Journal of South Asian Association of Pediatric Dentistry

Register      Login

VOLUME 5 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Upshot of Fluoride Varnish in Downgrading Hypersensitivity of Molar Incisor Hypomineralized Teeth: A Systematic Review and Clinical Considerations

U Deepika, Louis S Simon, Susmita Murmu, Kanika Chopra, Althwaf Shajahan, Soumit Kumar Hota

Keywords : Management of hypersensitivity of MIH, Management of MIH, MIH hypersensitive, MIH management

Citation Information : Deepika U, Simon LS, Murmu S, Chopra K, Shajahan A, Hota SK. Upshot of Fluoride Varnish in Downgrading Hypersensitivity of Molar Incisor Hypomineralized Teeth: A Systematic Review and Clinical Considerations. J South Asian Assoc Pediatr Dent 2022; 5 (2):110-115.

DOI: 10.5005/jp-journals-10077-3229

License: CC BY-NC 4.0

Published Online: 23-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: To critically evaluate and compare the effect of fluoride varnish (FV) with other recent materials used to reduce the hypersensitivity of molar incisor hypomineralization (MIH) affected teeth. Methodology: The search in electronic databases like MEDLINE, Cochrane, Scopus, Google Scholar, ScienceDirect, and Embase from January 2000 to December 2021 was done to identify studies on the management of hypersensitivity in MIH-affected teeth. The keywords used were MIH hypersensitive, MIH management, management of hypersensitivity of MIH, and management of MIH. Initially, the titles and abstracts were screened to rule out duplicate articles and to evaluate the materials, participants, and assessment methodology. The selected articles were completely screened to assess the risk of bias of the articles. Cochrane's risk of bias was at high risk and might be misleading, so a meta-analysis was not performed. Results: Thousand hundred eighteen studies were identified at the first level of search. After a thorough screening, three studies that met the inclusion criteria were selected. Conclusion: Non-fluoridated remineralizing agents had better efficacy in reducing the hypersensitivity in MIH-affected teeth than FV, fluoridated remineralizing agents, and low-level laser therapy (LLLT). At the same time, the effectiveness of the non-fluoridated remineralizing agent improved when it was used along with ozone therapy.

PDF Share
  1. Ogden AR, Pinhasi R, White WJ. Nothing new under the heavens: MIH in the past. Eur Arch Paediatr Dent 2008;9(4):166–171. DOI: 10.1007/BF03262632
  2. Weerheijm KL. Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. Dent Update 2004;31(1): 9–12. DOI: 10.12968/denu.2004.31.1.9
  3. Weerheijm KL, Jalevik B, Alaluusua S. Molar-incisor hypomineralisation. Caries Res 2001;35(5):390–391. DOI: 10.1159/000047479
  4. Weerheijm KL. Molar incisor hypomineralisation (MIH). Eur J Paediatr Dent 2003;4(3):114–120. PMID: 14529330.
  5. William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent 2006;28(3):224–232. PMID: 16805354.
  6. Beentjes VE, Weerheijm KL, Groen HJ. Factors involved in the aetiology of molar-incisor hypomineralisation (MIH). Eur J Paediatr Dent 2002;3(1):9–13. PMID: 12871011.
  7. Garot E, Rouas P, D'Incau E, et al. Mineral dentisty of hypomineralized and sound enamel. Bull Group Int Rech Sci Stomatol Odontol 2016;53(1):33–36.
  8. Jalevik B, Noren JG. Enamel hypomineralisation of permanent first molars: a morphological study and survey of possible etiological factors. Int J Paediatr Dent 2000;10(4):278–289. DOI: 10.1046/j.1365-263x.2000.00210.x
  9. Lygidakis NA, Wong F, Jalevik B, et al. Best clinical practice guidance for clinicians dealing with children presenting with molar incisior hypomineralization (MIH): an EAPD policy document. Eur Arch Paediatr Dent 2010;11(2):75–81. DOI: 10.1007/BF03262716
  10. Ozgül BM, Saat S, Sönmez H, et al. Clinical evaluation of desensitizing treatment for incisor teeth affected by molar-incisor hypomineralization. J Clin Pediatr Dent 2013; 38(2): 101–105. PMID: 24683770.
  11. Fütterer J, Ebel M, Bekes K, et al. Influence of customized therapy for molar incisor hypomineralization on children's oral hygiene and quality of life. Clin Exp Dent Res. 2020;6(1):33–43. DOI: 10.1002/cre2.245
  12. Muniz RSC, Carvalho CN, Aranha ACC, et al. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitization of molar incisor hypomineralisation (MIH): a randomised clinical trial. Int J Paediatr Dent 2020;30(3):323–333. DOI: 10.1111/ipd.12602
  13. Bakkal M, Abbasoglu Z, Kargul B. The effect of casein phospho peptide-amorphous calcium phosphate on molar-incisor hypomineralisation: a pilot study. Oral Health Prev Dent 2017;15(2):163–167. DOI: 10.3290/j.ohpd.a37928
  14. Biondi AM, Cortese SG, Babino L, et al. Comparison of Mineral Density in Molar Incisor Hypomineralization applying fluoride varnishes and casein phosphopeptide-amorphous calcium phosphate. Acta Odontol Latinoam 2017;30(3):118–123. English. PMID: 29750235.
  15. Kumar A, Goyal A, Gauba K, et al. An evaluation of remineralised MIH using CPP-ACP and FV: an in-situ and in-vitro study. Eur Arch Paediatr Dent 2022;23(1):79–87. DOI: 10.1007/s40368-021-00630-5
  16. Sobral APT, Santos EM, Aranha AC. The control of pain due to dentin hypersensitivity in individuals with molar-incisor hypomineralisation: a protocol for a randomised controlled clinical trial. BMJ Open 2021;11(3):e044653. DOI: 10.1136/bmjopen-2020-044653
  17. Pasini M, Giuca MR, Scatena M, et al. Molar incisor hypomineralization treatment with casein phosphopeptide and amorphous calcium phosphate in children. Minerva stomatol 2017;67(1):20–25. DOI: 10.23736/S0026-4970.17.04086-9
  18. Bekes K, Amend S, Priller J, et al. Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up. Clin Oral Investig 2022;26(2):1879–1888. DOI: 10.1007/s00784-021-04163-5
  19. Bekes K, Heinzelmann K, Lettner S, et al. Efficacy of desensitizing products containing 8% arginine and calcium carbonate for hypersensitivity relief in MIH-affected molars: an 8-week clinical study. Clin Oral Invest 2017;21(7):2311–2317. DOI: 10.1007/s00784-016-2024-8
  20. Restrepo M, Jeremias F, Santos-Pinto L, et al. Effect of fluoride varnish on enamel remineralization in anterior teeth with molar incisor hypomineralization. J Clin Pediatr Dent 2016;40(3):207–210. DOI: 10.17796/1053-4628-40.3.207
  21. Jalevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralisation of their permanent first molars. Int J Peadiatr Dent 2002;12(1):24–32. DOI: 10.1046/j.0960-7439.2001.00318.x
  22. Tominaga M, Caterina MJ, Malmberg AB, et al. The cloned capsaicin receptor integrates multiple pain-producing stimuli. Neuron 1998;21(3):531–543. DOI: 10.1016/s0896-6273(00)80564-4
  23. Davis JB, Gray J, Gunthorpe MJ, et al. Vanilloid receptor-1 is essential for inflammatory thermal hyperalgesia. Nature 2000;405(6783): 183–187. DOI: 10.1038/35012076
  24. Divyapriya GK, Yavagal P, Veeresh DJ. Casein phosphopeptideamorphous calcium phosphate in dentistry: an update. Inter J Oral Health Sci 2016;6(1):18. DOI: 10.4103/2231-6027.186660
  25. Walsh LJ. Contemporary technologies for remineralisation therapies: a review. Int Dent SA 2009;11(6):6–16.
  26. Shen P, Cai F, Nowicki A, et al. Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2001;80(12):2066–2070. DOI: 10.1177/00220345010800120801
  27. Cross KJ, Huq NL, Palamara JE, et al. Physicochemical characterization of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. J Biol Chem 2005;280(15):15362–15369. DOI: 10.1074/jbc.M413504200
  28. Abdelaziz RR, Mosallam RS, Yousry MM. Tubular occlusion of simulated hypersensitive dentin by the combined use of ozone and desensitizing agents. Acta Odontol Scand 2011;69(6):395–400. DOI: 10.3109/00016357.2011.572290
  29. Dähnhardt JE, Gygax M, Martignoni B, et al. Treating sensitive cervical areas with ozone. A prospective controlled clinical trial. Am J Dentistry 2008;21(2):74–76. PMID: 18578171.
  30. Azarpazhooh A, Limeback H, Lawrence HP, et al. Evaluating the effect of an ozone delivery system on the reversal of dentin hypersensitivity: a randomized, double-blinded clinical trial. J Endod 2009;35(1):1–9. DOI: 10.1016/j.joen.2008.10.001
  31. Jayarajan J, Janardhanam P, Jayakumar PD. Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization - an in vitro study using scanning electron microscope and DIAGNOdent. Indian J Dent Res 2011;22(1):77–82. DOI: 10.4103/0970-9290.80001
  32. Hagiwara S, Iwasaka H, Hasegawa A, et al. Pre-irradiation of blood by gallium aluminium arsenide low level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg 2008;107(3): 1058–1063. DOI: 10.1213/ane.0b013e31817ee43e
  33. Kimura Y, Wilder-Smith P, Yonaga K, et al. Treatment of dentine hypersensitivity by lasers: a review. J Clin Periodontol 2000;27(10): 715–721. DOI: 10.1034/j.1600-051x.2000.027010715.x
  34. Karu T. Photobiology of low-power laser effects. Health Phys 1989;56(5):691–704. DOI: 10.1097/00004032-198905000-00015
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.