Transillumination-Aided Infiltration of MIH-Affected Molars: Evaluation of the Clinical Workflow

Enamel affected by molar incisor hypomineralisation (MIH) exhibits reduced mechanical properties due to its disorganised prismatic structure, lower mineral density and higher protein content. These alterations increase porosity and susceptibility to posteruptive enamel breakdown. Minimally invasive treatments, such as resin infiltration, have been proposed to reinforce enamel integrity. Recent advances suggest that transillumination can guide infiltration more accurately, allowing better visualisation of lesion extent and potentially improving treatment outcomes.

This case series evaluated the clinical suitability of transillumination-aided resin infiltration, specifically the utility of using transillumination to support resin infiltration treatment, for MIH-affected molars.

Five MIH-affected first permanent molars from five paediatric patients, diagnosed according to EAPD criteria for MIH, were included. One molar presented with two distinct lesions, leading to the inclusion of six lesions in total. Transillumination was used to assess the lesion appearance, to assist with selective surface removal and to monitor the resin infiltration process to assess when it was completed, that is, when the lesion either fully disappeared visually or no change was visible anymore under transmitted light.

Transillumination was employed successfully to assist with resin infiltration treatment and to assess the treatment outcome. Four lesions showed partial and two complete infiltrations visually, indicating putatively that the porous lesion structure is strengthened. No complications were reported during treatment.

Transillumination was successfully utilised to support resin infiltration in MIH-affected molars and to visualise the quality of infiltration, serving as a potential surrogate outcome measure. Future research should explore long-term clinical outcomes and the impact on patients' quality of life.