MOLAR INCISOR HYPOMINERALIZATION

cocukdishekimligiozel11-1-25kapakv2

Management of Molar Incisor Hypomineralization-Affected Incisors and Bonding Strategies

Kerem YILMAZa,b
aAntalya Bilim University Faculty of Dentistry, Department of Prosthodontics, Antalya, Türkiye
bBilimdent Oral and Dental Health Center (ADSUAM), Antalya, Türkiye

Yılmaz K. Management of molar incisor hypomineralization-affected incisors and bonding strategies. In: Şen Tunç E, ed. Molar Incisor Hypomineralization. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.46-53.

ABSTRACT
Treatment of teeth with molar incisor hypomineralization (MIH) is more likely to fail than in healthy teeth. The aim of this chapter is to describe bonding strategies and treatment methods for anterior teeth with MIH. The main problem in teeth with MIH is the weak bond ability of the enamel due to the microstructural defect. Adhesion can be achieved with three-stage total-etch, two-stage etch-andrinse or self-etching adhesive systems. Generally, these methods have been modified in studies to find the method that achieves the longest survival. Deproteinisation prior to bonding has been reported to increase bond strength. Glass ionomers, resin composites or ceramics can be used as restorative materials. Fluoride or casein products are commonly used to reduce sensitivity and promote remineralisation. Microabrasion, resin infiltration and indirect crowns are other recommended methods. The MIH severity, the child’s age and the ability to cooperate are important factors in the choice of treatment.

Keywords: Ceramics; composite resins; crowns; dental enamel hypoplasia; fluorides

Referanslar

  1. Krämer N, Bui Khac NN, Lücker S, Stachniss V, Frankenberger R. Bonding strategies for MIH-affected enamel and dentin. Dent Mater. 2018;34(2):331-40. [Crossref]  [PubMed]
  2. Kotsanos N, Kaklamanos EG, Arapostathis K. Treatment management of first permanent molars in children with Molar-Incisor Hypomineralisation. Eur J Paediatr Dent. 2005;6(4):179-84.
  3. Baroni C, Marchionni S. MIH supplementation strategies: prospective clinical and laboratory trial. J Dent Res. 2011;90(3):371-6. [Crossref]  [PubMed]
  4. Mejàre I, Bergman E, Grindefjord M. Hypomineralized molars and incisors of unknown origin: treatment outcome at age 18 years. Int J Paediatr Dent. 2005;15(1):20-8. [Crossref]  [PubMed]
  5. Mangum JE, Crombie FA, Kilpatrick N, Manton DJ, Hubbard MJ. Surface integrity governs the proteome of hypomineralized enamel. J Dent Res. 2010;89(10):1160-5. [Crossref]  [PubMed]
  6. Jälevik B, Norén JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Paediatr Dent. 2000;10(4):278-89. [Crossref]  [PubMed]
  7. Lagarde M, Vennat E, Attal JP, Dursun E. Strategies to optimize bonding of adhesive materials to molar-incisor hypomineralization-affected enamel: A systematic review. Int J Paediatr Dent. 2020;30(4):405-20. [Crossref]  [PubMed]
  8. Fragelli CMB, Souza JF, Bussaneli DG, Jeremias F, Santos-Pinto LD, Cordeiro RCL. Survival of sealants in molars affected by molar-incisor hypomineralization: 18-month follow-up. Braz Oral Res. 2017;31:e30. [Crossref]  [PubMed]
  9. Sönmez H, Saat S. A Clinical Evaluation of Deproteinization and Different Cavity Designs on Resin Restoration Performance in MIH-Affected Molars: Two-Year Results. J Clin Pediatr Dent. 2017;41(5):336-42. [Crossref]  [PubMed]
  10. William V, Burrow MF, Palamara JE, Messer LB. Microshear bond strength of resin composite to teeth affected by molar hypomineralization using 2 adhesive systems. Pediatr Dent. 2006;28(3):233-41.
  11. de Souza JF, Fragelli CB, Jeremias F, Paschoal MAB, Santos-Pinto L, de Cássia Loiola Cordeiro R. Eighteen-month clinical performance of composite resin restorations with two different adhesive systems for molars affected by molar incisor hypomineralization. Clin Oral Investig. 2017;21(5):1725-33. [Crossref]  [PubMed]
  12. Ekambaram M, Anthonappa RP, Govindool SR, Yiu CKY. Comparison of deproteinization agents on bonding to developmentally hypomineralized enamel. J Dent. 2017;67:94-101. [Crossref]  [PubMed]
  13. Chay PL, Manton DJ, Palamara JE. The effect of resin infiltration and oxidative pre-treatment on microshear bond strength of resin composite to hypomineralised enamel. Int J Paediatr Dent. 2014;24(4):252-67. [Crossref]  [PubMed]
  14. Gandhi S, Crawford P, Shellis P. The use of a 'bleach-etch-seal' deproteinization technique on MIH affected enamel. Int J Paediatr Dent. 2012;22(6):427-34. [Crossref]  [PubMed]
  15. Saroğlu I, Aras S, Oztaş D. Effect of deproteinization on composite bond strength in hypocalcified amelogenesis imperfecta. Oral Dis. 2006;12(3):305-8. [Crossref]  [PubMed]
  16. Crombie F, Manton D, Palamara J, Reynolds E. Resin infiltration of developmentally hypomineralised enamel. Int J Paediatr Dent. 2014;24(1):51-5. [Crossref]  [PubMed]
  17. Hoan NQ, Huyen NP, Son DC, Thien DH, Sabet CJ, Ngoc VTN. Effectiveness of resin infiltration in the management of anterior teeth affected by molar incisor hypomineralisation (MIH): A systematic review and meta-analysis. J Dent. 2024;149:105254. [Crossref]  [PubMed]
  18. Fayle SA. Molar incisor hypomineralisation: restorative management. Eur J Paediatr Dent. 2003;4(3):121-6.
  19. Muniz RSC, Carvalho CN, Aranha ACC, Dias FMCS, Ferreira MC. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: Randomised clinical trial. Int J Paediatr Dent. 2020;30(3):323-33. [Crossref]  [PubMed]
  20. Yahya G, AlAlwi A, Shurayji F, Baroom W, Rajeh M, AbdelAleem N. Effectiveness of sodium fluoride varnish and/or diode laser in decreasing postbleaching hypersensitivity: A comparative study. Saudi Dent J. 2022;34(1):62-7. [Crossref]  [PubMed]  [PMC]
  21. Ozgül BM, Saat S, Sönmez H, Oz FT. Clinical evaluation of desensitizing treatment for incisor teeth affected by molar-incisor hypomineralization. J Clin Pediatr Dent. 2013;38(2):101-5. [Crossref]  [PubMed]
  22. Vicioni-Marques F, Paula-Silva FWG, Carvalho MR, Queiroz AM, Freitas O, Duarte MPF, et al. Preemptive analgesia with ibuprofen increases anesthetic efficacy in children with severe molar: a triple-blind randomized clinical trial. J Appl Oral Sci. 2022;30:e20210538. [Crossref]  [PubMed]  [PMC]
  23. Butera A, Pascadopoli M, Pellegrini M, Trapani B, Gallo S, Radu M, et al. Biomimetic hydroxyapatite paste for molar-incisor hypomineralization: A randomized clinical trial. Oral Dis. 2023;29(7):2789-98. [Crossref]  [PubMed]
  24. Fossati AL, Sobral APT, Hermida Bruno MLL, Viarengo NO, Sertaje MRF, Santos EM, et al. Photobiomodulation and glass ionomer sealant as complementary treatment for hypersensitivity in molar incisor hypomineralisation in children: protocol for a blinded randomised clinical trial. BMJ Open. 2023;13(6):e068102. [Crossref]  [PubMed]  [PMC]
  25. Ballikaya E, Ünverdi GE, Cehreli ZC. Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig. 2022;26(2):2197-205. [Crossref]  [PubMed]  [PMC]
  26. Lygidakis NA. Treatment modalities in children with teeth affected by molarincisor enamel hypomineralisation (MIH): A systematic review. Eur Arch Paediatr Dent. 2010;11(2):65-74. [Crossref]  [PubMed]
  27. Biondi AM, Cortese SG, Babino L, Fridman DE. Comparison of Mineral Density in Molar Incisor Hypomineralization applying fluoride varnishes and casein phosphopeptide-amorphous calcium phosphate. Acta Odontol Latinoam. 2017;30(3):118-23.
  28. Mahoney EK. The treatment of localised hypoplastic and hypomineralised defects in first permanent molars. N Z Dent J. 2001;97(429):101-5.
  29. Croll TP, Nicholson JW. Glass ionomer cements in pediatric dentistry: review of the literature. Pediatr Dent. 2002;24(5):423-9.
  30. Elhennawy K, Schwendicke F. Managing molar-incisor hypomineralization: A systematic review. J Dent. 2016;55:16-24. [Crossref]  [PubMed]
  31. Fragelli CM, Souza JF, Jeremias F, Cordeiro Rde C, Santos-Pinto L. Molar incisor hypomineralization (MIH): conservative treatment management to restore affected teeth. Braz Oral Res. 2015;29:S1806-83242015000100271. [Crossref]  [PubMed]
  32. Linner T, Khazaei Y, Bücher K, Pfisterer J, Hickel R, Kühnisch J. Comparison of four different treatment strategies in teeth with molar-incisor hypomineralization-related enamel breakdown-A retrospective cohort study. Int J Paediatr Dent. 2020;30(5):597-606. [Crossref]  [PubMed]
  33. Hakmi A, Dashash M. Direct or indirect composite for restoring permanent first molars affected by Molar Incisor Hypomineralisation (MIH): a randomized clinical controlled trial. BDJ Open. 2023;9(1):37. [Crossref]  [PubMed]  [PMC]
  34. Kaya R, Yavuz BŞE, Dokumacıgil NK, Kargül B. A Randomized Clinical Trial of Short Fiber Reinforced Composite and Glass Hybrid Restoration for Molars Affected by Molar Hypomineralization. Pediatr Dent. 2023;45(4):292-300.
  35. Özgür B, Kargın ST, Ölmez MS. Clinical evaluation of giomer- and resinbased fissure sealants on permanent molars affected by molar-incisor hypomineralization: a randomized clinical trial. BMC Oral Health. 2022;22(1):275. [Crossref]  [PubMed]  [PMC]
  36. Croll TP. Enamel microabrasion for removal of superficial dysmineralization and decalcification defects. J Am Dent Assoc. 1990;120(4):411-5. [Crossref]  [PubMed]
  37. Fejerskov O, Thylstrup A, Larsen MJ. Clinical and structural features and possible pathogenic mechanisms of dental fluorosis. Scand J Dent Res. 1977;85(7):510-34. [Crossref]  [PubMed]
  38. Sheoran N, Garg S, Damle SG, Dhindsa A, Opal S, Gupta S. Esthetic management of developmental enamel opacities in young permanent maxillary incisors with two microabrasion techniques--a split mouth study. J Esthet Restor Dent. 2014;26(5):345-52. [Crossref]  [PubMed]
  39. Nogueira VKC, Mendes Soares IP, Fragelli CMB, Boldieri T, Manton DJ, Bussaneli DG, et al. Structural integrity of MIH-affected teeth after treatment with fluoride varnish or resin infiltration: An 18-Month randomized clinical trial. J Dent. 2021;105:103570. [Crossref]  [PubMed]
  40. ICONic infiltration [İnternet]. StyleItaliano ©2024. [Erişim tarihi: 8 Kasım 2024]. Erişim linki: [Link]
  41. Gençer MDG, Kirzioğlu Z. A comparison of the effectiveness of resin infiltration and microabrasion treatments applied to developmental enamel defects in color masking. Dent Mater J. 2019;38(2):295-302. [Crossref]  [PubMed]
  42. William V, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006;28(3):224-32.
  43. Somani C, Taylor GD, Garot E, Rouas P, Lygidakis NA, Wong FSL. An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent. 2022;23(1):39-64. [Crossref]  [PubMed]  [PMC]
  44. Welbury RR. A clinical study of a microfilled composite resin for labial veneers. Int J Paediatr Dent. 1991;1(1):9-15. [Crossref]  [PubMed]
  45. Wong FS, Winter GB. Effectiveness of microabrasion technique for improvement of dental aesthetics. Br Dent J. 2002;193(3):155-8. [Crossref]  [PubMed]
  46. Dursun E, Monnier-Da Costa A, Moussally C. Chairside CAD/CAM Composite Onlays for the Restoration Of Primary Molars. J Clin Pediatr Dent. 2018;42(5):349-54. [Crossref]  [PubMed]
  47. Shao C, Jin B, Mu Z, Lu H, Zhao Y, Wu Z, et al. Repair of tooth enamel by a biomimetic mineralization frontier ensuring epitaxial growth. Sci Adv. 2019;5(8):eaaw9569. [Crossref]  [PubMed]  [PMC]