1. Clinical studies on Molar-Incisor-Hypomineralisation (MIH) and on Molar-hypomineralisation (MH)
Development of the severity index
(HSI)
Author: Orbán Timea
Co-authors: Cristina Bică, Crișan Mihaela Laura
Lecturer: Cristina Bică PHD

2. Definition

3. Clinical appearance, symptoms and signs
In MIH and MH we can see white-cream opacities or yellow-brown discoloration with or without post-eruptive breakdown
MH: one or more affected FPM
MIH: one or more affected FPM asociated with hypomineralised permanent incisors

4. Objective
To examine 261 children with or without hypomineralisation in order to develop the hypomineralisation severity index(HSI)
To clarify aetiological factors

5. Aetiology

6. Materials and methods Data collection
There were examinated 261 children between 9-11 years
63 of them showed signs of hypomineralisation (prevalence of 24,1%)
The parents completed a questionnaire describing their perinatal and medical histories

7. Questionnare Did you had any illnesses during pregnancy?
Did you take any antibiotics during pregnancy?
Birth prematurity?
Illnesses of the child: pneumonia? upper respiratory infections? fevers? otitis media?

8. Classification 1 Classification of Alaluusa (1996)
Mild- color change: white, yellow or brown
Moderate- loss of enamel only
Severe- loss of enamel in association with affected dentine

9. Classification 2 Classification of Leppaniemi (2001)
Mild- white-cream opacities
Moderate- yellow-brown coloration
Severe- PEB

10. HSI
An index of hypomineralisation severity was computed, based on the extension of the affection on dental surfaces
HSI=0: no signs of hypomineralisation
HSI=1: one surface is affected
HSI=2: two surfaces
HSI=3: three surfaces
HSI=4: four surfaces
HSI=5: five surfaces

11. Results
63 of the 261 children showed signs of hypomineralisation (prevalence 24,1%)

12. Results
Some medical conditions affect the mineralisation of the first permanent molars and permanent incisors
One or more conditions were collated with hypomineralisation (57 of 63 children, 90,47%)

13. Results of the questionnaire
9,52%-no illnesses
23,80%-fevers
14,28%-birth prematurity
9,52%-pneumonia
33,33%-upper respiratory infections
23,80%-tonsillitis

14. Results of the clinical examination
In MH in 77,77% there were only one affected first permanent molars
In MIH in 75% there were affected all four first permanent molars.
HSI-MIH>HSI-MH

15. Discussion
Melbourne Dental School, Australia: dentitions MIH had higher severity indices than those with MH
Medical histories showed that most of the children had one or more relevant conditions in the first three years of life

16. Conclusions
The severity index of the MH is always lower than the severity index of the MIH
MIH is more severe form of the hypomineralisation than MH
In most of the cases of MH there is only one FPM with hypomineralisation
In most of the cases of MIH there are affected all four FPMs
Some medical and perinatal conditions can affect the mineralisation of the enamel

17. Bibliografy
N.S.Willmott, R.A.E. Bryan, M.S. Duggal: Molar-Incisor-Hypomineralisation, A literature review
N.Chawla, L.B. Messer, M. Silva: Clinical studies on Molar-Incisor-Hypomineralisation
M. Pereira Alves dos Santos, L. Cople Maia: MIH:Morphological, Aetiological, Epidemiological and Clinical Considerations
Weerheijm: MIH
A.J. Munoz, J.D. Melendez, C.V. Gonzalez, C. Z. Sanchez: Frecvency and severity of Molar Incisor Hypomineralisation in Patients treated at the Dental Clinic of the Universidad de la Frontera, Chile

18. “MH is a sort of birth defect, where the tooth isn’t made properly before it’s born into your mouth”