Department of Stomatology, Federal University of Paraná, Curitiba, Brazil.
Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Monogr Oral Sci. 2024;32:117-139. doi: 10.1159/000538874. Epub 2024 Jul 1.
The etiology of molar incisor hypomineralisation (MIH) has been attributed to systemic and environmental factors since 2001. The identification of MIH etiology is fundamental to better understand this condition, for differential diagnosis, and to identify the patient group at risk of MIH. Although the etiology of MIH is still unclear, it is stated as a multifactorial origin, with an overlap of systemic and genetic risk factors. The aim of this chapter was to discuss the systemic and environmental factors associated with MIH according to scientific evidence in the literature, relating it to the basic knowledge of amelogenesis and tooth development chronology. In this chapter, amelogenesis is described and illustrated in detail. Some characteristics of the amelogenesis process could explain some clinical features of the developmental defect of enamel, especially MIH. The chronology of tooth development was also referred to as a characteristic for the occurrence of MIH. Finally, the literature about systemic and environmental risk factors was revised, and the prenatal, perinatal, and postnatal factors associated with MIH were discussed. During the prenatal period, maternal health status, including illnesses during pregnancy and maternal smoking, are the main investigated factors associated with MIH. Prematurity (<37 weeks), low birth weight, and cesarean delivery are the factors associated with MIH during the perinatal period. Moreover, postnatal factors, such as common childhood illnesses, respiratory disease, infections, and antibiotic use, have been associated with MIH. New longitudinal studies that consider the synergy between exposure to environmental factors and biological susceptibility are likely to provide a new understanding of the etiology of MIH.
自 2001 年以来，磨牙和切牙釉质发育不全（MIH）的病因被归因于系统和环境因素。确定 MIH 的病因对于更好地理解这种情况、进行鉴别诊断以及识别易患 MIH 的患者群体至关重要。尽管 MIH 的病因仍不清楚，但它被认为是多因素起源的，具有系统和遗传危险因素的重叠。本章旨在根据文献中的科学证据讨论与 MIH 相关的系统和环境因素，并将其与成釉细胞发生和牙齿发育的基本知识联系起来。本章详细描述和说明了成釉作用。成釉作用过程的一些特征可以解释釉质发育缺陷的一些临床特征，尤其是 MIH。牙齿发育的时间顺序也被认为是 MIH 发生的特征。最后，我们复习了关于系统和环境危险因素的文献，并讨论了与 MIH 相关的产前、围产期和产后因素。在产前阶段，母体健康状况，包括妊娠期间的疾病和母亲吸烟，是与 MIH 相关的主要研究因素。早产（<37 周）、低出生体重和剖宫产是围产期与 MIH 相关的因素。此外，与 MIH 相关的产后因素，如常见的儿童疾病、呼吸道疾病、感染和抗生素使用，也被认为与 MIH 有关。考虑到环境因素暴露和生物易感性之间协同作用的新纵向研究可能会提供对 MIH 病因的新理解。
