To assess the caries progression in molar incisor hypomineralization patients without treatment versus prior treatment with silver diamine fluoride/dentin bonding agent: A 24-month retrospective cohort study.

BACKGROUND

Children with molar incisor hypomineralization (MIH) frequently experience high caries burden. Although preventive interventions such as silver diamine fluoride (SDF) and other agents are increasingly used, the natural progression of untreated MIH-related caries remains poorly documented, limiting policy-relevant evaluation of proven benefits in the long term.

OBJECTIVE

To compare the 2-year caries progression in MIH-affected posterior teeth that were untreated versus those previously treated with SDF or universal bonding agents (UBAs).

MATERIALS AND

METHODS

The retrospective cohort study was conducted among schoolchildren aged 6-16 years. Children diagnosed with MIH according to the European Academy of Paediatric Dentistry criteria and presenting with International Caries Detection and Assessment System (ICDAS) 1-4 lesions were included. Exposure was defined as prior treatment with SDF or UBA; comparator was untreated teeth from children who had previously declined treatment. Caries progression was assessed using the ICDAS criteria over a 2-year follow-up. Relative risk (RR), absolute risk reduction (ARR), and number needed to treat (NNT) were calculated.

RESULTS

A total of 252 teeth had complete follow-up data: 142 untreated (56.3%) and 110 previously treated (43.7%). Caries progression occurred in 57.3% of treated teeth and 52.8% of untreated teeth. The unadjusted RR was 1.08 (95% confidence interval [CI]: 0.87-1.36). The ARR was - 4.5% (95% CI: -16.8% to 7.9%), indicating no statistically significant difference (χ 2 ; P = 0.48). The corresponding NNT suggested a number needed to harm of -23 (minus 23), though this estimate was unstable due to CIs crossing zero.

CONCLUSION

Over 2 years, prior preventive treatment with SDF or UBA did not confer a measurable advantage over no treatment, highlighting the importance of long-term metrics to make inform decisions.