Amna Tariq, Munawar Alam Ansari, Zahida Memon.
Developmental Enamel Defects: A Review.
J Pak Dent Assoc Jan ;22(4):241-50.

Dental enamel is an unusual tissue in that once formed it is not remodeled, unlike other hard tissues such as bone. Because of its non remodeling nature, alterations of enamel during its formation are permanently recorded on the tooth surface. As enamel formation can be affected by many factors, the changes induced in the enamel formation, can provide clues as to the timing and nature of these events. Enamel defects may thus be studied as a marker of many adverse biological events occurring during the time of its development. One such developmental defect of the enamel occurring due to changes in the environmental factors causing permanent damage of the enamel is Molar Incisor Hypomineralization (MIH). MIH presents the clinical picture of hypomineralization of systemic origin affecting one or more first permanent molars (FPMs) that are associated frequently with affected incisors. Systemic conditions or environmental insults during the child’s first 3 years have etiological associations. In treatment modalities complex care may involve, including the management of behavior and anxiety of affected children and aiming to provide a durable restoration under pain-free conditions. The challenges include a number of other requisites such as adequate anesthesia, suitable cavity design, and choice of restorative materials. The purpose of this review is to comprehend the knowledge about the diagnosis, prevalence, putative etiological factors, and features of hypomineralized enamel in molar incisor hypomineralization and to present a sequential approach to management.

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