目的:本系统综述旨在解决以下研究问题:“儿童和青少年(人群/患者)磨牙切牙低矿化(MIH)(暴露)的临床后果(结果)是什么?”
方法:定义策略后,在不同的数据库中进行了搜索(MEDLINEviaPubmed,科克伦图书馆,BBO,LILACS,Scopus,WebofScience,Embase)和2023年8月的灰色文献。确定MIH(龋齿,爆发后的结构损失,非典型修复,包括超敏反应和拔牙)。根据JoannaBriggs研究所的横断面研究方案评估偏倚风险。对每个结果进行荟萃分析,考虑到患者和牙齿的数量。考虑的效果测量是患病率;采用随机效果模型。使用I2统计和预测间隔(PI)评估异质性。
结果:共确定了903项研究;选择了41项进行定性分析,选择了38项进行定量分析。28项研究被归类为存在不确定的偏见风险,11为低风险,3为高风险偏倚。患病率水平,从最高到最低,考虑到牙齿和患者单位,分别,有:龋齿病变(0.252-95%CI0.158-0.375;0.512-95%CI0.385-0.639);超敏反应(0.286-95%CI0.190-0.407;0.417-95%CI0.197-0.674),萌出性骨折(0.125-95%CI0.099-0.158;0.257-95%CI0.145-0.412);非典型修复体(0.048-95%CI0.030-0.077;0.167-95%CI0.096-0.274);拔牙(0.012-95%CI0.007-0.019;0.090-95%CI0.019-0.331)。所有荟萃分析导致异质性大于85%,除了根据牙齿单位的结果“拔牙”(I2=57.83)。这种异质性可能归因于诸如研究实现地点的差异等因素,研究人群的社会经济状况,MIH的不对称性质,患者年龄。
结论:MIH最常见的后果是龋齿病变,超敏反应,和爆发后的崩溃。(PROSPERO:CRD42020201410)。
OBJECTIVE: This systematic review was conducted to address the following research question: \"What are the clinical consequences (outcome) of Molar Incisor Hypomineralization (MIH) (exposure) in children and adolescents (population/patient)?\".
METHODS: After defining the strategy, a search was performed in different databases (MEDLINE via Pubmed, Cochrane Library, BBO, LILACS, Scopus, Web of Science, Embase) and Grey literature in August 2023. Cross-sectional observational studies that identified clinical consequences of MIH (dental caries, post-eruptive structural loss, atypical restorations, hypersensitivity and tooth extraction) were included. The risk of bias was assessed following the Joanna Briggs Institute protocol for cross-sectional studies. Meta-analyses were conducted for each outcome, taking into account the number of patients and teeth. The effect measure considered was the prevalence; random-effects model was adopted. Heterogeneity was assessed using I2 statistics and prediction intervals (PI).
RESULTS: A total of 903 studies were identified; 41 were selected for qualitative analysis and 38 for quantitative analysis. Twenty eight studies were classified as presenting uncertain risk of bias, 11 as low risk and 3 as high risk of bias. The prevalence levels, ranked from highest to lowest and considering the tooth and patient units, respectively, were: caries lesions (0.252 - 95% CI 0.158-0.375; 0.512 - 95% CI 0.385-0.639); hypersensitivity (0.286 - 95% CI 0.190-0.407; 0.417 - 95% CI 0.197-0.674), post-eruptive fracture (0.125 - 95% CI 0.099-0.158; 0.257 - 95% CI 0.145-0.412); atypical restorations (0.048 - 95% CI 0.030-0.077; 0.167 - 95% CI 0.096 - 0.274); tooth extraction (0.012 - 95% CI 0.007-0.019; 0.090 - 95% CI 0.019 - 0.331). All meta-analyses resulted in heterogeneity greater than 85%, with the exception of the outcome \"tooth extraction\" according to the tooth unit (I2 = 57.83). This heterogeneity may be attributed to factors such as differences in the location where the study was realized, the socioeconomic conditions of the studied population, the asymmetric nature of MIH, and patient age.
CONCLUSIONS: The most common consequences of MIH are caries lesions, hypersensitivity, and post-eruptive breakdown. (PROSPERO:CRD42020201410).