Non-Cochrane · aetiology · PM41715122
Association of hypomineralized second primary molars (HSPM) and hypomineralized primary canines (HPC) with molar-incisor hypomineralization (MIH): a systematic review and meta-analysis.
Tarrahi Mohammad Saleh, Lotfi Rojina, Emami Saghar, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-07923-5
Findings
28 findings
| Population | ||||
|---|---|---|---|---|
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Temilola and Folayan (2015) | OR 9.00 [4.91, 16.48] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Bani-Hani (2025) | OR 9.13 [4.96, 16.81] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Rodríguez-Rodríguez (2021) | OR 9.13 [4.98, 16.75] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Cross-sectional or cohort assessment (HSPM before or concurrent with MIH) · Schools, clinics and community health centers · Overall (crude ORs) | OR 8.55 [4.72, 15.50] Very low Downgraded: risk of bias, imprecision, inconsistency 23 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Ghanim (2013) | OR 9.30 [5.11, 16.93] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Study design: cross-sectional studies | OR 8.78 [4.66, 16.52] GRADE not reported 20 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | MIH (adjusted odds ratios) Schools, clinics and community health centers · Adjusted ORs only | OR 4.34 [3.29, 5.72] GRADE not reported 2 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting da Silva Figueiredo Sé (2017) | OR 8.65 [4.64, 16.12] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Al-Huzaimi (2025) | OR 8.56 [4.59, 15.98] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Study design: prospective cohort studies | OR 2.56 [1.36, 4.83] GRADE not reported 2 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Almenawi (2023) | OR 8.07 [4.39, 14.84] GRADE not reported 22 studies |
| Children (primary, mixed or permanent dentition) with and without HSPM | Presence of hypomineralized second primary molars (HSPM) | Absence of HSPM | Molar-incisor hypomineralization (MIH) HSPM in primary dentition; MIH in permanent teeth · Schools, dental clinics and community health centers · Leave-one-out sensitivity analysis: omitting Elfrink (2012) | OR 8.97 [4.85, 16.60] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Estivals (2023) | OR 8.70 [4.66, 16.25] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Oyedele (2016) | OR 8.21 [4.43, 15.21] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Amend (2021) | OR 8.44 [4.52, 15.76] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Mittal and Sharma (2015) | OR 8.59 [4.60, 16.04] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Almuallem (2022) | OR 7.53 [4.29, 13.21] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Gambetta-Tessini (2018) | OR 8.98 [4.86, 16.60] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Negre-Barber (2016) | OR 8.26 [4.44, 15.34] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Quintero (2022) | OR 7.10 [4.38, 11.51] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Afzal (2024) | OR 8.67 [4.64, 16.20] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Sabbagh (2025) | OR 8.71 [4.66, 16.27] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Ferreira (2023) | OR 8.49 [4.57, 15.78] GRADE not reported 22 studies |
| Children (primary, mixed or permanent dentition) with and without HSPM | Presence of hypomineralized second primary molars (HSPM) | Absence of HSPM | Molar-incisor hypomineralization (MIH) HSPM in primary dentition; MIH in permanent teeth · Schools, dental clinics and community health centers · Leave-one-out sensitivity analysis: omitting Costa-Silva (2013) | OR 9.12 [4.97, 16.74] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Gambetta-Tessini (2019) | OR 8.91 [4.80, 16.52] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Marcianes (2023) | OR 8.81 [4.73, 16.41] GRADE not reported 22 studies |
| Children (primary, mixed and permanent dentition) under 18 years | Hypomineralized second primary molars (HSPM) present | Children without HSPM | Molar-incisor hypomineralization (MIH) Schools, clinics and community health centers · Leave-one-out sensitivity analysis: omitting Karakaya (2021) | OR 7.83 [4.32, 14.19] GRADE not reported 22 studies |
| Children with and without hypomineralized primary canines (HPC) | Presence of hypomineralized primary canines (HPC) | Absence of HPC | Molar-incisor hypomineralization (MIH) HSPM in primary dentition; MIH in permanent teeth · Schools, dental clinics and community health centers | OR 6.02 [1.46, 24.75] GRADE not reported 1 study |
Included primary studies 28
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Afzal 2024 Molar-Incisor Hypomineralisation: Severity, caries and hypersensitivity. PMID:38331377 | 2024 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Al-Huzaimi 2025 Prevalence, clinical presentation and risk factors of molar incisor hypomineralisation and hypomineralised second primary molars among… PMID:40416932 | 2025 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Almenawi 2023 Prevalence of Molar Incisor Hypomineralization in a Group of Egyptian Children DOI:10.54623/fdj.9019 | 2023 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Almuallem 2022 Prevalence and possible aetiological factors of molar incisor hypomineralisation in Saudi children: A cross-sectional study. PMID:35068897 | 2022 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Amarante 2025 Hypomineralized primary teeth and their association with Molar Incisor Hypomineralization: a cross-sectional study. PMID:40465949 | 2025 | this review only | Molar-incisor hypomineralization (MIH); MIH (adjusted odds ratios) | not extracted yet |
| Amend 2021 Prevalence of molar-incisor-hypomineralisation (MIH) among 6-12-year-old children in Central Hesse (Germany). PMID:32808178 | 2021 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Bani-Hani 2025 Hypomineralised Second Primary Molars (HSPM): Prevalence, Clinical Characteristics and Association with Molar Incisor Hypomineralisation… PMID:39960467 | 2025 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Costa-Silva 2013 Influence of deciduous molar hypomineralization on the development of molar-incisor hypomineralizarion DOI:10.1590/s1677-32252013000400011 | 2013 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Cots 2024 "Ethnic disparities in the prevalence of Molar-Incisor-Hypomineralisation (MIH) and caries among 6-12-year-old children in Catalonia,… PMID:38414345 | 2024 | this review only | not stated | not extracted yet |
| da Silva Figueiredo Se 2017 Are Hypomineralized Primary Molars and Canines Associated with Molar-Incisor Hypomineralization? PMID:29335050 | 2017 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Elfrink 2012 Deciduous molar hypomineralization and molar incisor hypomineralization. PMID:22370445 | 2012 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Estivals 2023 The prevalence and characteristics of and the association between MIH and HSPM in South-Western France. PMID:36511101 | 2023 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Ferreira 2023 Relação entre Hipomineralização Molar-Decíduo (HSMD) e Hipomineralização Molar-Incisivo (HMI): Um estudo transversal DOI:10.33448/rsd-v12i8.42821 | 2023 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Gambetta-Tessini 2018 Carious lesion severity and demarcated hypomineralized lesions of tooth enamel in schoolchildren from Melbourne, Australia. PMID:29876927 | 2018 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Gambetta-Tessini 2019 The impact of MIH/HSPM on the carious lesion severity of schoolchildren from Talca, Chile. PMID:30637683 | 2019 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Geiken 2021 Schweregrade der Milchmolaren-Hypomineralisation und Molaren-Inzisiven- Hypomineralisation in Zahnarztpraxen DOI:10.1007/s44190-021-0012-4 | 2021 | this review only | not stated | not extracted yet |
| Ghanim 2013 Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children. PMID:22276809 | 2013 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Karakaya 2021 The Relationship between Hypomineralized Second Primary Molars and Molar Incisor Hypomineralization in a Group of School-Aged Children in… DOI:10.1055/s-0041-1732951 | 2021 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Marcianes 2023 Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both… PMID:37685598 | 2023 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Mittal and Sharma 2015 Hypomineralised second primary molars: prevalence, defect characteristics and possible association with Molar Incisor Hypomineralisation… PMID:26092507 | 2015 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Negre-Barber 2016 Hypomineralized Second Primary Molars as Predictor of Molar Incisor Hypomineralization. PMID:27558479 | 2016 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Oyedele 2016 Hypomineralised second primary molars: prevalence, pattern and associated co morbidities in 8- to 10-year-old children in Ile-Ife, Nigeria. PMID:27259516 | 2016 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Petrou 2014 Prevalence of Molar-Incisor-Hypomineralisation among school children in four German cities. PMID:24372870 | 2014 | this review only | not stated | not extracted yet |
| Quintero 2022 Association between hypomineralization of deciduous and molar incisor hypomineralization and dental caries. PMID:36043563 | 2022 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Rodriguez-Rodriguez 2021 Prevalence and Distribution of Molar Incisor Hypomineralization in children receiving dental care in Caracas Metropolitan Area, Venezuela. PMID:34570857 | 2021 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Sabbagh 2025 Prevalence of molar incisor hypomineralization and characteristics of affected first permanent and second primary molars among children in… PMID:40423935 | 2025 | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Temilola and Folayan 2015 matched by author and year (probable) | NR | this review only | Molar-incisor hypomineralization (MIH) | not extracted yet |
| Velayos Galan 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children under 18 years with primary, mixed or permanent dentition, regardless of gender and ethnicity; studies on systemic or syndromic enamel diseases excluded | Children aged 1 to 19 years (n=22,678 in 28 studies; sample sizes 49 to 2395) |
| Intervention | Exposure: HSPM or HPC | HSPM (24 studies in meta-analysis); HPC (1 study) |
| Comparison | Children without HSPM or HPC | Children without HSPM or HPC |
| Outcomes | MIH | MIH |
| Study designs | Cross-sectional, case-control and cohort studies | 25 cross-sectional, 2 prospective cohort, 1 case-control study (n=28) |
| Timing | Not specified | Not specified |