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Adhesive system containing Bioglass 45S5 particles in teeth affected by molar-incisor hypomineralization and quality
Kamila Nogueira Borges da Costa1, Nicole Paiva Veras2, Ceci Nunes Carvalho2
1Postgraduate Program of Dentistry, Ceuma University (UNICEUMA), R. Anapurus, 1, São Luís, Maranhão, 65075-120, Brazil. kamilaborges@live.com.
Background:
Molar-incisor hypomineralization (MIH) is a systemic condition characterized by a qualitative defect in the dental enamel. It primarily affects the first permanent molars and is often associated with the permanent incisors. Resin restorations in MIH-affected teeth consistently show worse results than those in normal teeth because of the ultrastructure of hypomineralized enamel, which compromises adhesion. The incorporation of bioactive particles into adhesives is a promising option for inducing remineralization. This study protocol describes a randomized clinical trial evaluating restorative treatment using an adhesive system containing 45S5 bioactive glass for MIH-affected teeth.
Methods:
Restorations will be performed on the upper or lower first permanent molars in children with MIH aged 6-12 years. The inclusion criteria will include MIH teeth with post-eruptive enamel fractures that compromise the middle third of the dentin, with at least two surfaces of hypomineralized enamel near the cavity, without caries, pulpal, or periradicular involvement. Before treatment, children will complete the Child Perceptions Questionnaire 8-10 and 11-14 (CPQ8-10 and CPQ11-14). The teeth will be divided into two groups: a control group (commercial self-etching adhesive system: Clearfil SE Bond (CF) Primer + Bond) and an experimental group (CF Primer + experimental Bond using 10% 45S5 bioglass [Bond 45S5 10%]). Restorations will be made using composite resin, and quality will be assessed using digital radiographs (interproximal and periapical), intraoral photographs, and epoxy resin replicas. Clinical evaluation of the restorations will be performed immediately following the procedure (baseline) and after 1, 3, 6, and 12 months using the World Dental Federation (FDI) criteria. The impact of the treatment on the quality of life will be assessed after 3, 6, and 12 months through the re-administration of CPQ8-10 and CPQ11-14.
Discussion:
45S5 bioactive glass is capable of enhancing the effect of materials on bone and dental structures, promoting remineralization. The results of this study may aid in the clinical management of patients with MIH, given the challenges of treating sensitive and compromised teeth and the difficulty in achieving long-term restorative success while addressing the individual patient needs.
Trial Registration:
Rebec, U1111-1259-1738. Registered on January 10, 2021.
