Nascimento Patrícia Layane de Menezes Macêdo, Fernandes Micaelle Tenório Guedes, Figueiredo Fabricio Eneas Diniz de, Faria-E-Silva André Luis
Graduate Program in Dentistry, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Graduate Program in Health Sciences, Universidade Federal de Sergipe, Aracaju, SE, Brazil.
Braz Dent J. 2016 Jan-Feb;27(1):101-7. doi: 10.1590/0103-6440201600482.
The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.
正畸固定矫治器的使用与牙釉质脱矿之间的关系已得到充分证实。针对这一问题已提出了不同的预防方法，但关于哪种方法最佳仍存在争议。本研究的目的是对临床试验进行系统评价，这些试验调查了含氟材料用于粘结托槽或覆盖粘结界面以抑制白斑病变发生和发展的有效性。无效假设是氟化物材料不会影响托槽周围白斑病变的发生率。我们在MEDLINE数据库中检索了评估使用固定正畸矫治器患者白斑病变发生情况的随机临床试验，随后进行荟萃分析，比较使用含氟牙科材料的患者（实验组）和未使用这些材料的患者（对照组）的结果。实验组发生白斑病变的合并相对风险为0.42（95%置信区间：0.25至0.72）；因此，使用含氟释放材料时，患者发生白斑病变的风险降低58%。关于白斑病变的程度，实验组和对照组之间的合并平均差异无统计学意义（-0.12；95%置信区间：-0.29至0.04）。总之，本系统评价的结果表明，含氟释放材料可降低托槽周围白斑病变的风险。然而，当白斑病变已经发生时，没有证据表明含氟释放材料可减少这些病变的程度。
