MIH-Affected Teeth: Clinical Challenges from Diagnosis to Restorative Management

Teeth affected by molar incisor hypomineralization (MIH) present micromorphologic changes and hypersensitivity, which increase the risk of developing caries lesions and affect bonding procedures. Considering that practitioners still misdiagnose teeth affected by MIH, there is an urge for more knowledge about this topic in order to propose a more adequate and conservative treatment. The purpose of this study was to report the clinical challenges regarding the restorative management of a patient with MIH. A 13-year-old girl sought dental treatment, complaining about hypersensitivity in posterior teeth. Under clinical exams, notable enamel alterations mainly affecting posterior teeth (including molars) presented particular characteristics frequently attributed to MIH, and visible stains on maxillary central incisors were present. Because the mineral and organic content of MIH-affected enamel differ from sound enamel, it may imply special care for bonding of a restorative material. Thus, in order to promote a minimally invasive approach, selective removal of carious tissue and restoration with microhybrid composite resin was conducted after application of a universal bonding system used as self-etching strategy. After a 2-year follow-up, the restorations presented good clinical performance and the patient had limited hypersensitivity discomfort, suggesting a promising performance.