Panoramic Radiographic Diagnosis of Molar-Incisor Hypomineralization in Permanent Dentition

Purpose: To evaluate the diagnostic potential of panoramic radiographs for identifying Molar–Incisor Hypomineralization (MIH) in the permanent dentition of children and to compare the diagnostic performance of pediatric dental specialists with that of other dental professionals. Methods: This cross-sectional observer-based study was conducted in two phases. First, a retrospective analysis of 1,026 panoramic radiographs of children ages 5–12 years, obtained between 2016 and 2024, was performed to identify radiographic features suggestive of MIH, including enamel opacity, post-eruptive enamel breakdown, atypical caries, and atypical restorations. A total of 292 radiographs met the MIH inclusion criteria. In the second phase, 50 MIH‑positive radiographs were randomly selected and independently evaluated by 20 calibrated dental professionals (11 pediatric dentists and 9 general dentists/other specialists). Diagnostic sensitivity, specificity, predictive values, total agreement, and interobserver agreement were analyzed. Results: Radiographic signs suggestive of MIH were more frequently identified in erupted teeth at advanced developmental stages and in lesions involving multiple tooth surfaces. Significant associations were observed between lesion type, lesion extent, eruption stage, and dental development (P<.001). Pediatric dentists demonstrated significantly higher total agreement (76% vs 73%; P=.0346), sensitivity (21% vs 14%; P=.0439), and negative predictive value (79% vs 77%; P=.0185) compared with other dental professionals. No statistically significant differences were found for specificity or positive predictive value (P>.05). Overall diagnostic sensitivity was low across all evaluators, particularly for mild MIH presentations. Conclusions: Panoramic radiography may serve as a useful adjunctive tool for detecting moderate to severe MIH but demonstrates limited sensitivity and is insufficient as a standalone diagnostic method. Pediatric dental specialists showed modestly superior diagnostic performance; however, the clinical advantage was limited. Future studies should explore integrated diagnostic approaches combining radiographic assessment, clinical examination, and artificial intelligence based tools to improve MIH detection and diagnostic accuracy.

Author dc:creator

• Ana Aparecida Perucio Camargo Morschel (24399599)

• Molar Incisor Hypomineralization; MIH
• Health Sciences, Dentistry
• Dental Radiology
• Pediatric Dentistry

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32994017.v1

OAI identifier oai:identifier

oai:figshare.com:article/32994017