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European Archives of Paediatric Dentistry

, Volume 11, Issue 2, pp 53–58 | Cite as

Aetiology of Molar-Incisor Hypomineralisation: A systematic review

  • S. Alaluusua
Article

Abstract

AIM: This was to review and assess the studies on aetiology of Molar-Incisor Hypomineralisation (MIH) or, as a proxy, of demarcated opacities in permanent first molars and to consider the potential factors involved with findings obtained in animal experiments. METHODS: A systematic search by Medline® online database was performed. Abstracts behind appropriate titles were studied and finally the full articles were evaluated for their strength of evidence in the aetiology of MIH. RESULTS: From a total of 1,142 articles 28 were identified and selected for review. The selected papers covered medical problems in prenatal, perinatal and postnatal period, medication of the child during the first years of life, and exposure to fluoride or environmental toxicants (dioxins and PCBs) in the early childhood. Based on the assessment of the articles it was still not possible to specifically name those factors causing MIH although correlations between several potential factors and MIH were presented. Among the factors suggested and found to cause enamel defects in animal experiments were: high fever, hypoxia, hypocalcaemia, exposure to antibiotics (amoxicillin, a macrolide), and dioxins. CONCLUSION: Despite increased knowledge on the aetiology of MIH insufficient evidence to verify the causative factors exists. Further studies, especially prospective ones, are needed to improve the level and strength of evidence of the role of the present putative factors and to reveal new factors that may be involved. Any combined effect of several factors should be taken into account. Experimental dose/response studies and research on the molecular mechanisms causing the abnormal function of the ameloblasts are also necessary to deepen our knowledge of MIH.

Key Words

molar-incisor hypomineralisation aetiology 

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References

  1. Abe T, Miyajima H, Okada K. Effects of a macrolide antibiotic on enamel formation in rat incisors — primary lesion of ameloblast at the transition stage. J Vet Med Sci 2003;65:985–988.PubMedCrossRefGoogle Scholar
  2. Aine L, Backström MC, Mäki R et al. Enamel defects in primary and permanent teeth of children born prematurely. J Oral Pathol Med 2000;29:403–409.PubMedCrossRefGoogle Scholar
  3. Alaluusua S, Calderara P, Gerthoux PM, et al. Developmental dental aberrations after the dioxin accident in Seveso. Environ Health Perspect 2004;112:1313–1318.PubMedCrossRefGoogle Scholar
  4. Alaluusua S, Lukinmaa P-L. Developmental dental toxicity of dioxin and related compounds-a review. Int Dent J 2006;56:323–331.PubMedCrossRefGoogle Scholar
  5. Alaluusua S, Lukinmaa P-L, Koskimies M, et al. Developmental enamel defects associated with long breastfeeding. Eur J Oral Sci 1996a;104:493–497.PubMedCrossRefGoogle Scholar
  6. Alaluusua S, Lukinmaa P-L, 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 1996b;1:193–197.PubMedCrossRefGoogle Scholar
  7. Amerongen van WE, Kreulen CM. Cheese molars: A pilot study of the etiology of hypocalcifications in first permanent molars. ASDC J Dent Child 1995;62:266–269.PubMedGoogle Scholar
  8. Angelillo IF, Romano F, Fortunato L, Montanaro D. Prevalence of dental caries and enamel defects in children living in areas with different water fluoride concentrations. Community Dent Health 1990;7:229–236.PubMedGoogle Scholar
  9. Baumgardner KR, Walton RE, Osborne JW, Born JL. Induced hypoxia in rat pulp and periapex demonstrated by 3H-misonidazole retention. J Dent Res 1996;75:1753–1760.PubMedCrossRefGoogle Scholar
  10. Beentjes VE, Weerheijm KL, Groen HJ. Factors involved in the aetiology of Molar-Incisor Hypomineralisation (MIH). Eur J Paediatr Dent 2002;1:9–13.Google Scholar
  11. Bonucci E, Lozupone E, Silvestrini G, Favia A, Mocetti P. Morphological studies of hypomineralized enamel of rat pups on calcium-deficient diet, and of its changes after return to normal diet. Anat Rec 1994;239:379–395.PubMedCrossRefGoogle Scholar
  12. Crombie F, Manton D, Kilpatrck N. Aetiology of molar-incisor hypomineralisation: a critical review. Int J Paed Dent 2009;19:73–83.CrossRefGoogle Scholar
  13. de Liefde B, Herbison GP. The prevalence of development defects of enamel and dental caries in New Zealand children receiving differing fluoride supplementation, in 1982 and 1985. N Z Dent J 1989;85:2–8.PubMedGoogle Scholar
  14. Diedrich G, Sperling S, Hetzer G. Molar Incisor Hypomineralisation in a group of children and adolescents living in Dresden (Germany). Eur J Paediatr Dent 2003;3:133–137.Google Scholar
  15. Ekanayake L, van der Hoek W. Prevalence and distribution of enamel defects and dental caries in a region with different concentrations of fluoride in drinking water in Sri Lanka. Int Dent J 2003;53:243–248.PubMedCrossRefGoogle Scholar
  16. FDI Commission. A review of the developmental defects of enamel index (DDE index). Int J Dent 1992;42:411–426.Google Scholar
  17. Fearne J, Anderson P, Davis GR. 3D X-ray microscopic study of the extent of variations in dental density in first permanent molars with idiopathic enamel hypomineralisation. Br Dent J 2004;196:634–638.PubMedCrossRefGoogle Scholar
  18. Fredén H, Grönvik M, Prenatal urinary infection and materialisation of permanent teeth. Tandläkartidningen 1980;72:1382–1383.Google Scholar
  19. Gao Y, Sahlberg C, Kiukkonen A, et al. Lactational exposure of Han/Wistar rats to 2,3,7,8-tetrachlorodibenzo-p-dioxin interferes with enamel maturation and retards dentin mineralisation. J Dent Res 2004;83:139–144.PubMedCrossRefGoogle Scholar
  20. Grahnen H, Selander P. The effect of rickets and spasmophilia on the permanent dentition. Odontol Revy 1954;5:7–26.PubMedGoogle Scholar
  21. Heijs SC, Dietz W, Norén JG, Blanksma NG, Jälevik B. Morphology and chemical composition of dentin in permanent first molars with the diagnose MIH. Swed Dent J. 2007;31:155–164.PubMedGoogle Scholar
  22. Hess AF, Lewis JM, Roman B. A radiographic study of calcification of the teeth from birth to adolescence. Dental Cosmos 1932;74:1053–1060.Google Scholar
  23. Hiller KA, Wilfart G, Schmalz G. Developmental enamel defects in children with different fluoride supplementation — a follow-up study. Caries Res 1998;32:405–411.PubMedCrossRefGoogle Scholar
  24. Hong L, Levy SM, Warren JJ, et al. Association of amoxicillin use during early childhood with developmental tooth enamel defects. Arch Pediatr Adolesc Med 2005;139:943–948.CrossRefGoogle Scholar
  25. Jan J, Sovcikova E, Kocan A, Wsolova L, Trnovec T. Developmental dental defects in children exposed to PCBs in eastern Slovakia. Chemosphere 2007;67:S350–354.PubMedCrossRefGoogle Scholar
  26. Jan J, Vrbič V. Polychlorinated biphenyls cause developmental enamel defects in children. Caries Res 2000;34:469–473.PubMedCrossRefGoogle Scholar
  27. Jälevik B, Odelius H, Dietz W, Norén J. Secondary ion mass spectrometry and X-ray microanalysis of hypomineralized enamel in human permanent first molars. Arch Oral Biol 2001b;46:239–247.PubMedCrossRefGoogle Scholar
  28. Koch G, Hallonsten A-L, Ludvigsson N, et al. Epidemiological study of idiopathic enamel hypomineralisation in permanent teeth of Swedish children. Community Dent Oral Epidemiol 1987;15:279–285.PubMedCrossRefGoogle Scholar
  29. Kuscu OO, Caglar E, Aslan S, et al. The prevalence of molar incisor hypomineralisation (MIH) in a group of children in a highly polluted urban region and a windfarm-green energy island. Int J Paediatr Dent 2009;19:176–185.PubMedCrossRefGoogle Scholar
  30. Kuscu OO, Caglar E, Sandalli N. The prevalence and aetiology of molar-incisor hypomineralisation in a group of children in Istanbul. Eur J Paediatr Dent 2008;9:139–144.CrossRefGoogle Scholar
  31. Laisi S, Ess A, Sahlberg C, et al. Amoxicillin may cause molar incisor hypomineralisation. J Dent Res 2009;88:132–136.PubMedCrossRefGoogle Scholar
  32. Laisi S, Kiviranta H, Lukinmaa P-L, Vartiainen T, Alaluusua S. Molar-Incisor-Hypomineralisation and dioxins: New findings. Eur Arch Paediatr Dent 2008;9:224–227.PubMedGoogle Scholar
  33. Leppäniemi A, Lukinmaa PL, Alaluusua S. Nonfluoride hypomineralisations in the first molars and their impact on the treatment need. Caries Res 2001;35:36–40.PubMedCrossRefGoogle Scholar
  34. Logan W, Kronfeldt R. Development of the human jaws and surrounding structures from birth to the age of fifteen years. Am J Dent Assoc 1933;20:379–427.Google Scholar
  35. Lygidakis NA, Dimou G, Marinou D. Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors. Eur Arch Paediatr Dent 2008;9:207–217.PubMedGoogle Scholar
  36. Mackay TD, Thomson WM. Enamel defects and dental caries among Southland children. N Z Dent J 2005;101:35–43.PubMedGoogle Scholar
  37. Namiki Y, Takahashi M, Suga S. Disturbed formation of dental hard tissues due calcium deficiency. Odontology 1990;78:813–839.Google Scholar
  38. Nanci A, Mocetti P, Sakamoto Y, et al. Pathological and immunocytochemical analyses on the effects of diet-induced hypocalcemia on enamel maturation in the rat incisor. J Histochem Cytochem 2000;48:1043–1058.PubMedCrossRefGoogle Scholar
  39. Ranggård L, Norén JG. Effect of hypocalcemic state on enamel formation in rat maxillary incisors. Scand J Dent Res 1994;102:249–253.PubMedGoogle Scholar
  40. Reid DJ, Dean MC. Variation in modern human enamel formation times. J Hum Evol 2006;50:329–346.PubMedCrossRefGoogle Scholar
  41. Rugg-Gunn AJ, al-Mohammadi SM, Butler TJ. Effects of fluoride level in drinking water, nutritional status, and socio-economic status on the prevalence of developmental defects of dental enamel in permanent teeth in Saudi 14-year-old boys. Caries Res 1997;31:259–267.PubMedCrossRefGoogle Scholar
  42. Salmela E, Partanen A-M, Sahlberg C, Lukinmaa P-L, Alaluusua S. Combined effect of TCDD and fluoride on dental hard tissue formation in vitro. Int J Paed Dent 2009;19 (Suppl.1):83–84.Google Scholar
  43. Seow WK. A study of the development of the permanent dentition in very low birthweight children. Pediatr Dent 1996;18:379–384.PubMedGoogle Scholar
  44. Suga S. Enamel hypomineralisation viewed from pattern of progressive mineralisation of human and monkey developing enamel. Adv Dent Res 1989;3:188–198.PubMedGoogle Scholar
  45. Tapias-Ledesma MA, Jiménes R, Lamas R et al. Factors associated with first molar dental enamel defects: a multivariate epidemiological approach. J Dent Child 2003;70:215–220.Google Scholar
  46. Tung K, Fujita H, Yamashita Y, Tagaki Y. Effect of turpentine-induced fever during enamel formation of rat incisor. Arch Oral Biol 2006;51:464–470.PubMedCrossRefGoogle Scholar
  47. Weerheijm KL, Jälevik B, Alaluusua S. Molar incisor hypomineralisation. Caries Res 2001;35:390–391.PubMedCrossRefGoogle Scholar
  48. Whitford GM, Angmar-Månsson B. Fluorosis-like effects of acidosis, but not NH+4, on rat incisor enamel. Caries Res 1995;29:20–25.PubMedCrossRefGoogle Scholar
  49. Whatling R, Fearne JM. Molar incisor hypomineralisation: a study of aetiological factors in a group of UK children. Int J Paed Dent 2008;18:155–234.CrossRefGoogle Scholar
  50. Yamaguti PM, Arana-Chavez VE, Acevedo AC. Changes in amelogenesis in the rat incisor following short-term hypocalcaemia. Arch Oral Biol. 2005;50:185–188.PubMedCrossRefGoogle Scholar

Copyright information

© Adis International 2010

Authors and Affiliations

  1. 1.Dept. Pediatric and Preventive Dentistry, Institute of DentistryUniversity of HelsinkiHelsinkiFinland

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