Mih-affected tEeth: crossTalk between genetic bAckgrounD and ENviromenTal Influences

Molar incisor hypomineralization (MIH) is a phenomenon defined as a quality defect of enamel of systemic origin of one to four permanent first molars (PFMs), frequently associated with morphological changes of incisors. Children with MIH-affected teeth face a number of difficulties in their life such as hypersensitivity and pain even during brushing resulting in poor oral hygiene, rapid caries progression and consequent chewing difficulties. The low esthetics of the anterior teeth affected by MIH has a negative impact on child’s self-esteem, often preventing them from smiling. and, subsequently, leading to psychological problems. It has been universally proven that the physical and psychological problems consequent to this pathology result in an important social discomfort and in high therapeutic costs that affect in a not indifferent way the families and the national health service. In the last decade, the incidence of patients with MIH-affected teeth increased exponentially, thus making this disease a worldwide burden. Among the different causes that have been hypothesized at the root of this disease, the most advanced theories include genetic and environmental influences (factors related to air pollution, water or food contamination). A possible correlation with other pathologies has been also proposed, suggesting the potential use of MIH diagnosis as meaningful tool for detecting such diseases (allergies, topical dermatitis etc.). Despite the increasing attention paid to this pathology at medical level, to date its etiopathogenesis remains unknown, recalling the need to perform studies that can fully explore the causes triggering MIH to be able, consequently, to implement appropriate therapy and standardized protocols. Understanding the distribution and prevalence of the disease in different territories is of fundamental importance to outline its trend. A literature search revealed that hardly any attention has been given to exploring the prevalence, regional distribution, and clinical characteristics of MIH-affected children in Italy. Consequently, this project will aim to provide useful and distinctive information on the epidemiological, clinical, genetic, and structural characteristics of MIH to furnish a clear background on MIH disease. As to do so, a complete perspective on regional trend and perspective of MIH in Italy through an epidemiological survey will be conducted considering all the pre-, peri-, and post-natal influences. The clinical characteristics of the MIH-affected teeth and their impact on the quality of child’s life will be assessed. Concurrently, the genetic evaluation of MIH-affected patient will be conducted and correlated with other disease of allergic or infective origins. Lastly, this study would report, for the first time, the expression of matrix metalloproteinases (MMPs) in saliva and dentin in children diagnosed with MIH, and it will also investigate novel therapeutic approaches in treating MIH-affected teeth.

Molar incisor hypomineralization (MIH) is a phenomenon defined as a quality defect of enamel of systemic origin of one to four permanent first molars (PFMs), frequently associated with morphological changes of incisors. Children with MIH-affected teeth face a number of difficulties in their life such as hypersensitivity and pain even during brushing resulting in poor oral hygiene, rapid caries progression and consequent chewing difficulties. The low esthetics of the anterior teeth affected by MIH has a negative impact on child’s self-esteem, often preventing them from smiling. and, subsequently, leading to psychological problems. It has been universally proven that the physical and psychological problems consequent to this pathology result in an important social discomfort and in high therapeutic costs that affect in a not indifferent way the families and the national health service. In the last decade, the incidence of patients with MIH-affected teeth increased exponentially, thus making this disease a worldwide burden. Among the different causes that have been hypothesized at the root of this disease, the most advanced theories include genetic and environmental influences (factors related to air pollution, water or food contamination). A possible correlation with other pathologies has been also proposed, suggesting the potential use of MIH diagnosis as meaningful tool for detecting such diseases (allergies, topical dermatitis etc.). Despite the increasing attention paid to this pathology at medical level, to date its etiopathogenesis remains unknown, recalling the need to perform studies that can fully explore the causes triggering MIH to be able, consequently, to implement appropriate therapy and standardized protocols. Understanding the distribution and prevalence of the disease in different territories is of fundamental importance to outline its trend. A literature search revealed that hardly any attention has been given to exploring the prevalence, regional distribution, and clinical characteristics of MIH-affected children in Italy. Consequently, this project will aim to provide useful and distinctive information on the epidemiological, clinical, genetic, and structural characteristics of MIH to furnish a clear background on MIH disease. As to do so, a complete perspective on regional trend and perspective of MIH in Italy through an epidemiological survey will be conducted considering all the pre-, peri-, and post-natal influences. The clinical characteristics of the MIH-affected teeth and their impact on the quality of child’s life will be assessed. Concurrently, the genetic evaluation of MIH-affected patient will be conducted and correlated with other disease of allergic or infective origins. Lastly, this study would report, for the first time, the expression of matrix metalloproteinases (MMPs) in saliva and dentin in children diagnosed with MIH, and it will also investigate novel therapeutic approaches in treating MIH-affected teeth.