Int J Periodontics Restorative Dent. 2022 Mar-Apr;42(2):225-231. doi: 10.11607/prd.4896.
Teeth affected by molar incisor hypomineralization (MIH) present micromorphologic changes and hypersensitivity, which increase the risk of developing caries lesions and affect bonding procedures. Considering that practitioners still misdiagnose teeth affected by MIH, there is an urge for more knowledge about this topic in order to propose a more adequate and conservative treatment. The purpose of this study was to report the clinical challenges regarding the restorative management of a patient with MIH. A 13-year-old girl sought dental treatment, complaining about hypersensitivity in posterior teeth. Under clinical exams, notable enamel alterations mainly affecting posterior teeth (including molars) presented particular characteristics frequently attributed to MIH, and visible stains on maxillary central incisors were present. Because the mineral and organic content of MIH-affected enamel differ from sound enamel, it may imply special care for bonding of a restorative material. Thus, in order to promote a minimally invasive approach, selective removal of carious tissue and restoration with microhybrid composite resin was conducted after application of a universal bonding system used as self-etching strategy. After a 2-year follow-up, the restorations presented good clinical performance and the patient had limited hypersensitivity discomfort, suggesting a promising performance.
受磨牙牙釉质不全（MIH）影响的牙齿表现出微观形态变化和敏感性增加，这增加了发生龋齿病变的风险，并影响粘结程序。考虑到临床医生仍然误诊 MIH 影响的牙齿，因此需要更多关于该主题的知识，以便提出更合适和保守的治疗方案。本研究的目的是报告一名 MIH 患者的修复管理临床挑战。一名 13 岁女孩因后牙敏感而寻求牙科治疗。在临床检查中，明显的牙釉质改变主要影响后牙（包括磨牙），具有常归因于 MIH 的特殊特征，上颌中切牙可见明显的着色。由于 MIH 影响的牙釉质的矿物质和有机含量与正常牙釉质不同，这可能意味着粘结修复材料时需要特别注意。因此，为了促进微创方法，在使用通用粘结系统作为自酸蚀策略后，选择性地去除龋坏组织并用微混合复合树脂进行修复。经过 2 年的随访，修复体表现出良好的临床效果，患者的敏感不适有限，这表明该方法具有良好的前景。
