Comparison of Remineralization Potential of Different Remineralizing Agents on Carious Lesion of Primary Teeth: A Systematic Review and Meta-analysis.

Abstract

Aims: To compare the remineralization potential of nanohydroxyapatite (nHA), fluoridated nano hydroxyapatite (NHA-F), nanosilver fluoride (NSF), bioactive glass (BAG), nanobioactive glass (nBAG), silver diamine fluoride (SDF), sodium fluoride (NaF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), tricalcium phosphate (TCP) and fluoride in primary teeth.

Materials and methods: This study has included articles from databases such as MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, CINAHL, PsycINFO, Scopus, ERIC, and ScienceDirect published until December 31, 2023. The search resulted in the display of 3086 articles, of which 1396 cited as duplicates were eliminated, eventually providing with 15 articles for review after being subjected to the inclusion and exclusion criteria.

Statistical analysis: The extracted data were analysed in qualitative and quantitative methods, along with the generation of forest plots using RevMan software version 5. The risk of bias was assessed using the QUIN tool.

Results: 15 studies were included in the qualitative and 8 in the quantitative synthesis. The nHA vs Naf comparison resulted in pooled value [OR (CI)] 0.01 [95% CI (1.13 to 1.15)] p (0.99) not statistically significant, NSF vs NaF pooled value value [OR (CI)] 0.77 [95% CI (0.13 to 1.42)] p (0.02) was statistically significant, Subgroup analysis BAG and nBAG vs NaF pooled value [OR (CI)] 1.00 [95% CI (0.14 to 1.86)] p(0.02) was statistically significant.

Conclusions: This study concluded that the newer nanoparticulate and the nonfluoridated remineralizing agents are as effective as or more effective than other agents.

Key messages: This study highlights the newer agents, such as nanoparticulate and nonfluoridated remineralizing agents' potential in comparison to other commonly used agents, and focuses more on remineralization of primary teeth as a preventive treatment option.