Strategies to optimize bonding of adhesive materials to molar-incisor hypomineralization-affected enamel: A systematic review

Background Children with first permanent molar affected by molar-incisor hypomineralization (MIH) show high treatment failure rate. Aim To conduct a systematic review on bonding of adhesive materials to MIH-affected enamel, so as to identify all the methods suggested to optimize it and to determine the best bonding protocol(s). Design An exhaustive literature search was conducted on MEDLINE/PubMed, the Cochrane Library, and Web of Science databases, up to October 2018. Laboratory and clinical studies, involving adhesive restorations bonded to MIH-affected enamel, with at least a comparative group were included. Two authors independently selected studies, collected data, and assessed bias risk. Results After title and abstract review and duplicate exclusion, 14 articles were selected on the 496 eligible papers. After full reading, 4 articles were excluded. Finally, 10 studies (6 laboratory and 4 clinical studies) were included. Conclusions Bond strength of composite was not significantly different when using self-etch compared with etch-and-rinse adhesives. Deproteinization after etching for etch-and-rinse adhesives enhanced bond strength; this could allow to keep MIH-affected enamel. Icon (R) showed an erratic penetration; however, a preliminary deproteinization after etching could improve bond strength. A study reported no significant differences in sealant retention rate, whereas another recommended to previously apply an adhesive.