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治疗受磨牙切牙矿化不全(MIH)影响牙齿时的有效麻醉:一项系统评价

Effective anaesthesia when treating teeth affected by molar incisor hypomineralisation (MIH): a systematic review.

作者信息

Rhaiem Miniar, Chatti Marwa, Elelmi Yamina, Ben Haj Khalifa Aymen, Masmoudi Fatma, Baaziz Ahlem

机构信息

Paediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia.

Laboratory of Biological Clinical and Dento-Facial Approach (ABCDF Laboratory LR12ES10), University of Monastir, Monastir, Tunisia.

出版信息

Eur Arch Paediatr Dent. 2025 May 30. doi: 10.1007/s40368-025-01057-y.

Abstract

PURPOSE

The aim of the present review was to critically evaluate recent studies to determine the optimal combination of anaesthetic technique and agent for achieving effective anaesthesia in molar incisor hypomineralisation (MIH) patients, thereby addressing a significant need in evidence-based clinical practice. The search question was: What is the most effective modality of anaesthesia to reduce hypersensitivity in MIH-affected teeth in children?

METHODS

A systematic search was conducted using four databases, namely, MEDLINE via PubMed, Science Direct, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL), using a selection of MeSH terms. The "Modified Jadad Scale" and the "Newcastle Ottawa Scale" were used for the methodology assessment of the included studies.

RESULTS

Out of 134 articles identified in the initial search, six articles met all the inclusion criteria. The results showed that intraosseous anaesthesia with 4% articaine demonstrated the highest efficacy.

CONCLUSION

Achieving complete anaesthesia in teeth affected by MIH enhances comfort for both patients and practitioners, contributing to improved treatment quality. Intraosseous anaesthesia with 4% articaine and epinephrine has proven effective in reducing pain and hypersensitivity in pediatric patients with MIH. However, further studies are needed in this population to draw definitive conclusions.

摘要

目的

本综述的目的是严格评估近期的研究,以确定在磨牙切牙矿化不全(MIH)患者中实现有效麻醉的麻醉技术和药物的最佳组合,从而满足循证临床实践中的一项重大需求。检索问题为:在儿童MIH患牙中,哪种麻醉方式对减轻过敏最有效?

方法

使用四个数据库进行系统检索,即通过PubMed的MEDLINE、Science Direct、Scopus和Cochrane对照试验中央注册库(CENTRAL),使用一系列医学主题词。“改良Jadad量表”和“纽卡斯尔渥太华量表”用于对纳入研究的方法学评估。

结果

在初步检索中确定的134篇文章中,有6篇文章符合所有纳入标准。结果表明,4%阿替卡因骨内麻醉显示出最高的疗效。

结论

在MIH患牙中实现完全麻醉可提高患者和医生的舒适度,有助于提高治疗质量。4%阿替卡因加肾上腺素的骨内麻醉已被证明可有效减轻MIH患儿的疼痛和过敏。然而,需要对该人群进行进一步研究以得出明确结论。

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