Assessment of Genetical, Pre, Peri and Post Natal Risk Factors of Deciduous Molar Hypomineralization (DMH), Hypomineralized Second Primary Molar (HSPM) and Molar Incisor Hypomineralization (MIH): A Narrative Review

Abstract

Objectives: Analyze defects in the state of maturation of the enamel result in an adequate volume of enamel, but in an insufficient mineralization, which can affect both deciduous teeth and permanent teeth. Among the most common defects, we recognize Deciduous Molar Hypominerlization (DMH), Hypomineralized Second Primary Molar (HSPM), and Molar Incisor Hypomineralization (MIH). These, in fact, affect the first deciduous molars, the second deciduous molars and molars, and permanent incisors, respectively, but their etiology remains unclear. The objective of the paper is to review studies that focus on investigating possible associations between genetic factors or prenatal, perinatal, and postnatal causes and these enamel defects. Materials and methods: A comprehensive and bibliometric search for publications until January 2021 was conducted. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. Case-control, cross-sectional, cohort studies, and clinical trials investigating genetic and environmental etiological factors of enamel defects were included. Results: Twenty-five articles are included. For genetic factors, there is a statistical relevance for SNPs expressed in the secretion or maturation stage of amelogenesis (16% of studies and 80% of studies that investigated these factors). For prenatal, perinatal, and postnatal causes, there is a statistical relevance for postnatal factors, such as the breastfeeding period (2%), asthma (16%), high fever episodes (20%), infections/illnesses (20%), chickenpox (12%), antibiotic intake (8%), diarrhea (4%), and pneumonia (4%). Conclusions: The results are in agreement with the multifactorial idea of the dental enamel defects etiology, but to prove this, further studies enrolling larger, well-diagnosed, and different ethnic populations are necessary to expand the investigation of the genetic and environmental factors that might influence the occurrence of DMH, HPSM, and MIH.

Relationship between molar incisor hypomineralization, intrapartium medication and illnesses in the first year of life

“…Butera et al observed a higher prevalence in children whose mothers had complications during pregnancy and delivery 8 . For Pitiphat et al there is a statistically significant relationship with cesarean delivery, complications during vaginal delivery, and also with serious or chronic diseases in children under 3 years of age 9 .…”

Hypomineralized Primary Teeth in Preterm Low Birth Weight Children and Its Association with Molar Incisor Hypomineralization—A 3-Year-Prospective Study

“…The presence of enamel hypomineralization resulting from disturbances during matrix formation stage of enamel development increases the risk of dental caries both in primary and permanent dentition, thereby affecting a child’s quality of life [ 2 , 9 , 10 , 11 , 12 , 13 , 14 ]. These defects result from systemic, genetic or environmental factors and recent systematic reviews highlighted the influence of PTLBW on these enamel defects [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 20 ]. The prevalence of PTLBW is high among the Indian population because of low nutritional status [ 31 , 32 ], yet there is a lack of prospective studies at the population level to estimate the influence of PT-LBW with the prevalence of EH in primary teeth and MIH.…”

“…Enamel hypomineralization (EH) in primary teeth and molar incisor hypomineralization (MIH) in permanent teeth are qualitative defects of enamel resulting from disturbances during the matrix formation stage of enamel development [ 1 , 2 , 3 ]. The etiologies of EH and MIH are considered multifactorial and may be influenced by systemic, genetic and or environmental factors, which include premature birth, underweight birth, infections, hypoxia, malnutrition, or metabolic disorders, and are often reported in higher frequency among low socioeconomic families [ 4 , 5 , 6 , 7 , 8 , 9 ]. These hypomineralized areas are responsible for considerable esthetic problems, hypersensitivity of involved teeth and predisposition to dental caries both in primary and permanent dentition, affecting children’s quality of life [ 10 , 11 , 12 , 13 , 14 ].…”

Is Aberrant DNA Methylation a Key Factor in Molar Incisor Hypomineralization?

“…Clinically, it manifests as white, yellow, or brown spot lesions on the surface of the permanent molars or/and incisors, visible during tooth eruption [ 1 ]. The pathogenesis of MIH, which has been defined as a complex condition, has been thoroughly investigated by a number of researchers [ 2 , 3 , 4 ]. Potential causal factors are divided into three groups: prenatal, perinatal, and postnatal.…”