Daniela Rios, DDS, MSc, PhD, is a dentist and researcher who completed her undergraduate, Master’s, PhD, and postdoctoral training at the Bauru School of Dentistry, University of São Paulo (FOB-USP), Brazil. She works primarily in Pediatric Dentistry and Cariology, integrating clinical practice with research driven by patients’ needs. Her main research interests focus on erosive tooth wear and molar incisor hypomineralization (MIH). Dr. Rios has authored and co-authored numerous peer-reviewed scientific articles in international journals and recently served as editor of a book on Molar Incisor Hypomineralization, published by Karger in the Monographs in Oral Science series. Her work is grounded in evidence-based dentistry and aims to translate clinical challenges into impactful research to improve oral health outcomes, particularly in children.
This lecture will address current challenges in the management of molars affected by molar incisor hypomineralization (MIH) presenting with extensive post-eruptive enamel breakdown. The discussion will focus on critically re-examining the underlying causes of restorative failures in severely affected MIH molars to propose alternative and more effective treatment strategies. For many years, compromised adhesion of restorative materials to hypomineralized enamel has been considered the primary reason for restoration failure. However, recent clinical observations indicate that failures are more frequently associated with fractures of the surrounding hypomineralized enamel, rather than loss of the restorative material itself. This shift in understanding highlights the need to move away from conventional caries-based treatment concepts and to adopt strategies specifically designed to protect the fragile hypomineralized enamel, which often remains around restorations and is highly susceptible to fracture. The lecture will present current treatment approaches for severely affected MIH molars and critically discuss emerging strategies aimed at improving clinical outcomes. All proposals will be examined in light of the best available scientific evidence, with an emphasis on translating clinical challenges into evidence-based decision making.
