Extraction of permanent first molars with molar-incisor hypomineralization: Case report

Abstract

Introduction: Molar-incisor hypomineralization is a qualitative defect of the enamel that affects at least a permanent molar and may or may not affect the incisors. It occurs with different degrees of severity,  on which the therapeutic approach will depend, ranging from preventive treatments to extraction. Objective: To report a case of severe MIH where the four first definitive molars are affected and the therapeutic approach is extraction. Case report: 9-year-old male patient with severe affection of the first four permanent molars, which present areas of fractured enamel, caries associated with the defect, dental hypersensitivity, one molar with pulp involvement and a history of previous failed treatments. After analyzing the background of the case, an extraction of the first four permanent molars is proposed; considering the rehabilitative prognosis, as well as the intraosseous development of the second permanent molars and the presence of third molars.  In collaboration with a multidisciplinary scholastic team, the appropiate time to perform the extractions was established, which were carried out in order according to the level of coronary destruction and development of the second molar. Follow-up at 3 months revealed the eruption of two second molars in mesialized position.  Conclusion: Extraction proved to be a successful and cost-effective treatment alternative, given patient's age and the degree of destruction of all affected molars.