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Molar Incisor Hypomineralization (MIH) is a disease causing a structural defect in the enamel of permanent teeth. The treatment of these teeth consists of the removal of the affected part of the tooth and its reconstitution. Classically, the restoration is done with a resin in direct method. With the development of Computer-aided design (CAD) and Computer-aided manufacturing (CAM), it is possible to make a custom-made part to replace the affected part of the tooth. The main objective is to describe the effect of the 6-month management of CAD/CAM type restorations compared to direct restorations, performed in children aged 7 to 12 years with mild to moderate MIH on permanent molar teeth.
Molar Incisor Hypomineralization (MIH) is a structural defect of the enamel affecting at least one of the first four permanent molars. The prevalence is high, ranging from 20% to 40% of children. The consequences of MIH are multiple, including pain during food intake or an increased risk for the development of carious disease. The current standard protocol for mild to moderate MIH is the use of direct restorations (Glass Cement Ionomer type). However, this therapy is not suitable due to frequent failures. In terms of longevity, indirect restorations are superior to direct restorations. CAD/CAM in dentistry offers the possibility of making these inlay/onlay type perennial coronary restorations. It is faster to implement and does not require a conventional impression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CAD/CAM Group | Experimental | For the CAD/CAM group, an indirect ceramic restoration will be made using an optical impression. |
|
| Direct method Group | Active Comparator | For the direct method group, a restoration using a Glass Ionomer Cement will be performed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Indirect ceramic restoration | Procedure | Indirect ceramic restoration using an optical impression. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Treatment effect | The effect of the management of the MIH will be assessed by the occurrence of failure. Failure will be diagnosed from the degree of demineralisation measured, by laser fluorescence at the peripheral tooth/restoration joint. The values collected range from 0 to 99 and are categorised into 3 situations :
| 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Failure | Failure diagnosed according to the degree of demineralisation measured, every 3 months following the restoration, by laser fluorescence at the peripheral tooth/restoration joint. | 3 months |
| Failure |
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inclusion criteria:
Non-inclusion criteria:
Child presenting an allergy or a history of allergy to one of the constituents of biomaterials
Child with fluorosis
Child with amelogenesis imperfecta
Child with pacemaker (contraindication to CAD/CAM)
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mathieu MARTY | Contact | 06.79.97.47.11 | marty.mat@chu-toulouse.fr |
| Name | Affiliation | Role |
|---|---|---|
| Mathieu MARTY | University Hospital of Toulouse | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University hospital of Toulouse | Toulouse | 31062 | France |
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| ID | Term |
|---|---|
| D000094604 | Molar Hypomineralization |
| ID | Term |
|---|---|
| D000094603 | Dental Enamel Hypomineralization |
| D000094602 | Developmental Defects of Enamel |
| D014071 | Tooth Abnormalities |
| D018640 | Stomatognathic System Abnormalities |
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| Direct restoration | Procedure | Restoration using a Glass Ionomer Cement |
|
Failure diagnosed according to the degree of demineralisation measured, every 12 months following the restoration, by laser fluorescence at the peripheral tooth/restoration joint.
| 12 months |
| D009057 | Stomatognathic Diseases |
| D014076 | Tooth Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |