Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland.
Swiss Dent J. 2021 Dec 6;131(12):988-997. doi: 10.61872/sdj-2021-12-764. Epub 2021 Mar 25.
The objective was to systematically analyse clinical studies on restorative procedures for teeth affected by molar-incisor hypomineralisation (MIH). The databases PubMed, Embase, and Cochrane Library were searched. Only retrospective and prospective clinical studies dealing with sealing or restoration of MIH-affected teeth were included. The language was restricted to English or German. Thirteen of 36 potentially eligible studies were included focusing on the following subjects: extension of enamel preparation, adhesive procedures prior to restoration, application of fissure sealants as well as restoration with conventional glass ionomer cements (GIC), resin modified glass ionomer cements (RMGIC), resin composites, and indirect restorations. Seven clinical studies were controlled trials. However, only two included MIH-unaffected teeth as control. No meta-analysis was performed due to the heterogeneity of study designs (e.g. severity of MIH or the restorative materials investigated). Based on the present analysis, the annual failure rates were in average 21% for fissure sealants, 22% for GIC, 1-6% for RMGIC, 13-32% for resin composites, and 0-7% for indirect restorations. In summary, only few tendencies can be deduced from this review at a low level of evidence (number of studies): 1) preparation margins in sound enamel seem to be superior to preparations in hypomineralised enamel (1 study), 2) RMGIC seems to be superior to GIC (3 studies), 3) resin composites may be used for restoring all severities of MIH (7 studies) with self-etch and etch-and-rinse adhesive systems generally not performing differently (3 studies), and 4) in cases of severe MIH, indirect restorations showed a good clinical success (4 studies).
目的是系统分析关于磨牙-切牙釉质发育不全（MIH）患牙修复治疗的临床研究。检索了 PubMed、Embase 和 Cochrane 图书馆数据库。仅纳入了涉及 MIH 患牙封闭或修复的回顾性和前瞻性临床研究。语言限制为英语或德语。纳入了 36 项潜在合格研究中的 13 项，主要集中在以下几个方面：牙釉质预备的扩展、修复前的黏结程序、窝沟封闭剂的应用以及传统玻璃离子水门汀（GIC）、树脂改性玻璃离子水门汀（RMGIC）、树脂复合材料和间接修复的应用。7 项临床研究为对照试验。然而，只有两项研究将 MIH 未受影响的牙齿作为对照。由于研究设计的异质性（例如 MIH 的严重程度或研究的修复材料），未进行荟萃分析。根据目前的分析，窝沟封闭剂的年失败率平均为 21%，GIC 为 22%，RMGIC 为 1-6%，树脂复合材料为 13-32%，间接修复体为 0-7%。总之，在低证据水平（研究数量）下，只能从这篇综述中得出一些趋势：1）在正常牙釉质上制备边缘似乎优于在矿化不良的牙釉质上制备（1 项研究），2）RMGIC 似乎优于 GIC（3 项研究），3）树脂复合材料可用于修复所有严重程度的 MIH（7 项研究），自酸蚀和酸蚀-冲洗黏结系统的性能通常没有差异（3 项研究），以及 4）在严重 MIH 的情况下，间接修复体显示出良好的临床效果（4 项研究）。
