Turkiye Klinikleri Journal of Dental Sciences

.: REVIEW
Süt İkinci Azı Hipomineralizasyonu ve Klinik Önemi
Hypomineralized Second Primary Molars and its Clinical Implications
Elif BALLIKAYAa, Gizem ERBAŞ ÜNVERDİa, Zafer Cavit ÇEHRELİa
aHacettepe Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2021;27(1):108-16
doi: 10.5336/dentalsci.2020-74182
Article Language: TR
Full Text
ÖZET
 Diş çürüğü ve mine bozuklukları, çocuklarda çok yaygındır. Mine hipomineralizasyonu, çürük gelişimini ve çürüğün şiddetini artırabilen mine bozukluklarından biridir. Süt ikinci azı hipomineralizasyonu, minenin gelişimsel bir bozukluğu olmasının yanında büyük azı kesici hipomineralizasyonu (BKH) ile benzer klinik özelliklere sahiptir. SAH, klinik olarak 1-4 adet süt 2. azı dişi etkileyebilen, minede tipik olarak sarı-kahverengi renklenme ve belirgin bir opasite olarak tanımlanmaktadır. Süt 2. azılarda gözlenen, sınırları belirgin hipomineralizasyon varlığının, daimî dişlerde BKH görülmesinin bir işareti olabileceği bildirilmiştir. Diş sert dokularında meydana gelebilecek hızlı yıkımların, akut semptomların ve tekrarlayan tedavilerin önlenmesi açısından hipomineralizasyonun erken teşhis edilmesi önemlidir. Süt ve daimî dişlerde hipomineralizasyon varlığı; diş çürüğü, hassasiyet, ağrı, estetik kaygı ve diş yüzeyi kaybına neden olarak, çocuğun yaşam kalitesini olumsuz yönde etkileyebilir. Mine hipomineralizasyonlu tüm dişlerin tedavi yaklaşımında öncelikli olarak diş çürüğünün oluşumu önlenmelidir. Süt ikinci azı hipomineralizasyonu varlığı BKH'ye işaret edebileceğinden, veliyi konu hakkında bilgilendirmek, hijyen ve beslenme eğitimi vermek ve özellikle daimî 1. azıların sürme döneminde hastaları sık kontrollere çağırmak gerekmektedir. Bu tür dişlerin tedavi yaklaşımında etkilenen dişlerin tipi, defektlerin büyüklüğü ve şiddeti, diş yüzeyi kaybı ve ilişkili semptomlara bağlı olarak kısa ve uzun dönem tedavi planları gerektiren birçok restoratif yaklaşım bulunmaktadır. Bu kısa literatür derlemesinde, Süt ikinci azı hipomineralizasyonunun karakteristik özellikleri, görülme sıklığı, etiyolojisi, tanı kriterleri ve ayırıcı tanısı, klinik önemi ve tedavi yaklaşımı mevcut literatür ışığında değerlendirilecektir.

Anahtar Kelimeler: Süt dişi, mine hipomineralizasyonu, etiyoloji, ayırıcı tanı, hastalık yönetimi
ABSTRACT
 Dental caries and enamel defects are very common among children. Hypomineralization is one of the enamel defects that can increase caries experience and severity. Hypomineralization of second primary molars (HSPM) a developmental defect of dental enamel and has similar clinical features with molar incisor hypomineralization (MIH). HPSM typically present as white, yellow or brown demarcated opacities in the enamel, affecting one to four primary second molars. The presence of demarcated molars hypomineralization of second primary molars has been cited as a predictor of molar incisor hypomineralization. Early diagnosis is essential to prevent rapid breakdown of tooth structure, acute symptoms and repeated treatments. Hypomineralization in the primary and permanent dentition can result in dental caries, hypersensitivity, pain, esthetic concerns, and tooth surface loss, therefore, affecting the child's quality of life. The prevention of dental caries is essential in the management of all patients with hypomineralized enamel. The presence of HSPM can be considered as a predictor of MIH, indicating the need for informing the parents, managing the oral hygiene and diet, control the patients regularly regarding MIH especially during the eruption of the first permanent molars. Many restorative techniques for the management of such teeth are available that might require short and long management treatment plans depending on the type of teeth affected, extent and severity of defects, tooth surface loss and associated symptoms. In this mini-review, the characteristic features, prevalence, etiology, diagnostic criteria, differential diagnosis, clinical importance and treatment approach of hypomineralization of second primary molars will be reviewed in the light of the current literature.

Keywords: Deciduous tooth, dental enamel hypoplasia, etiology, differential diagnosis, disease management
REFERENCES:
  1. Simmer JP, Hu JC. Dental enamel formation and its impact on clinical dentistry. J Dent Educ. 2001;65(9):896-905.[Crossref] [PubMed] 
  2. Weerheijm KL, Jälevik B, Alaluusua S. Molar-incisor hypomineralisation. Caries Res. 2001;35(5):390-1.[Crossref] [PubMed] 
  3. 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. Br Dent J. 2004;22;196(10):634-8; discussion 625.[Crossref] [PubMed] 
  4. Jälevik B, Norén JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Paediatr Dent. 2000;10(4):278-89.[Crossref] [PubMed] 
  5. Beentjes VE, Weerheijm KL, Groen HJ. Factors involved in the aetiology of molar-incisor hypomineralisation (MIH). Eur J Paediatr Dent. 2002;3(1):9-13.[PubMed] 
  6. da Silva Figueiredo Sé MJ, Ribeiro APD, Dos Santos-Pinto LAM, de Cassia Loiola Cordeiro R, Cabral RN, et al. Are hypomineralized primary molars and canines associated with molar-incisor hypomineralization? Pediatr Dent. 2017;1;39(7):445-9.[PubMed] 
  7. Weerheijm KL, Duggal M, Mejàre I, Papagiannoulis L, Koch G, Martens LC, et al. Judgement criteria for molar incisor hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting on MIH held in Athens, 2003. Eur J Paediatr Dent. 2003;4(3):110-3.[PubMed] 
  8. Jälevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Paediatr Dent. 2002;12(1):24-32.[Crossref] [PubMed] 
  9. Elfrink ME, Schuller AA, Weerheijm KL, Veerkamp JS. Hypomineralized second primary molars: prevalence data in Dutch 5-year-olds. Caries Res. 2008;42(4):282-5.[Crossref] [PubMed] 
  10. Jälevik B, Odelius H, Dietz W, Norén J. Secondary ion mass spectrometry and X-ray microanalysis of hypomineralized enamel in human permanent first molars. Archives of oral biology. 2001;46(3):239-47.[Crossref] 
  11. Farah RA, Monk BC, Swain MV, Drummond BK. Protein content of molar-incisor hypomineralisation enamel. J Dent. 2010;38(7):591-6.[Crossref] [PubMed] 
  12. Fagrell TG, Dietz W, Jälevik B, Norén JG. Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars. Acta Odontol Scand. 2010;68(4):215-22.[Crossref] [PubMed] 
  13. Turner EG, Dean JA. Development and morphology of the primary teeth. In: Jones JE, Vinson LQA, eds. Dentistry for the Child and Adolescent. 10th ed. St. Louis: Elsevier; 2016. p.80-6.[Crossref] [PMC] 
  14. Ghanim AM, Morgan MV, Mari-o RJ, Bailey DL, Manton DJ. Risk factors of hypomineralised second primary molars in a group of Iraqi schoolchildren. Eur Arch Paediatr Dent. 2012;13(3):111-8.[Crossref] [PubMed] 
  15. 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] 
  16. Vieira AR, Kup E. On the etiology of molar-incisor hypomineralization. Caries Res. 2016;50(2):166-9.[Crossref] [PubMed] 
  17. Lopes-Fatturi A, Menezes JVNB, Fraiz FC, Assunção LRDS, de Souza JF. Systemic exposures associated with hypomineralized primary second molars. Pediatr Dent. 2019;15;41(5):364-70.[PubMed] 
  18. Chowdhury IG, Bromage TG. Effects of fetal exposure to nicotine on dental development of the laboratory rat. Anat Rec. 2000;1;258(4):397-405.[Crossref] [PubMed] 
  19. Erin L, Gross Nowak AJ. Conception to age three. In: John R, Christensen Tad R, Mabry Janice A. Townsend Wells MH, eds. Pediatric Dentistry Infancy Through Adolescence. 8th ed. Philadelphia: Elsevier; 2018. p.586-87.
  20. Elfrink ME, ten Cate JM, Jaddoe VW, Hofman A, Moll HA, Veerkamp JS, et al. Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res. 2012;91(6):551-5.[Crossref] [PubMed] 
  21. Ghanim A, Manton D, Mari-o R, Morgan M, Bailey D. Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children. Int J Paediatr Dent. 2013;23(1):48-55.[Crossref] [PubMed] 
  22. Lygidakis NA, Wong F, Jälevik B, Vierrou AM, Alaluusua S, Espelid I, et al. Best clinical practice Guidance for clinicians dealing with children presenting with Molar-Incisor-Hypomineralisation (MIH): an EAPD policy document. Eur Arch Paediatr Dent. 2010;11(2):75-81.[Crossref] [PubMed] 
  23. Elfrink ME, Veerkamp JS, Kalsbeek H. Caries pattern in primary molars in Dutch 5-year-old children. Eur Arch Paediatr Dent. 2006;7(4):236-40.[Crossref] [PubMed] 
  24. Elfrink ME, Schuller AA, Veerkamp JS, Poorterman JH, Moll HA, ten Cate BJ, et al. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children. Int J Paediatr Dent. 2010;20(2):151-7.[Crossref] [PubMed] 
  25. Lunardelli SE, Peres MA. Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children. Braz Oral Res. 2005;19(2):144-9.[Crossref] [PubMed] 
  26. Clarkson J, O'Mullane D. A modified DDE Index for use in epidemiological studies of enamel defects. J Dent Res. 1989;68(3):445-50.[Crossref] [PubMed] 
  27. Elfrink ME, Veerkamp JS, Aartman IH, Moll HA, Ten Cate JM. Validity of scoring caries and primary molar hypomineralization (DMH) on intraoral photographs. Eur Arch Paediatr Dent. 2009;10 Suppl 1:5-10.[Crossref] [PubMed] 
  28. Jälevik B. Prevalence and diagnosis of Molar-Incisor- Hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent. 2010;11(2):59-64.[Crossref] [PubMed] 
  29. Elfrink ME, Ghanim A, Manton DJ, Weerheijm KL. Standardised studies on Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM): a need. Eur Arch Paediatr Dent. 2015;16(3):247-55.[Crossref] [PubMed] 
  30. Ghanim A, Elfrink M, Weerheijm K, Mari-o R, Manton D. A practical method for use in epidemiological studies on enamel hypomineralisation. Eur Arch Paediatr Dent. 2015;16(3):235-46.[Crossref] [PubMed] [PMC] 
  31. Jälevik B, Klingberg G, Barregård L, Norén JG. The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand. 2001;59(5):255-60.[Crossref] [PubMed] 
  32. Calderara PC, Gerthoux PM, Mocarelli P, Lukinmaa PL, Tramacere PL, Alaluusua S, et al. The prevalence of Molar Incisor Hypomineralisation (MIH) in a group of Italian school children. Eur J Paediatr Dent. 2005;6(2):79-83.[PubMed] 
  33. Jasulaityte L, Veerkamp JS, Weerheijm KL. Molar incisor hypomineralization: review and prevalence data from the study of primary school children in Kaunas/Lithuania. Eur Arch Paediatr Dent. 2007;8(2):87-94.[Crossref] [PubMed] 
  34. Owen ML, Ghanim A, Elsby D, Manton DJ. Hypomineralized second primary molars: prevalence, defect characteristics and relationship with dental caries in Melbourne preschool children. Aust Dent J. 2018;63(1):72-80.[Crossref] [PubMed] 
  35. A review of the developmental defects of enamel index (DDE Index). Commission on Oral Health, Research & Epidemiology. Report of an FDI Working Group. Int Dent J. 1992;42(6):411-26.[PubMed] 
  36. Crawford PJ, Aldred M, Bloch-Zupan A. Amelogenesis imperfecta. Orphanet J Rare Dis. 2007;4;2:17.[Crossref] [PubMed] [PMC] 
  37. Lo EC, Zheng CG, King NM. Relationship between the presence of demarcated opacities and hypoplasia in permanent teeth and caries in their primary predecessors. Caries Res. 2003;37(6):456-61.[Crossref] [PubMed] 
  38. Broadbent JM, Thomson WM, Williams SM. Does caries in primary teeth predict enamel defects in permanent teeth? A longitudinal study. J Dent Res. 2005;84(3):260-4.[Crossref] [PubMed] 
  39. Weerheijm KL. Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. Dent Update. 2004;31(1):9-12.[Crossref] [PubMed] 
  40. Seow WK. Clinical diagnosis of enamel defects: pitfalls and practical guidelines. Int Dent J. 1997;47(3):173-82.[Crossref] [PubMed] 
  41. Weerheijm KL. Molar incisor hypomineralisation (MIH). Eur J Paediatr Dent. 2003;4(3):114-20.[PubMed] 
  42. Rodd HD, Boissonade FM, Day PF. Pulpal status of hypomineralized permanent molars. Pediatr Dent. 2007;29(6):514-20.[PubMed] 
  43. Fayle SA. Molar incisor hypomineralisation: restorative management. Eur J Paediatr Dent. 2003;4(3):121-6.[PubMed] 
  44. Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: a systematic review of the literature. J Am Dent Assoc. 2008;139(7):915-24.[Crossref] [PubMed] 
  45. Pasini M, Giuca MR, Scatena M, Gatto R, Caruso S. Molar incisor hypomineralization treatment with casein phosphopeptide and amorphous calcium phosphate in children. Minerva Stomatol. 2018;67(1):20-5.[PubMed] 
  46. Lygidakis NN, Chatzidimitriou K, Lygidakis NA. The Use of Fissure Sealants in MIH-Affected Posterior Teeth. Molar Incisor Hypomineralization ed. Springer; 2020. p.127-35.[Crossref] 
  47. Wright JT. Diagnosis and treatment of molar-incisor hypomineralization. Handbook of Clinical Techniques in Pediatric Dentistry. 2015.[Crossref] [PMC] 
  48. William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006;28(3):224-32.[PubMed] 
  49. Nazzal H, Duggal MS. Restorative management of dental enamel defects in the primary dentition. Clin Dent Rev. 2019;3(1):1-7.[Link] 

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