Aesthetic Management of Molar-Incisor Hypomineralization With Deep Resin Infiltration: A Case Report

Molar-incisor hypomineralization (MIH) is a qualitative enamel defect that affects the first permanent molars and often the permanent incisors. In the anterior sector, MIH manifests as localized opacities in the coronal half of the tooth, typically well-defined, asymmetric, and ranging from whitish to brownish discolorations. These opacities cause significant aesthetic concerns for patients, affecting their self-esteem and social interactions. Effective management of these lesions can lead to a marked improvement in the patient's well-being. However, the management of MIH presents significant challenges for clinicians. Indeed, these opacities are among the most problematic to treat among white spot lesions, with dental bleaching, resin infiltration, and composite restorations often proving insufficient to mask the lesion. In this context, the deep resin infiltration technique presents a promising solution. This method, in line with the therapeutic gradient, targets deeply localized lesions, such as those seen in MIH. It involves a slight micro-preparation of the enamel so that infiltration occurs exactly at the "ceiling" of the lesion. Through a clinical case report of a nine-year-old patient with MIH-related white opacities, we will describe the deep resin infiltration technique, illustrating its protocol and discussing its therapeutic considerations.