Abstract:

Molar–incisor hypomineralization (MIH) is a developmental enamel defect affecting at least one first permanent molar and often the incisors, presenting as asymmetrical, well-demarcated opacities ranging from mild discoloration to extensive post-eruptive breakdown. Affected teeth show reduced mineralization, increased sensitivity, and higher susceptibility to caries, fractures, and atypical wear. The etiology is multifactorial, involving systemic, genetic, environmental, and epigenetic factors, with environmental influences occurring during early tooth development.
This case report describes a 9-year-old healthy girl with MIH-affected first permanent molars and anterior teeth, presenting with hypersensitivity and recurrent restoration failures. Tooth 26 exhibited moderate structural loss and incomplete root development. A minimally invasive restoration protocol was implemented, including removal of defective material, cavity preparation, isolation, impression taking, and fabrication of a CAD–CAM ceramic inlay, cemented using adhesive techniques with occlusal adjustment.
At 12-month follow-up, the inlay demonstrated preserved integrity, maintenance of surrounding tooth structure, and positive pulp vitality. This case highlights the effectiveness of a conservative CAD–CAM inlay approach in MIH-affected molars, emphasizing the importance of early diagnosis, careful treatment planning, and adherence to adhesive protocols to achieve long-term functional and aesthetic outcomes.
Keywords: MIH, CAD-CAM technique, inlay restoration