Bader J D, Shugars D A, Bonito A J
Operative Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
Community Dent Oral Epidemiol. 2001 Dec;29(6):399-411. doi: 10.1034/j.1600-0528.2001.290601.x.
A systematic review of the periodic scientific literature was undertaken to determine the strength of the evidence for the efficacy of professional caries preventive methods applied to high risk individuals, and the efficacy of professionally applied methods to arrest or reverse non-cavitated carious lesions. An initial search identified 1435 articles, of which 27 were eventually included in the review. Among the 22 studies addressing the prevention of carious lesions in caries-active or high risk individuals, the strength of the evidence was judged to be fair for fluoride varnishes and insufficient for all other methods. Among the seven studies addressing the management of non-cavitated carious lesions, the strength of the evidence for efficacy was judged to be insufficient for all methods. The results do not indicate that the preventive and management methods reviewed are not efficacious; rather, they demonstrate that not enough is known to determine the efficacy of the methods. Suggestions for strengthening the limited evidence base involve the following: i) increasing the number of studies that examine prevention among high risk individuals and non-surgical management of non-cavitated lesions, ii) including a wider variety of subject ages, iii) targeting aspects of the efficacy questions not yet addressed, iv) strengthening research methods employed in the studies, and v) reporting methods and outcomes more completely.
我们对定期发表的科学文献进行了系统综述，以确定应用于高风险个体的专业龋齿预防方法的疗效证据强度，以及专业应用方法阻止或逆转非龋洞性龋损的疗效。初步检索确定了1435篇文章，其中27篇最终被纳入综述。在针对龋活跃或高风险个体预防龋损的22项研究中，氟化物涂膜的证据强度被判定为中等，而所有其他方法的证据强度不足。在针对非龋洞性龋损管理的7项研究中，所有方法的疗效证据强度均被判定为不足。结果并不表明所综述的预防和管理方法无效；相反，它们表明目前对这些方法疗效的了解还不够。加强有限证据基础的建议如下：i）增加针对高风险个体预防和非龋洞性病变非手术管理的研究数量，ii）纳入更广泛的受试者年龄范围，iii）针对尚未解决的疗效问题的各个方面，iv）加强研究所采用的研究方法，以及v）更全面地报告方法和结果。
