Recent conservative management protocol of hypomineralized first permanent molars in children: an overview

Abstract

Molar incisor hypomineralization (MIH) poses a significant clinical problem due to its diverse clinical scope. The severity of enamel defects can range from mild opacities with minimal functional impact to considerable post-eruptive disintegration and greater sensitivity, resulting in structural weakness and significant discomfort, as well as making affected teeth vulnerable to caries and pain. Consequently, these children develop a significant lack of cooperation and increased dental anxiety. Restoring first permanent molars affected with MIH is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures. The ability to treat a condition like MIH with a conservative technique could bring significant benefits in terms of patient comfort, enhanced caries resistance, and tooth structure preservation. Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in MIH affected permanent molars up to 1 year and decreased the hypersensitivity in moderate and severe groups. Most of children tolerated the treatment well.