CLINICAL DIAGNOSIS OF MOLAR-INCISOR HYPOMINERALIZATION (MIH): CRITERIA AND CHALLENGES

Abstract

Molar-Incisor Hypomineralization (MIH) is a qualitative defect of dental enamel of systemic origin, characterized by demarcated opacities in one or more permanent first molars, with frequent involvement of the incisors. This narrative review analyzes the scientific evidence of the last five years on the diagnostic criteria and clinical challenges of the condition. The diagnosis is based on the criteria of the European Academy of Pediatric Dentistry (EAPD), which include demarcated opacities, post-eruptive fractures, atypical restorations, and early extractions. The relevance of the topic lies in the high porosity of the affected enamel, which results in severe hypersensitivity, subclinical pulp inflammation, and increased susceptibility to caries. The study highlights the importance of differential diagnosis in relation to fluorosis and amelogenesis imperfecta, in addition to discussing the use of indices such as the MIH-TNI to guide intervention. It is concluded that early diagnosis, ideally at 8 years of age, and longitudinal monitoring are fundamental to minimizing the loss of dental structure and ensuring the effectiveness of restorative and desensitizing treatments.