Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization

Abstract

Molar incisor hypomineralization (MIH) is a developmental defect of dental enamel that shares features with hypomineralized second primary molars (HSPM). Prior to permanent tooth eruption, second primary molars could have predictive value for permanent molar and incisor hypomineralization. To assess this possible relationship, a cross-sectional study was conducted in a sample of 414 children aged 8 and 9 years from the INMA cohort in Valencia (Spain). A calibrated examiner (linear-weighted Kappa 0.83) performed the intraoral examinations at the University of Valencia between November 2013 and 2014, applying the diagnostic criteria for MIH and HSPM adopted by the European Academy of Paediatric Dentistry. 100 children (24.2%) presented MIH and 60 (14.5%) presented HSPM. Co-occurrence of the two defects was observed in 11.1% of the children examined. The positive predictive value was 76.7% (63.9–86.6) and the negative predictive value 84.7% (80.6–88.3). The positive likelihood ratio (S/1-E) was 10.3 (5.9–17.9) and the negative likelihood ratio (1-S/E) 0.57 (0.47–0.68). The odds ratio was 18.2 (9.39–35.48). It was concluded that while the presence of HSPM can be considered a predictor of MIH, indicating the need for monitoring and control, the absence of this defect in primary dentition does not rule out the appearance of MIH.

Pre‐term birth and asthma is associated with hypomineralized second primary molars in pre‐schoolers: A population‐based study

“…Studies conducted in different countries reported the prevalence of HSPM varying from 2.5% to 21.8% . In the present population‐based study, the prevalence was 14.9%, comparable to those found in and Australia (14.1%) and Spain (14.5%) .…”

“…When the HSPM affects two or more teeth, there is a 7.82‐fold increase in the chances of developing molar‐incisor hypomineralization (MIH) . The amelogenesis of the permanent first molars and primary second molars present a coincident period, and injuries that occur during this moment can affect both dentitions . It is assumed that the change in the maturation process of the enamel varies according to the intensity of the aggressor agent so that the more intense the injury, the greater the number of primary second molars affected.…”

“…Studies have shown that HSPM is a clinical predictor for molar‐incisor hypomineralization (MIH) . The chronology of enamel mineralization overlaps for first permanent molars and primary second molars .…”

“…The chronology of enamel mineralization overlaps for first permanent molars and primary second molars . In addition, there are few published studies on the epidemiology of the hypomineralized second primary molars . It is important to know the prevalence of this condition in order to stimulate the creation of public policies and awaken the dentist to the importance of early diagnosis, aiming at prevention, and minimization of damages.…”

Dental hypomineralization treatment: A systematic review

“…The most frequently suggested factors are neonatal problems (prematurity and/or low birth weight), early childhood illnesses (asthma or bronchitis), fever, hospitalization, oxygenation without intubation, and antibiotic therapy. Some authors have suggested a genetic‐based etiology . The prevalence of MIH in children and adolescents varies among different studies, with reported values between 2.8% and 40% .…”