Molar-Incisor Hypomineralization–A Review

Molar incisor hypomineralization (MIH) describes the hypomineralization of systemic origin affecting one or more first permanent molars (FPMs) and are associated with affected incisors. Etiological associations with systemic conditions or environmental insults during the prenatal, natal and postnatal times have been implicated. The comprehensive care involved in treating affected children must address their behavior and anxiety, aiming at early diagnosis, remineralization and desensitization, prevention of caries and posteruption breakdown; restorations and extractions under pain-free conditions and maintenance. The challenges include adequate anaesthesia, suitable cavity design, and choice of restorative materials. Restorations in hypomineralized molars appear to fail frequently; there is little evidence-based literature to facilitate clinical decisions on cavity design and material choice. The high prevalence of MIH indicates the need for research to clarify etiological factors and improve the durability of restorations in affected teeth. The purpose of this paper was to describe the prevalence, etiological factors, and clinical features of hypomineralized enamel in molar incisor hypomineralization and to present a sequential approach to management.