Treatment options for hypomineralized first permanent molars and incisors

The aim of this study was to discuss therapy possibilities in the management of molar incisor hypomineralization. Molar incisor hypomineralization (MIH) is defined as hypomineralization of one or more first permanent molars frequently affecting incisors. Etiology of MIH is not fully clarified and numerous etiological factors have been cited. Hypomineralized molars are more prone to caries, cause severe restorative problems and are frequently extracted due to serious damage and caries complications. Incisors can present demarcated enamel opacities, while enamel breakdown is uncommon. Clinically, affected molars can be sensitive to thermal and chemical irritations even when there is no enamel breakdown. Molars can be sensitive to mechanical irritations making even regular tooth brushing painful. Specific problems related to the treatment of these teeth are sensitivity and occlusion in molars and aesthetics in incisors. Considering the fact that permanent first molars with severe defects and incisors demand complex and multidisciplinary treatment they present serious problem for the patient as well as for the dentist.