Background: Severely hypomineralised first permanent molars (FPMs) in children with molar incisor hypomineralisation (MIH) often require comprehensive restorative treatment. Different types of treatment have been described in the literature, including conservative treatment and use of various types of crowns.
Aim: To describe a gentle and minimally invasive method for restoration of severely hypomineralised FPMs and to perform an initial, practice-based evaluation of the outcome for up to a 10-year follow-up period.
Methods: Thirty-three children (mean age 12.1 years, SD 2.6) were treated with 57 minimally invasive cast adhesive gold copings (CAC). Sedation, local analgesia using a computer-controlled injection device, and behaviour management techniques were used to secure gentle care of the child. In cases with need for treatment of several teeth, the teeth not under treatment were covered by splints. The preparation border was placed in sound enamel, allowing 1/2-2 mm space to secure sufficient strength of the final restoration, which was cemented with dual composite cement. Follow-up examinations were performed by the dentists referring the children.
Results: All the children referred for treatment could be treated using this procedure, and of the 57 CAC, 56 (98.2 %) were still functioning after a mean observation period of 38.6 months (SD 28.9).
Conclusion: In addition to existing types of treatment, minimally invasive CAC seems to be a feasible and useful method for restoration of FPMs with demarcated opacities and post-eruptive surface loss in children with MIH.