An Innovative Treatment Approach Using Digital Workflow and CAD-CAM Part 2: The Restoration of Molar Incisor Hypomineralization in Children

Esti Davidovich, Shlomi Dagon, Israel Tamari, Michael Etinger and Eitan Mijiritsky
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Esti Davidovich: Department of Pediatric Dentistry, Hebrew University—Hadassah School of Dental Medicine, Jerusalem 91120, Israel
Shlomi Dagon: Advanced Esthetic Program, Center of Aesthetic Dentistry and Clinical Research, Prosthodontic Department, Faculty of Dentistry, Tel Aviv University, Tel-Aviv 6139001, Israel
Israel Tamari: Private Clinic, Tel-Aviv 6139001, Israel
Michael Etinger: Department of Prosthodontics, Hebrew University—Hadassah School of Dental Medicine, Jerusalem 91120, Israel
Eitan Mijiritsky: Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv 6139001, Israel

IJERPH, 2020, vol. 17, issue 5, 1-11

Abstract: Until recently, the treatment for molar incisor hypomineralization (MIH) mainly included interim restorations such as resin restorations and stainless-steel crowns. These require replacement after adolescence. The use of intraoral scanners (IOS) has opened a new venue for restoring MIH teeth, by reducing the challenge of dealing with uncooperative children’s behavior and enabling tooth structure preservation and long-lasting restoration. We present an innovative treatment approach for children with MIH, using a digital workflow with IOS and CAD-CAM (computer-aided design and computer-aided manufacturing) fabrication of the restoration. The overall protocol involves a thorough diagnostic phase throughout treatment planning, which takes into consideration the child’s behavior and the parent’s cooperation and compliance. Initial preparation consists of inhalation sedation if needed, an effective local anesthesia, and the use of a rubber dam. Removal of all areas of enamel and dentin porosity is essential, and the tooth/teeth must be appropriately prepared to accommodate inlays or onlays for molars and labial veneers for incisors. IOS impressions are taken, including scanning of the prepared tooth and its antagonist, scanning of the bite, and CAD-CAM preparation of the restoration. Next is restoration, cementation, and follow up. Digital workflow provides definitive restorations in young patients due to the high accuracy of the scanning.

Keywords: CAD-CAM; molar incisor hypomineralization; children (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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