Association of hypomineralized second primary molars (HSPM) and hypomineralized primary canines (HPC) with molar-incisor hypomineralization (MIH): a systematic review and meta-analysis
Abstract
BACKGROUND: Molar-incisor hypomineralization is a common developmental enamel defect associated with pain, functional limitations, and restorative challenges in children. Because of overlapping risk factors of HSPM and MIH, and shared formation period of the first permanent molar, second molar, and deciduous canine, an association is plausible. Several studies have shown that HSPM and/or HPC have an association with MIH; however, the results regarding the strength of these studies are conflicting. This systematic review and meta-analysis aimed to investigate the association of HSPM and HPC with MIH, and to update the existing evidence by including newly published studies. METHODS: A comprehensive search was performed in PubMed, Scopus, Web of Science, Embase, ProQuest, and Google Scholar up to July 2025. Citation tracking was also applied to identify additional eligible studies. The methodological risk of bias was assessed using the Joanna Briggs Institute (JBI) checklists for cross-sectional, cohort, and case–control studies. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Random-effects meta-analysis was conducted with odds ratios (ORs) and 95% confidence intervals (CIs), using STATA version 18. Heterogeneity, sensitivity analyses, and publication bias were also examined. RESULTS: A total of 28 studies were qualitatively and 24 quantitatively analyzed (22,678 participants). The pooled…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 22,678 participants or records.
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