Molar Incisor Hypomineralisation-To Extract or to Restore beyond the Optimal Age?

Area of Science:

• Pediatric Dentistry
• Orthodontics
• Dental Public Health

Background:

• Molar incisor hypomineralisation (MIH) frequently affects first permanent molars (FPMs), causing post-eruptive breakdown and caries.
• Compromised FPMs pose a significant clinical challenge, often necessitating complex restorative interventions or extraction.

Observation:

• Planned extraction of severely compromised FPMs is a viable alternative to extensive restorative treatments.
• Early orthodontic assessment around age 8 is crucial for determining optimal extraction timing and therapeutic decisions for MIH-affected FPMs.

Findings:

• Extraction of poorly prognosed FPMs, followed by orthodontic space closure, offers a cost-effective management strategy.
• This approach eliminates the need for repeated restorative replacements and prevents the extraction of healthy premolars for orthodontic space creation.

Implications:

• An interdisciplinary approach involving dentists and orthodontists is key to achieving favorable outcomes in managing MIH-affected FPMs.
• Early intervention and strategic extraction can lead to better long-term dental health and more efficient orthodontic treatment planning.