Modified ZeroExpander for patients with MIH and HSPM.

BACKGROUND: Hypomineralisation of the first permanent molars (MIH) and second deciduous molars (HSPM) is an increasingly prevalent structural problem in paediatric patients. At the same time, the transverse palatal deficit is frequently found in that age group and necessitates early intervention. The purpose of this work is to present three new designs of the ZeroExpander, specifically developed for patients with hypomineralised teeth, which would otherwise be challenging to engage during orthodontic treatment. CASE REPORT: The ZeroExpanders for hypomineralised teeth are customized devices, digitally designed and produced from technopolymer. They feature overlay bands that fit over the hypomineralised teeth, combined with bioactive cements that facilitates continuous remineralisation of the dental enamel. These devices apply light forces within a pre-programmed, automatic expansion framework. Three examples of ZeroExpanders are presented: one for patients with both MIH and HSPM, one for MIH alone, and one for HSPM alone. Additionally, a case is illustrated where a patient with MIH in the early permanent dentition was successfully treated. CONCLUSION: The modified ZeroExpanders help preserve the integrity of both directly and indirectly involved hypomineralised teeth, including those in the lower arch. The workflow is effective and efficient, and they have the same level of effectiveness as the standard ZeroExpanders in terms of achieving the programmed expansion.