MIH Type Dental Developmental Anomalies

Pages: 92-96

Dr. Aneta Munteanu

In the current landscape of Romanian pedodontics, the book “MIH Type Dental Developmental Anomalies”, authored by Ioana-Andreea Stanciu, Ph.D., and Prof. Rodica Luca Ph.D., Pedodontics Department of the Faculty of Dentistry, “Carol Davila” Bucharest, stands out as a novelty.

Conceived as a monograph, the book, published by the EUROBIT publishing house, brings theoretical and practical contributions in a segment of modern pathology not yet presented in a unitary way in our country – the first permanent molar with emphasis on its structural abnormalities – and responds to the concerns and current interest of –but not only – paedodontists for the subject.

A brief history within the Introductory part shows that, starting with the years 1970-1980, the attention of practitioners was drawn towards structural anomalies of the enamel such as hypomineralization, mainly located on the first permanent molars, but which may affect other teeth whose mineralization takes place in the same period: permanent incisors and canines and the second primary molar. A number of terms were initially used for these clinical aspects, including “idiopathic enamel hypomineralisation”, “hypomineralized first permanent molars”, “cheese molars.” The term “MIH” (acronym from the English term “molar-incisor hypomineralization”, i.e. “molar-incisive hypomineralization”) was subsequently adopted, a term that defines a hypomineralization of systemic origin located on one to all four permanent first molars, frequently associated with hypomineralization of the incisors (Weerheijm et al., 2001). Since 2003, the year when diagnostic criteria were established at the Conference of the European Academy of Pediatric Dentistry (EAPD) in Athens, the term MIH is widely used internationally. Prevalence of MIH varies widely around the world, from 0.48% in India to 44% in Australia.

The book is structured in 8 chapters. The first chapter presents general notions of development of teeth and support structures, with a detailed description of the process of amelogenesis, the disruption of which leads to the occurrence of MIH-type lesions. The following 4 chapters describe in detail the etiological factors and mechanism of MIH along with the histological, biochemical and morphological changes in the enamel of affected teeth, as well as the clinical picture with emphasis on the topography and severity of lesions, but also on differential diagnosis. Chapter 6 details the therapeutic approach for both the first permanent molar and the permanent incisors. Thus, all the latest generation therapeutic methods are analyzed from simple to complex, including the presentation of the new MIH-TNI diagnostic and therapeutic index (Steffen et al., 2017; Bekes 2020). Chapter 7 is a synthesis of literature of the past few years, going deep into hypomineralization defects of primary 2nd molars as consequence of disturbances during the formation period. These defects are described and regarded as predictors for MIH lesions on the first permanent molar. The final chapter summarizes clinical and social implications of MIH, with emphasis on the quality of life.

The book brings forward a central topic of all EAPD and IAPD congresses from 2003 to present. The book, based upon an extensive and recent bibliography, stands out as a last-minute synthesis of the specialized literature on MIH, also adding specific data on the pediatric population in Romania. The authors emphasize the need for dental practitioners to know and recognize MIH-type defects, as on one hand these lesions have many clinical implications from hypersensitivity and aesthetic disorders to carious lesions with deep, extensive coronary destruction, and on the other hand treatment of MIH is a challenge for both doctor and patient, requiring multiple re-interventions.

Given these considerations, but also the fact that around the world “MIH is becoming more and more a public health problem”, the book “MIH Type Dental Developmental Anomalies” is a useful theoretical and practical guide accessible to all categories of dental practitioners and especially to residents and dental students. The useful recommendations for paedodontic practice enhanced by an iconography selected from personal clinical cases make of this book a valuable material for all dentists interested in the field.

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