PEDODONTICS
Case Reports
MOLAR INCISOR HYPOMINERALIZATION IN MONOZYGOTIC TWINS : A CASE REPORT
Marianna Velissariou 1a * , Neeta Chandwani 2b
1
Pediatric Dentistry Department , European University College , Dubai , UAE
2
Pediatric Dentistry Department , Hamdan bin Mohammed College of Dental Medicine , Dubai , UAE a
DMD , MScD , Specialist Pediatric Dentist b
DMD , MScD , Specialist Pediatric Dentist , Visiting Faculty
Academic Editor : Tamara Tserakhava , DDS , PhD , Professor and Chair , Belarusian State Medical University , Minsk , Belarus
Cite this article : Velissariou M , Chandwani N . Molar incisor hypomineralization in monozygotic twins : a case report . Stoma Edu J . 2017 ; 4 ( 3 ): 218-223 .
Received : June 21 , 2017
Revised : July 19 , 2017 Accepted : August 24 , 2017 Published : August 25 , 2017
Abstract DOI : 10.25241 / stomaeduj . 2017.4 ( 3 ). art . 7
Aim : The aim of this case report is to discuss the features of molar incisor hypomineralization ( MIH ), a developmental enamel defect , which was noted in a set of monozygotic twin males . Summary : MIH is the hypomineralization of one to four first permanent molars ( FPMs ) frequently associated with affected incisors and varies in clinical severity . Early diagnosis and management of the condition is paramount and will avoid the premature loss of the molars . Key learning points : The clinical characteristics , as well as the short and long term management of this condition are discussed . Keywords : molar incisor hypomineralization ( MIH ), prevalence , diagnosis , management .
1 . Introduction Molar incisor hypomineralization ( MIH ) is a developmental qualitative enamel defect that was first defined by Weerheijm et al . in 2001 1 as “ hypomineralization of systemic origin of 1-4 First Permanent Molars ( FPMs ), frequently associated with affected incisors ”. Clinically , the hypomineralized areas appear as well demarcated opacities affecting the FPMs and incisors . These demarcated areas are abnormalities in the translucency of the enamel and may vary in color from white to yellow to brown . They are often associated with post eruptive enamel breakdown in the molars due to the teeth being subjected to masticatory forces and are also more severely involved than the incisors . 2 The exact etiology of the condition remains unknown , however many factors that affect the stages of ameloblast formation during the prenatal , perinatal and postnatal periods were found to be possibly linked with MIH . Some of these potential risk factors include urinary tract infection during pregnancy , Caesarian section , premature delivery , exposure to environmental toxins , such as dioxin , childhood illnesses , asthma , pneumonia , high fever and antibiotic treatment especially during the first year of life . It is strongly believed that these factors act synergistically since none of them has a definite causative relation to the condition . 3 , 4 , 5 The prevalence of MIH has been studied extensively and it varies greatly from 2.4 % in Germany and Bulgaria to 40.2 % in Brazil . 6 The condition shows no gender predilection and the maxillary teeth , most specifically the molars , are most commonly affected . 7 The FPMs may not be affected to the same degree in an individual and some molars could be relatively unaffected . 8 Hypomineralized teeth were initially classified into three groups , based on the severity of the enamel defect : mild ( white , yellow or brown discoloration of the enamel ), moderate ( enamel loss only ) and severe ( loss of enamel in combination with affected dentin ). 9 Due to some similarities in the clinical appearance of the moderate and severe cases , Lygidakis et al . 8 suggested the use of only two categories : mild and moderate-severe . The mild cases include demarcated enamel opacities with intact surfaces , occasional sensitivity and mild esthetic concerns . In moderate-severe cases , there is enamel surface breakdown , persistent or spontaneous hypersensitivity with major esthetic concerns . 8 The aim of this case report is to discuss the features and management of MIH in a set of healthy monozygotic twin males .
2 . Case Report Two healthy monozygotic twin males , MB and SB , 9.6 years of age , presented with their father to the department of pediatric dentistry for a routine checkup with no major complaints .
* Corresponding author : Dr Marianna Velissariou , DMD , MScD , Specialist Pediatric Dentist European University College , PO Box 53382 , Dubai , UAE Tel / Fax : + 971 4 3624788 , e-mail : marianna . velissariou @ euc . ac . ae
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Stoma Edu J . 2017 ; 4 ( 3 ): 218-223 http :// www . stomaeduj . com