局部氟化物应用于成人和老年患者牙根龋齿的治疗方法：网络荟萃分析的系统评价。

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

Journal of dentistry Pub Date : 2025-08-31 DOI:10.1016/j.jdent.2025.106072

Júlia Macluf Torres , Guilherme Azario de Holanda , Yorrana Martins Corrêa , Tamara Kerber Tedesco , Anelise Fernandes Montagner

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引用次数: 0

摘要

目的：本系统综述评价局部应用氟化物抑制成人和老年患者活动性牙根龋病变的最有效策略。方法：检索数据库，以确定随机对照试验（rct），这些试验涉及在恒牙根表面出现龋齿病变的成人或老年患者，并暴露于任何局部应用氟化物的策略。考虑的结果是阻止根性龋齿病变。使用RoB 2.0工具进行偏倚风险评估。网络（NMA）和两两荟萃分析进行了6个月的随访。结果：本综述纳入13项随机对照试验。三个研究（907颗牙齿）被纳入NMA，随访6个月。常规牙液- CD、高浓度牙液- HCD、添加成分的牙液- dia对龋病的抑制效果均优于NAC（无氟牙液）。另一方面，在CD与HCD和HCD与DIA之间没有观察到差异。DIA对抑制龋齿病变的疗效高于CD。在纳入的13项随机对照试验中，有2项研究总体偏倚风险较高，大多数（n=11）存在一些担忧。证据的确定性从低到非常低。结论：含氟牙膏，无论配方如何，在阻止成人和老年患者6个月的活动性牙根龋齿病变方面比不含氟的对照组更有效。添加活性成分的牙膏最有可能成为最有效的策略。然而，这些发现应谨慎解释，因为证据的确定性低至非常低。临床意义：本研究强调了在临床实践中推荐含氟牙膏治疗活动性牙根龋病变的重要性，特别是在成人和老年患者中。与普通牙膏相比，添加成分（DIA）的牙膏显示出最高的功效，这表明添加特定成分（如精氨酸、氟化亚锡、木糖醇）可能会增强氟化物的抗氧化作用。

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Methods of topical fluoride application in the arrest of root carious lesions of adults and elderly patients: A systematic review with network meta-analysis

Objective

This systematic review evaluated the most effective strategy for the topical application of fluoride in arresting active root caries lesions in adults and elderly patients.

Methods

Databases were searched to identify randomized controlled trials (RCTs) involving adults or elderly patients who presented carious lesions on the root surface of permanent teeth and were exposed to any strategy for the topical application of fluoride. The outcome considered was the arrest of root carious lesions. The risk of bias assessment was performed with the RoB 2.0 tool. Network (NMA) and pairwise meta-analyses were performed for a follow-up of 6 months.

Results

Thirteen RCTs were included in the review. Three studies (907 teeth) were included in the NMA for a 6-month follow-up. All strategies (Conventional dentifrice - CD, High concentration dentifrice - HCD, Dentifrice with ingredient addition – DIA) showed the highest efficacy for caries lesion arrestment than NAC (non-fluoride dentifrice). On the other hand, no difference was observed between CD vs. HCD and HCD vs. DIA. DIA showed higher efficacy for caries lesion arrestment than CD. Among the 13 RCTs included, two studies present an overall high risk of bias, and the majority (n = 11) presented some concerns. The certainty of evidence was graded from low to very low.

Conclusion

Fluoride dentifrices, regardless of formulation, were more effective than non-fluoride controls in arresting active root carious lesions in adults and elderly patients at 6 months. Dentifrices with added active ingredients (DIA) showed the highest probability of being the most effective strategy. However, these findings should be interpreted cautiously due to the low to very low certainty of evidence.

Clinical significance

This study reinforces the importance of recommending fluoride-containing dentifrices in clinical practice for managing active root caries lesions, particularly in adults and elderly patients. Dentifrice with ingredient addition (DIA) showed the highest efficacy compared to conventional dentifrice and suggests that the addition of specific ingredients (e.g., arginine, stannous fluoride) may enhance the anticaries effect of fluoride.

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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.