Background: Clinical observations suggest molar incisor hypomineralisation (MIH)may present with other dental conditions. Aims: The study aimed to determine the prevalence and variety of dental anomalies in children presenting with MIH. Design: A convenience sample of children referred to a UK dental hospital was recruited. Orthopantogram radiographs, taken as part of routine care, were assessed for dental anomalies. Two calibrated examiners reviewed the films separately and determined the presence and character of anomalies. Results: Radiographs were obtained from 101 patients, with an age range of 6-15 years. Co-existing hypodontia was identified in 12%, with lower second premolars being the most commonly missing teeth. Concurrent ectopic first permanent molars were identified in 8%, and infraocclusion of one or more primary molars was identified in 9%. Abnormal morphology was found in 9%, including macrodont and microdont teeth. In total, 29% of patients had an associated dental anomaly.Examiners had perfect agreement using Cohen's kappa coefficient. Conclusion: This high prevalence of dental anomalies, particularly hypodontia, in children with MIH is a novel and clinically important finding. Further research is warranted considering the potential implications for assessment and treatment planning. K E Y W O R D Sdental anomalies, hypodontia, molar incisor hypomineralisation

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Objective: To evaluate the impact of the coronavirus pandemic on patients in active orthodontic treatment. Design: Digital online survey. Setting: Two secondary care orthodontic departments in the United Kingdom. Participants: A prospective convenience sample of 103 patients in active orthodontic treatment. Methods: A 12-item questionnaire developed using the platform SurveyMonkey was used to assess the following: (1) patient’s feelings towards attending their orthodontic appointments; (2) their desire to continue with their treatment; (3) how many patients encountered problems with their appliance during the lockdown; (4) how patients sought help during the first national lockdown period; and (5) any other concerns regarding impact on their orthodontic treatment. Results: A total of 103 participants responses were collected over a four-week period across two departments. Of them, 45% required a face-to-face appointment to solve a problem with their appliance; 45% of patients who had problems with their orthodontic appliance were able to resolve the issue through digital means either via telephone/email advice from their provider or from accessing help via the Internet; and 99% of patients wanted to continue with their orthodontic treatment. Conclusion: Our study has shown that a significantly higher percentage of patients are more concerned regarding attending face-to-face appointments after the first national lockdown due to the coronavirus pandemic. Providers of orthodontic care should ensure they support their patients by providing digital support and adopt virtual means of managing emergency cases patients in the event of any further imposed national or local lockdowns. Furthermore, access and availability of emergency face-to-face orthodontic care is necessary for many patients in active orthodontic treatment.

Infra-occluded deciduous molars can pose a great challenge to clinicians. The management and treatment of a severely infra-occluded tooth often requires a multidisciplinary team (MDT) approach. This case report demonstrates the effective management of a 7-year-old girl who presented with a severely infra-occluded maxillary deciduous second molar. It highlights the importance of early diagnosis and appropriate intervention to help prevent further disruption to a patient's occlusal development. Following removal of the submerging deciduous molar, an upper sectional (2x4) fixed appliance was used to recreate sufficient space for the developing premolars and correct the occlusal discrepancies caused as a result of the infra-occlusion. CPD/Clinical Relevance: A novel approach to managing an infra-occluded deciduous molar and correcting the associated space loss due to its submergence is described and the benefits of early MDT intervention are highlighted.