Silver Shield: Combined Use of Silver Diamine Fluoride and Stainless Steel Crowns for Managing Molar Incisor Hypomineralization-A Preliminary Case Study

Molar Incisor Hypomineralization (MIH) is a developmental condition affecting permanent first molars and often incisors, presenting with varied clinical severity ranging from mild opacities to severe post-eruption breakdown (PEB) with caries susceptibility.

This case study describes the management of three pediatric patients (aged 9.5-11 years) diagnosed with MIH, exhibiting diverse clinical presentations including discoloration, PEB, and hypersensitivity. Each subject presented with one or more severely affected molars requiring comprehensive treatment. Silver Diamine Fluoride (SDF), along with Stainless steel (SS) crowns, was selected as the definitive restorative solution due to their durability, full-coverage protection, and cost-effectiveness. All procedures were performed under local anesthesia as required. Follow-up assessments were conducted periodically over 24 months to evaluate crown retention, gingival health, symptom relief, and patient satisfaction.  The findings revealed favorable clinical results, with all SSCs remaining fully functional and intact throughout the observation period. No postoperative complications or recurrence of symptoms were observed, and both patients and caregivers reported high satisfaction.

This case study highlights the effectiveness of combined SS crowns with SDF as a pragmatic restorative option for severely affected MIH molars, ensuring long-term functional and symptomatic relief while preserving oral health in pediatric patients.