Evaluation Direct and Indirect Composite Restoration in Hypomineralization Molars.
Condition: Dental Enamel Hypoplasia; Dental Caries
MeSH terms: Dental Caries; Dental Enamel Hypoplasia
Study type: Interventional

Summary: 
      The aim of this study is to evaluate the effectiveness of direct and Indirect Composite
      Restoration in Children With Molar Incisor Hypomineralization Patients (MIH) and following up
      after 3 , 6 , 12 months (Clinically):

      Group A ( Control group ): Hypomineralization molars were restored by direct composite.

      Group B ( Experimental group ): Hypomineralization molars were restored by indirect
      composite.
    

Detailed description: 
      Pediatric dentists face a high prevalence of MIH ranging from 3 to 40%, so it is relatively
      common condition that would cause treatment challenges due to severe sensitivity, breakdown
      of the occlusal surface, difficulty anesthesia and relatively high failure of restorations as
      a result of marginal breakdown of restorations.

      There are many treatment options available to restore these teeth. In mild and moderate
      cases, they are restored using direct composite resin. In cases where teeth are severely
      affected, the treatment is more complicated, including stainless steel crowns and different
      types of full or partial indirect crowns.

      Direct composite resin restorations are the treatment option in the majority of clinical
      cases, but in severe cases, the results of treatment are often unsatisfactory.

      Indirect composite restorations are an aesthetic alternative to cast metal inlays and
      stainless steel crowns with minimal microleakage.
    

Intervention name(s): Direct restoration; Indirect restoration
Intervention type(s): Other; Other
Intervention description(s): Local anesthesia was achieved and the tooth were isolated using a rubber dam. Then, the entire caries and hypomineralized enamel were removed using diamond burs and removal the affected dentine caries by slow speed handpiece, the final preparation must be on intact enamel. The molars were wiped using 5.25% sodium hypochlorite followed by rinsing with water, etching using 37% phosphoric acid The surface of the restoration, bonding, applying composite and assessment of occlusion.; Local anesthesia was achieved and the tooth were isolated using a rubber dam. Then, the entire caries and hypomineralized enamel were removed using diamond burs and removal the affected dentine caries by slow speed handpiece, the final preparation must be on intact enamel. Preparation walls were vertical according to the longitudinal axis of the tooth and the occlusal depth 2 mm. The impressions were taken for both jaws and the bite were recorded for the using red wax. The cavity in example were painted with insulating material. Indirect composite resin were applied, finishined and polished.
Cementation:
Tooth surface: The molars were wiped using 5.25% sodium hypochlorite followed by rinsing with water, etching using 37% phosphoric acid The surface of the restoration: application of silane coupling agent to enhance the formation of resin tags.
Dual cure resin cement was used for final cementation followed by an assessment of occlusion.
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: Split mouth design
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: MIH; Direct composite; Indirect composite; Permanent molars