磨牙和切牙矿化不全与第二乳磨牙矿化不全的关联：一项包含Meta分析和试验序贯分析的更新系统评价
Association of Molar Incisor Hypomineralization with Hypomineralized Second Primary Molars: An Updated Systematic Review with a Meta-Analysis and Trial Sequential Analysis.
作者信息
Zhang Zhaoxin, Liu Yueying, Zhu Yaxin, Guo Jingya, Yang Mingzhen, Lu Yang, Zhang Yimeng, Jia Jie
机构信息
The First Affiliated Hospital of Henan University, Henan University School of Stomatology, Kaifeng, China,
The First Affiliated Hospital of Henan University, Henan University School of Stomatology, Kaifeng, China.
出版信息
Caries Res. 2025;59(1):58-70. doi: 10.1159/000540752. Epub 2024 Aug 26.
INTRODUCTION
There is a correlation between molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM), but this relationship has not been definitively confirmed. The purpose of this systematic review and meta-analysis was to reevaluate whether children with HSPM are more affected by MIH than non-HSPM children.
METHODS
A systematic search was conducted in four databases (PubMed, Embase, Web of Science, and the Cochrane Library) for literature, published up to December 2022. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk-of-bias assessment of all included cohort studies and case-control studies was assessed by the Newcastle-Ottawa Scale (NOS), and cross-sectional studies were assessed using the Agency for Healthcare Research Quality (AHRQ) scale. RevMan 5.4 software was used for all data analyses, with odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures. Sensitivity and subgroup analyses were conducted to identify the potential sources of heterogeneity among the studies. Publication bias was tested and corrected by funnel plots and Egger's test. Trial sequential analysis (TSA) was performed using TSA 0.9.5.10 Beta software to control for type-1 and type-2 errors.
RESULTS
A total of 12 studies involving 8,944 children were included in this meta-analysis. Compared with the non-HSPM group, the HSPM group had an increased likelihood of MIH (OR = 10.90, 95% CI = 4.59-25.89, p < 0.05). All the included studies were of moderate-to-high quality. TSA and sensitivity analyses suggested the robustness of this outcome.
CONCLUSION
This systematic review demonstrated a certain correlation between HSPM and MIH, suggesting that HSPM can play a predictive role in the occurrence of MIH. Further high-quality, multicenter, and large-sample longitudinal studies are highly recommended.
INTRODUCTION
There is a correlation between molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM), but this relationship has not been definitively confirmed. The purpose of this systematic review and meta-analysis was to reevaluate whether children with HSPM are more affected by MIH than non-HSPM children.
METHODS
A systematic search was conducted in four databases (PubMed, Embase, Web of Science, and the Cochrane Library) for literature, published up to December 2022. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk-of-bias assessment of all included cohort studies and case-control studies was assessed by the Newcastle-Ottawa Scale (NOS), and cross-sectional studies were assessed using the Agency for Healthcare Research Quality (AHRQ) scale. RevMan 5.4 software was used for all data analyses, with odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures. Sensitivity and subgroup analyses were conducted to identify the potential sources of heterogeneity among the studies. Publication bias was tested and corrected by funnel plots and Egger's test. Trial sequential analysis (TSA) was performed using TSA 0.9.5.10 Beta software to control for type-1 and type-2 errors.
RESULTS
A total of 12 studies involving 8,944 children were included in this meta-analysis. Compared with the non-HSPM group, the HSPM group had an increased likelihood of MIH (OR = 10.90, 95% CI = 4.59-25.89, p < 0.05). All the included studies were of moderate-to-high quality. TSA and sensitivity analyses suggested the robustness of this outcome.
CONCLUSION
This systematic review demonstrated a certain correlation between HSPM and MIH, suggesting that HSPM can play a predictive role in the occurrence of MIH. Further high-quality, multicenter, and large-sample longitudinal studies are highly recommended.
引言
第一恒磨牙和切牙矿化不全（MIH）与第二乳磨牙矿化不全（HSPM）之间存在关联，但这种关系尚未得到明确证实。本系统评价和荟萃分析的目的是重新评估患有HSPM的儿童是否比未患HSPM的儿童受MIH的影响更大。
方法
在四个数据库（PubMed、Embase、科学网和考克兰图书馆）中进行系统检索，以查找截至2022年12月发表的文献。两名独立的评审员根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行研究检索、筛选、质量评估和数据提取。所有纳入的队列研究和病例对照研究的偏倚风险评估采用纽卡斯尔-渥太华量表（NOS），横断面研究采用医疗保健研究质量机构（AHRQ）量表进行评估。所有数据分析均使用RevMan 5.4软件，以比值比（OR）和95%置信区间（CI）作为效应量。进行敏感性和亚组分析以确定研究之间异质性的潜在来源。通过漏斗图和埃格检验对发表偏倚进行检验和校正。使用TSA 0.9.5.10 Beta软件进行试验序贯分析（TSA）以控制I型和II型错误。
结果
本荟萃分析共纳入12项研究，涉及8944名儿童。与非HSPM组相比，HSPM组发生MIH的可能性增加（OR = 10.90，95% CI = 4.59 - 25.89，p < 0.05）。所有纳入的研究质量为中到高。TSA和敏感性分析表明该结果具有稳健性。
结论
本系统评价表明HSPM与MIH之间存在一定相关性，提示HSPM可对MIH的发生起到预测作用。强烈建议进一步开展高质量、多中心、大样本的纵向研究。
引言
第一恒磨牙和切牙矿化不全（MIH）与第二乳磨牙矿化不全（HSPM）之间存在关联，但这种关系尚未得到明确证实。本系统评价和荟萃分析的目的是重新评估患有HSPM的儿童是否比未患HSPM的儿童受MIH的影响更大。
方法
在四个数据库（PubMed、Embase、科学网和考克兰图书馆）中进行系统检索，以查找截至2022年12月发表的文献。两名独立的评审员根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行研究检索、筛选、质量评估和数据提取。所有纳入的队列研究和病例对照研究的偏倚风险评估采用纽卡斯尔-渥太华量表（NOS），横断面研究采用医疗保健研究质量机构（AHRQ）量表进行评估。所有数据分析均使用RevMan 5.4软件，以比值比（OR）和95%置信区间（CI）作为效应量。进行敏感性和亚组分析以确定研究之间异质性的潜在来源。通过漏斗图和埃格检验对发表偏倚进行检验和校正。使用TSA 0.9.5.10 Beta软件进行试验序贯分析（TSA）以控制I型和II型错误。
结果
本荟萃分析共纳入12项研究，涉及8944名儿童。与非HSPM组相比，HSPM组发生MIH的可能性增加（OR = 10.90，95% CI = 4.59 - 25.89，p < 0.05）。所有纳入的研究质量为中到高。TSA和敏感性分析表明该结果具有稳健性。
结论
本系统评价表明HSPM与MIH之间存在一定相关性，提示HSPM可对MIH的发生起到预测作用。强烈建议进一步开展高质量、多中心、大样本的纵向研究。
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