The role of endodontists in managing patients with molar incisor hypomineralisation.

Objective: To explore the role of endodontists in the management of molar incisor hypomineralisation (MIH) in children, focusing on the challenges of diagnosis, treatment, and interdisciplinary collaboration.

Methods: A review of the current literature and clinical approaches was conducted, emphasising the endodontic considerations regarding MIH.

Results: 37 relevant articles were identified. The findings suggest that selective caries removal and vital pulp therapy (VPT) are essential approaches to preserving the vitality of compromised first molars, although there is a scarcity of evidence addressing specifically the management of molars affected by MIH. Diagnosing pulpal conditions in children with MIH is challenging, as pulp tests may be unreliable. This can lead to exaggerated responses and an increased risk of misdiagnosis, resulting in unnecessary treatments like endodontic therapy or extractions. The involvement of endodontists is critical, especially when minimally invasive techniques are needed to preserve dental tissue. Endodontists face additional challenges related to pulp therapy in these patients due to subclinical pulp inflammation, which can impair anaesthesia effectiveness and reduce a child's cooperation.

Conclusion: Interdisciplinary collaboration between paediatric dentists and endodontists is essential for improving outcomes in MIH management. The development of advanced behaviour management skills and minimally invasive treatment approaches is recommended to enhance patient care.