Mohammed B. Q. Alfarra, Tarun Walia, Mawada Abdelmagied, Elias Berdouses, Raghavendra Shetty, Kusai Baroudi, Raghad Hashim, Murugan Muthu
{"title":"Effectiveness of Various Pain Control Methods in Managing MIH—A Systematic Review and Meta-Analysis","authors":"Mohammed B. Q. Alfarra, Tarun Walia, Mawada Abdelmagied, Elias Berdouses, Raghavendra Shetty, Kusai Baroudi, Raghad Hashim, Murugan Muthu","doi":"10.1111/ipd.70107","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Pain management in children with molar–incisor hypomineralisation (MIH) presents a significant challenge, as affected teeth often respond poorly to local anaesthesia due to altered enamel and heightened pulp sensitivity. Overcoming these difficulties is crucial to achieving effective dental outcomes.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>To evaluate the effectiveness of pharmacological, desensitising and behavioural strategies for pain control in children and adolescents with MIH.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Systematic search of multiple electronic databases identified studies published between 2001 and 2024. Eligible designs included randomised controlled trials, randomised crossover studies and clinical trials. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I V2 tools and certainty of evidence graded with GRADEpro. A random-effects meta-analysis was conducted to assess anaesthetic success with 4% articaine.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirteen studies were selected, with six included in the meta-analysis. Pooled success rates for 4% articaine were 0.849 for inferior alveolar nerve block and 0.915 for intraosseous injection. Findings suggest improved anaesthetic success compared with 2% lidocaine. Pre-emptive ibuprofen, laser desensitisation and virtual reality distraction also showed benefits for reducing pain and anxiety.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Current evidence suggests that an individualised, multimodal approach may improve pain management in children with MIH. However, further high-quality comparative studies are needed to guide clinical protocols.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>PROSPERO Registration: CRD42024474840</p>\n </section>\n </div>","PeriodicalId":14268,"journal":{"name":"International journal of paediatric dentistry","volume":"36 5","pages":"628-645"},"PeriodicalIF":2.2000,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of paediatric dentistry","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ipd.70107","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Pain management in children with molar–incisor hypomineralisation (MIH) presents a significant challenge, as affected teeth often respond poorly to local anaesthesia due to altered enamel and heightened pulp sensitivity. Overcoming these difficulties is crucial to achieving effective dental outcomes.
Aim
To evaluate the effectiveness of pharmacological, desensitising and behavioural strategies for pain control in children and adolescents with MIH.
Design
Systematic search of multiple electronic databases identified studies published between 2001 and 2024. Eligible designs included randomised controlled trials, randomised crossover studies and clinical trials. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I V2 tools and certainty of evidence graded with GRADEpro. A random-effects meta-analysis was conducted to assess anaesthetic success with 4% articaine.
Results
Thirteen studies were selected, with six included in the meta-analysis. Pooled success rates for 4% articaine were 0.849 for inferior alveolar nerve block and 0.915 for intraosseous injection. Findings suggest improved anaesthetic success compared with 2% lidocaine. Pre-emptive ibuprofen, laser desensitisation and virtual reality distraction also showed benefits for reducing pain and anxiety.
Conclusion
Current evidence suggests that an individualised, multimodal approach may improve pain management in children with MIH. However, further high-quality comparative studies are needed to guide clinical protocols.
期刊介绍：
The International Journal of Paediatric Dentistry was formed in 1991 by the merger of the Journals of the International Association of Paediatric Dentistry and the British Society of Paediatric Dentistry and is published bi-monthly. It has true international scope and aims to promote the highest standard of education, practice and research in paediatric dentistry world-wide.
International Journal of Paediatric Dentistry publishes papers on all aspects of paediatric dentistry including: growth and development, behaviour management, diagnosis, prevention, restorative treatment and issue relating to medically compromised children or those with disabilities. This peer-reviewed journal features scientific articles, reviews, case reports, clinical techniques, short communications and abstracts of current paediatric dental research. Analytical studies with a scientific novelty value are preferred to descriptive studies. Case reports illustrating unusual conditions and clinically relevant observations are acceptable but must be of sufficiently high quality to be considered for publication; particularly the illustrative material must be of the highest quality.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
