Search Results (68)

Molar-incisor hypomineralization (MIH) is a developmental enamel defect that poses significant challenges to achieving long-term restorative success. The aim of this bibliometric review is to map the research landscape on treatment strategies for teeth affected by MIH and to provide insights that will guide future research and clinical practice. A comprehensive search of the Web of Science (WoS) and PubMed/MEDLINE databases was conducted for studies on MIH treatment published between 2014 and 2024, using defined keywords related to MIH treatment. Eligible studies were analyzed using VOSviewer, Bibliometrix R-tool, and Carrot2 software to assess publication trends, authorship, citations, and thematic focus. The comprehensive database search of the databases retrieved 933 studies, of which 230 met the inclusion criteria. A notable increase in publications was observed from 2018 to 2022, accompanied by a substantial rise in citations from 2019 onwards. Most of the research is concentrated in pediatric dentistry journals. Key topics include “children”, “resin infiltration”, “resin composite”, and “management/performance”, with an increasing emphasis on innovative and conservative approaches. Although international collaboration remains limited, Brazil (18.7%), Germany (15.5%), and England/Italy (7.7%) lead in research output. This highlights the need for international collaboration and the development of standardized, effective treatment protocols. Full article

Molar incisor hypomineralization (MIH) is characterized by systemic hypomineralization affecting one to four first permanent molars (FPMs), often accompanied by lesions in incisors and potentially involving other primary or permanent teeth. MIH poses clinical challenges, including hypersensitivity, susceptibility to pulp involvement, and aesthetic concerns. Optical Coherence Tomography (OCT), an advanced, non-invasive imaging modality, has gained interest as a potential diagnostic tool in dentistry. This exploratory observational case-control study aims to compare the structural characteristics of MIH-affected and healthy teeth using in vivo OCT, focusing on identifying qualitative imaging patterns associated with enamel hypomineralization. This study included 50 mild MIH-affected permanent teeth from pediatric patients and 50 healthy permanent teeth as controls. Representative OCT scans were acquired, analyzed, and compared for both groups. In OCT imaging, healthy enamel and dentin appeared as two distinct superimposed layers defined by the dentin-enamel junction. Conversely, MIH-affected teeth exhibited characteristic subsurface hyper-reflective zones, indicative of hypomineralized enamel, with deeper hypo-reflective shadowing. This first in vivo study applying OCT to MIH-affected teeth demonstrates its potential as a non-invasive technique for the real-time assessment of enamel structural anomalies, supporting its future role in monitoring remineralization therapies and improving early detection strategies in pediatric dental care. Full article

Objective: This study aimed to assess, through a systematic review, the potential link between bisphenol A (BPA) exposure and molar incisor hypomineralization (MIH). Methods: A systematic review was performed according to the PRISMA grid. All international studies—in vitro, in vivo, or clinical—evaluating the relationships between bisphenol A and MIH were included. An iterative search of eligible publications was conducted on May 26, 2025, using three different databases: PubMed, Science Direct, and Google Scholar. Results: Eleven studies were included in the review, ten of which were experimental studies. They were published between 2013 and 2024. Among the selected articles, a rat model was used in eight studies and seven established a link between MIH and BPA (63.64% of the articles). In the included studies, the incisors of rats treated with BPA presented asymmetrical white spots at the enamel level, with a phenotype similar to human MIH. The authors highlight the hypothesis of the implication of steroid receptors expressed by ameloblasts, in particular at the stage of maturation, thus impacting enamel quality. Conclusions: The results presented in this review highlight a trend in the interaction of bisphenol A with steroid receptors, thus affecting enamel quality. However, these associations are weak, and future studies should investigate cofactors modulating BPA’s role in the development of MIH. Full article

Background/Objectives: Amelogenesis imperfecta (AI) represents a heterogeneous group of inherited disorders affecting the quality and quantity of dental enamel, making clinical diagnosis challenging. This study aimed to identify genetic variants in Slovenian patients with non-syndromic AI and to evaluate enamel morphology using radiographic parameters. Methods: Whole exome sequencing (WES) was performed on 24 AI patients and their families. Panoramic radiographs (OPTs) were analyzed using Fiji ImageJ to assess crown dimensions, enamel angle (EA), dentine angle (DA), and enamel–dentine mineralization ratio (EDMR) in lower second molar buds, compared to matched controls (n = 24). Two observers independently assessed measurements, and non-parametric tests compared EA, DA, and EDMR in patients with and without disease-causing variants (DCVs). Statistical models, including bootstrap-validated random forest and logistic regression, assessed variable influences. Results: DCVs were identified in ENAM (40% of families), AMELX (15%), and MMP20 (10%), including four novel variants. AI patients showed significant enamel deviations with high reproducibility, particularly in hypomineralized and hypoplastic regions. DA and EDMR showed significant correlations with DCVs (p < 0.01). A bootstrap-validated random forest model yielded a 90% (84.0–98.0%) AUC-estimated predictive power. Conclusions: These findings highlight a novel and reproducible radiographic approach for detecting developmental enamel defects in AI and support its diagnostic potential. Full article

Molar Incisor Hypomineralization (MIH) is a common dental condition that affects the mineralization of the enamel, primarily affecting the first permanent molars and often the incisors. This condition can lead to a wide range of clinical presentations, from mild opacities to severe post-eruptive breakdown, which can significantly impact a child’s oral health and quality of life. Background/Objectives: The prevalence and complex management of MIH have posed a significant challenge for dental practitioners. Our preceding investigation found that 14.3% of school-aged children have MIH. Based on this finding, we wanted to understand what other Romanian dental professionals think about this condition. Therefore, the aim of the present study was to assess the awareness, perception, and clinical management approaches of Romanian dentists toward MIH in order to inform future educational strategies and contribute to the development of dedicated preventive programs. Methods: To gain a comprehensive understanding of MIH in actual clinical settings, we developed and administered a questionnaire consisting of three distinct sections. Our objective was to capture the collective knowledge and perspectives of dental practitioners. We distributed the survey, which included 14 pertinent questions, to a large professional group of Romanian dentists. Results: This study collected responses from 219 Romanian dental practitioners (median age: 34 years) about their experiences with MIH. The vast majority (86.76%) had encountered MIH cases in their practice, with half reporting moderate prevalence among their patients. The most frequently observed complications were hypersensitivity (41.95%), pulp exposure (33.33%), and failed restorations (24.71%). While adhesive restorations were identified as the overall preferred treatment approach (70.00%), notable differences emerged in both clinical complications encountered and therapeutic approaches implemented across dental specialties. There was near-unanimous agreement on the importance of early MIH diagnosis (99.09%), and almost all participants (98.63%) expressed a desire for more information about this condition, demonstrating high awareness and concern about MIH among Romanian dental professionals. Conclusions: This study highlights that general dentists, endodontists, and pedodontists encounter MIH patients frequently in their practice, emphasizing the critical need to enhance awareness and education about MIH among both dental professionals and the general public. Full article

Histology remains a cornerstone in medical and dental education, providing essential insights into tissue structure, function, and pathology. However, despite its foundational importance, interest in histology is declining, often due to outdated pedagogical methods, insufficient clinical context, and limited use of diverse teaching strategies. Modern health professionals require not only microscopic knowledge but also an understanding of the genetic mechanisms driving tissue development and disease. This paper critically evaluates current histology teaching strategies, identifying a gap in linking molecular genetics to tissue development, particularly in dental education. For instance, oral histology covers tooth development as a core subject yet often neglects the genetic foundations of odontogenesis. This disconnects risks undermining students’ ability to understand clinically relevant conditions, such as amelogenesis imperfecta, dentinogenesis imperfecta, molar incisor hypomineralization, and tooth agenesis—disorders where genetics play a key role. To address this, we propose a vertically integrated teaching model and a merged approach for teaching where several teaching methods, like flipped classrooms, team-based learning, and personalized digital tools, are designed for institutional curricula. Early pre-clinical exposure to genetic principles, revisited with clinical relevance in later years, can strengthen students’ appreciation of histology’s clinical value. This approach modernizes pedagogy, aligns with students’ preferences for digital learning, and ensures histology retains its central role in shaping competent healthcare professionals. Ultimately, developing multi-modal, genetics-integrated strategies is crucial to revitalizing histology education and fostering a deeper, clinically relevant understanding of human biology. Full article

Background/Objectives: This systematic review aims to investigate the potential association between vitamin D levels and the occurrence of developmental enamel defects (DDE) in children, including conditions like molar–incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPMs). DDEs, which occur during tooth development, can result in significant aesthetic and functional issues, and their exact etiology remains unclear, with both genetic and environmental factors contributing. Among environmental factors, vitamin D deficiency has been proposed as a possible risk factor, given its role in enamel mineralization. Methods: A thorough literature search was conducted in PubMed, Scopus, and Embase. The search strategy included terms such as “vitamin D”, “vitamin D deficiency”, “developmental defects of enamel”, “enamel hypoplasia”, “molar-incisor hypomineralization”, and “hypomineralized second primary molars”. Studies were included if they were original human observational research (cohort, case–control, or cross-sectional) conducted in children under 18 years of age or involving maternal–child cohorts. Ten studies were included in the analysis, with a total of 15,891 participants. The primary data extracted from the selected studies included the following: study design, participants’ age, sample size, vitamin D status in relation to developmental defects of enamel, and statistical significance Results: The findings were mixed, with only a few studies suggesting a significant association between low vitamin D levels and the presence of DDEs. Specifically, one study found a link between insufficient maternal vitamin D levels during pregnancy and an increased number of teeth affected by MIH in children. However, the majority of the studies did not report a significant association. Conclusions: This review concludes that while there is some evidence to suggest a possible relationship between vitamin D and DDEs, more research is needed to confirm these findings and better understand the underlying mechanisms. Full article

Molar incisor hypomineralization (MIH) is a dental condition that affects the enamel of permanent molars and/or incisors, often leading to tooth decay. Although several etiological hypotheses have come forward, including prenatal medical problems and postnatal illness, the pathogenesis of MIH is yet unclear. Aimed at exploring the epigenomic landscape of this dental condition, we collected dental tissue from a MIH-affected child and an age-matched control patient and investigated their DNA methylation status through an in-depth analysis of nanopore long-read sequencing data. We identified 780,141 CpGs with significantly different methylation levels between the samples; intriguingly, the density of these dinucleotides was higher in the regions containing genes involved in dental morphogenesis and inflammatory processes leading to periodontitis. Further examination of 54 genes associated with MIH or hypomineralized second primary molar disorders revealed very distinct methylation of intragenic transposable elements (SINEs, LINEs, and LTRs), while functional profiling analysis of 571 differentially methylated regions genome-wide uncovered significant enrichment processes including ameloblasts differentiation and calcium ion binding, as well as SP1 and other zinc finger transcription factors. Taken together, our findings suggest that DNA methylation could play a role in the pathogenesis of MIH and represent a stepping stone towards a comprehensive understanding of this multifactorial disorder. Full article

Compromised first permanent molars (FPMs) in children pose major challenges for dentists and patients even in low-caries-risk populations. Whether due to caries or Molar Incisor Hypomineralization (MIH), compromised FPMs at an early age require careful treatment planning and timing of extraction, if necessary, to eventually have good space closure with healthy dentition. This comprehensive review explains the concept of early extraction of the FPMs in children and lists the results of published studies and systematic reviews regarding spontaneous or orthodontical space closure after the extraction of an FPM, including its consequences in the long term. In general, the majority of the studies confirm that spontaneous space closure after the early extraction of the maxillary FPM could be achieved if the extraction is performed before the eruption of the second permanent molar (SPM). On the other hand, space closure in the mandible is possible in case of optimal timing of extraction and supporting co-factors, but in practice, it would most probably require orthodontic treatment. The decision to retain or extract compromised FPMs must always be made on an individual basis, taking into account all relevant factors and the long-term effects on the entire stomatognathic system. Early prophylaxis to prevent caries and early management of MIH-affected FPMs should, however, be the first-line approach. Full article

Background/Objectives: Molar–incisor hypomineralization (MIH) is a prevalent dental condition characterized by hypomineralized enamel affecting the first permanent molars and incisors. It leads to visible enamel opacities, with varying severity. Children with MIH often experience dental hypersensitivity, which can result in increased dental fear and anxiety, complicating dental treatment. Salivary cortisol, a well-established biomarker of stress, has been used to assess stress levels in various pediatric conditions but has not been extensively studied in MIH. This study aimed to assess salivary cortisol levels as a stress biomarker in children with MIH and compare them to those in children without MIH. Methods: Sixty children aged 5–9 years were divided into two groups: 31 with MIH and 29 healthy controls. Salivary cortisol levels were measured using ELISA, and statistical analysis was performed using IBM SPSS software, version 23 The Mann–Whitney test was used for group comparison, and the Kruskal–Wallis test evaluated the correlation between MIH severity and cortisol levels. Results: Children with MIH showed significantly higher mean cortisol levels (2.63 ng/mL) compared to controls (0.96 ng/mL), with a p-value of 0.0001. A progressive increase in cortisol levels was observed with the severity of MIH, with the highest levels recorded in grade 3 (4.38 ng/mL), in contrast to grade 0 (0.95 ng/mL), with a p-value of 0.001. Conclusions: Salivary cortisol levels are significantly higher in children with MIH, suggesting that MIH-related stress may contribute to dental anxiety and hypersensitivity. These findings highlight the importance of stress management in pediatric dental care. Full article

Molar incisor hypomineralization (MIH) is a developmental defect that affects the enamel tissue of permanent teeth. Clinicians may observe a range of opacities in the affected teeth, varying from white to creamy, yellow, and brown. Of particular interest is an etiology of MIH that has not been rigorously elucidated. Researchers believe that there are many potential etiological factors with strong genetic and/or epigenetic influence. The primary factors contributing to the risk of MIH development include specific medical conditions and circumstances. These encompass prematurity, cesarean delivery, perinatal hypoxia, and various health issues such as measles, urinary tract infections, otitis media, gastrointestinal disorders, bronchitis, kidney diseases, pneumonia, and asthma. Although genetic research in this area has received substantial attention, the investigation of epigenetic factors remains comparatively underexplored. Special attention is given to genes and their protein products involved in amelogenesis. Examples of such genes are AMELX, AMBN, ENAM, TUFT1, FAM83H, and MMP20. The median relative FAM83H gene expression in the control group was 0.038 (0.031–0.061) and 0.045 (0.032–0.087) in the study group in buccal swabs. The median relative TUFT1 gene expression in the control group was 0.328 (0.247–0.456) and 0.704 (0.334–1.183) in the study group in buccal swabs. Furthermore, children with MIH had significantly higher TUFT1 expression levels compared to the control group (p-value = 0.0043). Alterations in the expression of the TUFT1 and FAM83H genes could be contributing factors to MIH pathogenesis. Nonetheless, further investigation is essential to comprehensively elucidate the roles of all analyzed genes in the pathogenesis of MIH. Full article

Molar incisor hypomineralization (MIH) is a qualitative developmental defect that affects the enamel tissue of permanent molars and can also occur in permanent incisors. Enamel affected by MIH has reduced hardness, increased porosity, and a higher organic content than unaffected enamel. These characteristics predispose the enamel to accumulation of bacteria and a higher prevalence of caries lesions. Through a groundbreaking metagenomic analysis of the buccal mucosal sample from a patient with MIH, we explored the intricacies of its microbiome compared to a healthy control using state-of-the-art nanopore long-read sequencing. Out of the 210 bacterial taxa identified in the MIH microbiome, we found Streptococcus and Haemophilus to be the most abundant genera. The bacteria with the highest read counts in the patient with MIH included Streptococcus mitis, Haemophilus parainfluenzae, Streptococcus pneumoniae, Rothia dentocariosa, and Gemella haemolysans. Our results revealed a striking contrast between healthy and MIH affected children, with a higher dominance and number of pathogenic species (S. pneumoniae, H. influenzae, and N. meningitidis) and reduced diversity in the MIH-affected patient. This distinct microbial profile not only sheds light on MIH-affected patients, but paves the way for future research, inspiring deeper understanding and larger scale studies. Full article

Background: Molar–incisor hypomineralization (MIH) is an enamel defect affecting molars and incisors, often leading to hypersensitivity, enamel breakdown, and increased caries risk. Non-invasive treatments, such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and fluoride varnish, show potential in remineralizing affected enamel and reducing sensitivity, but their efficacy is still debated. This study systematically reviews and analyzes the effectiveness of CPP-ACP and other non-invasive agents in improving remineralization and reducing hypersensitivity in MIH-affected teeth. Methods: A systematic search was conducted on PubMed, Embase, and Central in July 2024, including interventional and observational studies on remineralization and hypersensitivity in pediatric MIH patients (<18 years). A total of 1566 studies were found, with 15 included in the meta-analysis. A random-effects model was applied, including subgroup analysis by lesion severity. Results: CPP-ACP showed no statistically significant advantage over fluoride in remineralization (MD −3.80, 95% CI: −8.57; 0.98), but it significantly reduced hypersensitivity compared to fluoride varnish (MD −2.36, 95% CI: −3.83; −0.89). Although this reduction in hypersensitivity may be clinically relevant, the high heterogeneity (I² = 83%) and wide confidence intervals limit the reliability of these findings. Conclusions: CPP-ACP has a moderate effect in reducing hypersensitivity but does not outperform fluoride in remineralization. Other agents, such as calcium glycerophosphate and silver diamine fluoride, showed mild benefits. The current evidence base is limited and heterogeneous, highlighting the need for high-quality, long-term studies to confirm these findings and guide MIH management. Full article

Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to contribute to the literature by identifying possible etiological factors. Methods: This research was conducted with children aged 8–11 years old and their parents from Konya province and surrounding provinces. While children who were diagnosed with MIH as a result of the examination constituted the study group, children with no findings of MIH during intraoral examination were included in the control group. Between February and October 2020, 104 patients for the study group and 104 patients for the control group were reached, and a survey was administered to a total of 208 parents. Results: Asthma, pneumonia, lower respiratory tract infections, diarrhea, a fever, and febrile convulsions between the ages of 0–4 have been found to be related to MIH (p < 0.05). Conclusions: The association between medical diseases in children and enamel defect formation draws attention to the importance of pediatricians in the early diagnosis of MIH cases. Pediatricians can be very helpful in informing parents of children with health problems about possible dental defects and referring them to a pediatric dentist. Full article

Background: Molar incisor hypomineralization (MIH) is a congenital qualitative disorder of the enamel tissue. During examinations, clinicians may observe a range of enamel opacities during examinations. The aim of this study was to assess the knowledge and awareness of dental students in Poland regarding MIH. Methods: This study was conducted among dental students who participated in scientific conferences for dental students in Poland. An electronic questionnaire was created for this purpose, accessible via a QR code. Results: The respondents consisted of dental students from the first to the fifth year of study, including 98 fourth-year students and 76 fifth-year students. The students represented 10 medical universities in Poland. Of the 341 respondents, 256 (75.07%) stated that they were familiar with the term MIH, but only 61 (17.89%) correctly indicated the diagnostic criteria of MIH. The most frequently indicated condition resembling MIH was enamel hypoplasia, with 158 (46.33%) respondents identifying it. Conclusions: Dental students at Polish medical universities have basic knowledge of MIH, but it is insufficient and needs to be improved during their educational training. Full article