ArticlePDF Available

Abstract and Figures

This was to study an archaeological population of subadult teeth in 17th and 18th century skeletal material from a London (England) cemetery for enamel defects including molar-incisor-hypomineralisation (MIH). Dentitions of 45 sub-adults were examined using standard macroscopic methods and systematically recorded. A total of 557 teeth were examined with a *5 lens and photographed. Ages of the individuals were estimated from their dental crown and root development stages and not from charts that combine tooth eruption with development stages. The dental age of the individual and the approximate age of onset of enamel defects was then calculated on the basis of the chronological sequence of incremental deposition and calcification of the enamel matrix. Affected enamel was graded macroscopically as: - Mild: <30% of the tooth's enamel surface area visibly disrupted (this encompasses the entire range reported in most other studies), Moderate: 31-49% of the tooth's enamel surface area visibly disrupted and Severe: >50% of the tooth's enamel surface area visibly disrupted. Of the total number of individuals 41 (93.2%) showed signs of enamel developmental dysplasia or MIH, 28 of them showing moderate or severe lesions of molars, primary or permanent (63.6% of the sample). Incisors and canines, though surviving much less often, showed episodes of linear hypoplasia. The extensive lesions seen on many of the molars displayed cuspal enamel hypoplasia (CEH). Many of these teeth also exhibited Molar Incisal Hypomineralisation (MIH).
Content may be subject to copyright.
A preview of the PDF is not available
... A prevalência de HMI varia entre 2,8 a 44% de acometimento (HERNANDEZ; BOJ; ESPASA, 2016), e essa variação pode ser explicada pelo uso de diferentes critérios de diagnóstico e diferentes populações avaliadas. Apesar desta disparidade, uma revisão sistemática recente apresentou a prevalência global de HMI como sendo de 14,2% (ZHAO et al., 2018), existente desde a antiguidade e que desperta, até hoje, o interesse da classe odontológica (KUHNISCH et al., 2016;LANG et al., 2016;OGDEN;PINHASI;WHITE, 2008). ...
... A prevalência de HMI varia entre 2,8 a 44% de acometimento (HERNANDEZ; BOJ; ESPASA, 2016), e essa variação pode ser explicada pelo uso de diferentes critérios de diagnóstico e diferentes populações avaliadas. Apesar desta disparidade, uma revisão sistemática recente apresentou a prevalência global de HMI como sendo de 14,2% (ZHAO et al., 2018), existente desde a antiguidade e que desperta, até hoje, o interesse da classe odontológica (KUHNISCH et al., 2016;LANG et al., 2016;OGDEN;PINHASI;WHITE, 2008). ...
... A prevalência de HMI varia entre 2,8 a 44% de acometimento (HERNANDEZ; BOJ; ESPASA, 2016), e essa variação pode ser explicada pelo uso de diferentes critérios de diagnóstico e diferentes populações avaliadas. Apesar desta disparidade, uma revisão sistemática recente apresentou a prevalência global de HMI como sendo de 14,2% (ZHAO et al., 2018), existente desde a antiguidade e que desperta, até hoje, o interesse da classe odontológica (KUHNISCH et al., 2016;LANG et al., 2016;OGDEN;PINHASI;WHITE, 2008). ...
... It was also suggested that contaminating environmental factors (Kuscu et al. 2009) could be related to the condition, although interestingly, archaeological studies indicated the presence of MIH (Ogden et al. 2008;Kühnisch et al. 2016) and DMH/HSPM (Garot et al. 2017) in ancient populations. In addition, despite the increase in the number of publications between 2016 and 2020 assessing contaminating environmental factors, most of these studies exclusively assessed the knowledge of dentists regarding the etiology of MIH through questionnaires and literature reviews, not really contributing to the evidence in the field. ...
Article
Aim: To identify the worldwide trends in scientific evidence and gaps in knowledge regarding molar incisor hypomineralisation (MIH) and deciduous molar hypomineralisation/hypomineralised second primary molars (DMH/HSPM), exploring the contribution of authors and countries, possible etiological factors and proposed treatments, in order to guide future research in the area. Methods: Searches were conducted in MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, Embase and Google Scholar. Studies employing the terms MIH, DMH/HSPM and their linguistic variations were included. The following data were extracted: title, authors, year and journal of publication and first author's affiliation country. Studies were categorized according to topic, dentition, study design, etiological factors and types of treatments. Categories were analysed in relation to their distribution, co-occurrence, cross-correlation and/or autocorrelation. Results: Five hundred and three studies were included. The most published authors were Manton D (n = 47), de Souza JF (n = 22) and Ghanim A (n = 22) and four main collaboration clusters have been identified. Most of the studies were conducted on permanent dentition (MIH) (87.4%); with observational design (57.2%). The "European Archives of Paediatric Dentistry" was the most published journal (13.3%) and a significant increase in the number of publications was observed in the last decade. MIH was most studied in relation to prevalence/incidence, systemic factors involved in its aetiology and treatment with composite restorations, while a gap in knowledge was observed for extraction and sealants. Less studies were published on DMH/HSPM and most of them evaluated risk factors or prevalence/incidence. The gap of knowledge was observed in relation to treatments and patient's quality of life. Conclusions: This bibliometric review provided a comprehensive overview of research in MIH and DMH/HSPM over the past 19 years. Within the limitations of the present study, the following conclusions can be drawn: global trends point to an increasing peak of scientific publication, especially in the last decade, while there is a shortage of clinical studies on treatments, mainly evaluating tooth extractions. Finally the multifactorial nature should be further explored, considering environmental and systemic factors together.
... The increasing number of MIH cases in archaeological skeletal remains in France and England may help to lower the significance of some reported aetiological factors, such as Bisphenol A and other endocrine disruptors, antibiotics, dioxins, and other pollutants, as these were not present in the medieval time (Ogden et al. 2008;Curzon et al. 2015;Garot et al. 2017Garot et al. , 2019. Some of these studies, besides clinical observations, undertook laboratory investigations to confirm the observational findings (Garot et al. 2017). ...
Article
Full-text available
Aim: To update the existing European Academy of Paediatric Dentistry (EAPD) 2010 policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH).' Methods: Experts, assigned the EAPD, worked on two different topics: (A) Aetiological factors involved in MIH, and (B) Treatment options for the clinical management of MIH. The group prepared two detailed systematic reviews of the existing literature relevant to the topics and following a consensus process produced the updated EAPD policy document on the 'Best Clinical Practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH).' The GRADE system was used to assess the quality of evidence regarding aetiology and treatment which was judged as HIGH, MODERATE, LOW or VERY LOW, while the GRADE criteria were used to indicate the strength of recommendation regarding treatment options as STRONG or WEAK/CONDITIONAL. Results: (A) Regarding aetiology, it is confirmed that MIH has a multifactorial aetiology with the duration, strength and timing of occurrence of the aetiological factors being responsible for the variable clinical characteristics of the defect. Perinatal hypoxia, prematurity and other hypoxia related perinatal problems, including caesarean section, appear to increase the risk of having MIH, while certain infant and childhood illnesses are also linked with MIH. In addition, genetic predisposition and the role of epigenetic influences are becoming clearer following twin studies and genome and single-nucleotide polymorphisms analyses in patients and families. Missing genetic information might be the final key to truly understand MIH aetiology. (B) Regarding treatment options, composite restorations, preformed metal crowns and laboratory indirect restorations provide high success rates for the posterior teeth in appropriate cases, while scheduled extractions provide an established alternative option in severe cases. There is great need for further clinical and laboratory studies evaluating new materials and non-invasive/micro-invasive techniques for anterior teeth, especially when aesthetic and oral health related quality of life (OHRQoL) issues are concerned. Conclusions: MIH has been studied more extensively in the last decade. Its aetiology follows the multifactorial model, involving systemic medical and genetic factors. Further focused laboratory research and prospective clinical studies are needed to elucidate any additional factors and refine the model. Successful preventive and treatment options have been studied and established. The appropriate choice depends on the severity of the defects and the age of the patient. EAPD encourages the use of all available treatment options, whilst in severe cases, scheduled extractions should be considered.
... Animal studies have shown ameloblast susceptibility to BPA and other endocrine disruptors such as genistein and vinclozolin, but the mechanism by which disruptors affect ameloblast gene expression is unclear (Jedeon et al. 2013). The confirmed existence of MIH in archaeological populations in England and France (Ogden et al. 2008;Garot et al. 2017Garot et al. , 2019 may, however, challenges the role of BPA and other endocrine disruptors as they were not present at that time. ...
Article
PurposeTo systematically review the aetiological factors associated with molar incisor hypomineralisation (MIH). To this day, the aetiology remains unknown. Determining risk factors would allow risk assessment and enhance early diagnosis of MIH in young patients. The aim was to assess, evaluate and summarise the relationship between MIH and reported aetiological hypotheses.Methods Electronic database searches of MEDLINE, EMBASE, EBSCO, LILACS and Cochrane Library were conducted. Authors conformed to PRISMA guidelines. Studies were screened, data extracted, assessment of risk of bias and calibration was completed by two independent reviewers. Meta-analyses with heterogeneity calculations were performed.ResultsOf the potential 8949 studies, 64 studies were included in the qualitative analysis whilst 45 were included in the quantitative analysis. Prenatal factors: results are inconclusive as only unspecified maternal illnesses appear to be linked to MIH. Perinatal factors: prematurity (OR 1.45; 95% CI 1.24–1.70; p = 0.0002) and caesarean delivery (OR 1.45; 95% CI 1.09, 1.93; p < 0.00001) are associated with an increased risk of developing MIH. Birth complications are also highlighted. These three factors can lead to hypoxia, and children with perinatal hypoxia are more likely to develop MIH (OR 2.76; 95% CI 2.09–3.64; p < 0.0001). Postnatal factors: measles, urinary tract infection, otitis media, gastric disorders, bronchitis, kidney diseases, pneumonia and asthma are associated with MIH. Fever and antibiotic use, which may be considered as consequences of childhood illnesses, are also associated with MIH. Genetic factors: an increasing number of studies highlight the genetic and epigenetic influences in the development of MIH.Conclusion Several systemic and genetic and/or epigenetic factors acting synergistically or additively are associated with MIH, revealing a multifactorial aetiology model. Peri- and postnatal aetiological factors are more likely to increase the odds of causing MIH than prenatal factors.
... During the various stages of enamel formation, there can be interruptions. [2] The permanent first molar (PFM) is one of the first permanent teeth to erupt in oral cavity and a cornerstone tooth in function and occlusion. [3] They exhibit a greater control over the teeth that erupt later. ...
Article
Full-text available
Background: Molar incisor hypomineralization (MIH) is a developmental dental defect and has a significant impact on the quality of life of affected individuals. Most of the prevalence studies of MIH have been carried out in the European countries; very little data are available from India. Aim: The aim and objective of this study was to determine the prevalence of MIH in 8-15-year-old Malayalee school children in and around Muvattupuzha, Kerala. Settings and design: A cross-sectional epidemiological study was conducted in 5318 healthy Malayalee school children aged between 8 and 15 years in and around Muvattupuzha. Materials and methods: The first permanent molars (FPMs) and all permanent incisors were examined for MIH using the European Academy of Paediatric Dentistry 2003 diagnostic criteria. The severity of hypomineralization was recorded according to the Wetzel and Reckel scale. Statistical analysis: The data were analyzed using the Statistical Package for the Social Sciences software version 20.0, and a comparison between groups was carried out using the Chi-square test. P ≤ 0.05 was considered for statistical significance. Results: A total of 216 children were diagnosed with MIH. The maximum MIH-affected tooth was found to be mandibular right FPM (186), followed by mandibular left FPM (172), maxillary left FPM (160), and maxillary right FPM (156). Conclusion: The prevalence of MIH in permanent dentition of Malayalee school children in and around Muvattupuzha was 4.1%. Among the MIH-affected children, very few have undertaken dental treatment for the same. Hence, proper awareness and planned preventive and restorative programs are required to minimize the problem.
... Des réflexions sur les autres facteurs de risque cités dans la littérature pourraient être utiles. Si OGDEN et al., en 2008, auraient retrouvé cette atteinte dans une population de Londres datée du 17 ème -18 ème siècles, aucune autre étude ne mentionne la présence de cette anomalie dans des populations anciennes[47]. D'autres études sur des populations archéologiques seraient nécessaires. ...
Thesis
Molar-incisor-hypomineralisation (MIH) is defined as the developmentally derived dental defect that involves hypomineralisation of 1 to 4 permanent first molars (FPM) that is frequently associated with similarly affected permanent incisors (Wheerheijm, 2001) . The prevalence of the defect is between 3 and 25%, which given the damage that may result is a real public health problem. Our study aims to isolate the most common etiologic hypotheses, to establish a link between etiological hypotheses and severity of damage, localization of damage and the presence of other dental anomalies, to assess the prevalence of MIH in siblings of a patient and to determine the preferential localization of these defects. We conducted a retrospective study from may 2010 to october 2011 of 77 patients with MIH and their siblings in the Bordeaux University Hospital and two private center of pediatric dentistry. Parents answered a questionnaire completed by the examiner with support from the health record. The distribution of defects was observed according to their degree of severity. Our results on the etiological hypotheses show correlations between hypoxia at birth and the onset of the HMI (OR = 6.1, CI = 1.7-21.85), between cesarean births and MIH (OR = 2.9, CI = 1.2-6.9) and between the ear and the HMI (p = 0.05). Hypoxia can include setting a ventilator, prolonged labor, cord prolapse. Some authors have shown that there could be hypoxia in the newborn at a cesarean operation. We found that the maxillary first permanent molars and incisors are more frequently affected than mandibular ones and in 78% of patients with MIH, at least one incisor is affected. It is important to support the importance of isolating etiological hypotheses. This would allow us to develop detection and targeted and appropriate prevention.
Article
Introduction The term molar incisor hypomineralisation (MIH) was used by Weerheijm, Jälevik and Alaluusa in 2001 to describe hypomineralisation of systemic origin of 1–4 permanent first molars, frequently associated with affected incisors. MIH had previously been described by various terms such as, mottling of enamel and cheese molars. Assessment of MIH between studies is confounded by different terminology, resulting in difficulty in being able to ascertain when this disorder initially presented. Asking whether MIH is a new disease of the 21st century, or whether it existed previously, may help to establish if aetiological factors are liked to contemporary lifestyle. Materials and methods Cochrane Library, Embase, Medline and Web of Science were the databases used to conduct an extensive literature search. Specific search terms and inclusion/exclusion criteria were used to identify relevant publications. After the screening process, 13 articles were included in this review, 5 investigated archaeological specimens, whilst the remaining 8 were clinical studies, where participants were born before the 21st century. Results Four common themes identified on review of the selected publications were: suggested rates of MIH between archaeological studies vastly differ, clinical studies carried out before 2001 suggest similar rates of MIH to present day, despite use of different terminology. Both archaeologic and clinical studies suggest MIH existed before the 21st century and publications using clinical assessment either focus on children or adolescents. Conclusion Analysis of the selected publications suggests that MIH was present before the 21st century. This is demonstrated in both clinical and archaeological studies.
Article
Full-text available
Aim and objectives: To evaluate the prevalence of molar incisor hypomineralization (MIH) in schoolchildren of the ages between 8 and 14 years of Gannavaram Mandal, Krishna district, Andhra Pradesh, India. Materials and methods: A total of 2,250 children of ages between 8 and 14 years were selected randomly from different schools. After obtaining requisite permissions from Mandal Educational Officer (MEO), children was screened for the prevalence of MIH according to European Academy of Paediatric Dentistry (EAPD) 2003 diagnostic criteria and severity for MIH was examined using Wetzel and Reckel scale. Results: Prevalence of MIH was observed to be 2.1% with higher cases of mild severity and with no sex predilection (p > 0.05). Conclusion: Early diagnosis and treatment can significantly reduce complications associated with MIH. Very few studies have been conducted in India and studies encompassing extensive population are warranted to better understand its etiology. Clinical significance: MIH lesions lead to carious development. Hence there is need to identify MIH in children as early as possible to reduce the clinical complications. How to cite this article: Tarannum, Ravichandra KS, Muppa R, et al. Molar Incisor Hypomineralization Prevalence in the Schoolchildren of Gannavaram Mandal, Krishna District, Andhra Pradesh, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(6):737-740.
Article
Full-text available
Molar Incisor Hypomineralisation (MIH) is a common developmental anomaly characterized by presence of enamel defects affecting permanent first molars and often to a lesser degree, permanent incisors with variable severity. Since first recognized, this condition and its etiology has been unclear and interpreted as a distinct phenomenon unlike other enamel disturbances. In order to prevent acute symptoms and complicated treatment resulting from rapid breakdown of tooth in MIH, early diagnosis is essential. The purpose of this article is to provide comprehensive overview of MIH, its diagnosis ,illustration of various recent advances in treatment modalities, all of which may update pedodontists role in clinical management of this condition.
Article
Full-text available
Numerous studies and various interpretations of the prevalence of linear enamel hypoplasias (LEH) based on populations living in different cultural and economic conditions are causing some confusion and raising doubts about whether or not such LEH are reliable indicators of life conditions. An analysis of LEH prevalence patterns was performed on the adults of three populations: Tirup—a Danish Medieval rural population of the 12–14th centuries (131 individuals), Subačiaus str. in Vilnius—a Lithuanian Late Medieval urban population of the 16–17th centuries (88 individuals), and the aristocracy—a Lithuanian pooled sample population from several churches of the 15–18th centuries (66 individuals). Statistical testing of the influence of population affinity, sex and age at death was also performed. Since the same investigator scored all the samples, possible inter-observer error bias was minimized. In all the populations, LEH formation ages were similar. Statistically significant sex differences were found only in the aristocratic sample (with higher male frequency). It was found that the town population was characterized by the highest frequency of affected individuals, with the highest severity and highest number of stress episodes per individual. A reliable relationship with age at death was found only in the town sample: individuals with more numerous and more marked LEH had shorter life expectancies in adulthood. Different “most vulnerable years” for subsequent life expectancies were noted for different populations. A tentative explanation of these differences could be the pooled effect of differential morbidity and mortality. It seems that the rural population experienced the highest morbidity and nutrition deficiency as well as the highest child mortality whereas, in the urban sample, high morbidity was accompanied by a lower child mortality. Both lower morbidity and mortality seem to be characteristic for the aristocracy. Copyright
Article
This chapter presents a synthesis of recent advances made in bioarchaeology, an emerging discipline that emphasizes the human biological component of the archaeological record. The chapter presents an examination of the impact of economy and behavior on skeletal and dental tissues. Skeletal and dental tissues are remarkably sensitive to the environment. Such factors as diet, disease, population size and mobility, physical exercise, and work leave indelible marks on these tissues. The chapter describes the means by which skeletal remains have been and can be used for understanding processes that underlie human behavior. It also explores the impact of different lifeways on the skeleton with reference to nonpathological and pathological changes in articular joints, bone form and function, and the nature of skeletal and dental changes in light of the use of the jaws and teeth in both masticatory and non-masticatory roles.
Article
To many historians, and to most of their students, the question of the impact of the Industrial Revolution upon the poor of Britain has become confused, an arcane debate of ever greater statistical complexity. This is a pity, for “the most sustained single controversy in British economic history” still has, and should have, the capacity to excite and rouse the imagination, as it did for those who began, in the first half of the nineteenth century, the Condition of England debate (Mathias, 1975: vii; Taylor, 1975: xi). For Friedrich Engels, Edwin Chadwick, John Stuart Mill, or Lord Shaftesbury, and for many who as government inspectors or members of local statistical societies provided the evidence, the condition of the working classes was something tangible, to be seen in the streets of Manchester or London, demonstrated in the faces and bodies of the artisans and laborers who walked those streets and worked in the workshops and factories. The moral outrage felt by Engels, Chadwick, Shaftesbury, Barnardo, and many others in the nineteenth century came from the sight not only of squalid living conditions but of the malnourished bodies of the poor themselves.
Article
In the publisher's series, Cambridge geographical studies, this is the first book about the population of London during the early modern period and the first detailed account of the population of a European metropolitan city at that time. Mainly concerned with the internal demography of London, new techniques in historical demography are applied, principally aggregative analysis and family reconstitution of parish registers. Because the death rate was much higher than that of the countryside, and there was no marked compensation in the birth rate, London's population would have declined without migration. There is discussion on the bearing of London's social structure on demography, the impact of plague, and child care practices. -J.Sheail