Comparison of Two Minimally Invasive Approaches for Masking Molar-Incisor Hypomineralization Opacities

Comparison of Two Minimally Invasive Approaches for Masking Molar-Incisor Hypomineralization Opacities: Effects on Esthetic Perceptions of Children and Their Parents

This clinical study aimed to compare the effectiveness of two minimally invasive approaches for masking molar-incisor hypomineralization (MIH) opacities and to evaluate esthetic perceptions of children and their parents. Participants with MIH-affected incisors received either resin infiltration or etch-bleach-seal treatment. Esthetic outcomes and satisfaction levels were assessed using standardized scales.

Study Overview

• Status: Completed
• Conditions: Tooth Discoloration; Molar Incisor Hypomineralisation; Enamel Hypomineralization
• Intervention / Treatment: Other: Resin infiltration; Other: Etch Bleach Seal Technique

Detailed Description

Molar-incisor hypomineralization (MIH) is a qualitative enamel defect that often leads to esthetic concerns, particularly in anterior teeth. Minimally invasive treatment approaches such as resin infiltration and etch-bleach-seal techniques have been proposed to improve the appearance of MIH opacities.

This study aimed to compare the effectiveness of these two approaches in masking MIH opacities in permanent incisors and to evaluate esthetic perceptions from both children and their parents. Esthetic perceptions related to dental appearance were evaluated using the ''Child's and Parent's Questionnaire about Teeth Appearance''. The color masking effectiveness of resin infiltration and the etch-bleach-seal (EBS) technique on MIH-related anterior enamel opacities were evaluated using a spectrophotometer (VITA Easyshade® V, Sackingen, Germany).

The findings are expected to contribute to evidence-based decision-making for minimally invasive esthetic management of MIH.

• Study Type: Interventional
• Enrollment (Actual): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Denizli, Turkey (Türkiye), 20160
    • Pamukkale University Faculty of Dentistry , Denizli

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age between 8 and 10 years,
• Diagnosis of MIH according to the European Academy of Paediatric Dentistry (EAPD) criteria [19], with at least one permanent incisor exhibiting well-demarcated white-cream and/or yellow-brown enamel opacities causing esthetic concern to the child and/or parents,
• Absence of urgent dental treatment needs, with completed treatment of posterior teeth,
• Ability of both children and parents to read and understand Turkish.

Exclusion Criteria:

• Presence of urgent dental treatment or requirement for restorative treatment of MIH affected permanent first molars during the study period,
• Presence of dental or facial anomalies other than MIH (e.g. hypodontia, cleft lip and/or palate),
• Presence of dental caries, crown fractures, or extrinsic/intrinsic tooth discolorations that could compromise esthetic perception,
• Presence of other developmental enamel defects (e.g. enamel hypoplasia, amelogenesis imperfecta, fluorosis, or hypoplasia related to previous dental trauma),
• Previous restorative treatment, resin infiltration, microabrasion, and/or tooth whitening on the affected incisors,
• Children and/or parents who were unlikely to attend follow-up visits or were unable to read and understand Turkish.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Resin infiltration; Participants in this arm received resin infiltration treatment for masking molar incisor hypomineralization-related enamel opacities. The procedure involved etching with hydrochloric acid, ethanol application for dehydration, and application of a low-viscosity resin infiltrant (Icon®, DMG) followed by light curing and polishing in a single clinical session.	Other: Resin infiltration; A minimally invasive dental procedure used to mask enamel opacities associated with molar incisor hypomineralization. The technique involves etching the enamel surface, drying with ethanol, and applying a low-viscosity resin infiltrant (Icon®, DMG), followed by light curing and polishing in a single clinical session.
Experimental: Etch Bleach Seal Technique; Participants in this arm received the etch bleach seal technique for masking molar incisor hypomineralization-related enamel opacities. The procedure included phosphoric acid etching, application of sodium hypochlorite for bleaching, and sealing with a resin-based sealant, followed by light curing and polishing in a single clinical session.	Other: Etch Bleach Seal Technique; A minimally invasive dental procedure used to improve the appearance of enamel opacities associated with molar incisor hypomineralization. The technique includes phosphoric acid etching, application of sodium hypochlorite for bleaching, and sealing with a resin-based sealant, followed by light curing and polishing in a single clinical session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in esthetic perception of children and parents	Esthetic perception was assessed using the Child's and Parent's Questionnaire about Teeth Appearance. Changes in physical, psychological, and social domains, as well as satisfaction with tooth appearance, were evaluated before treatment and at 3-month follow-up.	Baseline and 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Color change of MIH-related anterior enamel opacities	Color changes were measured using a spectrophotometer based on the CIELAB system. Color differences (ΔE values) were calculated to assess the effectiveness of masking enamel opacities.	Baseline, 1 month, 3 months

Collaborators and Investigators

• Sponsor: Pamukkale University
• Investigators: Study Director: Arif Bolaca, Dr, Pamukkale University

Study record dates

Study Major Dates

• Study Start (Actual): May 6, 2024
• Primary Completion (Actual): September 24, 2024
• Study Completion (Actual): December 20, 2024

Study Registration Dates

• First Submitted: March 20, 2026
• First Submitted That Met QC Criteria: March 20, 2026
• First Posted (Actual): March 27, 2026

Study Record Updates

• Last Update Posted (Actual): March 27, 2026
• Last Update Submitted That Met QC Criteria: March 20, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Molar incisor hypomineralization; Minimally invasive treatment; Resin infiltration technique; Etch bleach seal technique; Esthetic perception
• Additional Relevant MeSH Terms: Developmental Defects of Enamel; Stomatognathic Diseases; Tooth Diseases; Stomatognathic System Abnormalities; Congenital Abnormalities; Tooth Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Molar Hypomineralization; Dental Enamel Hypomineralization; Tooth Discoloration
• Other Study ID Numbers: 2024DİŞF001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared due to ethical and privacy considerations, as the study involves pediatric participants. Data are available from the corresponding author on reasonable request and with appropriate ethical approval.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No