Abstract
Background/Aim: Molar incisor hypomineralization (MIH) is a qualitative defect of systemic origin, affecting permanent first molars and often permanent incisors. The treatment modalities can include, amongst others, fissure sealants for prevention of dental caries and composite restorations. Both require adhesion to tooth structure. The aim of this study was to review the literature on the adhesion to enamel affected by MIH. Material and Methods: A search of PupMed/Medline, Research Gate and Google Scholar was performed and limited between 2003, when the judgement criteria for MIH were set, and 2016. Thirty-three papers were considered relevant to the subject including five in vivo and six in vitro studies. Studies involving less than ten teeth were excluded. Results: A fouryear clinical trial showed that the application of a total-etch 2-step adhesive system prior to sealant placement is superior to the etch-seal technique. Despite the high success rate of composite restorations shown in three clinical longitudinal studies, there are conflicting results over self-etch being superior to total etch adhesive systems. Pretreating the enamel surface, prior to the adhesive system, with fluoride preventive solutions could reduce the mikroleakage under orthodontic brackets. Three in vitro studies provide inconsistent data about NaOCl pretreating potentials to improve adhesion of composite restorations. Resin infiltration, prior to resin restorations, could improve the microhardness of defected enamel, which may lead to increased bond strength, especially in combination with NaOCl pretreatment. Conclusions: Adhesion to enamel affected by molar incisor hypomeralization is inferior compared to normal enamel. Sealants applied with the etch-bondseal technique have greater retention than with the etch-seal technique. Further research is required to provide evidence of the effectiveness of the adhesive system and pretreatment to achieve optimal bonding to MIH.
Highlights
Molar incisor hypomineralization is defined as a dental defect of systemic origin, that affects 1 to 4 permanent first molars, and frequently is associated with permanent incisors[1]
The aim of this paper is to review the literature concerning the adhesion to enamel affected by Molar incisor hypomineralization (MIH)
Adhesion to enamel affected by molar incisor hypomeralization is inferior compared to normal enamel
Summary
Molar incisor hypomineralization is defined as a dental defect of systemic origin, that affects 1 to 4 permanent first molars, and frequently is associated with permanent incisors[1]. The clinical appearance includes demarcated opacities, varying in color from white to yellow or brown[4]. These opacities are located on the occlusal and buccal surface of the tooth and ranging in size[4], while the thickness of the enamel is normal. Post eruptive breakdown of the enamel can occur due to masticatory forces[4]. These teeth are more prone to caries, more sensitive to external stimuli and may be more difficult to anaesthetize[4]. The etiology is yet unknown, but has been associated with different hypotheses including genetics, medical problems
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