Molar incisor hypomineralisation: a cross-sectional study of knowledge, clinical decision-making, and the influence of clinical experience in aesthetic and restorative dental practice

Abstract

Molar incisor hypomineralisation (MIH) presents considerable diagnostic and restorative challenges in clinical practice due to its heterogeneous clinical presentation and compromised enamel structure. The present study aimed to evaluate MIH-related knowledge, confidence, and clinical decision-making amongst clinicians engaged in aesthetic and restorative dentistry and to assess the influence of clinical experience on knowledge levels and treatment preferences. A cross-sectional survey was conducted amongst 214 clinicians practising aesthetic and restorative dentistry in Türkiye. The questionnaire included sections addressing demographic and professional characteristics, MIH-related knowledge, clinical practice patterns, diagnostic and treatment confidence, and case-based treatment preferences. Knowledge scores were calculated using 13 factual knowledge items. Statistical analyses included descriptive statistics, chi-square tests, one-way analysis of variance (ANOVA), Welch’s t-test, Spearman correlation analysis, and multivariable logistic regression. The mean knowledge score was 8.85 ± 1.99 (range: 3–13). Clinicians with fewer than 10 years of clinical experience demonstrated significantly higher knowledge scores than those with greater experience (9.19 ± 1.61 vs. 8.02 ± 2.54; p = 0.001). Knowledge scores were positively correlated with both diagnostic confidence (rho = 0.570, p < 0.001) and treatment confidence (rho = 0.532, p < 0.001). Resin composite restoration and resin infiltration (ICON) were the most frequently selected treatment options for anterior MIH lesions, whereas glass ionomer–based approaches were more commonly preferred for posterior lesions. Multivariable logistic regression demonstrated that higher knowledge scores independently associated with an increased likelihood of selecting resin composite restoration in anterior cases (OR = 1.29, 95% CI: 1.02–1.63; p = 0.035). Greater clinical experience was associated with a lower likelihood of selecting resin infiltration (OR = 0.32, 95% CI: 0.13–0.78; p = 0.012). Significant variability exists in MIH-related knowledge and clinical decision-making amongst clinicians engaged in aesthetic and restorative dentistry. Knowledge level was associated with diagnostic confidence and restorative treatment preferences, whereas clinical experience influenced minimally invasive treatment selection.