儿童早期全系统接触抗生素与磨牙-切牙低矿化（MIH）之间的关系：一项系统综述和荟萃分析。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-04 DOI:10.1016/j.jdent.2025.106094

Éva Mlinkó , Dalma Tábi , Bianca Golzio Navarro Cavalcante , Bence Szabó , Péter Hegyi , János Vág , Enikő Vasziné Szabó , Noémi Katinka Rózsa , Gábor Varga

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引用次数: 0

摘要

目的：磨牙切牙低矿化（MIH）是一种发育性牙釉质缺陷，全世界每6个儿童中就有1个受到影响。虽然抗生素被认为影响牙齿发育，但它们与MIH的关系尚不清楚。本系统综述和荟萃分析评估了儿童早期抗生素暴露与发生MIH风险之间的关系。数据来源：检索截止到2024年12月17日的MEDLINE（通过PubMed）、Embase和Cochrane Central Register of Controlled Trials （Central）。研究选择：观察性研究（横断面，病例对照）包括6-14岁诊断为MIH的儿童，使用有效的标准。接触被定义为在4岁之前使用抗生素。排除了涉及特殊人群或其他牙釉质缺陷的研究。使用QUIPS工具评估偏倚风险。随机效应模型计算优势比（ORs）和95%置信区间（ci）。结果：从3308项记录中，41项研究符合标准，31项纳入荟萃分析，共有22141名6-14岁的参与者。4岁前使用抗生素与MIH显著相关（OR:1.50, 95% CI 1.13 - 1.99, p=0.0070）。阿莫西林（OR: 1.87; 95% CI: 0.83-4.21, p=0.104）和青霉素（OR: 2.15; 95% CI: 0.73-6.34, p=0.130）导致发生MIH的几率更高。结论：4岁前早期使用抗生素与发生MIH的几率较高相关。然而，鉴于证据的低确定性，这一发现应该谨慎解释，因为尚不清楚这种联系是直接的还是间接的，强调需要进一步的研究来指导预防策略。临床相关性：MIH对诊断和治疗提出了挑战。必须审慎地确定影响因素。谨慎使用抗生素应纳入临床实践，以减少潜在风险，促进儿童更好的长期口腔健康。

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Association between systemic exposure to antibiotics in early childhood and molar-incisor hypomineralization (MIH): A systematic review and meta-analysis

Objective

Molar Incisor Hypomineralization (MIH) is a developmental enamel defect affecting one in six children worldwide. Although antibiotics have been suggested to influence dental development, their association with MIH remains unclear. This systematic review and meta-analysis evaluated the association between early childhood antibiotic exposure and the risk of developing MIH.

Data Sources

MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to December 17, 2024.

Study Selection

Observational studies (cross-sectional, case-control) including children aged 6–14 years diagnosed with MIH using validated criteria were eligible. Exposure was defined as antibiotic use before age 4. Studies involving special populations or other enamel defects were excluded. Risk of bias was assessed using the QUIPS tool. A random-effects model calculated odds ratios (ORs) and 95% confidence intervals (CIs).

Results

From 3308 records, 41 studies met the criteria and 31 were included in the meta-analysis, with 22,141 participants aged 6–14. Antibiotic use before age 4 was significantly associated with MIH (OR:1.50, 95% CI 1.13 – 1.99, p = 0.0070). Amoxicillin (OR: 1.87; 95% CI: 0.83–4.21, p = 0.104) and penicillin (OR: 2.15; 95% CI: 0.73–6.34, p = 0.130) resulted in higher odds for the development of MIH.

Conclusion

Early antibiotic use before age 4 is associated with higher odds of developing MIH. However, given the low certainty of evidence, this finding should be interpreted with caution, as it remains unclear whether the link is direct or indirect, highlighting the need for further research to guide prevention strategies.

Clinical Relevance

MIH poses diagnostic and treatment challenges. Contributing factors must be identified judiciously. Prudent antibiotic use should be integrated into clinical practice to reduce potential risk and promote better long-term oral health in children.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.