Departament of Dentistry, State University of Ponta Grossa, Av. General Carlos Cavalcanti, 4748 - Uvaranas, Ponta Grossa, Paraná, CEP 84030-900, Brazil.
Departament of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
Clin Oral Investig. 2022 Oct;26(10):5989-6002. doi: 10.1007/s00784-022-04612-9. Epub 2022 Jul 6.
This overview analyzed the quality of the systematic reviews (SRs) available on treatments for molar-incisor hypomineralization (MIH).
Six electronic databases were searched (PubMed/MEDLINE, Scopus, Web of Science, LILACS, Brazilian Bibliography of Dentistry and Cochrane Library) until March 2022. Two reviewers independently performed the selection, the quality assessment (Assessment of Multiple Systematic Reviews 2 - AMSTAR-2), and the risk of bias assessment of the SR (Risk of Bias in Systematic Reviews - ROBIS).
Two hundred nine records were retrieved; after removing duplicates and applying the inclusion/exclusion criteria, 5 SRs remained. Three SRs were rated as showing critically low methodological quality and high risk of bias, and two were rated as moderate methodological quality and low risk of bias. The identified treatments that may be suitable for MIH were classified as (1) non-invasive - casein incorporated into toothpaste and sugar-free chewing gum, toothpaste containing arginine, 0.4% stannous fluoride gel; fluoride varnish; (2) micro-invasive - resin sealants for pits and fissures, microabrasion, dental whitening, resin infiltration; (3) invasive - ART restorations, indirect restorations (metal, composite, or ceramic); and (4) mixed intervention - stainless steel crowns.
Despite the considerable number of published papers included in this set of systematic reviews, the evidence supporting the effectiveness of treatments for treating MIH is limited due to the methodological quality and risk of bias of the systematic reviews, as well as the quality of the primary studies (PROSPERO: CRD42020144831).
Different treatments have been purposed for MIH treatment, but there is still not enough scientific evidence of good quality for the establishment of a definitive clinical protocol for the treatment of MIH.
本综述分析了针对摩尔牙-恒前牙牙釉质发育不全（MIH）治疗的系统评价（SR）的质量。
检索了 6 个电子数据库（PubMed/MEDLINE、Scopus、Web of Science、LILACS、巴西牙科文献和 Cochrane 图书馆），截至 2022 年 3 月。两名评审员独立进行了选择、质量评估（评估多项系统评价 2 - AMSTAR-2）以及 SR 的偏倚风险评估（系统评价中的偏倚风险 - ROBIS）。
共检索到 209 条记录；在去除重复项并应用纳入/排除标准后，保留了 5 项 SR。3 项 SR 被评为方法学质量极低且偏倚风险高，2 项被评为方法学质量中等且偏倚风险低。被认为可能适用于 MIH 的治疗方法被分为（1）非侵入性 - 含酪蛋白的牙膏和无糖口香糖、含精氨酸的牙膏、0.4% 氟化亚锡凝胶；氟化物漆；（2）微侵入性 - 窝沟封闭剂、微磨损、牙齿美白、树脂渗透；（3）侵入性 - ART 修复体、间接修复体（金属、复合或陶瓷）；和（4）混合干预 - 不锈钢冠。
尽管纳入这组系统评价的已发表论文数量相当多，但由于系统评价的方法学质量和偏倚风险以及主要研究的质量，支持 MIH 治疗的治疗方法的有效性的证据有限（PROSPERO：CRD42020144831）。
针对 MIH 的治疗提出了不同的治疗方法，但仍缺乏足够的高质量科学证据来制定 MIH 治疗的明确临床方案。
