An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol
Abstract
:1. Introduction
1.1. Background and Rationale
1.2. Aim and Objectives
- compare the overall prevalence of a dental anomaly (specifically hypodontia) in the permanent dentition of children (seven to sixteen years-of-age) with and without MIH.
- determine the prevalence of other developmental dental anomalies, including: microdont maxillary lateral incisors; dens invaginatus/evaginatus; double teeth; supernumerary teeth; infraocclusion of primary molars; hypomineralisation of second primary molars; ectopic (palatal) position of maxillary canines; ectopic/failed eruption of first permanent molars, and taurodontism of mandibular first permanent molars and investigate the influence of gender and ethnicity/country;
- measure children’s self-reported global evaluation of their oral health in relation to their dental condition.
1.3. Null Hypothesis
2. Materials and Methods
2.1. Overall Study Design
2.2. Establishment of the Investigatory Team and Study Setting
2.3. Eligibility Criteria
- No significant medical history (ASA ≤ 2), syndromic conditions, cleft lip and/or palate
- Have an existing (full) panoramic radiograph at recruitment or subsequently undergoes one for routine diagnostic purposes
- Child able to accept detailed clinical examination, radiographs, and photographs
- Parents and children are able to consent/assent to participate in the study and have a sufficient level of literacy/understanding to complete written consent forms (with support if necessary).
- Children referred to the host centre for the management of any dental condition other than MIH
- MIH-group specific exclusion criteria:
- Children with an enamel defect that is not typical of MIH
- Comparison-group specific exclusion criteria
2.4. Interventions
2.5. Outcomes
- The primary outcome measure for this study is the presence or absence of MIH and its association with the presence of another dental anomaly (specifically hypodontia) in the participants. Details of the index used to score the enamel defect are described in Section 2.8 below.
- Secondary outcome measures for this study include the clinical and/or radiographic severity of MIH in relation to participants’ gender, ethnicity/country, and their global self-reported oral health, details of which are also provided in the subsequent Section 2.8.
2.6. Timeline and Participant Involvement
2.7. Sample Size
2.8. Data Collection
2.8.1. Participants’ Demographics
2.8.2. Clinical Variables
- -
- The primary dental diagnosis will be recorded for both MIH and comparison participants (e.g., the comparison group could include patients presenting with orthodontic concerns, dental caries, traumatic dental injury, oral pathology/oral medicine-related issues, tooth surface loss, periodontal condition, or no dental condition but medical/behavioural reason for referral).
- -
- Any known close family history (siblings or parents) of enamel defects, or missing or extra teeth, will be documented.
- -
- -
- Any other anomalies detected clinically will be noted, including: microdontia of permanent maxillary lateral incisors, dens invaginatus/evaginatus, double teeth, erupted supernumerary teeth, infraocclusion of primary molars (categorised as >1 mm below occlusal level of adjacent tooth/teeth), and ectopic eruption of first permanent molars.
2.8.3. Participants’ Perspectives
- □
- Excellent
- □
- Very good
- □
- Good
- □
- Fair
- □
- Poor
- □
- Not at all
- □
- Very little
- □
- Some
- □
- A lot
- □
- Very much
2.8.4. Radiographic Characteristics
- -
- Presence of any developing third molars.
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- Hypodontia of permanent dentition (excluding third molars).
- -
- Presence of any supernumerary teeth (specifying number and location).
- -
- Presence of ectopic maxillary canines—this can only be coded ‘yes’ if patient has also had an additional intra-oral radiographic view.
- -
- Presence of ectopic first permanent molars (a positive result would include evidence of distal resorption of second primary molars even if the first permanent molars have erupted subsequently).
- -
- Any other anomaly that was not detected clinically (e.g., double tooth, dens invaginatus).
- -
- Any other findings of note (e.g., any anomalies seen in the primary dentition).
2.8.5. Assessment of Taurodontism
- -
- Crown/body:root ratio < 1.1 = normal
- -
- Crown/body:root ratio 1.1–1.29 = hypotaurodontism
- -
- Crown/body:root ratio 1.29–2.00 = mesotaurontism
- -
- Crown/body:root ratio > 2.00 = hypertaurodontism
2.9. Clinical Photographs
2.10. Investigator Training and Calibration
2.11. Data Management
2.12. Statistical Methods
2.13. Research Ethics and Governance
2.14. Dissemination Policy
3. Preliminary Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Rodd, H.D.; Nazzal, H.; Bonifacio, C.C.; Ruth, C.W.; Crombie, F.; El Shahawy, O.; Folayan, M.O.; Gambetta-Tessini, K.; Goyal, A.; Hasmun, N.; et al. An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol. Dent. J. 2023, 11, 117. https://doi.org/10.3390/dj11050117
Rodd HD, Nazzal H, Bonifacio CC, Ruth CW, Crombie F, El Shahawy O, Folayan MO, Gambetta-Tessini K, Goyal A, Hasmun N, et al. An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol. Dentistry Journal. 2023; 11(5):117. https://doi.org/10.3390/dj11050117
Chicago/Turabian StyleRodd, Helen D., Hani Nazzal, Clarissa Calil Bonifacio, Choe Wei Ruth, Felicity Crombie, Osama El Shahawy, Morenike Oluwatoyin Folayan, Karla Gambetta-Tessini, Ashima Goyal, Noren Hasmun, and et al. 2023. "An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol" Dentistry Journal 11, no. 5: 117. https://doi.org/10.3390/dj11050117
APA StyleRodd, H. D., Nazzal, H., Bonifacio, C. C., Ruth, C. W., Crombie, F., El Shahawy, O., Folayan, M. O., Gambetta-Tessini, K., Goyal, A., Hasmun, N., Issa, A. I., Jundi, S., Manton, D. J., Narasimhan, S., Omar, S., Parekh, S., Popoola, B. O., Silva, M., Taylor, G., & Naomi, Y. Q. (2023). An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol. Dentistry Journal, 11(5), 117. https://doi.org/10.3390/dj11050117