Clinical evaluation of complete digital workflow ceramic overlays in treatment of children with molar incisor hypomineralization

Abstract

Pediatric dentists frequently encounter challenges in management of first permanent molars with molar incisor hypomineralization (MIH). They are found to have posteruptive breakdowns, active growth phase, inconclusive occlusal contacts, and wide pulp chambers with prominent pulp horns. The previous led to poor compliance, defective anesthesia, and restoration adhesion problems. Objectives Evaluate clinically indirect lithium disilicate glass–ceramic overlay versus indirect composite resin overlay using complete digital workflow in treatment of permanent molars with MIH in children. Patients and methods This split mouth randomized clinical trial compared full digital workflow lithium disilicate glass–ceramic overlay in comparison with the same workflow indirect computer aided design-computer aided manufacturing resin overlay in treatment of MIH molars in 12 children aged between 8 and 13 years with total of 24 first permanent molars into two groups. These MIH vital molars fell in the array of index 2 and 4 upon which the entire carious and hypomineralized enamel was removed with uniform reduction with final shoulder margin on sound enamel to receive the overlays. Results Both groups were assessed according to United States Public Health Services criteria of evaluation on 3 months interval for 9 months where the lithium disilicate glass ceramic overlay group showed 100% cumulative survival rate with consistent retention and anatomic form results as well as complete absence of pain and hypersensitivity at 9 months. No significant difference between both groups except for the anatomic form in which significant difference was found in favor of the lithium disilicate glass–ceramic group. Conclusion Overlays serve as esthetic, conservative and long-term treatment option with digital dentistry incorporation in every aspect of dentistry nowadays to provide accurate and quick delivery of the restorations with both groups behaved in a clinically acceptable performance.