Management of Molar Incisor Hypomineralization With Silver Diamine Fluoride or SMART

Clinical Evaluation of Permanent Molars With Molar Incisor Hypomineralization Treated With Silver Diamine Fluoride or Silver Modified Atraumatic Restorative Technique

The purpose of this study is to evaluate and compare the clinical performance of Silver diamine Fluoride+Potassium Iodide (SDF+KI) and Silver-Modified Atraumatic Restorative Technique (SMART/SDF+KI+GIC) on molars with MIH

SDF+KI and SMART (SDF+KI+GIC) were placed on two permanent molar teeth with MIH, in a split mouth design. 48 patients were included in the study. The teeth were randomized into two groups according to the dental restorative material.

Group 1: SDF+KI (Riva Star), Group 2: SDF+KI (Riva Star) +GIC (Equia Forte). The US Public Health Service criteria (secondary caries, anatomical form, marginal adaptation, marginal discoloration) was used for clinical evaluation of atraumatic resin restorations. The restorations were evaluated at baseline and 1., 6., 12., 18., 24. months. Intra-oral photos were taken directly after treatment and at control appointments to evaluate discoloration and seconder caries under magnification.

Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis.

Inclusion Criteria:

• Patients and parents of the patients who accept to participate and sign the informed consent
• Patients whose molar teeth are diagnosed as molar incisor hypomineralization by EAPD
• Teeth that are fully erupted
• Patients who have at least two permanent first molars that need fissure sealant
• Teeth that have white-yellow-brown discoloration that indicate high-caries risk

Exclusion Criteria:

• Teeth that are previously restored or have caries
• Patients who have orthodontic treatment
• Patients who are not cooperative for the dental procedure
• Teeth that have dental fluorosis or enamel malformation according to the specific syndromes