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Mih Case Study

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MIH – Treatment Treatment approaches The available treatment modalities for MIH is extensive but the decision on which treatment should be used is complex and multi-factorial. Factors may include: condition severity, the patient’s dental age, the child/parent’s social background and expectations. [1] Prevention Prevention is of prior importance at an early developmental age as the defective tooth is more likely to have caries and post-eruptive breakdown due to its increased porosity. [1] Appropriate dietary advice and toothpaste with a fluoride level of at least 1,000 ppm F should be recommended. [2] For treating spontaneous hypersensitivity, professional applications of fluoride varnish (e.g. Duraphat 22,600ppm F) or 0.4% stannous…show more content…
[8] Creamy-yellow or whitish-creamy defects are less porous and variable in depth [6], and may respond to microabrasion with 18% hydrochloric acid or 37.5% phosphoric acid and abrasive paste. [9] [10] Again, this should be undertaken cautiously as microabrasion may result in loss of enamel. [11] Cavity Design There is still much debate of whether margin extension should include removal of all defective enamel or only the porous enamel. The former provides sound enamel for bonding but leads to excessive tooth tissue loss, the latter is less invasive, but the margins may have a high risk of breakdown due to defective bonding. [1] Yet, it is agreed that adhesive restorations should be used as opposed to those reliant upon mechanical retention (such as amalgam). [12] Glass ionomer cement (GIC) restorations. GIC materials have adhesive capabilities with both enamel and dentine, long-term fluoride release and hydrophilicity when there is inadequate moisture control intra-orally, during early post-eruptive stages. However GIC’s poorer mechanical properties suggest avoidance in stress-bearing areas. In later post-eruptive stages GIC may be valuable as sub-layer beneath composite restorations. [1] Composite resin restorations Composite resin material has been shown to have longer-term stability in MIH teeth, with a median survival rate of 5.2 years [13] and a success rate of 74%-100% [14] [12] during a 4-year follow-up period. Self-etching adhesive was found to have
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