Hypomineralised second primary molars: the Würzburg concept

• Published in: European archives of paediatric dentistry Vol. 25; no. 4; pp. 597 - 602
• Main Authors: Bekes, K., Steffen, R., Krämer, N.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2024; Springer Nature B.V
• Subjects: Child; Defects; Dental enamel; Dental Enamel Hypoplasia - therapy; Dentistry; Disease prevention; Fluorides; Health services; Humans; Literature reviews; Medicine; Molar; Pediatrics; Short Communication; Teeth; Tooth, Deciduous; Würzburg concept; MIH treatment need index (MIH-TNI); Treatment plan; Molar incisor hypomineralisation (MIH); Hypomineralised second primary molars (HSPM); HSPM treatment need index (HSPM-TNI)
• ISSN: 1818-6300; 1996-9805; 1996-9805
• DOI: 10.1007/s40368-024-00913-7

Purpose
In addition to molar incisor hypomineralisation, the occurrence of enamel hypomineralisation in the primary dentition has become increasingly important in recent years. Hypomineralised second primary molar (HSPM) is defined as hypomineralisation of systemic origin affecting from one to all four second primary molars. Some years ago, the “Würzburg concept” was introduced, which proposed a grading of MIH findings (MIH treatment need index) in combination with an appropriate treatment plan depending on the severity of the affected tooth. Recently, this concept was updated and new treatment approaches have been added. However, currently, the concept solely addresses the treatment plan for permanent teeth. As there is a need to expand its scope to encompass primary teeth and, consequently, HSPM, this paper seeks to develop the second component of the Würzburg concept, the treatment plan, for the primary dentition in response to the increased focus on the disease in recent years. Although the evidence base for the different treatment options is still weak, there is a need for guidance for clinicians in their day-to-day practice.
Methods
The authors conducted a comprehensive review of the literature, encompassing clinical and laboratory studies along with published guidelines.
Results
The treatment plan of the HSPM Würzburg concept contains prophylactic and regenerative aspects, non-invasive interventions, temporary and permanent restorative techniques, and extraction.
Conclusions
The intention is to provide practical guidance to practitioners, acknowledging the necessity for further validation through clinical trials.