Informationen aus Orthodontie & Kieferorthopädie 2016; 48(03): 195-199
DOI: 10.1055/s-0042-116380
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Molaren-Inzisiven-Hypomineralisation – Überblick, klinische Aspekte, Behandlungsempfehlungen

Molar Incisor Hypomineralisation – Overview, Clinical Aspects, Treatment Recommendations
P. Fischer
1   Department für Zahn-, Mund- und Kieferheilkunde, Klinik für Zahnerhaltungskunde und Parodontologie, Universitätsklinikum Freiburg
› Author Affiliations
Further Information

Publication History

Publication Date:
17 October 2016 (online)

Zusammenfassung

Die Molaren-Inzisiven-Hypomineralisation (MIH) ist eine entwicklungsbedingte Schmelzbildungsstörung mit bislang ungeklärter Ursache. Bei den erkrankten Zähnen handelt es sich vornehmlich um die ersten bleibenden Molaren und/oder die ersten bleibenden Inzisivi. In der ersten Dentition können auch die zweiten Molaren von einer Molaren-Inzisiven-Hypomineralisation betroffen sein. Unterschiedliche intraindividuelle Ausprägungsgrade einer MIH erschweren die Therapieplanung und in vielen Fällen auch die restaurative Therapie. Ein häufiges Phänomen bei diesen Zähnen ist eine oftmals in Zusammenhang mit Hypersensibilitäten vorkommende Unwirksamkeit von Lokalanästhetika. Um eine adäquate Behandlungsentscheidung für die meist noch sehr jungen Patienten zu treffen, ist ein enges Behandlungskonzept zwischen Zahnerhaltung und Kieferorthopädie unerlässlich.

Die vorliegende Übersicht beleuchtet zum einen ätiologische und klinisch-diagnostische sowie therapeutische Aspekte, zum anderen soll sie als Hilfestellung bei der interdisziplinären Entscheidungsfindung zur Planung einer suffizienten Therapie bei Vorliegen einer Molaren-Inzisiven-Hypomineralisation dienen.

Abstract

Molar incisor hypomineralisation (MIH) is an enamel developmental defect with a currently indistinct etiology. Affected teeth primarily are first permanent molars and/or first permanent incisors. In the first dentition second molars may show the typical structures of molar-incisor hypomineralisation as well. Therapy planning and in many cases restaurative therapy itself is complicated by the occurence of different intra-individual grades of MIH as well as by an ineffectiveness of local anesthetics, that often comes along with dental hypersensitivities caused by MIH. In order to make a good decision of treatment for the young patients, close cooperation and communication between restorative dentistry and orthodontics is essential.

This article on the one hand lights up aspects concerning the etiology of molar-incisor hypomineralisation and deals with clinical, diagnostic and therapeutic matters. On the other hand this overview is supposed to serve as an assistance concerning sufficient therapy planning following interdisciplinary decision-making.

 
  • Literatur

  • 1 Weerheijm KL, Jalevik B. Molar-Incisor Hypomineralisation. Caries Res 2001; 35: 390-391
  • 2 Elfrink ME, Schuller AA, Werheijm KL et al. Hypomineralizes second primary molars: prevalence data in Durch 5-year-olds. Caries Res 2008; 42: 282-285
  • 3 Ovedele TA, Folayan MO, Oziegbe EO. Hypomineralised second primary molars: prevalence, pattern and associated co morbidities in 8–10-year-old children in Ile-Ife, Nigeria. BMC Oral Health 2016; 16 im Druck
  • 4 Mittal N, Sharma BB. Hypomineralised second primary molars: prevalence, defect characteristics and possible association with Molar Incisor Hypomineralisation in Indian children. Eur Arch Paediatr Dent 2015; 16: 441-447
  • 5 Jälevik B. Prevalence and diagnosis of molar-incisor-hypomineralisation (MIH): a systemic review. Eur Arch Paediatr Dent 2010; 11: 59-64
  • 6 Fischer P, Bardenheuer V, Piehlmeier L et al. Bayerisches Zahnärzteblatt 2009; 4: 54-58
  • 7 Kühnisch J, Lauenstein A, Pitchika V et al. Was molar incisor hypomineralisation (MIH) present in archaeological case series?. Clin Oral Invest 2016; 1 im Druck
  • 8 Silva MJ, Scurrah KJ, Craig JM et al. Etiology of molar incisor hypomineralization – A systematic review. Community Dent Oral Epidemiol 2016; 44: 345-353
  • 9 Onat H, Tosun G. Molar incisor hypomineralization. J Pediatr Dent 2013; 1: 53-57
  • 10 Pitiphat W, Luangchaichaweng S, Pungchanchaikul P et al. Factors associated with molar incisor hypomineralization in Thai children. Eur J Oral Sci 2014; 122: 265-270
  • 11 Kühnisch J, Mach D, Thiering E et al. Respiratory diseases are associated with molar-incisor hypomineralisations. Swiss Dent J 2014; 124: 286-293
  • 12 Sönmez H, Yldirim G, Bezgin T. Putative factors associated with molar incisor hypomineralisation: an epidemiological study. Eur Arch Paediatr Dent 2013; 14: 375-380
  • 13 Fagrell TG, Ludvigsson J, Ullbro C et al. Aetiology of severe demarcated enamel opacities – an evaluation based on prospective medical and social data from 17 000 children. Swed Dent J 2010; 35: 57-67
  • 14 Jälevik B, Noren JG, Klingberg G et al. Etiologic factors influencing the prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Eur L Oral Sci 2001; 109: 230-234
  • 15 Durmus B, Abbasoglu Z, Peker S et al. Possible medical aetiological factors and characteristics of molar incisor hypomineralisation in a group of Turkish children. Acta Stomatol Croat 2013; 47: 297-305
  • 16 Ghanim A, Manton D, Bailey D et al. Risk factors in the occurrence of molar-incisor hypomineralization amongst a group of Iraqui children. Int J Paediatr Dent 2013; 23: 197-206
  • 17 Whatling R, Fearne JM. Molar incisor hypomineralization: a study of aetiological factors in a group of UK children. Int J Paediatr Dent 2008; 18: 155-162
  • 18 Dietrich G, Sperling S, Hetzer G. Molar incisor hypomineralisation in a group of children and adolescents living in Dresden (Germany). Eur J Paediatr Dent 2003; 4: 133-137
  • 19 Beentjes V, Weerheijm K, Groen H. Factors involved in the aetiology of molar-incisor hypomineralisation (MIH). Eur J Paediatr Dent 2002; 3: 9-13
  • 20 Alaluusua S, Lukinmaa PL, Koskimies M et al. Developmental dental defects associated with long breast feeding. Eur J Oral Sci 1996; 104: 493-497
  • 21 Ciarrocchi I, Masci C, Spadaro A et al. Dental enamel, fluorosis and amoxicillin. Pediatr Med Chir 2012; 34: 148-154
  • 22 Arrow P. Risk factors in the occurrence of enamel defects of the first permanent molars among schoolchildren in Western Australia. Community Dent Oral Epidemiol 2009; 37: 405-415
  • 23 Bekes K. Ätiologie und Therapie von MIH-Zähnen. ZWP Zahnarzt Wirtschaft Praxis 2015; 6: 60-64
  • 24 Mast P, Rodriguez Tapia MT, Daeniker L et al. Understanding MIH: definition, epidemiology, differential diagnosis and new treatment guidelines. Eur J Paediatr Dent 2013; 14: 204-208
  • 25 Crawford PJ, Aldred M, Bloch-Zupan A. Amelogenesis imperfecta. Orphanet J Rare Dis 2007; 2: 17
  • 26 Atia GS, May J. Dental fluorosis in the paediatric patient. Dent Update 2013; 40: 836-839
  • 27 Kellerhoff NM, Lussi A. Molar-incisor-hypomineralization. Schweiz Monatsschr Zahnmed 2004; 114: 243-253
  • 28 Wetzel WE, Reckel U. Fehlstrukturierte Sechsjahrmolaren nehmen zu – eine Umfrage. Zahnärztl Mitt 1991; 81: 650-652
  • 29 Alaluusua S, Lukinmaa PL, Vartiainen T et al. Polychlorinated dibenzo-p-dioxins and dibenzofurans via mother’s milk may cause developmental defects in the child’s teeth. Environ Toxicol Pharmacol 1996; 1: 193-197
  • 30 Americano GC, Jacobsen PE, Soviero VM et al. A systematic review on the association between molar incisor hypomineralization and dental caries. Int J Paediatr Dent 2016; im Druck
  • 31 Rodd HD, Boissonade FM, Day PF. Pulpal status of hypomineralized permanent molars. Paediatr Dent 2007; 29: 514-520
  • 32 Steffen R, van Waes H. Die Behandlung von Kindern mit Molaren-Inzisiven-Hypomineralisation. Eine Herausforderung bei der Schmerzkontrolle und Verhaltenssteuerung. Quintessenz 2011; 65: 1585-1592
  • 33 Crombie F, Manton D, Palamara J et al. Resin infiltration of developmentally hypomineralised enamel. Int J Paediatr Dent 2014; 24: 51-55
  • 34 Kumar H, Palamara J, Burrow MF et al. Resin infiltration – taking the first steps to filling the holes in cheese molars. Ann R Australas Coll Dent Surg 2012; 21: 120-123
  • 35 Crombie F, Manton D, Kilpatrick N. Aetiology of molar-incisor-hypomineralization: a critical review. Int J Paediatr Dent 2009; 19: 73-83
  • 36 Lygidakis NA, Wong E, Jälevik B et al. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an EAPD policy document. Eur Arch Paediatr Dent 2010; 11: 75-81
  • 37 Lygidakis NA, Chaliasou A, Siounas G. Evaluation of composite restorations in hypomineralised permanent molars: a four year clinical study. Eur J Paediatr Dent 2003; 4: 143-148
  • 38 Jälevik B, Klingberg G. Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls – a longitudinal study. Int J Paediatr Dent 2012; 22: 85-91
  • 39 Kuijpers MA, Loomans B. Combined orthodontic and restorative treatment. Ned Tijdschr Tandheelkd 2015; 122: 575-581