Association between molar-incisor hypomineralization and dental developmental anomalies: a systematic review and meta-analysis

Background: Molar-incisor hypomineralization (MIH) is a common developmental enamel defect, and its potential association with developmental dental anomalies (DDAs) has been suggested but remains inconclusive. This systematic review and meta-analysis aimed to evaluate the association between MIH and DDAs in children and adolescents. Methods: A comprehensive search was performed in PubMed, Web of Science, Scopus, and Embase. Studies comparing the occurrence of DDAs between individuals with and without MIH were included. The quality of each study was assessed using the modified Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: A total of 2343 records were identified, and six studies were included. According to the modified NOS, the methodological quality of the included studies ranged from moderate to very high. Analysis by anomaly type indicated that children with MIH had higher odds of hypodontia than those without MIH (OR = 1.63, 95% CI: 1.03–2.59, p = 0.04, I² = 67%); however, this CI was wide, with its lower bound close to unity. No significant association was identified for hyperdontia (OR = 0.79, 95% CI: 0.47–1.33, p = 0.37, I² = 0%), microdontia (OR = 1.79, 95% CI: 0.96–3.36, p = 0.07, I² = 18%), or positional and morphological anomalies. An exploratory meta-analysis of overall DDAs showed no significant association between MIH and overall DDAs (OR = 1.71, 95% CI: 0.96–3.07, p = 0.07, I² = 71%). The certainty of evidence was rated as very low for all outcomes as per the GRADE framework. Conclusions: MIH is weakly associated with hypodontia, while no clear associations were identified for other DDAs. The certainty of the evidence was very low, and the findings should be interpreted with caution. The PROSPERO Registration: CRD420261294642.

Developmental dental anomalies; Molar-incisor hypomineralization; Hypodontia

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