Therapeutic Alternatives in a Pediatric Patient With Molar Incisor Hypomineralization: A Clinical Case Report

儿童磨牙切牙釉质矿化不足的治疗选择:一例临床病例报告

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Abstract

A notable increase in the incidence of molar incisor hypomineralization (MIH) has been observed in recent years. This trend may be attributed to a combination of factors, including increased public awareness, improved diagnostic techniques, and a greater emphasis on early childhood oral health. Clinically, MIH initially presents as white-to-brown opacities without enamel loss, progressing to post-eruptive breakdown in severe cases, often accompanied by hypersensitivity and atypical caries that may lead to pulp involvement. MIH treatment requires a correct clinical assessment of the tooth as the first step toward selecting a therapy that will ensure long-term success for the patient. The choice of dental materials is a decision that the clinician must make based on scientific evidence, the manufacturer's instructions, and the patient's general condition. The purpose of this case report was to present the clinical results of a 15-month follow-up of different therapy options in an 11-year-old male patient with MIH. The symptoms reported by the patient included hypersensitivity to hot and cold stimuli in the upper first permanent molars (FPMs) and tissue rupture in the lower FPM, which interfered with his eating function. The use of biomaterials, application of infiltrative resin (Icon®, DMG, Hamburg, Germany), preformed bands, topical applications of fluoride, as well as changes in oral hygiene habits and diet, were employed as therapeutics. The main contribution of this clinical case is that preserving the integrity of three molars with MIH in the same oral environment posed the greatest challenge to rehabilitation. However, with an individualized treatment plan, the evolution can be successful.

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