402 - 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 children and to compare the diagnostic performance of pediatric dentists with other dental professionals.

Methods:
This cross-sectional, observer-based study was conducted in two phases. First, 292 MIH-positive panoramic radiographs of children aged 5–12 years (2016–2024) were retrospectively collected from UIC electronic dental records using standardized forms and analyzed to identify associations between demographic variables and MIH, including dental development stage according to Nolla classification, and the number of affected teeth and surfaces. In the second phase, 50 MIH-positive panoramic radiographs were selected and independently evaluated by 20 dental professionals (board-certified pediatric dentists and residents, general practitioners, and other specialists). Diagnostic sensitivity, specificity, predictive values, total agreement, and interobserver agreement were assessed.

Results:
Radiographic signs suggestive of MIH were more frequently identified in erupted teeth at advanced developmental stages and in lesions involving multiple surfaces. Significant associations were observed between lesion type and extent, eruption stage, and dental development (P < .001). Pediatric dentists demonstrated higher total agreement (76% vs. 73%; P = .035), sensitivity (21% vs. 14%; P = .044), and negative predictive value (79% vs. 77%; P = .019). No significant differences were observed for specificity or positive predictive value (P > .05). Overall diagnostic sensitivity was low, particularly for mild MIH cases.

Conclusions:
Panoramic radiography may aid in detecting moderate to severe MIH but shows limited sensitivity and is inadequate as a standalone diagnostic method. Although pediatric dentists demonstrated slightly better performance, the clinical benefit was modest. Integrated clinical and radiographic approaches may improve MIH diagnosis.