Prevalence and severity of molar incisor hypomineralization in children aged 11-16 years of a city in Karnataka, Davangere

Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data

Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.

MIH and Dental Caries in Children: A Systematic Review and Meta-Analysis

(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7-10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology.

Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization

Context

The etiology of molar incisor hypomineralization (MIH) has been extensively explored. Recently, the effect of drugs used in aerosol therapy in childhood has been implicated as a possible factor in the development of MIH.

Aim

A case-control study was conducted in children aged 6-13 years to determine the association between aerosol therapy and other factors in the development of MIH.

Materials and methods

A total of 200 children were examined for the presence of MIH according to the European Academy of Paediatric Dentistry (EAPD) criteria (2003). Their mothers or primary caregivers were interviewed regarding the preterm history and perinatal, and postnatal history of the child up to 3 years of life.

Statistical analysis

The collected data were subjected to statistical analysis using descriptive and inferential analyses. The p-value ≤ 0.05 was considered statistically significant.

Results

Statistically significant association was observed between the development of MIH and exposure to aerosol therapy in childhood and the use of antibiotics before 1 year of life.

Conclusion

Exposure to aerosol therapy and antibiotics before 1 year of age are risk factors in MIH. Children who had aerosol therapy and antibiotics are 2.01 times and 1.61 times more prone to MIH.

How to cite this article

Shinde MR, Winnier JJ. Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2022;15(5):554-557.

Molar Incisor Hypomineralization: Prevalence, Associated Risk Factors, Its Relation with Dental Caries and Various Enamel Surface Defects in 8–16-year-old Schoolchildren of Lucknow District

Introduction

Aim

Methodology

Results

Conclusion

Clinical significance

How to cite this article

Prevalence, Pattern, and Severity of Molar Incisor Hypomineralization in 8-12-year-old Schoolchildren of Moradabad City

Aim and objective

Recently, molar incisor hypomineralization (MIH) has become more evident and one of the most common reasons for loss of teeth in children after dental caries. Being a country with a diverse ethnic population, the prevalence of MIH in different regions of India may differ. Hence, the present study was undertaken to determine the prevalence, pattern, and severity of MIH in 8-12-year-old Schoolchildren in Moradabad city.

Materials and methods

This study was conducted in various schools of Moradabad city to target a sample of 2,300 children aged between 8 and 12 years. The examination was done in their respective schools by a calibrated examiner in natural daylight using European Academy of Pediatric Dentistry diagnostic criteria for MIH 2015. The results, thus obtained, were statistically analyzed using Pearson's Chi-square test.

Results

A prevalence of 3.96% (91/2300) for MIH was reported without any gender predilection. Molar hypomineralization showed a prevalence of 1.3% (29/2300) whereas the prevalence for hypomineralization of second primary molars was 1.4% (22/1620). The most common type of defect was type 2 and most of the affected teeth were of grade I. Mandibular molars were more commonly affected compared to the maxillary molars.

Conclusions

A prevalence of 3.96% (91/2300) was observed for MIH. Frequent dental screening camps should be organized in schools at the community level for the enhancement of early diagnosis of MIH and designing appropriate management strategies.

How to cite this article

Khan A, Garg N, Mayall SS, et al. Prevalence, Pattern, and Severity of Molar Incisor Hypomineralization in 8-12-year-old Schoolchildren of Moradabad City. Int J Clin Pediatr Dent 2022;15(2):168-174.

The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis

Molar-Incisor Hypomineralization (MIH) is a qualitative defect of enamel of unknown etiology, affecting one or more permanent molars and may include incisors. This condition is a clinical challenge and its prevalence is still uncertain given the recent increase in research. Thus, we aimed to comprehensively estimate the overall prevalence of MIH and associated characteristics. This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS and TRIP databases, until July 2021. Heterogeneity and publication bias were computed via I2 test statistics and Egger's significance test, respectively. Random-effects meta-analysis of prevalence were processed. We used the Strength of Recommendation Taxonomy [SORT] to grading the strength of evidence. Overall, 116 observational studies were included, with one study with moderate methodological quality and the remaining of high methodological quality. Subgroup analysis confirmed an influence of not using the 2003 MIH case definition (p = 0.0066). The pooled prevalence of MIH was 13.5% (95% CI 12.0-15.1, I2 = 98.0%). Affected incisors were seen in 36.6% (95% CI 30.0-43.7, I2 = 92.5%) of the cases. Lastly, the prevalence of hypomineralization of the second primary molars was observed in 3.6% of the MIH cases (95% CI 1.9-6.8, I2 = 96.3%). America was the continent with highest prevalence (15.3, 95% CI 12.8-18.3, p < 0.001, I2 = 96.3%) and Asia had the lowest prevalence (10.7, 95% CI 8.5-13.5, p < 0.001, I2 = 98.7%), however no continental differences were found. Sample size and year of publication were slight contributing factors to the heterogeneity in the analysis. Overall, these results were classified with a SORT A recommendation.

Prevalence and Clinical Characteristics of Molar-Incisor Hypomineralization in 8-16-year-old Children in Industrial Town of Solan District of Himachal Pradesh

Aim

The aim of the present study was to investigate the prevalence and etiology of molar–incisor hypomineralization (MIH) in 8- to 16-year-old children from town (Baddi) of Himachal Pradesh.

Materials and methods

A cross-sectional study was conducted with 2000 children from various schools of Baddi. Molar–incisor hypomineralization was diagnosed on the basis of EAPD 2003 criteria revised in 2009.

Results

Prevalence of MIH found was to be 2.9%. Demarcated opacities were predominant among all the defects. Postnatal illnesses were highly associated with MIH. The prevalence of dental caries reported in MIH patients was 82.7%.

Conclusion

Postnatal illnesses are significantly associated with MIH. Molar–incisor hypomineralization predisposes the tooth to dental caries.

How to cite this article

Thakur H, Kaur A, Singh R, et al. Prevalence and Clinical Characteristics of Molar–Incisor Hypomineralization in 8–16-year-old Children in Industrial Town of Solan District of Himachal Pradesh. Int J Clin Pediatr Dent 2020;13(3):230–234.

The prevalence of molar incisor hypomineralization of school children in and around Muvattupuzha, Kerala

BACKGROUND

Molar incisor hypomineralization (MIH) is a developmental dental defect and has a significant impact on the quality of life of affected individuals. Most of the prevalence studies of MIH have been carried out in the European countries; very little data are available from India.

AIM

The aim and objective of this study was to determine the prevalence of MIH in 8-15-year-old Malayalee school children in and around Muvattupuzha, Kerala.

SETTINGS AND DESIGN

A cross-sectional epidemiological study was conducted in 5318 healthy Malayalee school children aged between 8 and 15 years in and around Muvattupuzha.

MATERIALS AND METHODS

The first permanent molars (FPMs) and all permanent incisors were examined for MIH using the European Academy of Paediatric Dentistry 2003 diagnostic criteria. The severity of hypomineralization was recorded according to the Wetzel and Reckel scale.

STATISTICAL ANALYSIS

The data were analyzed using the Statistical Package for the Social Sciences software version 20.0, and a comparison between groups was carried out using the Chi-square test. P ≤ 0.05 was considered for statistical significance.

RESULTS

A total of 216 children were diagnosed with MIH. The maximum MIH-affected tooth was found to be mandibular right FPM (186), followed by mandibular left FPM (172), maxillary left FPM (160), and maxillary right FPM (156).

CONCLUSION

The prevalence of MIH in permanent dentition of Malayalee school children in and around Muvattupuzha was 4.1%. Among the MIH-affected children, very few have undertaken dental treatment for the same. Hence, proper awareness and planned preventive and restorative programs are required to minimize the problem.

Prevalence of molar-incisor hypomineralization in Milwaukee, Wisconsin, USA: a pilot study

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA. Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, and bivariate analysis were done to identify factors associated with MIH. Results: A total of 375 children (average age =8.66 years, range 7-12) were examined, 60% females and 41% Hispanics. Overall, 36 (9.6%) of the children demonstrated findings consistent with the diagnosis of MIH. Among the teeth with MIH defects, severe defects were higher in lower molars. There were no statistically significant differences between those with and without MIH by sex, race/ethnicity, and socioeconomic status in this study. Conclusion: The study revealed that 9.6% of the children examined were affected by MIH. Future studies should focus on statewide and/or nationwide surveys in the United States to ascertain the extent and severity of the condition.

Prevalence of Molar Incisor Hypomineralization among School Children Aged 9 to 12 Years in Virajpet, Karnataka, India

BACKGROUND:

The molar incisor hypomineralization (MIH) is defined as a qualitative defect of the enamel characterised by the progressive and simultaneous hypomineralization of the enamel structure of the first permanent molars which is of systemic origin, which may be associated frequently with incisors. Although the reported prevalence of MIH ranges from 2.4% to 40.2% worldwide, very little data is available from India.

AIM:

To determine the prevalence of molar incisor hypomineralization among school children aged 9 to 12 years in virajpet, Karnataka.

METHODS:

This cross-sectional descriptive study consisted of 1600 school children aged 9-12 years selected by stratified cluster sampling procedure. The European Academy of Pediatric Dentistry criteria were followed for MIH diagnosis. Chi-square test was used to analyse the categorical data. P ≤ 0.05 was considered for statistical significance.

RESULTS:

The prevalence of MIH is 13.12% with no gender predilection. Ten-year-old children showed the highest prevalence (15%) among all the age group. Majority of children with MIH (70.2%) have lesions in both molars and incisors with demarcated opacities and atypical restorations being the most frequent defect type.

CONCLUSION:

Prevalence of MIH was 13.12% in the 9-12-year child population in Virajpet. There is a need for a proper planned preventive and restorative program about the increasing prevalence of MIH.

Prevalence and etiology of molar-incisor hypomineralization (MIH) in the city of Istanbul

Background/purpose

Molar-Incisor-Hypomineralisation (MIH) is the term used to depict a condition in which one or more of the permanent molar teeth and usually no less than one incisor tooth is hypomineralised and the prevalence rates vary from 2.4 to 40.2%. The aim of this study was to assess the prevalence and the risk factors of MIH in children in Istanbul, Turkey.

Materials and methods

A total of 1511 (760 M, 751 F), 8- to 11-year-old children were examined who had their first permanent molar and incisors evaluated using the EAPD criteria for MIH. Hypomineralized molars and incisors were recorded based on developmental defects of enamel index. The potential aetiological factors were retrieved through personal interview and etiological questions were asked to the parents. Statistical analysis was performed with a chi-Square test.

Results

MIH was observed in 215 (14.2%; 102 male, 113 female) children. The sample (1511 children) comprised 71 (9.9%) 8 year-olds with MIH and 144 (18.2%) 11 year-olds with MIH. A significant difference was found between 8 (9.9%) and 11-year-old (18.2%) children with MIH (p ≤ 0.001). Complications during the mother's pregnancy, birth prematurity, average breast feeding period, diarrhea frequency, digestive system diseases, asthma, frequent high fever, ear infection, renal failure, rubeola, chickenpox and parotitis were found to be significantly associated with MIH (p < 0.001).

Conclusion

There are many events that can cause MIH which we cannot control or predict. Therefore, longitudinal studies with large sample size are needed so as to determine how various likely etiological factors described affect the etiological role.

Molar Incisor Hypomineralization and Its Prevalence

Background:

Molar incisor hypomineralization (MIH) is the hypomineralization of systemic origin of one to four permanent first molars, frequently associated with affected incisors. It is presented as demarcated enamel opacities of different colors, occasionally undergoing posteruptive breakdown. The characteristic feature of MIH is the clear demarcation between the affected and sound enamel. There is asymmetry of defects present in the molars and incisors where one molar or incisor can be severely affected, while the contralateral tooth may be clinically sound or have only minor defects.

Aim and Objective:

The aim of this study is to evaluate schoolchildren of 7–12 years of age with at least one of the first permanent molars fully or partially erupted from randomly selected government and private schools in Chennai using the European Academy of Pediatric Dentistry (EAPD) criteria for MIH, to determine the prevalence and characteristics of MIH.

Materials and Methods:

The dental examinations were performed in the classroom using a mouth mirror and explorer under a headlight. Teeth were wiped with gauze when necessary to remove plaque or the food accumulations. Surfaces that were examined were the buccal, lingual, palatal, and occlusal surfaces of permanent first molars and labial surfaces of upper and lower incisors. A single examiner was involved to avoid interexaminer bias. All the data were collected and scored using the EAPD criteria for MIH.

Results:

A total of 22 (12.9%) children out of the examined 170 had MIH.

Conclusion:

Distribution of MIH was more in males, more in 9 years of age. A total of 13 children had first molars affected and 9 children had both incisors and molars affected. Molars were affected more than the incisors. Mandible was affected more in comparison with the maxilla. Right side was affected more than the left side. The distribution of MIH was more in government schools compared to private schools.

Efficacy of Intraosseous Local Anesthesia for Restorative Procedures in Molar Incisor Hypomineralization-Affected Teeth in Children

Background

Treatment of teeth affected with molar incisor hypomineralization (MIH) in young patients is challenging due to chronic subclinical pulpal inflammation caused by porous enamel and exposed dentin. Hypersensitivity of the teeth and difficulty in achieving local anesthesia due to altered nerve potential affects the successful completion of the treatment.

Aim

The aim of the study was to compare the anesthetic efficacy of the intraosseous (IO) anesthetic technique with conventional local infiltration technique in anesthetizing first permanent molars (FPMs) affected by MIH for restorative procedures in children.

Materials and Methods

This randomized controlled clinical trial recruited 54 MIH-affected mandibular or maxillary FPMs requiring restorations or stainless steel crowns. The teeth were randomly allocated to two equal groups to receive either IO injection or buccal infiltration (control), both using 4% articaine. Onset, time required, and pain experienced for administration, need for repeat, efficacy of anesthetic technique, heart rate, and postoperative complications were recorded in both the groups. Collected data were subjected to statistical analysis.

Results

Onset was significantly faster and pain experienced during administration was significantly lower with IO technique. Need for repeat of anesthesia was significantly more with infiltration (44.4% vs. 7.4% in IO, P = 0.004). Local infiltration failed to produce profound anesthesia in 74.1% MIH-affected teeth. IO anesthesia profoundly anesthetized 88.9% MIH-affected teeth. Anesthetic efficacy was significantly better with IO anesthesia (P < 0.001). Postoperative complications were significantly lower with IO anesthesia (P = 0.003).

Conclusion

IO local anesthesia was found to be an effective and safe technique to achieve profound anesthesia in MIH-affected teeth in children in comparison to local infiltration.

Prevalence of Molar Incisor Hypomineralization in Mexican Children

OBJECTIVE

To determine the prevalence of and factors associated with molar incisor hypomineralization (MIH) in schoolchildren aged 6-12 years.

STUDY DESIGN

This study included 1156 schoolchildren aged 6-12 years, living in Mexico City. A previously standardised examiner (k = 0.79) applied the diagnostic criteria for MIH from the European Academy of Paediatric Dentistry. Children's parents completed a questionnaire about medical conditions in the perinatal period and the first 3 years of their children's lives. Descriptive measures were examined, multivariate logistic regression analysis was performed, and odds ratios (ORs) were calculated.

RESULTS

The subjects were 582 (50.4%) females and 574 (49.6%) males, with an average age of 8.4 ± 1.6 years. The prevalence of MIH was 15.8%, and this condition was more prevalent in children aged 9-12 years than in those aged 6-8 years (18% vs. 13.7%, p < 0.05). Risk factors for MIH were low birth weight (OR = 1.905, 95% confidence interval [CI] 1.130-3.211, p = 0.014), urinary tract infection (OR = 4.841, 95% CI 2.863-8.186, p = 0.001), chickenpox (OR = 1.826, 95% CI 1.196-2.786, p = 0.005), and history of allergies (OR = 4.370, 95% CI 2.538-7.523, p < 0.001).

CONCLUSIONS

The prevalence of MIH in a group of Mexican schoolchildren was 15.8%. Medical conditions in the first years of life were more prevalent in children affected by MIH.