Clinical challenges and knowledge gaps in molar incisor hypomineralization: a cross-sectional survey with an illustrative case report.

OBJECTIVES: The aim was to describe the main clinical challenges in managing molar incisor hypomineralization (MIH), evaluate dental practitioners' knowledge and clinical decision-making, and illustrate a timed extraction approach through a clinical case. METHOD AND MATERIALS: A narrative review was combined with a cross-sectional digital questionnaire assessing dental practitioners' knowledge, diagnostic ability, and treatment preferences, stratified by experience (≤ 10 years vs > 10 years) and training (general dental practitioners vs specialists/residents). Scores were calculated on a 0 to 100 scale. Additionally, a case report of an 8.5-year-old girl with bilateral post-eruptive breakdown (PEB) of maxillary first permanent molars was presented to demonstrate the management of severe MIH. RESULTS: A total of 145 dental practitioners participated: 61.4% general dental practitioners and 38.6% specialists/residents. Specialists/residents scored significantly higher than general dental practitioners (P .05), particularly in diagnostic and management domains. Glass-ionomer restorations were the most frequently chosen treatment (43%), followed by stainless steel crowns (26%). Younger practitioners more often selected inlays/onlays. The case demonstrated favorable eruption of second molars following timed extraction. CONCLUSION: MIH management requires early diagnosis and severity-based treatment planning. Persistent knowledge gaps, especially among general dental practitioners, emphasize the need for enhanced continuing education. Timed extraction, when appropriately planned, may provide a predictable outcome in severe MIH cases.