Conservative management of molar incisor hypomineralization using biomimetic material in a 9-year-old boy

Abstract

Comprehensive management of severe molar incisor hypomineralization with dental caries in a 9-year-old boy is reported. After the consultation, diagnosis and treatment planning; upon obtaining the consent from parents, and behavior modification of the child over a preparatory visit, three of the four permanent first molars (PFMs) were treated: two with indirect pulp therapy and one with direct pulp capping using tricalcium silicate cement. After observation of 1 month for each tooth, preformed stainless steel crowns (SSCs) were placed on all three PFMs in a diagonal manner for minimizing occlusal discomfort. The remaining PFM (36), restored earlier by another dentist, developed a dentoalveolar abscess during the course; the same was treated endodontically and a coronal seal was established with an SSC. A quadrant approach was adopted to complete extractions of all carious primary teeth along with the treatments of PFMs during the same appointments to minimize the number of visits. Local anesthesia with 4% articaine with adrenaline infiltrations was used for all quadrants except for the third where an inferior alveolar nerve block with 2% lignocaine with adrenaline was given. Follow-up of all PFMs, over a period of over 9 months, was uneventful. The endodontically treated PFM, too, showed satisfactory recovery, posttreatment.