Molar-Incisor Hypomineralization (MIH): An Unusual Case with Literature Review

Abstract

Background: Enamel defects are known to occur due to depressed activity of the enamel-forming ameloblasts which result in the formation of linearly distributed pits or grooves. These alterations can be found in two different stages: Enamel matrix formation (secretion phase) and enamel mineralization (maturation phase). If an unbalance occurs during the secretion phase, the enamel defect is called hypoplasia. Molar incisor hypomineralization (MIH) is a common developmental condition resulting in enamel defects in first permanent molars (FPM) and permanent incisors. One to four molars, and often also the incisors, could be affected. Since first recognized, the condition has been puzzling and interpreted as a distinct phenomenon unlike other enamel disturbances. Early diagnosis is essential since, rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. The relevance of each event is difficult to establish, as many can happen more than once in early childhood. Also, the literature refers to the first years of life as a critical period for crown formation of FPM and incisors, and therefore more likely at risk for MIH. Objective: This article is a literature review for MIH and rare case illustration with Clinical appearance, symptoms and signs, diagnostic criteria associated with MIH. Clinical management of MIH also described in particular molars and hypoplastic incisors. Conclusion/Result: A case of a 9 years old male patient reported with severe dental sensibility, masticatory difficulties. Clinical examination revealed severe enamel structural defects affecting all four permanent first molars and opaque stains affecting permanent lateral incisors, which is very rare entity.