SynthesisBMC oral health2026
Association of hypomineralized second primary molars (HSPM) and hypomineralized primary canines (HPC) with molar-incisor hypomineralization (MIH): a systematic review and meta-analysis.
Synthesis in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
backgroundMolar-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.
methodsA 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.
resultsA total of 28 studies were qualitatively and 24 quantitatively analyzed (22,678 participants). The pooled crude OR for the MIH–HSPM association was 8.55 (95% CI: 4.72–15.50; I2 = 96.97%, p < 0.001), showing a strong and consistent association. Additionally, subgroup analyses were performed and study design and type of OR (crude vs adjusted) were the only factors showing a statistically significant difference across groups. No strong evidence of publication bias was detected (Begg’s p = 0.60; Egger’s p = 0.61). Only one study assessed the HPC–MIH association, reporting a significant but limited relationship (OR = 6.02; 95% CI: 1.46–24.75).
conclusionsChildren with HSPM are approximately nine times more likely to present MIH. The evidence supports an association rather than a confirmed predictive relationship, mainly due to the predominance of cross-sectional studies and high heterogeneity. Further longitudinal studies are needed to clarify causality.
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