title: ["Molar-incisor hypomineralization"].
abstract: Hypocalcification of the enamel is the most common developmental disorder observed in teeth. The prevalence of this kind of hypomineralisation is about 10-19%. These molars are often referred to as cheese molars, because the lesions clinically resemble cheese in color and consistency. Other descriptions are: idiopathic enamel hypomineralisation in the permanent first molars, idiopathic enamel opacities in the permanent first molars, non fluoride enamel hypomineralisation in the permanent first molars, non-endemic mottling of enamel in the permanent first molars. Molar-Incisor Hypomineralisation is today the proposed expression for this disease. Occlusal surfaces of the first permanent molar are most commonly affected. The lesions are more frequent in the upper jaw than in the lower jaw. The incisors are affected to a lesser degree than the molars. Several aetiological factors can cause these defects. Some studies show a relation between intake of dioxins via mother's milk after prolonged breast feeding and developmental defects of the child's teeth. Because the ameloblasts are very sensitive to oxygen supply, complications involving oxygen shortages during birth or respiratory diseases such as asthma or bronchitis and pneumonia are discussed as further aetiological factors. Renal insufficiency, hypoparothyroidism, diarrhoea, malabsorption and malnutrition and high-fever diseases can be other reasons for the occurrence of these defects. Defective enamel can be a locus of lowered resistance for caries. Histologically there are areas of porosity of varying degrees. The affected teeth can be very sensitive to air, cold, warm and mechanical stimuli. Toothbrushing may create toothache in these teeth. We therefore suggest that these patients receive intensified prevention with fluoride varnish, a fissure sealing, GIZ, composits, stainless steel crowns or implants. In some cases an interdisciplinary approach with an orthodontist can result in the extraction of the molars in the age of 8 to 10 years.
authors.affiliation: Universität Bern, Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Bern.
authors.forename: Nadja-Marina
authors.initials: NM
authors.lastname: Kellerhoff
authors.forename: Adrian
authors.initials: A
authors.lastname: Lussi
mesh_terms: D002118:Calcium / Q000378:metabolism; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D003141:Communicable Diseases / Q000150:complications; D003744:Dental Enamel Hypoplasia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003793:Dental Restoration, Permanent; D003937:Diagnosis, Differential; D004147:Dioxins / Q000009:adverse effects; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D000860:Hypoxia / Q000150:complications; D007180:Incisor / Q000473:pathology*; D008286:Malabsorption Syndromes; D008895:Milk, Human / Q000737:chemistry; D008963:Molar / Q000473:pathology*; D009910:Oral Hygiene; D010710:Phosphates / Q000378:metabolism; D009626:Terminology as Topic
chemical_list: D002327:Cariostatic Agents; D004147:Dioxins; D010710:Phosphates; D005459:Fluorides; D002118:Calcium