An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review

Abstract

Purpose To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, ‘What are the treatment options for teeth in children affected by molar incisor hypomineralisation?’ Methods An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers. Results Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed. Conclusion The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.

Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document

“…The interpretation of the gradings for quality of evidence and strength of recommendation are shown in Tables 1 and 2 . Details of all studies evaluated and the methodology implemented, are included in the two relevant systematic reviews prepared by the study group (Garot et al 2021 ; Somani et al 2021 ).…”

“…The study group, comprising six experts, worked intensively for eight months prior to the 12th EAPD Interim Seminar in Oslo, on two different topics: (A) aetiological factors involved in MIH, and (B) treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews and meta-analyses, where appropriate, of the existing literature relevant to the topics (Garot et al 2021 ; Somani et al 2021 ). Thereafter, and following a consensus process, the updated EAPD policy document on the ‘Best Clinical Practice guidance for clinicians treating children with molar incisor hypomineralisation (MIH)’ was produced and presented at the 12th EAPD Interim Seminar in Oslo.…”

Dental Students’ Knowledge, Attitudes and Beliefs Regarding Molar Incisor Hypomineralization (MIH): A Survey in Vienna, Austria

“…Available treatment modalities are extensive, ranging from prevention, restoration, to extraction. 18 The suitability of these, however, differs depending on a number of factors. Commonly identified factors are severity of the condition (eg extent of the defective enamel and quality of both, defective enamel and unaffected parts of the tooth), presence of symptoms (with or without association of hypersensitivity), patient's dental age and child/parent's social background and expectation.…”

Management of a Hypomineralisation of the Enamel by Applying a Remineraliser Based on Zinc Hydroxyapatite (microRepair)

“…MIH has a reported overall prevalence of 12.9% (11.7-14.3%) [ 2 ]. To date, the aetiology of this disease remains unclear.…”