Abstract
Until recently, the treatment for molar incisor hypomineralization (MIH) mainly included interim restorations such as resin restorations and stainless-steel crowns. These require replacement after adolescence. The use of intraoral scanners (IOS) has opened a new venue for restoring MIH teeth, by reducing the challenge of dealing with uncooperative children’s behavior and enabling tooth structure preservation and long-lasting restoration. We present an innovative treatment approach for children with MIH, using a digital workflow with IOS and CAD-CAM (computer-aided design and computer-aided manufacturing) fabrication of the restoration. The overall protocol involves a thorough diagnostic phase throughout treatment planning, which takes into consideration the child’s behavior and the parent’s cooperation and compliance. Initial preparation consists of inhalation sedation if needed, an effective local anesthesia, and the use of a rubber dam. Removal of all areas of enamel and dentin porosity is essential, and the tooth/teeth must be appropriately prepared to accommodate inlays or onlays for molars and labial veneers for incisors. IOS impressions are taken, including scanning of the prepared tooth and its antagonist, scanning of the bite, and CAD-CAM preparation of the restoration. Next is restoration, cementation, and follow up. Digital workflow provides definitive restorations in young patients due to the high accuracy of the scanning.
Highlights
Molar incisor hypomineralization (MIH) was first described in 2001 by Weerheijm et al [1], as hypomineralization of systemic origin of one to four permanent first molars, commonly with the involvement of incisors [1]
We present an innovative treatment approach for children with molar incisor hypomineralization (MIH), using a digital workflow with intraoral scanners (IOS) and CAD-CAM fabrication of the restoration
Attention should be given to pregnancy, birth and the first year of life
Summary
Molar incisor hypomineralization (MIH) was first described in 2001 by Weerheijm et al [1], as hypomineralization of systemic origin of one to four permanent first molars, commonly with the involvement of incisors [1]. The range of prevalence reported globally for MIH is wide, 3%−44% [2], as is the variability in clinical presentation. This corresponds with the lack of standardization of a research protocol and the differences that have been observed between samples of children [2]. The documentation of multiple affected molars in four of five children who were deemed to have MIH supports the possibility that some children are more susceptible than others [3]. Public Health 2020, 17, 1499; doi:10.3390/ijerph17051499 www.mdpi.com/journal/ijerph
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