Tratamento restaurador com giômeros em molares hipomineralizados: relato de caso

Abstract

Molar–Incisor Hypomineralization (MIH) is a qualitative defect of the dental enamel that compromises the structure and resistance of the first permanent molars and often the incisors, making them more susceptible to post-eruptive fractures, sensitivity, and atypical carious lesions. Given the clinical challenges presented by this condition, early diagnosis and the selection of appropriate restorative materials are essential to ensure the preservation of dental structure and the success of treatment. The aim of this study was to report the conservative restorative treatment of a 9-year-old patient diagnosed with MIH, highlighting the selection and performance of the bioactive giomer Beautifil Flow Plus (Shofu Inc.), which was used in the definitive restorations. The methodology included detailed anamnesis, clinical and radiographic examination, followed by individualized treatment planning. The patient presented well-defined white-yellowish opacities consistent with MIH on tooth 16 and a post-eruptive fracture associated with an atypical carious lesion on tooth 36, without signs of pain or sensitivity, which allowed a minimally invasive approach. Initially, dentin protection of tooth 36 was performed using glass ionomer cement due to its chemical adhesion and continuous fluoride release. After achieving satisfactory clinical stability, the affected teeth were definitively restored using Beautifil Flow Plus, selected for its excellent marginal adaptation, mechanical strength, aesthetic properties, and especially its bioactivity provided by S-PRG technology, capable of releasing ions such as fluoride, calcium, and strontium, thus promoting remineralization of hypomineralized enamel. Clinical results demonstrated stability, absence of postoperative sensitivity, excellent esthetic outcome, and functional restoration. The restorations showed adequate integration with the remaining dental structure, contributing to pulp vitality preservation and avoiding invasive procedures or extractions. It is concluded that the use of bioactive materials such as giomers, combined with early diagnosis and continuous monitoring, represents a safe and effective alternative in the management of MIH, promoting durable restorative outcomes and contributing to the patient’s oral health and well-being.