Managing molar-incisor hypomineralization: A systematic review

Area of Science:

• Dental Science
• Pediatric Dentistry
• Restorative Dentistry

Background:

• Molar Incisor Hypomineralization (MIH) is a common enamel defect affecting permanent molars and incisors.
• Effective and evidence-based treatment strategies for MIH remain a clinical challenge.

Purpose of the Study:

• To systematically review and synthesize evidence on treatment modalities for MIH-affected molars and incisors.
• To assess the effectiveness and failure rates of different restorative and non-restorative treatments for MIH.

Main Methods:

• Systematic review of published trials on human subjects with MIH.
• Inclusion of studies reporting on various treatment interventions for MIH molars and incisors.
• Estimation of sample-size-weighted annual failure rates and risk of bias assessment.

Main Results:

• For MIH molars, indirect restorations and preformed metal crowns showed the lowest annual failure rates (1-4%).
• Fissure sealants and glass-ionomer restorations had higher failure rates (12%).
• Desensitizing agents and micro-abrasion/composite veneers were effective for MIH incisor hypersensitivity and aesthetics, respectively.

Conclusions:

• Limited evidence exists for MIH treatments, with moderate to high risk of bias in most studies.
• Remineralization or sealants may suit mild MIH molars; severe cases benefit from composites, indirect restorations, or crowns.
• Extraction is a last resort for molars, requiring careful consideration of patient factors; no definitive recommendations for incisors.