Making white spots disappear! Do minimally invasive treatments improve incisor opacities in children with molar incisor hypomineralisation?

BACKGROUND Children with molar incisor hypomineralisation (MIH) frequently seek aesthetic treatment for incisor opacities. Surprisingly few studies have evaluated the clinical success of such interventions. AIM To quantify the effectiveness of minimally invasive treatments in reducing enamel opacity visibility in children with MIH. DESIGN This in-vitro study used digital clinical images of 23 children aged 8-16 years with MIH who underwent microabrasion and/or resin infiltration for management of incisor opacities. Standard images were taken pre- and six-months post-treatment. Image software (Image-Pro Plus®V7) was employed to convert 24-bit RGB images to 16-bit grey-scale and 45% magnification. Measurement repeatability was assessed using Intra-class Correlation Coefficients (ICC). Post-treatment changes in visible opacity area (mm2 ) and brightness (greyscale value) were tested using Wilcoxon Signed Rank Test for Related-Samples. RESULTS Mean total opacity surface area significantly reduced from 14.3mm2 (SD=7.5) to 9.4mm2 (SD=9.0) post-treatment. The proportion of tooth surface affected by the opacity also significantly reduced from 22.5% (SD=10.5) to 14.7% (SD=12.7). Mean maximum opacity brightness significantly reduced from 53066 greyscale value (SD=4740) to 49040 (SD=3796). ICC was good/excellent (0.75-1.0). CONCLUSION Minimally invasive treatment is effective in reducing size and brightness of discrete incisor opacities. Future research should compare objective findings with patient-reported outcomes.