Modified glass ionomer and orthodontic band: An interim alternative for the treatment of molar incisor hypomineralization. A case report.

Abstract

Introduction: Molar incisor hypomineralization (MIH) is a developmental condition resulting in defects in the enamel characterized by demarcated opacities mainly affecting first permanent molars and occasionally permanent incisors in 1 of every 6 children worldwide. Affected molars have greater susceptibility to post eruptive breakdown, extensive caries and, in severe cases, are difficult to restore. When the MIH-affected molar presents severe crown destruction, it is necessary to perform an intermediate restoration to preserve the remaining dental structure in order to maintain occlusion, proper hygiene and periodontal health. The case of an 11-year-old patient with severe MIH is reported. The patient had extensive crown destruction by caries in tooth 1.6 without clinical or radiographic signs of pulp pathology. After an initial preventive intervention, enamel without dentin support and carious dentin were removed from tooth 1.6. Subsequently, crown restoration was performed with resin-modified glass ionomer, followed by the cementation of an orthodontic band. After 18 months of follow-up, the patient reported no pain or discomfort. The restoration was preserved intact, maintaining occlusal functionality, pulp and gingival health. Conclusion: The interim treatment, cementing an orthodontic band over a tooth restored with glass ionomer seems to favor retention and compressive strength, keeping the MIH-affected molar asymptomatic for at least 18 months. Further studies evaluating this treatment option in similar clinical situations are recommended.

Dentists’ perception, knowledge, and clinical management of molar-incisor-hypomineralisation in Kuwait: a cross-sectional study

“…Recently, a new interim treatment alternative was described for a molar with severe MIH using a glass ionomer restoration followed by a placement of an orthodontic band. This interim technique showed a successful result after 18 months of follow-up without further intervention [ 27 ]. Extraction was the least selected treatment option for severely affected molar presented in the case.…”

Rehabilitation Treatment in Pediatric Patients with Molar Incisor Hypomineralization: A Scoping Review

“…These studies were published between 2010 and 2022, and most of them come from Europe [10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and Brazil [5,[28][29][30][31][32][33][34][35][36][37][38]. In terms of the included studies' design, 20 were case reports [8,13,15,16,19,[25][26][27]31,[33][34][35][38][39][40][41][42][43][44], 7 were cohort studies [14,18,20,…”

“…MIH affected teeth are often extremely sensitive to thermal and mechanical stimuli influencing children's quality of life by increasing their risk to develop caries, their susceptibility to breaking their teeth, failure of bonding to materials, as well as influencing on their behavior [5,7,8]. In addition, treatment may be more painful due to difficulties in applying local analgesia (due to altered nerve potential) and chronic subclinical inflammation caused by enamel porosity [5].…”

Underdiagnosis of enamel defects in Family Health Centres of Talca city, Chile.

“…1 Children with enamel defects may experience pain, post-eruptive enamel breakdown and increased risk of extensive carious lesions, which makes the restoration of affected teeth a clinical challenge. [1][2][3] Enamel defects comprise a variety of alterations in the quality and quantity of dental enamel which are caused by disruption and/or damage of the enamel organ. 4 In general terms, these defects can be classified as hypoplasia (i.e., lack of enamel with soft edges), diffuse opacities (e.g., some types of dental fluorosis) and demarcated opacities.…”