Diagnóstico e planejamento de tratamento de molares afetados pela hipomineralização molar incisivo: um relato de caso

Abstract

Molar incisor hypomineralization (MIH) is defined as a qualitative defect of the enamel that affects one or more permanent molars, and can also affect the incisors. Patients who face this condition show several clinical problems, such as accentuated wear, dental hypersensitivity and increased risk of developing caries. The aim of this case report is show the main clinical characteristics of MIH lesions for their differential diagnosis, make a retrospective analysis of the glass ionomer cement restorations on molars with MIH, and present a possible restorative planning for molar teeth affected by MIH. This case report presents data that elucidate important characteristics for the differential diagnosis of the disease which is given by the clinical perception of opacities with defined limits and discolored from white to yellow/brownish on molars, and possibly incisors, enamel surfaces. These lesions can be already associated to enamel breakdown and caries. This case mentioned above also shows the durability of glass ionomer cement such as a prevent restorative material against enamel breakdown and caries, and presents a possible definitive restorative planning using an ultraconservative technique with minimum teeth preparation in order to preserve healthy dental structure in teeth that are already weakened. The use of the mock-up technique in the planning of indirect restorations allows to test and to prepare the teeth from the volume and morphology of the waxed restoration. Finally, the glass ionomer cement showed clinical success for 5 years against recurrent acute caries lesions and mineralized adjacent tissues breakdown on molars affected by MIH. The authors suggest the mock-up technique to plan conservative and adhesive indirect restorations for teeth affected by MIH with structural loss in young patients.