Indirect restorations with digital workflow in hypomineralized permanent molars: A series of pediatric cases

Kelly Maria Silva Moreira¹ image, Fernanda Guzzo Tonial2 image,  José Carlos Pettorossi Imparato3 image

Highlights

Molar incisor hypomineralization (MIH) compromises dental enamel, causing sensitivity and difficulties in chewing, which impacts children’s quality of life.

This study documented the use of the computer-aided design and manufacturing (CAD/CAM) digital workflow to treat permanent molars affected by severe MIH.

CAD/CAM indirect restorations demonstrated good marginal adaptation, fracture resistance, aesthetics, and reduced dental sensitivity.

Abstract

Molar incisor hypomineralization (MIH) is an enamel defect that presents significant challenges in clinical management due to its complexity and functional impact. This study evaluated the efficacy of indirect restorations in severely MIH-affected first permanent molars using digital technology and advanced restorative materials, including polymethyl methacrylate (PMMA), three-dimensional (3D) printed resin (Prizma Bio Crown, Makertech Labs, Tatuí, SP, Brazil), hybrid ceramic (Vita Enamic®, VITA Zahnfabrik, Bad Säckingen, Germany), and hybrid resin (Shofu Block HC, Shofu Inc., Kyoto, Japan). Molars from four pediatric patients were treated between August 2022 and August 2023 using a minimally invasive preparation approach, computer-aided design and manufacturing (CAD/CAM), and resin cementation techniques. The results demonstrated excellent marginal adaptation, high fracture resistance, improved aesthetics, reduced dental sensitivity, enhanced chewing function, and better oral hygiene maintenance over a follow-up period of 6 to 24 months. These findings suggest that indirect restorations are a suitable treatment option for severe MIH cases, with digital technology facilitating behavioral management and ensuring durable, high-quality restorations. Further studies comparing the performance of different restorative materials and evaluating cost-effectiveness are recommended to optimize clinical outcomes and practice.

Keywords: Computer-Aided Design; Molar Hypomineralization; Onlays; Pediatric Dentistry

Author Affiliations

  1. Associate Professor, Department of Dentistry, São Leopoldo Mandic College, Brazil
  2. Professor, Course of Dentistry, Faculty of Medical Sciences (AFYA), Brazil (Correspondence:fertonial@yahoo.com.br)
  3. Professor, Department of Dentistry, São Leopoldo Mandic College, Brazil
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Article Info

Contemp Pediatr Dent 2024:5(3):147-157

Received: 28 August 2024

Accepted: 26 November 2024

Online First: 18 December 2024

DOI: 10.51463/cpd.2024.44

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					Kelly Maria Silva Moreira, Fernanda Guzzo Tonial, José Carlos Pettorossi Imparato. Indirect restorations with digital workflow in hypomineralized permanent molars: A series of pediatric cases. Contemp Pediatr Dent 2024:5(3):147-157.

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