Root malformation associated with a cervical mineralized diaphragm – a distinct form of tooth abnormality?

Microscopic analysis of molar–incisor malformation

“…In addition, Lee et al 24 analyzed multiple cases and concluded that the lower permanent first molars are always involved and that in 50% of cases, there are associated symptoms in the deciduous second molars and upper central incisors. Both Witt et al 23 and the present study found hypermineralized tissues in a thickened pulpal floor and observed the tissues using SEM and transmission electron microscopy. SEM in the present study revealed unique crystals that are thought to be formed by precipitation in a supersaturated solution, rather than by cell-controlled deposition.…”

“…The conclusions drawn herein both agree and disagree with the findings of Witt et al 23 First, the findings of both studies indicated that MIM is caused not by genetic factors but by environmental factors and that it is related to past medical history, such as medication and central nervous systemerelated …”

“…Using transmission electron microscopy, Witt et al concluded that the mineralized globules in CMD consisted of hydroxyapatite. Witt et al 23 named the hypermineralized tissues cervical mineralized diaphragm and noted that it has a density between that of enamel and dentin and that it has the same constituents, including hydroxyapatite.…”

“…Witt el al. 23 reported a distinct form of root malformation associated with a cervical mineralized diaphragm (CMD), and Lee et al 24 named this condition molareincisor malformation (MIM), based on their discovery in 12 patients of a dental anomaly that was characterized by root malformation of the permanent first molars and deciduous second molars and a cervical notch in the permanent maxillary central incisors. The etiology of these symptoms is thought to be systemic diseases contracted at or medications taken at 1 to 2 years of age.…”

“…The etiology of these symptoms is thought to be systemic diseases contracted at or medications taken at 1 to 2 years of age. 23 In a Poorly organized enamel and coronal dentin, more normal radicular dentin MIM, molar-incisor malformation; DD I, dentin dysplasia type I; ROD, regional odontodysplasia; SOD, segmental odontomaxillary dysplasia; Vit-D rickets, vitamin-D-resistant rickets; SIOD, Schimke immuno-osseous dysplasia; SEM, scanning electron microscopy. *Disorders occurred during the development of the teeth with no known reason.…”