MOLAR INCISOR HYPOMINERALIZATION

cocukdishekimligiozel11-1-25kapakv2

Morphological, Histological and Biochemical Characteristics of Molar Incisor Hypomineralization-Affected Teeth

Seval TÜRKa , Zerrin BARUTa
aAntalya Bilim University Faculty of Dentistry, Department of Basic Sciences, Antalya, Türkiye

Türk S, Barut Z. Morphological, histological and biochemical characteristics of molar incisor hypomineralization-affected teeth. In: Şen Tunç E, ed. Molar Incisor Hypomineralization. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.19-24.

ABSTRACT
Enamel hypomineralization is a common developmental disorder observed in teeth. Disruption occurring during the calcification or maturation phase of amelogenesis results in hypomineralized defects in the enamel. Molar incisor hypomineralization (MIH) is described as a developmental anomaly in enamel formation, marked by insufficient mineral content and an elevated proportion of organic material within the enamel. This condition results in altered coloration and a higher tendency for structural breakdown in the impacted teeth. The hypomineralized enamel in these teeth demonstrates inferior mechanical properties in terms of elastic modulus and hardness compared to normal enamel. Additionally, alterations in the prism structure and boundaries, prismatic patterns, and intercrystalline spaces can be observed, including loosely packed crystals and wider sheath regions. The mild to moderate hypomineralization lesions present on each affected tooth surface vary in size, color, and shape. Furthermore, the mineral and protein content of these teeth differ from that of healthy teeth. This variability in findings suggests that differences in the degrees of mineralization may stem from varying levels of sensitivity in the ameloblastic response to environmental insults.

Keywords: Biochemistry; histology; molar incisor hypominerilization; morphology

Referanslar

  1. Davis KA, Mountain RV, Pickett OR, Den Besten PK, Bidlack FB, Dunn EC. Teeth as Potential New Tools to Measure Early-Life Adversity and Subsequent Mental Health Risk: An Interdisciplinary Review and Conceptual Model. Biol Psychiatry. 2020;15;87(6):502-13. [Crossref]  [PubMed]  [PMC]
  2. Alaluusua S. Aetiology of molar-incisor hypomineralisation: a systematic review. European Archives of Paediatric Dentistry. 2010;11:53-8. [Crossref]  [PubMed]
  3. Silva MJ, Scurrah KJ, Craig JM, Manton DJ, Kilpatrick N. Etiology of molar incisor hypomineralization - A systematic review. Community Dent Oral Epidemiol. 2016;44(4):342-53. [Crossref]  [PubMed]
  4. Alpayçetin E, Tuna EB. Molar kesici hipomineralizasyonu'ndan etkilenmiş dişlerde remineralizasyon ve hassasiyet giderici ajanların değerlendirilmesi/ evaluation of remineralization and desensitizing agents in molar incisor hypomineralization-affected teeth.ADO J Clin Sci. 2024;13(1):191-201. [Crossref]
  5. Desai D. ORban's Oral Histology&Embryology. In: Kumar GS, ed. Elsevier; 2015. p.40-67.
  6. Mahoney EK, Farah R. Planning and care for children and adolescents with dental enamel defects: etiology, research and contemporary management. Springer; 2015. p.73-84. [Crossref]
  7. Yanık D. Diş Çürüğünün Biyokimyası. İşbir T, Altay AN, editörler. Oral Biyokimya: Temel ve Klinik Kavramlar. Ankara: Türkiye Klinikleri; 2023. p.116-63.
  8. Kierszenbaum AL, Tres LL. Histoloji ve Hücre Biyolojisi Patolojiye Giriş. Çev. ed: Demir R. Ankara: Palme Yayınevi; 2021. p. 473-8.
  9. Nanci A. Ten Cate's Oral Histology, Development, Structure, and Function. Elsevier; 2018. p.125-55.
  10. Butera A, Maiorani C, Morandini A, et al. Assessment of genetical, pre, peri and post natal risk factors of deciduous molar hypomineralization (DMH), hypomineralized second primary molar (HSPM) and molar incisor hypomineralization (MIH): a narrative review. Children. 2021;8(6):432-32. [Crossref]  [PubMed]  [PMC]
  11. Elhennawy K, Bekes K, Dobsak A, Tangl S, Shokoohi-Tabrizi H, Schwendicke F. Structural, Mechanical, and Chemical Evaluation of Molar Incisor Hypomineralization-Affected Enamel. In: Bekes K,.ed. Molar Incisor Hypomineralization, A Clinical Guide to Diagnosis and Treatment. Springer; 2019. p.11-9. [Crossref]
  12. Alzahrani AY, Alamoudi NMH, El Meligy OAE. Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review. Dent J. 2023;11:157:1-14. [Crossref]  [PubMed]  [PMC]
  13. Cardoso IL, Lemmouchi R, Teles AM, Pina C, Leal F. Genetic and Environmental causes of enamel hypoplasia. In: Cardoso IL, Leal F, Teles AM, Pina C, eds. Aetiology of Oral Diseases and their association with systemic. Cambridge Scholars Publishing; 2024. p.63-79.
  14. Simmer JP, Hu JC. Dental enamel formation and its impact on clinical dentistry. J Dent Educ. 2001;65:896-905. [Crossref]
  15. Vieira AR, Manton DJ. On the variable clinical presentation of molar-incisor hypomineralization. Caries Res. 2019;53(4):482-8. [Crossref]  [PubMed]
  16. Charisi C, Kodonas K, Keklikoglou K, Arhakis A, Arapostathis KA, Kotsanos N. Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation. Eur Arch Paediatr Dent. 2022;23(4):601-8. [Crossref]  [PubMed]
  17. William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006;28(3):224-32.
  18. Gil-Bona, A, Bidlack, FB. Tooth Enamel and Its Dynamic Protein Matrix. Int. J. Mol. Sci. 2020;21:4458. [Crossref]  [PubMed]  [PMC]
  19. Farah RA, Monk BC, Swain MV, Drummond BK. Protein content of molar-incisor hypomineralisation enamel. J Dent. 2010;38(7):591-6. [Crossref]  [PubMed]
  20. Taube F, Marczewski M, Norén JG. Deviations of inorganic and organic carbon content in hypomineralised enamel. J Dent. 2015;43(2):269-78. [Crossref]  [PubMed]
  21. Almuallem Z, Busuttil-Naudi A. Molar incisor hypomineralisation (MIH) - an overview. Br Dent J 2018;225:601-609. [Crossref]  [PubMed]
  22. Fagrell TG, Salmon P, Melin L, Noren JG. Onset of Molar Incisor Hypomineralization (MIH). Swed Dent J. 2013;37:61-70.
  23. Kwak SY, Yamakoshi Y, Simmer JP, et al. MMP20 proteolysis of native amelogenin regulates mineralization in vitro. J Dent Res. 2016;95(13):1511-1517. [Crossref]  [PubMed]  [PMC]
  24. Mubarak R, Ali W. Morpho-Histological and Biochemical study of enamel in sound and hypomineralized Permanent first Molars. Egypt Dent J. 2010;56(1):1-11.
  25. Amend S, Stork S, Lücker S, Seipp A, Gartner U, Frannkenberger R, et al. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dental Materials. 2024;40:1015-24. [Crossref]  [PubMed]
  26. Gonçalves JdL, Carvalho FKd, Queiroza AMMd, Paula-Silva FWGd. Implications of Histological and Ultrastructural Characteristics on the Chemical and Mechanical Properties of Hypomineralised Enamel and Clinical Consequences. In: Rios D, Santos-Pinto L, eds. Molar Incisor Hypomineralisation:New Perceptions. Monographs in Oral Science. Basel, Karger; 2024;32:43-55. [Crossref]  [PubMed]
  27. Seremidi K, Gizani S, Schindler-Hultzsch G, Niem T, Franzen R, Kramer N, et al. The microstructure of MIH-affected enamel after irradiation with Er,Cr: YSGG laser - a qualitative in vitro study. Lasers in Dental Sci. 2024;8(48):1-9. [Crossref]
  28. Crombie FA, Manton DJ, Palamara JE, Zalizniak I, Cochrane NJ, Reynolds EC. Characterisation of developmentally hypomineralised human enamel. J Dent. 2013;41:611-8. [Crossref]  [PubMed]
  29. Farah RA, Swain MV, Drummond BK, Cook R, Atieh M. Mineral density of hypomineralised enamel. J Dent. 2010;38(1):50-8. [Crossref]  [PubMed]
  30. Bozal CB, Kaplan A, Ortolani A, Cortese SG, Biondi AM. Ultrastructure of the surface of dental enamel with molar incisor hypomineralization (MIH) with and without acid etching. Acta Odontol Latinoam. 2015;28:192-8.
  31. Rao MH, Aluru SC, Jayam C, Bandlapalli A,Patel N. Molar Incisor Hypomineralization. J Contemp Dent Pract. 2016;17(7):609-13. [Crossref]  [PubMed]
  32. Fearne J, Anderson P, Davis GR. 3D X-ray microscopic study of the extent of variations in enamel density in first permanent molars with idiopathic enamel hypomineralisation. British Dental J. 2004;196(10), 634-8. [Crossref]  [PubMed]
  33. Martinovic B, Ivanovic M, Milojkovic Z, Mladenovic R. Analysis of the mineral composition of hypomineralized first permanent molars. Vojnosanit Pregl. 2015;72:864-9. [Crossref]  [PubMed]
  34. Melin L, Lundgren J, Malmberg P, Norén JG, Taube F, Cornell DH. XRMA and ToF-SIMS analysis of normal and hypomineralized enamel. Microsc Microanal. 2015;21(2):407-21. [Crossref]  [PubMed]
  35. 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. 2001;46(3):239-47. [Crossref]  [PubMed]
  36. Spizzirri PG, Cochrane NJ, Prawer S, Reynolds EC. A comparative study of carbonate determination in human teeth using Raman spectroscopy. Caries Res. 2012;46(4):353-60. [Crossref]  [PubMed]
  37. Srot V, Bussmann B, Salzberger U, Koch CT, van Aken PA. Linking microstructure and nanochemistry in human dental tissues. Microsc Microanal. 2012;18(3):509-23. [Crossref]  [PubMed]
  38. Rovera A, Rovera G, Alzahrani A, Hector M, Anderson P. Correlation between parotid saliva composition and dental caries using 31P-NMR and ICDAS score. Arch Oral Biol. 2020; 111: 104651. [Crossref]  [PubMed]
  39. Ismayilova N, Gungor OE, Karayilmaz H. Assessment of severity and mineral composition of saliva in schoolchildren with molar-incisor hypomineralization (MIH). J Clin Pediatr Dent. 2024;48(3):86-93.
  40. Küchler EC, Pecharki GD, Castro ML, Ramos J, Barbosa Jr F, Brancher JA, et al. Genes involved in the enamel development are associated with calcium and phosphorus level in Saliva. Caries Res. 2017; 51: 225-30. [Crossref]  [PubMed]  [PMC]
  41. da Silva FMF, de Carvalho FM, Franco ALMM, Soares TRC, Fonseca-Gonçalves A, Vieira AR, et al. Association between molar hypomineralization, genes involved in enamel development, and medication in early childhood: A preliminary study. Int J Paediatr Dent. 2023. [Crossref]  [PubMed]
  42. Mangum JE, Crombie FA, Kilpatrick N, Manton DJ, Hubbard MJ. Surface integrity governs the proteome of hypomineralized enamel. J Dent Res. 2010;89:1160-5. [Crossref]  [PubMed]
  43. Masurier N, Arama DP, El Amri C, Lisowski V. Inhibitors of kallikrein-related peptidases: An overview. Med Res Rev. 2018;38:655-83. [Crossref]  [PubMed]
  44. Giacaman RA, Perez VA, Carrera CA. Mineralization processes in hard tissues: Teeth. Biomineralization and biomaterials. Woodhead Publishing; 2016. p.147-85. [Crossref]
  45. Perez VA, Mangum JE, Hubbard MJ. Pathogenesis of Molar Hypomineralisation: Aged Albumin Demarcates Chalky Regions of Hypomineralised Enamel. Front Physiol. 2020;30(11):579015. [Crossref]  [PubMed]  [PMC]
  46. Williams R, Perez VA, Mangum JE, Hubbard MJ. Pathogenesis of molar hypomineralisation: hypomineralised 6-year molars contain traces of fetal serum albumin. Front Physiol. 2020;11, 619. [Crossref]  [PubMed]  [PMC]