Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stomatol. Feb 20, 2019; 7(2): 20-27
Published online Feb 20, 2019. doi: 10.5321/wjs.v7.i2.20
Molar incisor hypomineralization and pre-eruptive intracoronal lesions in dentistry-diagnosis and treatment planning
Uri Zilberman, Jomanna Hassan, Shirley Leiboviz-Haviv
Uri Zilberman, Jomanna Hassan, Shirley Leiboviz-Haviv, Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon 7830604, Israel
Author contributions: All authors contributed to the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Uri Zilberman, DMD, PhD, Senior Lecturer, Pediatric Dental Clinic, Barzilai Medical University Center, 2nd Hahistadrut Street, Ashkelon 7830604, Israel.
Telephone: +972-8-6745854
Received: December 11, 2018
Peer-review started: December 12, 2018
First decision: January 4, 2019
Revised: January 14, 2019
Accepted: January 28, 2019
Article in press: January 28, 2019
Published online: February 20, 2019

The aim of this study is to report the diagnostic features, prevalence, mineral content, clinical significance and treatment options of molar incisor hypomineralization (MIH) and pre-eruptive intracoronal lesions (PEIR), in order to minimize miss-treatment of primary and permanent teeth in young children. MIH was defined as the occurrence of hypomineralization of one up to four permanent first molars from a systemic origin and frequently associated with affected incisors. PEIR are lesions that are located in the occlusal portion of the crown of unerupted permanent or primary teeth. The prevalence of MIH was reported between 2.5%-40% in the permanent first molars and 0%-21.8% in primary second molars. PEIR was observed in 2%-8% of children, mainly in mandibular second premolars and second and third permanent molars. A number of possible causes for MIH were mentioned, including environmental changes, diet and genetics in prenatal and postnatal periods, but all are questionable. In PEIR, the resorption of the intracoronal dentine begins only after crown development is complete and is caused by giant cells resembling osteoclast observed histologically on the dentine surface close to the pulp. The mineral content in MIH is reduced in comparison to normal enamel and dependent on the severity of the lesion. In PEIR the resorbed surface of enamel showed less mineral content. The hypomineralized enamel in MIH is not suitable for restorations with amalgam or composite materials, and the best material should be based on remineralization material like glass-ionomers. Similar, the resorbed dentin surface in PEIR should be covered by the biocompatible and re-mineralizing glass-ionomer cement.

Keywords: Molar incisor hypomineralization, Pre-eruptive intracoronal lesions, Glass-ionomer cements, Enamel, Dentin

Core tip: Molar incisor hypomineralization and pre-eruptive intracoronal lesions are an increasing concern in pediatric dentistry. Since both conditions are developmental and not caused by carious attack, correct diagnosis of the conditions is significant in order to successfully treat the teeth. Early diagnosis can improve the survival rate of these teeth, because breakdown of the enamel can occur in both lesions and subsequent carious attack may lead to pulpal involvement and extraction of teeth at a very young age. The optional restorative material should be based on the re-mineralizing properties of glass-ionomer cements.