015.151.33

    Article  Google Scholar 

  15. Ghanim A, Elfrink M, Weerheijm K, Mariño R, Manton D (2015) A practical method for use in epidemiological studies on enamel hypomineralisation. Eur Arch Paediatr Dent 16(3):235–246. https://doi.org/10.1007/s40368-015-0178-8

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lanford MW, Yu Q, Ballard RW, Johnson JT, Armbruster PC (2021) Prevalence of molar-incisor hypomineralization within an orthodontic department in the United States. Pediatr Dent 43(5):51E-57E

    PubMed  Google Scholar 

  17. Schneider PM, Silva M (2018) Endemic molar incisor hypomineralization: a pandemic problem that requires monitoring by the entire health care community. Curr Osteoporos Rep 16(3):283–288. https://doi.org/10.1007/s11914-018-0444-x

    Article  PubMed  Google Scholar 

  18. Hussain G, Al-Halabi M, Kowash M, Hassan A (2018) The prevalence and severity of molar incisor hypomineralization and molar hypomineralization in Dubai. UAE J Dent Child (Chic) 85(3):102–107

    PubMed  Google Scholar 

  19. Hernández M, Boj JR, Espasa E, Peretz B (2018) Permanent first molars and permanent incisors teeth by tooth prevalence of molar-incisor-hypomineralisation in a group of Spanish schoolchildren. Acta Stomatol Croat 52(1):4–11. https://doi.org/10.15644/asc52/1/1

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kevrekidou A, Kosma I, Arapostathis K, Kotsanos N (2015) Molar incisor hypomineralization of eight- and 14-year-old children: prevalence, severity, and defect characteristics. Pediatr Dent 37(5):455–461

    PubMed  Google Scholar 

  21. Jälevik B, Szigyarto-Matei A, Robertson A (2018) The prevalence of developmental defects of enamel, a prospective cohort study of adolescents in Western Sweden: a Barn I Tanadvarden (BITA, children in dental care) study. Eur Arch Paediatr Dent 19(3):187–195. https://doi.org/10.1007/s40368-018-0347-7

    Article  PubMed  PubMed Central  Google Scholar 

  22. Vieira AR, Manton DJ (2019) On the variable clinical presentation of molar-incisor hypomineralization. Caries Res 53(4):482–488. https://doi.org/10.1159/000496542

    Article  PubMed  Google Scholar 

  23. Bussaneli DG, Restrepo M, Fragelli CMB et al (2019) Genes regulating immune response and amelogenesis interact in increasing the susceptibility to Molar-Incisor Hypomineralization. Caries Res 53(4):217–227. https://doi.org/10.1159/000491644

    Article  PubMed  Google Scholar 

  24. Lygidakis NA, Wong F, Jälevik B, Vierrou AM, Alaluusua S, Espelid I (2010) Best Clinical Practice Guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH): an EAPD Policy Document. Eur Arch Paediatr Dent 11(2):75–81. https://doi.org/10.1007/s40368-021-00668-5

    Article  PubMed  Google Scholar 

  25. Chagas TF, Martins MM, Mucha JN (2017) The facial profile in brazilian adults. Braz J Oral Sci 16:1–8. https://doi.org/10.20396/bjos.v16i0.8651062

    Article  Google Scholar 

  26. Oliveira MDV, Silveira BL, Mattos CT, Marquezan M (2015) Facial profile esthetic preferences: perception in two Brazilian states. Dental Press J Orthod 20(3):88–95. https://doi.org/10.1590/2176-9451.20.3.088-095.oar

    Article  PubMed  PubMed Central  Google Scholar 

  27. Network for excellence in health innovation (2015) Real world evidence: new era for health care innovation. https://www.nehi-us.org/writable/publication_files/file/rwe_issue_brief_final.pdf. Accessed 15 June 2022

  28. Santos-Pinto L, Fragelli C, Girotto Bussaneli D, Restrepo M, Nogueira V, de Farias AL, Yupanqui KV, Paschoal M, Cordeiro R (2021) Real-world evidence in the context of molar incisor hypomineralization: a new perspective. Int J Paediatr Dent 31(4):483–485. https://doi.org/10.1111/ipd.12714

    Article  PubMed  Google Scholar 

  29. Sherman RE, Anderson SA, Dal Pan GJ et al (2016) Real-world evidence - what is it and what can it tell us? N Engl J Med 375(23):2293–2297. https://doi.org/10.1056/NEJMsb1609216

    Article  PubMed  Google Scholar 

  30. Golkari A, Sabokseir A, Pakshir HR, Dean MC, Sheiham A, Watt RG (2011) A comparison of photographic, replication and direct clinical examination methods for detecting developmental defects of enamel. BMC Oral Health 21:11–16. https://doi.org/10.1186/1472-6831-11-16

    Article  Google Scholar 

  31. Cruz-Orcutt N, Warren JJ, Broffitt B, Levy SM, Weber-Gasparoni K (2012) Examiner reliability of fluorosis scoring: a comparison of photographic and clinical examination findings. J Public Health Dent 72(2):172–175. https://doi.org/10.1111/j.1752-7325.2012.00315.x

    Article  PubMed  PubMed Central  Google Scholar 

  32. Wong HM, McGrath C, Lo EC, King NM (2005) Photographs as a means of assessing developmental defects of enamel. Community Dent Oral Epidemiol 33(6):438–446. https://doi.org/10.1111/j.1752-7325.2012.00315.x

    Article  PubMed  Google Scholar 

  33. Cochran JA, Ketley CE, Arnadóttir IB et al (2004) A comparison of the prevalence of fluorosis in 8-year-old children from seven European study sites using a standardized methodology. Community Dent Oral Epidemiol 32(Suppl 1):28–33. https://doi.org/10.1111/j.1600-0528.2004.00136.x

    Article  PubMed  Google Scholar 

  34. Iijima Y (2008) Early detection of white spot lesions with digital camera and remineralization therapy. Aust Dent J 53(3):274–280. https://doi.org/10.1111/j.1834-7819.2008.00062.x

    Article  PubMed  Google Scholar 

  35. de Farias AL, Rojas-Gualdrón DF, Mejía JD, Bussaneli DG, Santos-Pinto L, Restrepo M (2022) Survival of stainless-steel crowns and composite resin restorations in molars affected by molar-incisor hypomineralization (MIH). Int J Paediatr Dent 32(2):240–250. https://doi.org/10.1111/ipd.12849

    Article  PubMed  Google Scholar 

  36. Restrepo M, Rojas-Gualdrón DF, de Farias AL, Girotto-Bussaneli D, Santos-Pinto L (2022) Association between frequency and severity of dental fluorosis and molar incisor hypomineralization. J Clin Pediatr Dent 46(1):30–34. https://doi.org/10.17796/1053-4625-46.1.6

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We express our gratitude to Dr. Carlos Eduardo Tuma (scientific director of the Sero radiological center, Amazonas, Brazil) and to Ms. Savana Maia (directress of Savana Maia Clinics, Amazonas, Brazil) for their collaboration and support during this study.

Author information

Authors and Affiliations

  1. Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, São Paulo State University (Unesp), Araraquara School of Dentistry, Araraquara, São Paulo, Brazil

    Simone Assayag Hanan, Aline Leite de Farias & Lourdes Santos-Pinto

  2. School of Dentistry, Amazonas Federal University, Ayrão Avenue, Manaus, Amazonas, 1539, Brazil

    Simone Assayag Hanan

Authors
  1. Simone Assayag Hanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aline Leite de Farias
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lourdes Santos-Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

S.A.H. conceived the idea, designed the project, and wrote the manuscript. A.L.F. and L.S.P. were involved in the project and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Simone Assayag Hanan.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hanan, S.A., de Farias, A.L. & Santos-Pinto, L. Molar Incisor Hypomineralization in adolescents and adults and its association with facial profile and occlusion. Clin Oral Invest 27, 1243–1253 (2023). https://doi.org/10.1007/s00784-022-04756-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-022-04756-8

Keywords

Search

Navigation