Shah Malayka, Patel Megha C, Patel Foram, Fernandes Miyola, Makwani Disha, Mehta Miral
Pedodontics and Preventive Dentistry, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND.
Pedodontics and Preventive Dentistry, Karnavati School Of Dentistry, Karnavati University, Gandhinagar, IND.
Cureus. 2025 Mar 27;17(3):e81265. doi: 10.7759/cureus.81265. eCollection 2025 Mar.
Restorative treatment for molars affected by molar incisor hypomineralization (MIH) presents a challenge due to the altered enamel structure. It is critical to understand the evidence base of the available restorative options, due to the high treatment burden for such teeth. This systematic review and meta-analysis aimed to evaluate and compare the success rates of glass ionomer cement (GIC) and composite resin restorations in hypomineralized first permanent molars and to further evaluate the restorations on the basis of modified United States Public Health Service (USPHS) criteria. This review was registered in International Prospective Register of Systematic Reviews (PROSPERO) database as CRD42024566898. Searches were conducted in PubMed, Google Scholar and Ebsco from January 2000 to May 2024. A total of 13 studies were included according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines in qualitative synthesis and meta-analysis. The over-all success rate was calculated for each study as the primary outcome. The success rates for different parameters of the modified USPHS criteria was calculated as secondary outcome. The Cochrane Collaboration's tool and risk of bias in non-randomized studies of intervention (ROBINS-I) tool were used to assess the risk of bias. The combined effect, heterogeneity and publication bias were analyzed using Stata 17.0 (StataCorp LLC, College Station, TX, USA). A p-value <0.05 was regarded as statistically significant. Composite resin restorations presented significantly superior results over GIC for overall success (p = 0.0004), marginal adaptation (p = 0.0124) and surface texture (p <0.0001). For the parameters such as retention (p = 0.06), secondary caries (p = 0.20), marginal discolouration (p = 0.3830) and colour match (p = 0.1440) composite resin performed better; however, the difference was statistically nonsignificant. Considering the constraints of this systematic review and meta-analysis, it can be recommended that composite resin restorations presented superior results over GIC for hypomineralized permanent first molars. Complete removal of the hypomineralized tissue is recommended.
由于牙釉质结构改变，对受磨牙切牙矿化不全（MIH）影响的磨牙进行修复治疗具有挑战性。鉴于此类牙齿的治疗负担较重，了解现有修复选择的证据基础至关重要。本系统评价和荟萃分析旨在评估和比较玻璃离子水门汀（GIC）和复合树脂修复在矿化不全的第一恒磨牙中的成功率，并根据修改后的美国公共卫生服务（USPHS）标准进一步评估修复情况。本评价已在国际前瞻性系统评价注册库（PROSPERO）数据库中注册，注册号为CRD42024566898。于2000年1月至2024年5月在PubMed、谷歌学术和Ebsco中进行检索。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，在定性合成和荟萃分析中纳入了13项研究。将每项研究的总体成功率作为主要结局进行计算。将修改后的USPHS标准不同参数的成功率作为次要结局进行计算。使用Cochrane协作工具和干预非随机研究中的偏倚风险（ROBINS-I）工具评估偏倚风险。使用Stata 17.0（美国德克萨斯州大学城StataCorp有限责任公司）分析合并效应、异质性和发表偏倚。p值<0.05被视为具有统计学意义。在总体成功率（p = 0.0004）、边缘适应性（p = 0.0124）和表面质地（p <0.0001）方面，复合树脂修复的效果明显优于GIC。在固位（p = 0.06）、继发龋（p = 0.20）、边缘变色（p = 0.3830）和颜色匹配（p = 0.1440）等参数方面，复合树脂表现更好；然而，差异无统计学意义。考虑到本系统评价和荟萃分析的局限性，对于矿化不全的第一恒磨牙，建议使用复合树脂修复，其效果优于GIC。建议彻底去除矿化不全的组织。
