The aim of this study was to evaluate the clinical effects of deproteinization of the hypomineralized enamel and different cavity designs on the performance of the composite resin restorations(CRRs) placed into the cavities of MIH (molar incisor hypomineralization)-affected molars. Study design: 95 MIH-affected permanent first molars (PFMs) and 31 caries but not MIH- affected PFMs (126 teeth in total) were included in the study. The MIH-affected molars were divided into three groups. In Group I, all hypomineralized tissue was removed until healthy enamel was reached. In Group II, carious and cheesy hypomineralized tissue was removed until a reasonable resistance was detected in the hypomineralized tissue. In Group III, cavities designed as Group II, differently from this group deproteinization of the left hypomineralized tissue was performed prior to the placement of CRRs. Group IV served as the control group consisting of unaffected carious PFMs. Restorations were evaluated according to modified USPHS criteria for 24 months. Results: The retention rates were 93.7% for Group I, 80.7% for Group II, 93.5% for Group III and 100% for Group IV. The success rate for the restorations in Group II proved significantly lower (p<0.05) than that of the other three groups. No significant difference in success rates was observed between Group I, Group III and Group IV (p>0.05) at the end of 24 months. Conclusions: Failure of the restorations was predominant in the group that the hypomineralized tissue was left surrounding the cavities. Deproteinization of the hypomineralized enamel was found to enhance the retention rates of CRRs.

Molar Incisor Hypomineralization, composite resin restoration, , deproteinization.

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