Molar incisor hypomineralization: supplementary, restorative, orthodontic, and esthetic long-term treatment

This article describes the esthetic results in a paradigmatic case of hypomineralized enamel correction on both anterior and posterior teeth to establish a minimal intervention protocol for similar cases. Clinical considerations: The subject was initially provided with casein-calcium-phosphate mineral supplementation. Unpublished laboratory images collected as part of a previously published study depict the results of initial calcium-phosphate supplementation on molar incisor hypomineralization (MIH) molar enamel morphology and indicate that this procedure is mandatory in moderate/severe cases. Prior to defect restoration, in-office bleaching of the anterior segment was conducted with bioactivated Opalescence Boost. Filtek Supreme Ultra Universal Restorative was used as a masking agent, and Filtek A2 enamel was applied as the final layer.

An 8-year follow-up period is necessary in most moderate/severe MIH cases involving orthodontics and bleaching.