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Developmental enamel defects

Enamel hypoplasia in the primary incisor

Hypoplasias

These are areas where the enamel thickness and shape are distorted due to effects such as mechanical impact in the early stages of tooth development, chronic infection around the tooth bud, and radiotherapy.

Enamel hypomineralization in permanent premolar

Hypomineralizations

These are areas where the enamel mineral content is lower than in healthy areas due to effects such as periods of high-fever illness during the enamel-building phase of tooth development, repeated drug use, exposure to toxic substances, and congenital hypoxia.

Enamel hypomineralization and post-eruptive destruction in permanent central incisors
Hypomineralization of the permanent first molar - hypomineralization of the incisor molar
6-year-old tooth with severe destruction of incisor molar hypomineralization

  • During the tooth development period (0-4 years):

  • Recurrent high fever diseases

  • Repeated antibiotic use

  • Environmental toxic substances (dioxins, BPA, etc.)

Possible Causes

Developmental Enamel Defects, areas in the mouth that are sensitive to hot or cold foods that can be easily broken by chewing due to their rough shape or difference in mineral content composition, and different surface features or colors on the front teeth are revealed by careful observation. However, since enamel development anomalies in the back teeth can easily break with chewing forces after the tooth is inserted into the mouth, it can progress to rapid tooth destruction and subsequent caries, and to toothaches and abscesses in the newly erupted back teeth before even the tooth root development is completed. 

Especially in incisor molar hypomineralization, if the destruction that develops due to hypomineralized areas in the molars is not noticed in the early stages, the treatment needs and complexity of these teeth will increase. These procedures will be difficult depending on the age of the children who will receive the treatment. These procedures cannot be performed in the clinic and may cause them to need advanced treatment techniques and even lose these teeth. 

While the destruction can be prevented or slowed down with the use of remineralization agents in the early stages. In the following stages, restoration techniques such as direct composite, amalgam, prefabricated stainless steel crown, inlay, onlay can be applied together with methods such as pulp coatings, amputation, apexification and root canal treatment in case of endodontic intervention needs.

Dental examination at the age of 5.5-6 is important to detect hypomineralization of the incisor molars, especially in the early eruption period, and to prevent destruction with preventive treatments.

Incisor molar hypomineralization- MIH- molar incisal hypomineralization treatment options
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