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儿童和青少年恒磨牙牙釉质发育不全(MIH)患牙治疗方式的更新:系统评价。

An update of treatment modalities in children and adolescents with teeth affected by molar incisor hypomineralisation (MIH): a systematic review.

机构信息

Department of Paediatric Dentistry, Institute of Dentistry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

出版信息

Eur Arch Paediatr Dent. 2022 Feb;23(1):39-64. doi: 10.1007/s40368-021-00635-0. Epub 2021 Jun 10.

Abstract

PURPOSE

To systematically review the treatment modalities for molar-incisor hypomineralisation for children under the age of 18 years. The research question was, 'What are the treatment options for teeth in children affected by molar incisor hypomineralisation?'

METHODS

An electronic search of the following electronic databases was completed MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey identifying studies from 1980 to 2020. The PRISMA guidelines were followed. The studies were screened, data extracted and calibration was completed by two independent reviewers.

RESULTS

Of 6220 potential articles, 34 studies were included. Twenty studies investigated management of molars with fissure sealants, glass ionomer cement, polyacid modified resin composite, composite resin, amalgam, preformed metal crowns, laboratory-manufactured crowns and extractions. In four articles management of incisors with microabrasion, resin-infiltration and a combination of approaches was reported. Eight studies looked at strategies to mineralise MIH-affected teeth and/or reduce hypersensitivity. Two studies investigated patient-centred outcomes following treatment. Due to the heterogeneity between the studies, meta-analysis was not performed.

CONCLUSION

The use of resin-based fissure sealants, preformed metal crowns, direct composite resin restorations and laboratory-made restorations can be recommended for MIH-affected molars. There is insufficient evidence to support specific approaches for the management of affected incisors. Products containing CPP-ACP may be beneficial for MIH-affected teeth.

摘要

目的

系统回顾 18 岁以下儿童磨牙-切牙牙釉质发育不全的治疗方法。研究问题是,“患有磨牙-切牙牙釉质发育不全的儿童的牙齿有哪些治疗选择?”

方法

对以下电子数据库进行电子检索:MEDLINE、EMBASE、Cochrane 对照试验中心注册库、LILACS、Google Scholar 和 Open Grey,以确定 1980 年至 2020 年的研究。遵循 PRISMA 指南。两名独立审查员筛选了研究、提取了数据并进行了校准。

结果

在 6220 篇潜在文章中,有 34 篇研究被纳入。20 项研究调查了窝沟封闭剂、玻璃离子水门汀、聚酸改性树脂复合树脂、复合树脂、汞合金、预成型金属冠、实验室制造的冠和拔牙对磨牙的管理。在 4 篇文章中,报告了用微研磨、树脂渗透和联合治疗方法对切牙的处理。8 项研究探讨了矿化 MIH 受累牙齿和/或减轻过敏的策略。两项研究调查了治疗后患者为中心的结果。由于研究之间存在异质性,因此未进行荟萃分析。

结论

可以推荐使用树脂基窝沟封闭剂、预成型金属冠、直接复合树脂修复体和实验室制作的修复体来治疗 MIH 受累磨牙。目前没有足够的证据支持特定的治疗方法来处理受累的切牙。含有 CPP-ACP 的产品可能对 MIH 受累牙齿有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9690/8927013/f1c5a192eccc/40368_2021_635_Fig1_HTML.jpg

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