Molar Incisor Hypomineralization
Morphological and chemical aspects, onset and possible etiological factors
Abstract
Overall aim: The general objective of this thesis was to enhance the understanding of Molar Incisor Hypomineralization (MIH) in areas of the histological, chemical and mechanical properties of the hypomineralized enamel, objective and subjective clinical symptoms in relation to bacteria findings. Further, to estimate a time for onset of the disturbance and investigate possible etiological factors. Material & Methods: 22 teeth diagnosed with MIH were used in the histological and chemical studies. A number of analytical methods were used; Light microscopy, Polarized light microscopy, Scanning electron microscopy, X-ray microanalysis, Vickers hardness test and X-ray Micro Computed Tomography. Decalcified sections were stained with bacterial staining. An ozone device was tested for the ability to kill strains of oral bacteria. In collaboration with the prospective ABIS study, 17.000 individuals were examined and possible etiological causes of severe demarcated opacities were tested. Results & Conclusions: The hypomineralized enamel was mainly located in the buccal enamel of the teeth and had a high degree of porosity extending from enamel-dentin-junction with a distinct border to the normal cervical enamel. Teeth diagnosed MIH had lower hardness values in hypomineralized enamel and differences in the chemical composition. Bacteria were observed in the enamel and deep into the dentin. Ozone treatment for 20 seconds or more was effective to kill oral microorganisms. Significant relations were found between MIH in first molars and breast feeding more than 6 months, late introduction to gruel and infant formula (later than 6 months). The onset for the hypomineralized enamel was estimated to around 200 days from start of the enamel mineralization.
Parts of work
I. Fagrell TG, Dietz W, Jälevik B, Norén JG. Chemical, mechanical and morphological properties of hypomineralized enamel of permanent first molars. Acta Odontol Scand. 2010;68:215-22.
::PMID::20392131 II. Fagrell TG, Lingström P, Olsson S, Steiniger F, Norén JG. Bacterial invasion of dentinal tubules beneath apparently intact but hypomineralized enamel in molar teeth with molar incisor hypomineralization. Int J Paediatr Dent. 2008;18:333-40.
::PMID::18328044 III. Fagrell TG, Dietz W, Lingström P, Steiniger F, Norén JG. Effect of ozone treatment on different cariogenic microorganisms in vitro. Swed Dent J. 2008;32:139-47.
::PMID::18973084 IV. Fagrell TG, Ludvigsson J, Ullbro C, Lundin SA, Koch G. Aetiology of severe demarcated enamel opacities - an evaluation based on prospective medical and social data from 17,000 children. Swed Dent J. 2011;35:57-67.
::PMID::21827015 V. Fagrell TG, Salmon P, Melin L, Norén JG. Onset of Molar Incisor Hypomineralization (MIH).
Submitted for publication.
Degree
Doctor of Philosophy (Odontology)
University
University of Gothenburg. Sahlgrenska Academy
Institution
Institute of Odontology. Department of Pedodontics
Disputation
Fredagen den 2 december 2011, kl. 13.00, föreläsningssal 9, Institutionen för Odontologi, Medicinaregatan 12E
Date of defence
2011-12-02
tobias.fagrell@vgregion.se
Date
2011-11-18Author
Fagrell, Tobias
Keywords
Teeth
Molar Insicor Hypomineralisation
hypomineralisation
Enamel
Etiology
ozone
Scanning electron microscopy
Publication type
Doctoral thesis
ISBN
978-91-628-8341-6
ISSN
0348-6672
Language
eng