Severe Molar-Incisor Hypomineralization: A comprehensive aproach in Pediatric Dentistry

Abstract

Ntroduction: Molar-Incisor Hypomineralization (MIH) is a developmental enamel defect that affects the first permanent molars and incisors. The main complication is the increased susceptibility to dental caries due to the reduced resistance and porosity of the affected enamel.
Case Report: A 10-year-old male patient presented with intermittent pain in the "molars." During the intraoral examination, well-demarcated yellow-brown opacities were observed on teeth 26 and 46, compatible with MIH. Both molars presented ICDAS 6 lesions. Radiographically, tooth 26 showed pulpal involvement. The tooth germs of 28 and 38 were developing, with no germ of tooth 48. Tooth 46 presented pulpal necrosis.
Treatment Plan: Comprehensive and multidisciplinary management including referral to endodontics, prosthodontics, and orthodontics. Tooth 26 was extracted due to poor prognosis. Endodontic treatment and prosthetic rehabilitation were performed on tooth 46, and the patient was referred to the orthodontics department.
Conclusion: This case highlights the complexity of severe MIH, particularly its association with extensive caries, dental sensitivity, and functional impairment. The rapid destruction of dental structure emphasizes the importance of early diagnosis and a comprehensive approach to preserve oral health and restore function. One molar was extracted due to poor prognosis, and the other received endodontic treatment and provisional restoration.