Comparative Survival of Restorations in MIH-Affected Pediatric Teeth Using Total-Etch Versus Self-Etch Adhesive Systems: A Systematic Review and Meta-Analysis

Featured Application: This study provides strong scientific evidence for improving conservative treatment in patients with MIH. This study aimed to investigate adhesive techniques applied to MIH-affected teeth by analyzing the one-year failure rate of restorations performed using total-etch and self-etch adhesive methods. This systematic review was conducted in accordance with the PRISMA 2020 statement. Eligibility criteria were defined using the PICO acronym. In vivo studies published from 2017 onward were evaluated. Two independent reviewers conducted the search on PubMed, Scopus, Cochrane, and Web of Science. The risk of bias was assessed with RoB2 and the Newcastle-Ottawa Scale. Statistical analysis was performed using the Open Meta [Analyst] software based on the absolute risk of failure. Results were presented as a pooled estimate with a 95% confidence interval (CI) and visualized in forest plots. Four RCTs and one retrospective cohort study were selected for the analysis. Data collected included information such as authors, study design, age, restorations, degree of hypomineralization, protocol, and follow-up. The meta-analysis showed no statistically significant differences between the techniques (p = 0.338) on MIH-affected teeth. This meta-analysis supports the use of both adhesive techniques for managing MIH teeth, emphasizing the need for further studies to examine the specific clinical and technical conditions under which each technique might be more advantageous.