Laser managed in the treatment of hypomineralized occlusal defects in teeth enamel affected by molar-incisor hypomineralization: A randomized controlled clinical study / Uso do laser no tratamento dos defeitos oclusais hipomineralizados em esmalte de dentes afetados pela hipomineralização molar-incisivo: estudo clínico controlado randomizado

Abstract

Background: Nowadays, observed a growing rate of teeth affected by molar incisor hypomineralization (MIH). These teeth can present persistent inflammation of the pulp, increasing the dentin hypersensitivity and consequently, directly affecting the cleaning of the affected tooth and contributing to the progression of caries lesions. Aims: This study aims to compare the use of diode laser (DL) irradiation (970nm) with the application of a glass ionomer-based sealant (GIC) for the most clinically and cost-effective strategy for the management of first permanent molars affected with MIH. Methods: This is a two-arm, parallel-group, patient randomized superiority-controlled trial, children present MIH molars will be selected and treated either with the application of DL or with the application of GIC-based sealants. Baseline and follow-up evaluations will be assessed through clinical examination and analysis of dental impressions that will be carried out of the affected teeth. The outcomes evaluated will be: 1) presence of post-eruptive breakdown and/or atypical dentin caries lesions, 2) retention rate of sealants 3) parent’s satisfaction, 4) children’s hypersensitivity 5) child-self-reported discomfort 6) impact on the quality of life and 7) the incremental cost-effectiveness. Evaluations will be performed by one trained evaluator after one week, and 1, 6, 12, 18, and 24 months. Multilevel statistical analyzes will be conducted to establish the ability of DL treatment compared to sealing, in joining to plausible factors associated with this efficacy. Discussion: We expect that this study contributes to the best scientific proof concerning the most cost-effective treatment for permanent molars affected with MIH.