Hipomineralização molar-incisivo: um relato de caso

Abstract

Molar-incisor hypomineralization (MIH) is a multifactorial condition that affects the enamel quality of the first permanent molars and may also involve the permanent incisors. Clinically, it is characterized by opacities ranging from creamy white to yellowish-brown, which make the enamel more susceptible to post-eruptive fractures, hypersensitivity, and premature wear. The clinical management of MIH is challenging, requiring accurate diagnosis, individualized planning, and careful selection of restorative materials. This case report describes the treatment of a 24 year-old patient diagnosed with MIH. After thorough clinical and radiographic evaluation, diagnostic wax-up was performed, followed by functional and esthetic rehabilitation. The clinical management included the removal of affected enamel, use of macromechanical retention when necessary, evidence-based adhesive protocols, and direct composite resin restorations in both molars and incisors, applying incremental and stratified layering techniques for optimal esthetic integration. The results demonstrated significant improvement in esthetics, masticatory function, and occlusal balance, in addition to a positive impact on the patient’s self-esteem and overall satisfaction. It can be concluded that direct composite resin restorations represent a conservative, functional, and esthetically effective approach for the management of molar-incisor hypomineralization, provided they are associated with thorough planning, appropriate adhesive techniques, and regular clinical follow-up.