Adhesion to Enamel of Teeth Affected by Molar Incisor Hypomineralization: Literature Review

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Apostolina Theocharidou, Konstantinos Arapostathis

Department of Paediatric Dentistry, Aristotle University of Thessaloniki, Greece

Summary

Background/Aim: Molar incisor hypomineralization (MIH) is a qualitative defect of systemic origin, affecting permanent first molars and often permanent incisors. The treatment modalities can include, amongst others, fissure sealants for prevention of dental caries and composite restorations. Both require adhesion to tooth structure. The aim of this study was to review the literature on the adhesion to enamel affected by MIH.

Material and Methods: A search of PupMed/Medline, ResearchGate and Google Scholar was performed and limited between 2003, when the judgement criteria for MIH were set, and 2016. Thirty-three papers were considered relevant to the subject including five in vivo and six in vitro studies. Studies involving less than ten teeth were excluded.

Results: A four-year clinical trial showed that the application of a total-etch 2-step adhesive system prior to sealant placement is superior to the etch-seal technique. Despite the high success rate of composite restorations shown in three clinical longitudinal studies, there are conflicting results over self-etch being superior to total etch adhesive systems. Pretreating the enamel surface, prior to the adhesive system, with fluoride preventive solutions could reduce the mikroleakage under orthodontic brackets. Three in vitro studies provide inconsistent data about NaOCl pretreating potentials to improve adhesion of composite restorations. Resin infiltration, prior to resin restorations, could improve the microhardness of defected enamel, which may lead to increased bond strength, especially in combination with NaOCl pretreatment.

Conclusions: Adhesion to enamel affected by molar incisor hypomeralization is inferior compared to normal enamel. Sealants applied with the etch-bond-seal technique have greater retention than with the etch-seal technique. Further research is required to provide evidence of the effectiveness of the adhesive system and pretreatment to achieve optimal bonding to MIH.

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