Considerations in Orthodontic Bracket Adhesion to Hypomineralized Enamel

Developmental defects of enamel (DDE) are frequently observed. In both pediatric and orthodontic dental practices. DDE consist mainly of hypoplasia, diffuse and demarcated opacities.1 Often, a combination of enamel defects may be recognized in the same child (Fig. 1). Weerheijm et al. defined the term Molar Incisor Hypomineralization (MIH) to describe a more specific pattern of DDE: hypomineralization of systemic origin of one to four permanent first molars frequently associated with affected incisors (Fig. 2).2 Clinically, MIH can be seen as an abnormality in the translucency of the enamel. Some lesions have significant subsurface porosity, leading to posteruptive breakdown of the surface.