Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review

Abstract

Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.

Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review

“…The findings of this research also took MIH treatment plans into account. (5) Study types: we used case-control, crosssectional, cohort, and clinical trial studies that had been duly registered and authorized by their respective ethical committees. The studies included were all in English.…”

“…The sealant should be examined in regular appointments and replaced if it becomes lost. Furthermore, the professional application of fluoride in gel, foam, or varnish form could be utilized to reduce caries and sensitivity [5,23].…”

“…All studies that investigated the management of hypersensitivity revealed a reduction after therapy, according to a recent systematic review. However, none of these tactics can be entirely advised due of the moderate-to-high bias risk of the research, short follow-up periods, and small sample sizes [5,23,29].…”

“…Furthermore, it exhibits an increase in the protein content accompanied with an apparent porosity in the enamel's structure. The enamel crystals in MIH have been observed to have a lower density, higher organic content within and between the crystals, and thicker prism sheaths [4,5].…”

Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

“…In this context, the effectiveness of SDF and CPP-ACP in preventing or managing the outcomes of MIH has become an important area of investigation. 19 While both SDF and CPP-ACP have been shown to have potential benefits in managing this condition, it is important to understand the relative efficacy of these treatments in a well-controlled, randomized clinical trial. The results of such a trial can inform the development of evidence-based guidelines for the management of MIH in children, and help to ensure that children receive the most effective, and appropriate oral health care.…”