Vollú Ana Lúcia, Pintor Andrea Vaz Braga, Maranón-Vásquez Guido A, Magno Marcela Barauna, Maia Lucianne Cople, Fonseca-Gonçalves Andréa
Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Evid Based Dent. 2024 Jun;25(2):110. doi: 10.1038/s41432-023-00967-4. Epub 2024 Jan 10.
To identify, qualify and synthesize all studies that assessed if low serum level of 25(OH)D (<50 nmol/L) is associated with dental developmental defects (DDD) in primary teeth.
Observational studies or clinical trials were included if measured 25(OH)D serum levels in pregnant women and/or in their children (up to 3 years old) and evaluated the occurrence of DDD in the primary dentition of offspring associated with the low 25(OH)D levels. Literature reviews, case reports, laboratory and/or animals' studies, conference abstracts, letters to the editor, book chapters and clinical protocols were excluded. Searches were carried out in 6 electronic databases and in the gray literature until March 2023, without restrictions. The study quality was assessed by the Newcastle-Ottawa Scale and the certainty of the evidence by GRADE. Data were descriptively synthesized considering the association between DDD and 25(OH)D levels.
Seven studies were included. Only developmental enamel defects (DED) were observed after examination of 6651 children. The incidence of DED ranged from 8.9% to 66%. Six studies found no association between low levels of 25(OH)D and DED. However, one reported correlation between hypomineralization of the primary second molar (HSMD) and low levels of 25(OH)D at birth. Methodological flaws were observed in all studies and the certainty of the evidence was very low.
Although HSMD was the only DDD associated with low levels of 25(OH)D in children, the available evidence is still not conclusive. More robust studies are needed to endorse the biological plausibility of DDD in primary teeth due to low serum levels of 25(OH)D in pregnant women or in their children. FAPERJ financed this study, which was registered in PROSPERO (CRD42022357511).
识别、筛选并综合所有评估血清25(OH)D水平低（<50 nmol/L）是否与乳牙牙发育缺陷（DDD）相关的研究。
纳入观察性研究或临床试验，条件为测量孕妇及其子女（3岁及以下）的血清25(OH)D水平，并评估与低25(OH)D水平相关的后代乳牙列中DDD的发生情况。排除文献综述、病例报告、实验室和/或动物研究、会议摘要、致编辑的信、书籍章节和临床方案。截至2023年3月，在6个电子数据库和灰色文献中进行检索，无限制条件。采用纽卡斯尔-渥太华量表评估研究质量，采用GRADE评估证据的确定性。考虑DDD与25(OH)D水平之间的关联，对数据进行描述性综合分析。
纳入7项研究。在检查6651名儿童后，仅观察到发育性釉质缺陷（DED）。DED的发生率在8.9%至66%之间。6项研究未发现低水平25(OH)D与DED之间存在关联。然而，有一项研究报告称，出生时乳牙第二磨牙矿化不全（HSMD）与低水平25(OH)D之间存在相关性。所有研究均存在方法学缺陷，证据的确定性非常低。
虽然HSMD是儿童中与低水平25(OH)D相关的唯一DDD，但现有证据仍不确凿。需要更有力的研究来证实孕妇或其子女血清25(OH)D水平低导致乳牙DDD的生物学合理性。本研究由里约热内卢州研究资助基金会资助，已在国际前瞻性系统评价注册库（PROSPERO）注册（注册号：CRD42022357511）。
