Restorative Management of Molar Incisor Hypomineralization-Affected Molars With Lithium Disilicate Overlays: An...

Molar incisor hypomineralization (MIH) is a qualitative enamel defect characterized by reduced mineralization, increased porosity, and compromised mechanical properties, making affected teeth highly susceptible to posteruptive breakdown, hypersensitivity, and restorative failure. Conventional direct restorations often exhibit limited longevity in severely affected molars due to weak enamel bonding and structural fragility. Consequently, indirect restorations with cuspal coverage have been increasingly recommended as a more durable and protective treatment option. This clinical case reports the restorative management of MIH-affected maxillary first molars in a 24-year-old patient using lithium disilicate ceramic overlays. Following the removal of defective amalgam restorations, a minimally invasive tooth preparation with a butt-joint design was performed, combined with immediate dentin sealing to enhance adhesion. Impressions were taken using polyvinylsiloxane materials, and overlays were fabricated via CAD/CAM technology. Adhesive cementation was carried out under strict isolation, including surface treatment of both the restoration and dental tissues. The use of lithium disilicate overlays provided a conservative yet effective approach, ensuring reinforcement of weakened tooth structure while preserving remaining sound tissues. The literature supports the high survival rates of such restorations in MIH cases, with reduced hypersensitivity and satisfactory functional and aesthetic outcomes. In conclusion, lithium disilicate overlays represent a reliable and minimally invasive solution for the rehabilitation of compromised MIH molars. Careful case selection, proper adhesive protocols, and regular follow-up are essential to ensure long-term success, particularly given the inherent fragility of MIH-affected enamel.