Boneta A E, Neesmith A, Mankodi S, Berkowitz H J, Sánchez L, Mostler K, Stewart B, Sintes J, De Vizio W, Petrone M E, Volpe A R, Zhang Y P, McCool J J, Bustillo E, Proskin H M
School of Dentistry, University of Puerto Rico, San Juan, Puerto Rico, USA.
Am J Dent. 2001 May;14 Spec No:13A-17A.
To clinically evaluate and compare a dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate (Test Dentifrice delivering 0.243% sodium fluoride), to a dentifrice containing 0.243% sodium fluoride in a silica base (Positive Control Dentifrice).
This study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. This 2-yr caries clinical study employed a double-blind, parallel-group design, and involved 5-17 yr-old children from the Central and South areas of Florida and from the Lares area of Puerto Rico. Qualifying subjects were stratified according to age and sex, and were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. Two calibrated examiners performed all the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to enforce compliance with the study. Post-baseline examinations were performed after 1 yr of product use, and again after 2 yrs of product use.
Two thousand five hundred six (2,506) subjects completed this 2-yr study. For these subjects, the mean caries scores (DMFS, decayed, missing and filled tooth surfaces) at baseline were 2.29 for the Test Dentifrice group, and 2.47 for the Positive Control Dentifrice group. For caries increments after 1 yr, the respective means were 0.69 for the Test Dentifrice group and 0.81 for the Positive Control Dentifrice group. Finally, after 2 yrs, the mean caries increments were 1.25 for the Test Dentifrice group, and 1.46 for the Positive Control Dentifrice group. No statistically significant difference was indicated between the treatment groups at baseline or between the 1-yr caries increment scores. However, there was a statistically significant difference in the 2-yr caries increment scores between the treatment groups. Relative to the Positive Control Dentifrice group, the Test Dentifrice group presented a 14.38% reduction in caries increment scores at 2 yrs. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that the dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate, delivering 0.243% sodium fluoride, provided a superior level of anticaries efficacy than did the dentifrice containing 0.243% sodium fluoride in a silica base.
临床评估并比较一种双腔管牙膏系统与一种含0.243%二氧化硅基氟化钠的牙膏(阳性对照牙膏),双腔管牙膏系统中一个腔室含有二氧化硅基氟化钠,另一个腔室含有二水磷酸二钙(测试牙膏,含0.243%氟化钠)。
本研究按照1988年美国牙科协会发布的关于含氟牙膏比较研究的指南进行。这项为期2年的龋齿临床研究采用双盲、平行组设计,涉及佛罗里达州中部和南部地区以及波多黎各拉雷斯地区5至17岁的儿童。符合条件的受试者按年龄和性别分层,随机分配到两个治疗组,同一家庭中的多个受试者全部随机分配到首先分配给其中一人的牙膏组。龋齿检查按照美国食品药品监督管理局预防龋齿药物临床评估指南进行。两名经过校准的检查人员进行所有测量。治疗分组后,研究参与者被指示在家中每天至少用分配的牙膏刷牙两次。牙科专业人员通过适当口腔卫生技术的灌输来强化刷牙指导,并由赞助商提供的宣传册以及每年给参与者的邮件进行补充,强调良好的口腔卫生以及遵守研究的必要性。在产品使用1年后和2年后分别进行基线后检查。
2506名受试者完成了这项为期2年的研究。对于这些受试者,测试牙膏组基线时的平均龋齿评分(DMFS,龋、失、补牙面)为2.29,阳性对照牙膏组为2.47。1年后的龋齿增量,测试牙膏组的相应平均值为0.69,阳性对照牙膏组为0.81。最后,2年后,测试牙膏组的平均龋齿增量为1.25,阳性对照牙膏组为1.46。治疗组在基线时或1年龋齿增量评分之间无统计学显著差异。然而,治疗组在2年龋齿增量评分上存在统计学显著差异。相对于阳性对照牙膏组,测试牙膏组在2年时的龋齿增量评分降低了14.38%。根据美国牙科协会发布的含氟牙膏防龋效果比较指南所提供的程序和标准,本研究结果支持以下结论:双腔管牙膏系统,其中一个腔室含有二氧化硅基氟化钠,另一个腔室含有二水磷酸二钙,含0.243%氟化钠,其防龋效果优于含0.243%二氧化硅基氟化钠的牙膏。