Contemporary management options for molar incisor hypomineralisation

Abstract

##Background Molar incisor hypomineralisation (MIH) is a well-known and prevalent qualitative enamel defect, which can carry a heavy treatment burden for many patients. Early identification of MIH is paramount in order to instigate preventive regimes and potentially spare children from the restorative cycle many endure. Once enamel breakdown occurs management is challenging, as all cases present different individual considerations, from behaviour management issues to restorative decisions. The aim of this article was to review the recent literature on MIH in order to give the reader an update on contemporary management options for MIH-affected molars and incisors, and their evidence base. ##Conclusion Effective management can be very difficult for the clinician and there are limited treatment guidelines available. The individual needs of the patient will often dictate the most appropriate management and therefore clinicians need to be aware of all available options.

Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review

“…Bioactive glasses can remineralize dentin and decrease its permeability, thus treating teeth sensitivity. To enhance the effect of bioactive glass materials, we can apply it in a vacuum-formed clear retainer which the patient can wear during their sleep [7,23,30].…”

“…As a result, no advice for a specific technique can be offered. A combination of approaches could be required due to the variability in the opacities and discoloration [7,23,35].…”

“…Although its effectiveness has been questioned in MIH, the etch-bleach-seal procedure is a less invasive technique for removing yellow-brown stains. The tooth is bleached for up to twenty minutes with 5% sodium hypochlorite, then etched with 37% phosphoric acid, and sealed with clear resin [7,23].…”

“…It comes in the form of hydrogen peroxide (up to 6%) or carbamide peroxide (10% or 16%) gels utilized in custom-made trays. Gingival irritation and sensitivity are common side effects that should be taken seriously, especially in young children [7,37].…”

“…Furthermore, MIH, the most frequent enamel defect, exhibits a wide range of severity with variation in the clinical presentation [6]. Therefore, from an epidemiologic standpoint, MIH is gaining more attention every year from the community of pediatric dentists due to its global prevalence and negative impact on affected children [7].…”