Elsa Garot

Background: Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM) have been extensively studied; however the specific diagnostic boundaries distinguishing them from other developmental enamel defects remain unclear. Objectives: This review aims to systematically map the literature describing clinical, radiological, histological or structural features and patient-reported symptoms useful for the differential diagnosis of MIH and HSPM, and additionally to identify knowledge gaps for future research. Methods: Primary studies addressing the differential diagnosis of developmental defects of enamel published in the period 1985–2025, written in English and involving human subjects were considered for inclusion in this scoping review. PubMed/MEDLINE, EMBASE, Cochrane Library and Scopus were searched. Two reviewers screened retrieved papers independently for eligibility and charted the data. The protocol was registered with the Open Science Framework registration number 10.17605/OSF.IO/P9UKD. Results: A total of 23 reports were included in the review. More than half of the studies were case series (39.1%) and case reports (17.4%), including small samples (in 50.0% of the studies the sample size was fewer than 10 subjects). Amelogenesis Imperfecta (AI) was found in most papers (65.2%); other conditions included dental fluorosis, white spot lesions, and developmental defects associated with cleft lip and palate, antineoplastic therapy, syphilis, Turner syndrome and vitamin D-dependent rickets type 1. No single study directly compared MIH and HSPM with other enamel developmental defects in a controlled manner, representing a major limitation in establishing evidence-based differential diagnostic criteria. Conclusions: Future studies should include well-designed comparative analyses using standardized diagnostic criteria and objective measures in larger and more diverse patient samples.

Les diagnostics d’hypominéralisations molaire-incisive (HMI) et de colorations post-mortem de l’émail sont peu fiables et reproductibles dans des séries archéologiques. Notre guide de diagnostic a permis de distinguer les hypominéralisations de l’émail des colorations taphonomiques. L'émail hypominéralisé est caractérisé par des taux de β-carbonate plus élevés et une densité minérale plus faible. Les colorations taphonomiques présentent une concentration plus élevée en manganèse, en fer, en cuivre et en plomb, mises en évidences par des analyses en fluorescence X. Les dentures d’individus immatures issus de 21 séries archéologiques ont été examinés et comprenaient : 4 séries françaises, Sains-en-Gohelle (Pas-de-Calais), Cognac-Saint-Martin (Charente), Beauvais (Oise) et Jau-Dignac-et-Loirac (Gironde) provenant de cimetières médiévaux et post-médiévaux et 17 séries anglaises (Londres) provenant de cimetières romains, médiévaux et post-médiévaux. Nous avons dénombré 555 individus dont l’âge au décès est compris entre 5 et 19 ans et dont la datation chronologique s’étale sur une période allant du 1er au 19ème siècle. Au total, sur les 290 individus avec au moins une première molaire permanente (PMP) présente, 42 avaient au moins une opacité délimitée de l’émail sur une PMP (soit 14,5%). Parmi les 17 individus dont les dents ont été analysées, les tests statistiques n’ont mis en évidence que 9 cas de HMI, soit 52,9% de l’effectif. Une prévalence de 9,3% de HMI a été estimée dans nos séries archéologiques ce qui avoisine les prévalences connues à l’heure actuelle dans les populations du vivant en Europe. Les défauts du développement de d'émail sont souvent utilisés comme indicateurs de la santé générale dans les populations archéologiques passées. La possibilité de trouver des HMI dans des populations anciennes minimise l’importance de certaines hypothèses étiologiques contemporaines (par exemple les dérivés de dioxines, les bisphénols ou les antibiotiques) sans exclure l'aspect multifactoriel possible de l'anomalie.

The human mandibular symphysis concentrates multiaxial loads during function and remodels throughout growth, but the precise mechanisms underlying cortical bone shape during growth remain relatively unexplored. Approaches based solely on thickness or external cortical contours provide only partial insights and do not capture the functional, genetic, and allometric interactions driving morphogenesis. In this study, we analyzed symphyseal cross‐sections from 63 subadult mandibles from two French archeological assemblages using elliptic Fourier analysis. Micro‐computed tomography volumes were reconstructed, and external and internal cortical outlines digitized and quantified with Fourier descriptors. Principal component analysis summarized shape variation, and linear models tested the effects of size, age, total cortical area, and geographic origin on each outline. A similar workflow was applied to the size variable expressed as the logarithm of centroid size to test the following predictors: age, total cortical area and archeological site of origin. Across cortical outlines, symphyseal shape was governed primarily by allometry, with a smaller additional contribution of total cortical area. Age significantly affected the inner cortical outline but not the outer one, and geographic origin had no detectable influence. Individuals examined before and after eruption of the first permanent molar occupied largely overlapping morphospaces, indicating a continuous developmental trajectory rather than a shift at eruption. Collectively, the results support bone‐tissue remodeling that progresses throughout growth and is dominated early by size‐related change, with the hypothesis that inter‐individual divergence emerges later. The approach provides a reproducible, resolved framework for quantifying bone remodeling across ontogeny and for testing form‐function relationships.

Objective: We are aimed at describing the clinical and psychosocial benefits of resin infiltration as a minimally invasive treatment option for hypomature amelogenesis imperfecta in a child. Hypomature amelogenesis imperfecta is a rare hereditary enamel defect that significantly compromises dental esthetics, function, and psychosocial well‐being. Conventional management often involves invasive restorative approaches such as composites, veneers, or crowns, which may require removal of sound tooth tissue and pose challenges in pediatric patients. Clinical Considerations: An 11‐year‐old girl presenting with hypomature amelogenesis imperfecta and severe esthetic concerns associated with impaired oral health–related quality of life was treated using an erosion infiltration technique with resin (Icon, DMG). Following enamel surface conditioning, a low‐viscosity resin infiltrant was applied to penetrate and mask hypomature enamel opacities. The procedure led to immediate and significant esthetic improvement, with enhanced enamel translucency and high patient satisfaction. Esthetic outcomes remained stable over a 3‐year follow‐up period, including during orthodontic treatment, and were associated with a marked improvement in oral health–related quality of life. Conclusions: This case highlights the potential of resin infiltration to offer a conservative alternative to conventional restorative methods in hypomature amelogenesis imperfecta, with meaningful improvement in dental esthetics and oral health–related quality of life. Nevertheless, further clinical studies and long‐term follow‐up are required to validate its durability and to establish standardized treatment protocols.

Hypomineralised enamel presents a significant challenge for resin bonding due to its altered mechanical and structural properties. Our innovative clinical approach of resin infiltration prior to the bonding of a posterior indirect adhesive restoration aims to preserve dental tissues, reduce post‐operative sensitivity, and strengthen the supporting enamel. A 14‐year‐old male experienced cold‐induced pain from his maxillary left first permanent molar (26) affected by molar incisor hypomineralisation (MIH). Resin infiltration (Icon, DMG) of the remnant hypomineralised enamel after tooth preparation was performed before the bonding of a lithium disilicate glass–ceramic restoration, which avoided extending the margin sub‐gingivally. The six‐month follow‐up confirmed satisfactory results: an optimal marginal adaptation without visible leakage, an absence of dental sensitivity, and satisfactory aesthetic appearance.

Objectives: This split‐mouth multicentre randomized controlled trial (RCT) aimed to compare the clinical and radiographic success rates of zirconia crowns (ZCs) and stainless steel crowns (SSCs) on primary molars. Secondary objectives were to compare the study groups in terms of retention and preferences of both parents and children. Methods: In 105 children, 210 teeth were randomized to receive either ZC or SSC. The primary outcome success rate was defined by the absence of major failure, such as signs of irreversible pulpitis or infectious complications, over a 2‐year follow‐up period. Secondary outcomes included retention rate and participant preference. Data were analyzed with Poisson regression, paired t ‐tests, and ANCOVA, with the significance level set at 5%. Results: Success rates were comparable between the ZC and SSC groups (Rate Ratio [RR] = 0.99, 95% confidence interval [CI]:0.96–1.01, p = 0.350). Retention rate was lower for ZCs compared to SSCs (RR = 0.95, 95% CI:0.92–0.98, p = 0.001). Approximately two‐thirds of parents preferred ZCs, while children did not show a clear preference for either type of crown. Conclusions: The success rate between ZC and SSC was similar over 2 years, but ZC showed lower retention. Unlike children, parents tended to prefer ZC.