Molaren-Inzisiven-Hypomineralisation – Überblick, klinische Aspekte, Behandlungsempfehlungen

Zusammenfassung

Die Molaren-Inzisiven-Hypomineralisation (MIH) ist eine entwicklungsbedingte Schmelzbildungsstörung mit bislang ungeklärter Ursache. Bei den erkrankten Zähnen handelt es sich vornehmlich um die ersten bleibenden Molaren und/oder die ersten bleibenden Inzisivi. In der ersten Dentition können auch die zweiten Molaren von einer Molaren-Inzisiven-Hypomineralisation betroffen sein. Unterschiedliche intraindividuelle Ausprägungsgrade einer MIH erschweren die Therapieplanung und in vielen Fällen auch die restaurative Therapie. Ein häufiges Phänomen bei diesen Zähnen ist eine oftmals in Zusammenhang mit Hypersensibilitäten vorkommende Unwirksamkeit von Lokalanästhetika. Um eine adäquate Behandlungsentscheidung für die meist noch sehr jungen Patienten zu treffen, ist ein enges Behandlungskonzept zwischen Zahnerhaltung und Kieferorthopädie unerlässlich.

Die vorliegende Übersicht beleuchtet zum einen ätiologische und klinisch-diagnostische sowie therapeutische Aspekte, zum anderen soll sie als Hilfestellung bei der interdisziplinären Entscheidungsfindung zur Planung einer suffizienten Therapie bei Vorliegen einer Molaren-Inzisiven-Hypomineralisation dienen.

Abstract

Molar incisor hypomineralisation (MIH) is an enamel developmental defect with a currently indistinct etiology. Affected teeth primarily are first permanent molars and/or first permanent incisors. In the first dentition second molars may show the typical structures of molar-incisor hypomineralisation as well. Therapy planning and in many cases restaurative therapy itself is complicated by the occurence of different intra-individual grades of MIH as well as by an ineffectiveness of local anesthetics, that often comes along with dental hypersensitivities caused by MIH. In order to make a good decision of treatment for the young patients, close cooperation and communication between restorative dentistry and orthodontics is essential.

This article on the one hand lights up aspects concerning the etiology of molar-incisor hypomineralisation and deals with clinical, diagnostic and therapeutic matters. On the other hand this overview is supposed to serve as an assistance concerning sufficient therapy planning following interdisciplinary decision-making.

Schlüsselwörter

Zahnschmelz - Zahnanomalien - restaurative Zahnheilkunde - Kieferorthopädie

Key words

dental enamel - tooth abnormalities - restorative dentistry - orthodontics

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