J of IMAB 2012; 18(2):174-180
Clinical treatment approach of a child with molar incisor hypomineralization (MIH) combined with malocclusion.
Rossitza Kabaktchieva¹, Vladimir Bogdanov²
1) Department of Pediatric Dental Medicine, Faculty of Dental Medicine, Medical University, Sofia,
2)  Department of Orthodontics, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria

ABSTRACT:
Introduction. Molar incisor hypomineralization (MIH) was defined as "hypomineralisation of systemic origin of permanent first molars, frequently associated with affected incisors". MIH includes the presence of demarcated opacity, post eruptive enamel breakdown, atypical restoration. Тhe approach to management suggested: risk identification, early diagnosis, remineralization for prevention of caries and post eruption breakdown, restorations. The clinicians very seldom notice that children with MIH usually have both- hypomineralisation and malocclusions, and they do not discuss combine treatment plan.
Aim. To present our interdisciplinary approach to a patient with MIH, combined with malocclusion.
Material and methods. We are presenting 9 year old child with contusio and fractura coronae dentis noncomplicata, distal occlusion, overjet, overbite and retrusion. Two consecutive stages were defined:
First stage:
- Professional oral hygiene and local remineralisation therapy
- Vital pulp therapy of tooth 21
- Space gaining for restoration of the lost height of the molars by the means of posterior bite-plane removable appliance
- Restoration of the molars with metal inlays
- Lingual tipping of the lower incisors
Second stage:
- Class II correction
- Growth control
Results.
First phase:
- The tooth 21 was restored with aesthetic composite material;
- Occlusion was raised with occlusal restorations (inleys) and orthodontic appliance.
Second phase:
Medialisation of mandible and holding maxillary growth with functional appliance and occipital EOA until class one occlusal relations.
Conclusion. Children with MIH should be examined and treated complex in collaboration with orthodontist and if necessary by other specialists too.

Key words: Molar incisor hypomineralization (MIH).

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Please cite this article as: Kabaktchieva R, Bogdanov V. Clinical treatment approach of a child with molar incisor hypomineralization (MIH) combined with malocclusion. J of IMAB. 2012; 18(2):174-180. doi: 10.5272/jimab.2012182.174

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Accepted for publication: 19 December 2011
Issue published online: 05 April 2012

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