Effective anaesthesia when treating teeth affected by molar incisor hypomineralisation (MIH): a systematic review

The aim of the present review was to critically evaluate recent studies to determine the optimal combination of anaesthetic technique and agent for achieving effective anaesthesia in molar incisor hypomineralisation (MIH) patients, thereby addressing a significant need in evidence-based clinical practice. The search question was: What is the most effective modality of anaesthesia to reduce hypersensitivity in MIH-affected teeth in children?

A systematic search was conducted using four databases, namely, MEDLINE via PubMed, Science Direct, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL), using a selection of MeSH terms. The "Modified Jadad Scale" and the "Newcastle Ottawa Scale" were used for the methodology assessment of the included studies.

Out of 134 articles identified in the initial search, six articles met all the inclusion criteria. The results showed that intraosseous anaesthesia with 4% articaine demonstrated the highest efficacy.

Achieving complete anaesthesia in teeth affected by MIH enhances comfort for both patients and practitioners, contributing to improved treatment quality. Intraosseous anaesthesia with 4% articaine and epinephrine has proven effective in reducing pain and hypersensitivity in pediatric patients with MIH. However, further studies are needed in this population to draw definitive conclusions.