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Management of molar–incisor hypomineralization and hypodontia in monozygotic twins: a case report Nikita Joshi Claire Mcloughlin Dental Update 2024 49:6, 707-709.
Molar–incisor hypomineralization (MIH) is the hypomineralization of permanent first molars and is often associated with similarly affected incisors. This can lead to caries development and post-eruptive enamel breakdown. Early diagnosis and management are of prime importance to prevent premature loss of these molars at a young age, and to mitigate against negative changes on the patient's quality of life. This is particularly true when the patients also present with hypodontia. Wherever possible, conservative management in primary care should be undertaken. This case report explores the presentation and on-going treatment of MIH, and hypodontia, illustrated in monozygotic twin males.
CPD/Clinical Relevance: It is important to consider factors involved in the early identification of MIH and hypodontia and to develop strategies to treat the patient.
Article
Molar–incisor hypomineralization (MIH) is the hypomineralization of the enamel of permanent first molars (usually maxillary molars1,2,3) and is often associated with less severely affected incisors. Some earlier nomenclature included cheese molars, idiopathic enamel opacities and internal enamel hypoplasia.1 This condition may present as demarcated qualitative defects, with enamel translucency varying from white to yellow to brown.1 MIH has a prevalence of about 16% in UK children,4 but its aetiology remains unclear. Hypomineralized teeth are more prone to enamel breakdown soon after eruption, leading to increased sensitivity, caries, pain and problems with dental hygiene posing a challenge for dentists.1
Hypodontia is the developmental absence of one or more teeth in the dentition5 and acquired hypodontia is often a long-term implication for severe MIH,1 if teeth require extraction. In the literature, there are few studies relating hypodontia to MIH. A UK study of 101 children has identified co-existing hypodontia in 12% of these patients.6 Although there are no similar studies in children, Baccetti found that children with a missing second premolar had a significantly higher prevalence of enamel hypoplasia compared to a control group (11% and 5%, respectively).7
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