MOLAR-INCISOR HYPOMINERALIZATION: WHY DOES IT OCCUR? / WHAT TO DO?

Giriş: Büyük azı-keser diş hipomineralizasyonu (BAKH), etkilenmiş dişin mine tabakasında inorganik içerik ve mineralizasyon yetersizliğine bağlı olarak ortaya çıkan kalitatif bir defekt olarak tanımlanmaktadır. Farklı boyuttaki opasite ve gözenekler ile karakterize olup rengi beyazdan sarımsı kahverengiye değişebilmektedir. BAKH defektli hastaların çoğunda, diş sürmesinden kısa süre sonra, dişlerde madde kayıpları, plak birikimi, çürük oluşumunun başladığı ve hızlı ilerlediği görülmektedir. Hastalar için estetik ve hassasiyet sorunlarına yol açmasının yanı sıra, diş hekimleri için tedavi zorluklarını beraberinde getirmektedir. Dolayısıyla; BAKH etiyolojisinin bilinmesi, oluşumunun engellenmesi açısından önemlidir. Amaç: BAKH defekti ile ilişkili etiyolojik faktörleri ortaya koyarak farkındalık yaratmak ve alınabilecek tedbirleri belirlemektir. Yöntem: Bir ve/veya daha fazla sayıda daimi birinci büyük azı dişi içeren, daimi keser dişleri de etkileyebilen BAKH defekti için olası etiyolojik faktörler ile ilgili literatür araştırması yapıldı. Bulgular: BAKH etiyolojisi hakkında mevcut bilgiler sınırlıdır. Etiyolojik faktörleri belirlemeye yönelik gözlemsel çalışmalar yapılmış, prenatal/perinatal/postnatal dönemlerde görülen hastalıklar söz konusu olsa da postnatal dönemde ortaya çıkan hastalıkların daha fazla etkili olduğu bildirilmiştir. Literatürde; sistemik hastalıklar ve ilaç kullanımı, beslenme bozuklukları, erken doğum ve düşük doğum ağırlığı, uzun süreli emzirme ve dioksinler, bisfenol A (BPA) gibi faktörler BAKH ile ilişkilendirilmiştir. Solunum sistemi hastalıklarının, bazı antibiyotiklerin, kalsiyum eksikliğinin ve bebeklerin temas halinde olduğu materyallerde bulunan BPA’nın etkisi özellikle vurgulanmıştır. Bazı çalışmalarda, genetik faktörlerin rol oynadığı da belirtilmiştir. Sonuç: BAKH defektinin kesin etiyolojik faktörlerini belirlemek için daha fazla çalışma yapılması gerekmektedir. Bu çalışmalarda; prenatal/perinatal/postnatal dönemlerde meydana gelen sistemik hastalıklar, uygulanan tedaviler, beslenme bozuklukları, maruz kalınan kimyasal ajanlar, genetik faktörler ve olası diğer durumlar ayrıntılı olarak ele alınmalıdır.

Anahtar Kelimeler:

Mine defektleri, Etiyoloji, Büyük azı-keser diş hipomineralizasyonu

MOLAR-INCISOR HYPOMINERALIZATION: WHY DOES IT OCCUR? / WHAT TO DO?

Introduction: Molar Incisor Hypomineralization (MIH) is defined as a qualitative defect resulting from the decrease in inorganic content and lack of mineralization in enamel layer of affected tooth. Its characterization is presence of opacities/pores of varying sizes from white to yellowish brown in color. Loss of tooth substance, plaque accumulation, caries formation started and progressed rapidly short after tooth eruption in majority of patients with MIH. Additionally to esthetics and sensitivity problems in patients, it presents treatment challenges for dentists. Therefore, understanding its etiology is important to prevent. Aim: This study aims to raise awareness of etiologic factors related to MIH and to determine necessary measures for prevention. Method: We performed a literature review of potential etiologic factors of MIH, which involve one or more permanent first molars, and may also affect permanent incisors. Results: Limited information is available regarding etiology of MIH. Observational studies have been conducted to determine etiological factors, and diseases occurring postnatally are found more effective considering prenatal/perinatal/postnatal periods. Various factors such as systemic diseases, drug use, malnutrition, preterm birth, low birth weight, long-term lactation, dioxins, and bisphenol A (BPA) have been associated with MIH. Respiratory tract diseases, certain antibiotics, calcium deficiency, and BPA in materials in contact with infants have been particularly emphasized. Genetic factors are also reported by some studies. Conclusion: Further studies are required to determine clear-cut etiologic factors for MIH. Systemic diseases, applied treatments, malnutrition, chemical agents, genetic factors, and other possible conditions occurring during prenatal/perinatal/postnatal periods should be discussed in detail.

Keywords:

Enamel Defects, Etiology, Molar-Incisor Hypomineralization,

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