Craveia J, Rouas P, Carat T, Manton D J, Boileau M J, Garot E
J Clin Pediatr Dent. 2020;44(1):20-27. doi: 10.17796/1053-4625-44.1.4.
Molar Incisor Hypomineralization (MIH) is a developmental enamel anomaly of systemic origin affecting the first permanent molars and often the permanent incisors. Despite MIH being a prevalent anomaly, its diagnosis and management are challenging for practitioners; including poor anesthesia, failure of restorations, rapid enamel breakdown, poor resin adhesion, and related child anxiety. This study aimed to evaluate knowledge regarding and management of MIH amongst orthodontists and dentists. The study was performed from March to September 2017 and included 336 dentists and 32 orthodontists. Questionnaires comprised questions on MIH diagnosis, socio-demographic characteristics of the subjects, and photographs of a case of MIH with related questions regarding management. Our results showed that 48% of dentists and 25% of orthodontists misdiagnosed MIH; with misdiagnosis associated with graduation prior to 1986 (p < 0.001). Amongst dentists, 59% applied a fluoridated product and 34% applied fissure sealants in the case of moderate MIH. The application of fluoride was associated with graduation after 1986 (p < 0.0001). Large disparities about knowledge and management of MIH exist between dental practitioners in France. Education regarding diagnosis and management of MIH is necessary.
磨牙症伴牙釉质矿化不全（MIH）是一种全身性起源的发育性牙釉质异常，影响第一恒磨牙，通常还会影响恒切牙。尽管MIH是一种常见的异常情况，但对从业者来说，其诊断和治疗具有挑战性，包括麻醉效果不佳、修复失败、牙釉质快速损坏、树脂粘结性差以及相关儿童焦虑等问题。本研究旨在评估正畸医生和牙医对MIH的了解程度及治疗情况。该研究于2017年3月至9月进行，纳入了336名牙医和32名正畸医生。问卷包括关于MIH诊断的问题、受试者的社会人口学特征，以及一例MIH病例的照片及相关治疗问题。我们的结果显示，48%的牙医和25%的正畸医生误诊了MIH；误诊与1986年之前毕业有关（p<0.001）。在牙医中，59%在中度MIH病例中使用了含氟产品，34%使用了窝沟封闭剂。使用氟化物与1986年之后毕业有关（p<0.0001）。法国牙科从业者在MIH的知识和治疗方面存在很大差异。有必要开展关于MIH诊断和治疗的教育。
