Influência da presença e da gravidade da hipomineralização molar incisivo no acúmulo de placa dentária: uma revisão sistemática com metanálise

Abstract

Molar Incisor Hypomineralization (MIH) is a defect in enamel quality, characterized by opacity and porosity. Therefore, it affects enamel resistance and is often associated with increased hypersensitivity and a greater predisposition to dental caries lesions. The rough surface and heightened hypersensitivity can promote an environment conducive to greater dental plaque accumulation on the affected teeth as well as on adjacent ones. This systematic review aimed to synthesize the evidence regarding the association between the presence and severity of MIH and dental plaque accumulation. A study protocol was registered in PROSPERO (International Prospective Register of Systematic Reviews) under the protocol number CRD42023470222. Searches were conducted in four databases by two independent reviewers, in addition to gray literature. There were no restrictions on language or publication date. The risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. A total of 474 articles were identified, and after removing duplicates, screening titles and abstracts, and subsequently reading the full texts, eight studies were included in this review. Most studies identified significant differences in comparisons; however, these results were not homogeneous. The findings suggest that the severity of MIH is associated with increased plaque accumulation in a dose- response manner. When comparing mild MIH to moderate MIH, a greater plaque accumulation was observed in children with moderate MIH (MD: 0.48, CI = 0.15-0.81). The difference increased when comparing mild to severe MIH (MD: 1.04, CI = 0.66- 1.42), and between moderate and severe MIH, a higher accumulation was also noted in the severe MIH group (MD: 0.57, CI = 0.15-1.0). However, when comparing groups with and without MIH, no difference in the mean values was observed (MD: 0.06, CI = -0.12-0.25). It should be noted that in one of the included studies, the index used to assess plaque presence differed from the other two studies, and after its removal, a difference in mean plaque accumulation between children with and without MIH was observed (MD: 0.14, CI = -0.06-0.22). Therefore, based on the data from the included studies, both the presence and greater severity of MIH contribute to higher plaque accumulation at the individual level.