|Year : 2017 | Volume
| Issue : 6 | Page : 243-250
Systematic review and meta-analysis of the prevalence of molar-incisor hypomineralization
Kalyana Chakravarthy Pentapati1, Sravan Kumar Yeturu2, Hanan Siddiq1
1 Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
2 Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
|Date of Web Publication||20-Dec-2017|
Dr. Kalyana Chakravarthy Pentapati
Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka
Source of Support: None, Conflict of Interest: None
Aims: This systematic review and meta-analysis aimed to evaluate the pooled prevalence of molar-incisor hypomineralization (MIH) among children. Methods: Three databases (PubMed, Scopus, and CINAHL) were searched till January 1, 2017, for the prevalence of MIH among children. The heterogeneity of the publications was evaluated using I2 statistics. Two trained reviewers conducted risk of bias assessment with nine item checklist for prevalence studies. Results: Analysis of the included publications revealed a pooled prevalence of 11.24 (confidence interval = 9.23–13.45) with the use of quality effects model. Heterogeneity among the included publications was high. The risk of bias assessment showed that majority of them were in the low-risk category. Conclusions: MIH is a common problem and one in 10 children could be affected by MIH.
Keywords: Children, hypomineralization, incisor, meta-analysis, molar, systematic review
|How to cite this article:|
Pentapati KC, Yeturu SK, Siddiq H. Systematic review and meta-analysis of the prevalence of molar-incisor hypomineralization. J Int Oral Health 2017;9:243-50
|How to cite this URL:|
Pentapati KC, Yeturu SK, Siddiq H. Systematic review and meta-analysis of the prevalence of molar-incisor hypomineralization. J Int Oral Health [serial online] 2017 [cited 2019 Nov 14];9:243-50. Available from: http://www.jioh.org/text.asp?2017/9/6/243/221260
| Introduction|| |
Molar incisor hypomineralization (MIH) can be defined as “Hypomineralization of systemic origin from one to four first permanent molars frequently associated with affected incisors.” This condition was known with multiple names, namely, cheese molars or idiopathic enamel hypomineralization or nonfluoride hypomineralization. As discussed previously, it occurs due to a disturbance in one of the stages of amelogenesis thus leading to a qualitative defect.
Studies that have been conducted reported a prevalence ranged from 0.48% to 40.16%., The published studies used a variety of criteria for evaluation of MIH thus making it more complicated to compare the same with different population groups. The most widely used criteria before the congress of the European Academy of Pediatric Dentistry (EAPD) was developmental defects of enamel index and its modification given by Fédération Dentaire Internationale (FDI).
Although many prevalence studies have been reported in the past, there was no attempt to consolidate and report the pooled prevalence using a systematic review and meta-analysis. However, many literature reviews reported various aspects such as age, gender, race, geographic distribution, and etiological agents concerning the prevalence of MIH.,,
MIH can have serious consequences such as increased dental fear and anxiety in children, plus fragile, and sensitive teeth. These conditions might also lead to decay due to avoidance of brushing and posteruptive enamel breakdown. A thorough knowledge of prevalence and determinants of MIH would help dentists, and oral health-care provider understands the distribution of this condition. Hence, we aimed to systematically review the literature, consolidate, and report pooled prevalence of MIH. The objective of this systematic review and meta-analysis was to evaluate the prevalence of MIH with respect to gender and geographical distribution and to report the pooled prevalence of MIH.
| Methods|| |
Studies published among children where the prevalence of MIH was reported or could be calculated were included in this review. The details of the inclusion and exclusion criteria are mentioned in [Table 1]. Only articles published in the English language were included.
We conducted comprehensive search in three databases (PubMed, Scopus, and CINAHL) up to January 1, 2017. The search strategy used keywords related to MIH and terms related to study design. The detailed keywords included in the search strategy for all databases are shown in [Table 2]. Additional articles were hand searched in the citation list of the published articles and reviews. The studies from these three databases were imported to Covidence website for the removal of duplicate titles. The remaining articles had their titles and abstracts screened (PKC and YS) to identify studies for inclusion in the systematic review that matched the inclusion and exclusion criteria. Then, the articles were subjected to full-text screening by two reviewers (PKC and YS) where certain articles were excluded with reasons.
|Table 2: Keywords included in the search strategy for all three databases (title, abstract, and MeSH terms of papers)|
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The risk of bias assessment
All the articles after full-text screening were subjected to risk of bias assessment using nine item checklist adapted from Hoy et al. [Table 3]. Based on the assessment, studies were identified as a high, moderate, or low risk. The risk of bias assessment was done by two trained and calibrated reviewers (YS and HS). Disagreements if any were resolved after discussion with a third reviewer (PKC).
A specially designed data extraction form was used to extract information from each study. Information included were geographic distribution, criteria used for the assessment of MIH, age, and gender distribution of the sample along with prevalence estimates as per gender.
Heterogeneity of the studies was assessed using I2 statistic which evaluates the variation other than that of sampling error. A level of >75% indicates a high degree of heterogeneity. Meta-analysis was undertaken using MetaXL Version 5.3 (Epigear international Pty Ltd., Queensland, Australia) plugin of Microsoft excel (Microsoft Office 2010). Pooled prevalence with 95% confidence intervals (CIs) was reported using quality effects model for meta-analysis. It was done taking into account the quality score obtained from the risk of bias assessment tool. The quality scores were converted into quality ranks by dividing each score by the score of the highest scored study.
| Results|| |
The search resulted in a total of 853 publications from the three databases and additional 2 articles from citation lists through manual search. A total of 744 publications were included in the title and abstract screening after the removal of duplicates. Ninety-three publications were assessed for eligibility in full-text screening, and 651 irrelevant publications were excluded. Further, 25 publications were excluded due to wrong study design/outcome (n = 8), letter to the editor (n = 1), and hospital-based study (n = 16). A total of 68 publications were included in the qualitative synthesis out of which seven studies were excluded (secondary data analysis), and only 61 studies were included in the final meta-analysis [Figure 1].
Almost all the included publications had cross-sectional study design (n = 59) and had the calibration of the examiners specified in the text (n = 57). All included studies reported age distribution of the sample population except for one study where they mentioned the year of birth of the cohort. Fourteen studies have not reported the gender distribution of the sample population,,,,,,,,,,,,,, and 20 studies have not reported the gender distribution of MIH.,,,,,,,,,,,,,,,,,,,,
Risk of bias assessment
The risk of bias assessment was done for 61 publications out of which two were in moderate risk and the remaining were at low risk. The studies with moderate risk had nonrepresentative population and sampling frame, nonrandom sampling, and nonresponse rates.,
Two-thirds of the included studies (n = 41) have used EAPD 2003 criteria and one-fifth of them used DDE index for MIH. Two studies have reported custom criteria,, and in one study, the criteria were not clearly described. The evaluation criteria by Weerheijm, Koch, Jalevik, Cho, and Kemoli  were less commonly used [Table 4].
The prevalence of MIH ranged from 0.48% to 40%., In the majority of the studies, prevalence ranged from 8% to 20%. Estimates of <5% were seen in only four studies.,,, Ten publications reported a prevalence of >20%.,,,,,,,,,
Five studies have reported that girls have a significant higher predilection for MIH than boys ,,,, while 41 studies reported no difference between boys and girls. However, nine out of these 46 studies have not reported gender distribution of the sample  or gender-wise MIH distribution ,,,,, or both.,, The girl to boy ratio among the 37 studies ranged from 0.72 to 3.99., In more than half of these studies, girls had a higher prevalence than boys.
One out of all the included studies have not specified the age; six of the 61 studies have mentioned only the mean age.,,,,, The age ranged from 6 to 17 years among the included studies.
The lowest prevalence was from India (0.48) and the highest was from Brazil (40.16). The highest number of studies (n = 25) were from Europe with a prevalence range from 3.58 to 36.51., This was followed by Asian countries (n = 18; prevalence range 0.48–27.66), and South American countries (n = 9; prevalence range 2.54–40.16)., Country-wise distribution revealed that highest number of studies were reported from India (n = 10) with a range from 0.48 to 26.99,, nine studies were reported from Brazil with a range from 2.54 to 40.16,, and six studies from Germany with a prevalence range from 5.61 to 36.51.,
Seven publications were excluded ,,,,,, as they were secondary analysis, and a total of 61 publications were included in the analysis of pooled prevalence of MIH which yielded 61 prevalence estimates. The overall quality effects model yielded a prevalence of 11.24 (CI = 9.23–13.45) with high heterogeneity among the included publications (I2 = 98.05; CI = 97.18–98.26; df = 60; Cochran's Q = 3080.35; P < 0.001) [Figure 2]. The analysis was not done separately for low and moderate risk studies as the quality rank score was incorporated in the calculation of pooled prevalence of MIH. A sensitivity analysis was performed by excluding each included publication revealed similar prevalence estimates. Doi plot was used to evaluate the possible publication bias. The plot revealed a minor asymmetry which had an Luis Furuya-Kanamori index of 1.74.
| Discussion|| |
Our review aimed to evaluate the pooled prevalence of MIH among children. Sixty-one prevalence estimates constituted to the pooled prevalence of MIH in this meta-analysis. This review evaluated three major databases and only articles in English were included. A hand search of all the included full-text articles was done. We have not attempted to search gray literature. No attempt was made to translate the other language articles as there was a paucity of resources. A minor asymmetry in Doi plot suggested a possible role of publication bias which may not be systematic and can be concluded that the studies represent a reasonable prevalence of MIH among the general population. We used a quality assessment tool that was developed and modified by Hoy et al. in 2012. It was reported to be easy to use tool with good reliability. To eliminate any chance of subjectivity in the quality assessment, two calibrated reviewers performed the exercise with minimal disagreements.
The prevalence estimates were calculated based on the information from the publications, and no attempt was made to contact the individual authors for the data. Although there was a lot of variation with respect to the criteria that was used for the assessment of MIH, EAPD 2003 was the most acceptable criteria. However, we included all the studies irrespective of the working definition for diagnosis of MIH because all the studies used the criteria for MIH prevalence that was based on its presence on molars. Considering the variation and heterogeneity among the included studies, the estimates that were presented have to be interpreted with caution.
Geographic variation in the prevalence of MIH was evident with a lower prevalence in Asian countries when compared with European and South American countries. No study was reported from North American countries. The highest prevalence estimate was from Brazilian middle social class school children  whereas the lowest prevalence estimate was of Indian urban school children. A total of 41 publications reported a higher prevalence in girls than boys and five publications reported that the difference was statistically significant. Overall, we can conclude that the prevalence of MIH was 11.24% with a high degree of geographic variation and mild variation with respect to gender. High-quality prevalence studies are required, and emphasis should be on presentation of prevalence figures based on age and gender.
| Conclusion|| |
Our review showed the prevalence of MIH along with heterogeneity in the studies and minimal risk of publication bias among the published studies. MIH is a major problem, and one in ten children among general population might be affected. It can cause far-reaching complications for both the child and the dentist. Dentists should be aware of this common problem, and early diagnosis and preventive management can help to delay or intercept the complications such as posteruption breakdown, sensitivity, and caries. Non-English publications were not included; high heterogeneity and publication bias were some of the limitations of this review. Further studies should incorporate the prevalence estimates based on the widely accepted EAPD criteria. Future studies on the prevalence of MIH should incorporate the distribution of the same with respect to gender, age, and demographic variables to further understand the role of these factors. 
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Weerheijm KL, Duggal M, Mejàre I, Papagiannoulis L, Koch G, Martens LC, et al.
Judgement Criteria for Molar Incisor Hypomineralisation (MIH) in epidemiologic studies: A summary of the European meeting on MIH held in Athens, 2003. Eur J Paediatr Dent 2003;4:110-3.
Beentjes VE, Weerheijm KL, Groen HJ. Factors involved in the aetiology of molar-incisor hypomineralisation (MIH). Eur J Paediatr Dent 2002;3:9-13.
Subramaniam P, Gupta T, Sharma A. Prevalence of molar incisor hypomineralization in 7-9-year-old children of Bengaluru city, India. Contemp Clin Dent 2016;7:11-5.
] [Full text]
Soviero V, Haubek D, Trindade C, Da Matta T, Poulsen S. Prevalence and distribution of demarcated opacities and their sequelae in permanent 1st
molars and incisors in 7 to 13-year-old Brazilian children. Acta Odontol Scand 2009;67:170-5.
Clarkson J, O'Mullane D. A modified DDE index for use in epidemiological studies of enamel defects. J Dent Res 1989;68:445-50.
Hernandez M, Boj JR, Espasa E. Do we really know the prevalence of MIH? J Clin Pediatr Dent 2016;40:259-63.
Salgado-Peralvo AO, Peralvo-Garcia V, Torres A, Mateos-Moreno MV, Ribas-Perez DC. A literature prevalence of molar-incisor hypo mineralization: Review. Odontol Pediatr 2016;24:134-48.
Willmott NS, Bryan RA, Duggal MS. Molar-incisor-hypomineralisation: A literature review. Eur Arch Paediatr Dent 2008;9:172-9.
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al.
Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 2012;65:934-9.
Doi SA, Thalib L. A quality-effects model for meta-analysis. Epidemiology 2008;19:94-100.
Koch G, Hallonsten AL, Ludvigsson N, Hansson BO, Holst A, Ullbro C, et al.
Epidemiologic study of idiopathic enamel hypomineralization in permanent teeth of Swedish children. Community Dent Oral Epidemiol 1987;15:279-85.
Mittal N. Phenotypes of enamel hypomineralization and molar incisor hypomineralization in permanent dentition: Identification, quantification and proposal for classification. J Clin Pediatr Dent 2016;40:367-74.
Elfrink ME, ten Cate JM, Jaddoe VW, Hofman A, Moll HA, Veerkamp JS, et al.
Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res 2012;91:551-5.
Dietrich G, Sperling S, Hetzer G. Molar incisor hypomineralisation in a group of children and adolescents living in Dresden (Germany). Eur J Paediatr Dent 2003;4:133-7.
Muratbegovic A, Markovic N, Ganibegovic Selimovic M. Molar incisor hypomineralisation in bosnia and herzegovina: Aetiology and clinical consequences in medium caries activity population. Eur Arch Paediatr Dent 2007;8:189-94.
Nogueira Rodrigues FC, Batista Ribeiro PH, Abreu Fonseca Thomaz EB, Tobias Lima GQ, Moreno Neves PA, Costa Ribeiro CC. Molar-Incisor hypomineralization in schoolchildren of Sao Luis, Brazil Maranhao: Prevalence and associated factors. Pesqui Bras Odontopediatr Clin Integr 2015;15:271-8.
Balmer R, Toumba J, Godson J, Duggal M. The prevalence of molar incisor hypomineralisation in Northern England and its relationship to socioeconomic status and water fluoridation. Int J Paediatr Dent 2012;22:250-7.
Pitiphat W, Luangchaichaweng S, Pungchanchaikul P, Angwaravong O, Chansamak N. Factors associated with molar incisor hypomineralization in Thai children. Eur J Oral Sci 2014;122:265-70.
Mittal N, Sharma BB. Hypomineralised second primary molars: Prevalence, defect characteristics and possible association with molar incisor hypomineralisation in Indian children. Eur Arch Paediatr Dent 2015;16:441-7.
Dantas-Neta NB, Moura LF, Cruz PF, Moura MS, Paiva SM, Martins CC, et al.
Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren. Braz Oral Res 2016;30:117.
Mittal NP, Goyal A, Gauba K, Kapur A. Molar incisor hypomineralisation: Prevalence and clinical presentation in school children of the Northern region of India. Eur Arch Paediatr Dent 2014;15:11-8.
Weerheijm KL, Groen HJ, Beentjes VE, Poorterman JH. Prevalence of cheese molars in eleven-year-old Dutch children. ASDC J Dent Child 2001;68:259-62.
Opydo-Szymaczek J, Gerreth K. Developmental enamel defects of the permanent first molars and incisors and their association with dental caries in the region of Wielkopolska, Western Poland. Oral Health Prev Dent 2015;13:461-9.
Kukleva MP, Petrova SG, Kondeva VK, Nihtyanova TI. Molar incisor hypomineralisation in 7-to-14-year old children in Plovdiv, Bulgaria – an epidemiologic study. Folia Med (Plovdiv) 2008;50:71-5.
Grošelj M, Jan J. Molar incisor hypomineralisation and dental caries among children in Slovenia. Eur J Paediatr Dent 2013;14:241-5.
Kühnisch J, Thiering E, Kratzsch J, Heinrich-Weltzien R, Hickel R, Heinrich J, et al.
Elevated serum 25(OH)-Vitamin D levels are negatively correlated with molar-incisor hypomineralization. J Dent Res 2015;94:381-7.
Tadikonda AN, Acharya S, Pentapati KC. Prevalence of molar incisor hypomineralization and its relation with dental caries in school children of Udupi district, South India. World J Dent 2015;6:143-6.
Jasulaityte L, Weerheijm KL, Veerkamp JS. Prevalence of molar-incisor-hypomineralisation among children participating in the Dutch National Epidemiological Survey (2003). Eur Arch Paediatr Dent 2008;9:218-23.
Arrow P. Prevalence of developmental enamel defects of the first permanent molars among school children in Western Australia. Aust Dent J 2008;53:250-9.
Heitmüller D, Thiering E, Hoffmann U, Heinrich J, Manton D, Kühnisch J, et al.
Is there a positive relationship between molar incisor hypomineralisations and the presence of dental caries? Int J Paediatr Dent 2013;23:116-24.
Preusser SE, Ferring V, Wleklinski C, Wetzel WE. Prevalence and severity of molar incisor hypomineralization in a region of Germany – A brief communication. J Public Health Dent 2007;67:148-50.
Mahoney EK, Morrison DG. The prevalence of molar-incisor hypomineralisation (MIH) in wainuiomata children. N
Z Dent J 2009;105:121-7.
Kühnisch J, Heitmüller D, Thiering E, Brockow I, Hoffmann U, Neumann C, et al.
Proportion and extent of manifestation of molar-incisor-hypomineralizations according to different phenotypes. J Public Health Dent 2014;74:42-9.
Yannam SD, Amarlal D, Rekha CV. Prevalence of molar incisor hypomineralization in school children aged 8-12 years in Chennai. J Indian Soc Pedod Prev Dent 2016;34:134-8.
] [Full text]
Wuollet E, Laisi S, Salmela E, Ess A, Alaluusua S. Background factors of molar-incisor hypomineralization in a group of Finnish children. Acta Odontol Scand 2014;72:963-9.
Kemoli AM. Prevalence of molar incisor hypomineralisation in six to eight year-olds in two rural divisions in Kenya. East Afr Med J 2008;85:514-9.
Calderara PC, Gerthoux PM, Mocarelli P, Lukinmaa PL, Tramacere PL, Alaluusua S, et al.
The prevalence of molar incisor hypomineralisation (MIH) in a group of Italian school children. Eur J Paediatr Dent 2005;6:79-83.
Oyedele TA, Folayan MO, Adekoya-Sofowora CA, Oziegbe EO. Co-morbidities associated with molar-incisor hypomineralisation in 8 to 16 year old pupils in ile-ife, Nigeria. BMC Oral Health 2015;15:37.
Kirthiga M, Poornima P, Praveen R, Gayathri P, Manju M, Priya M, et al.
Prevalence and severity of molar incisor hypomineralization in children aged 11-16 years of a city in Karnataka, Davangere. J Indian Soc Pedod Prev Dent 2015;33:213-7.
] [Full text]
Temilola OD, Folayan MO. Distinguishing predisposing factors for enamel hypoplasia and molar-incisor hypomineralization in children in Ile-Ife, Nigeria. Brazilian J Oral Sci 2015;14:318-22.
Fteita D, Ali A, Alaluusua S. Molar-incisor hypomineralization (MIH) in a group of school-aged children in Benghazi, Libya. Eur Arch Paediatr Dent 2006;7:92-5.
Ghanim A, Bagheri R, Golkari A, Manton D. Molar-incisor hypomineralisation: A prevalence study amongst primary schoolchildren of Shiraz, Iran. Eur Arch Paediatr Dent 2014;15:75-82.
Tourino LF, Corrêa-Faria P, Ferreira RC, Bendo CB, Zarzar PM, Vale MP, et al.
Association between molar incisor hypomineralization in schoolchildren and both prenatal and postnatal factors: A Population-based study. PLoS One 2016;11: 0156332.
Kevrekidou A, Kosma I, Arapostathis K, Kotsanos N. Molar incisor hypomineralization of eight- and 14-year-old children: Prevalence, severity, and defect characteristics. Pediatr Dent 2015;37:455-61.
Garcia-Margarit M, Catalá-Pizarro M, Montiel-Company JM, Almerich-Silla JM. Epidemiologic study of molar-incisor hypomineralization in 8-year-old Spanish children. Int J Paediatr Dent 2014;24:14-22.
Negre-Barber A, Montiel-Company JM, Boronat-Catalá M, Catalá-Pizarro M, Almerich-Silla JM. Hypomineralized second primary molars as predictor of molar incisor hypomineralization. Sci Rep 2016;6:31929.
Jeremias F, de Souza JF, Silva CM, Cordeiro Rde C, Zuanon AC, Santos-Pinto L, et al.
Dental caries experience and Molar-Incisor Hypomineralization. Acta Odontol Scand 2013;71:870-6.
Zawaideh FI, Al-Jundi SH, Al-Jaljoli MH. Molar incisor hypomineralisation: Prevalence in Jordanian children and clinical characteristics. Eur Arch Paediatr Dent 2011;12:31-6.
Krishnan R, Ramesh M, Chalakkal P. Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: An epidemiological study. Eur Arch Paediatr Dent 2015;16:455-60.
Kuscu OO, Caglar E, Aslan S, Durmusoglu E, Karademir A, Sandalli N, et al.
The prevalence of molar incisor hypomineralization (MIH) in a group of children in a highly polluted urban region and a windfarm-green energy Island. Int J Paediatr Dent 2009;19:176-85.
Ng JJ, Eu OC, Nair R, Hong CH. Prevalence of molar incisor hypomineralization (MIH) in Singaporean children. Int J Paediatr Dent 2015;25:73-8.
Zagdwon AM, Toumba KJ, Curzon ME. The prevalence of developmental enamel defects in permanent molars in a group of english school children. Eur J Paediatr Dent 2002;3:91-6.
Balmer R, Toumba KJ, Munyombwe T, Duggal MS. A comparison of the presentation of molar incisor hypomineralisation in two communities with different fluoride exposure. Eur Arch Paediatr Dent 2015;16:257-64.
van der Tas JT, Elfrink ME, Vucic S, Heppe DH, Veerkamp JS, Jaddoe VW, et al.
Association between bone mass and dental hypomineralization. J Dent Res 2016;95:395-401.
Lygidakis NA, Dimou G, Marinou D. Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors. Eur Arch Paediatr Dent 2008;9:207-17.
Muratbegovic A, Zukanovic A, Markovic N. Molar-incisor-hypomineralisation impact on developmental defects of enamel prevalence in a low fluoridated area. Eur Arch Paediatr Dent 2008;9:228-31.
Ghanim AM, Manton DJ, Morgan MV, Mariño RJ, Bailey DL. Trends of oral health care and dental treatment needs in relation to molar incisor hypomineralisation defects: A study amongst a group of Iraqi schoolchildren. Eur Arch Paediatr Dent 2012;13:171-8.
Jälevik B, Klingberg G, Barregård L, Norén JG. The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand 2001;59:255-60.
Jasulaityte L, Veerkamp JS, Weerheijm KL. Molar incisor hypomineralization: Review and prevalence data from the study of primary school children in Kaunas/Lithuania. Eur Arch Paediatr Dent 2007;8:87-94.
da Costa-Silva CM, Jeremias F, de Souza JF, Cordeiro Rde C, Santos-Pinto L, Zuanon AC, et al.
Molar incisor hypomineralization: Prevalence, severity and clinical consequences in Brazilian Children. Int J Paediatr Dent 2010;20:426-34.
Ghanim A, Morgan M, Mariño R, Bailey D, Manton D. Molar-incisor hypomineralisation: Prevalence and defect characteristics in Iraqi children. Int J Paediatr Dent 2011;21:413-21.
Mahoney EK, Morrison DG. Further examination of the prevalence of MIH in the Wellington region. N
Z Dent J 2011;107:79-84.
Ahmadi R, Ramazani N, Nourinasab R. Molar incisor hypomineralization: A study of prevalence and etiology in a group of Iranian children. Iran J Pediatr 2012;22:245-51.
Sönmez H, Yıldırım G, Bezgin T. Putative factors associated with molar incisor hypomineralisation: An epidemiological study. Eur Arch Paediatr Dent 2013;14:375-80.
Janković S, Ivanović M, Davidović B, Lecić J. Distribution and characteristics of molar-incisor hypomineralization. Vojnosanit Pregl 2014;71:730-4.
Shrestha R, Upadhaya S, Bajracharya M. Prevalence of molar incisor hypomineralisation among school children in Kavre. Kathmandu Univ Med J 2014;12:38-42.
Pitiphat W, Savisit R, Chansamak N
SA. Molar Incisor Hypomineralization and Dental Caries in Six- to Seven-year-old Thai Children. Pediatr Dent 2014b;36:478-82.
Bhaskar SA, Hegde S. Molar-incisor hypomineralization: Prevalence, severity and clinical characteristics in 8- to 13-year-old children of Udaipur, India. J Indian Soc Pedod Prev Dent 2014;32:322-9.
] [Full text]
Petrou MA, Giraki M, Bissar AR, Basner R, Wempe C, Altarabulsi MB, et al.
Prevalence of molar-incisor-Hypomineralisation among school children in four German cities. Int J Paediatr Dent 2014;24:434-40.
Temilola OD, Folayan MO, Oyedele T. The prevalence and pattern of deciduous molar hypomineralization and molar-incisor hypomineralization in children from a suburban population in Nigeria. BMC Oral Health 2015;15:73.
de Lima Mde D, Andrade MJ, Dantas-Neta NB, Andrade NS, Teixeira RJ, de Moura MS, et al.
Epidemiologic study of molar-incisor Hypomineralization in Schoolchildren in North-Eastern Brazil. Pediatr Dent 2015;37:513-9.
Hanan SA, Filho A, Medina PO, Cordeiro R, Santos-Pinto L, Zuanon ÂC. Molar-Incisor hypomineralization in schoolchildren of Manaus, Brazil. Pesqui Bras Odontopediatr Clin Integr 2015;15:309-17.
da If Jr., Aguiar NL, Barros WR, da Silva LS, Arantes DC, Nascimento LS. Prevalence and severity of molar incisor hypomineralization in students of belém, Brazil. Pesqui Bras Odontopediatr Clin Integr 2015;15:377-85.
Mittal R, Chandak S, Chandwani M, Singh P, Pimpale J. Assessment of association between molar incisor hypomineralization and hypomineralized second primary molar. J Int Soc Prev Community Dent 2016;6:34-9.
Wuollet E, Laisi S, Salmela E, Ess A, Alaluusua S. Molar-incisor hypomineralization and the association with childhood illnesses and antibiotics in a group of Finnish children. Acta Odontol Scand 2016;74:416-22.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]