Update of the molar incisor hypomineralization: Würzburg concept

• Published in: European archives of paediatric dentistry Vol. 24; no. 6; pp. 807 - 813
• Main Authors: Bekes, K., Steffen, R., Krämer, N.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2023; Springer Nature B.V
• Subjects: Defects; Dental enamel; Dentistry; Disease prevention; Fluorides; Health services; Medicine; Patients; Pediatrics; Prophylaxis; Short Communication; Teeth; Würzburg concept; MIH Treatment Need Index; MIH-TNI; Treatment plan; MIH; Molar incisor hypomineralization
• ISSN: 1818-6300; 1996-9805
• DOI: 10.1007/s40368-023-00848-5

Purpose
Molar incisor hypomineralization (MIH) is playing an increasingly important role in dental practice. MIH is defined as hypomineralization of systemic origin of one to four permanent first molars, often associated with affected incisors. Affected teeth are more susceptible to caries and post-eruptive enamel loss and should be diagnosed and treated as early as possible. In 2016, the Würzburg concept was developed for German-speaking countries including a classification index—the MIH Treatment Need Index (MIH-TNI)—and a treatment plan based on it for the use in daily practice. In the meantime, the concept has also gained international recognition. The aim of this paper is to update part 2 of the Würzburg concept, the treatment plan, as knowledge about MIH has increased and the disease has been studied more extensively in the last years. Other treatment approaches are now available and therefore need to be included in the concept. Although, the evidence of the different treatment options is still weak, practitioners need guidance in their daily practice.
Methods
The authors reviewed the available literature, including clinical and laboratory studies and published guidelines.
Results
The updated version of the Würzburg concept includes additional non-invasive strategies and temporary therapy options, as well as treatment approaches for incisors. It therefore covers currently available treatment modalities for MIH-affected teeth, ranging from prophylaxis, non-invasive treatment to restorative approaches and possibly even extraction.
Conclusions
This is intended to help guide the practitioner and will need to be further validated by clinical trials.