Which diagnostic tools and criteria to use for diagnosis of HSPM and MIH? A systematic review

Abstract Purpose To make an overview of the (1) diagnostic tools and (2) diagnostic criteria for MIH and HSPM. Methods This systematic review was registered with Prospero (CRD420251146107). Only studies in humans were included. The phenomenon of interest was enamel hypomineralisation, MIH and HSPM, in the primary and permanent dentition. Outcomes of interest were: definition; terminology used; clinical characteristics; radiological; and structural features; patient-reported symptoms; and differential diagnosis. The searches were completed on September 25th 2025 using the following databases: PubMed, Embase, Web of Science, Open Grey, and Cochrane Library. This search gave 2536 articles. After removal of duplicates, 1194 articles were screened for eligibility based on abstracts. Each abstract was rated by one of the reviewers (NS, ICM), in case of disagreement to be discussed among them, and if needed with a third author (ME). For 39 abstracts, the complete article was retrieved and rated. NS and ICM split the amount of articles, and ME assessed half of the articles from both of them as a second check. Results Thirteen articles were included. There were three articles that compared different indices to diagnose MIH, and five articles on the use of artificial intelligence (AI) in diagnosing MIH. Other papers handled either sensitivity, transillumination, fluorescence, or diagnosis from photographs. The articles on AI had a moderate-to-high risk of bias. Conclusions There are few articles on diagnostic tools and diagnostic criteria for HSPM and MIH. The lack of good research on these topics influences the quality of the research in the field of HSPM and MIH.