Hani Thikrayat Bani, O'Connell Anne C, Duane Brett
Dublin Dental University Hospital, Dublin, Eire.
Evid Based Dent. 2016 Jun;17(2):46-7. doi: 10.1038/sj.ebd.6401168.
Data sourcesMedline, Embase, PreMedline and Cochrane Central Register of Controlled Trials.Study selectionClinical trials, investigating only clinical caries outcomes on participants of any age comparing the use of Tooth Mousse(®) or Tooth Mousse Plus(®) to a routine oral care regimen for the prevention of dental caries with or without comparison to additional preventive products. Studies that used other formulations of CCP-ACP were excluded. Trials using split-mouth design were also excluded. Only English language papers were considered.Data extraction and synthesisPapers were assessed independently by both authors using the Cochrane Collaboration tool for assessing risk of bias in randomised trials.1 Meta-analysis was not possible due to study heterogeneity.ResultsTwelve studies were available for the final review; three studies on caries prevention were assessed as having low risk of bias. The remaining nine studies, with high risk of bias, reported on treatment or regression of early carious lesions. Two RCTs reported no significant benefits in the use of Tooth Mousse(®) over brushing with a fluoride toothpaste, a third study demonstrated a statistically significant increase in enamel microhardness for the Tooth Mousse(®) group compared to control group but no difference to the group who had fluoride gel treatment. Overall the authors concluded that Tooth Mousse(®) performs no better than fluoride in the prevention of carious lesions.Seven of nine studies evaluated caries lesion severity in orthodontic patients, with four demonstrating statistically significant white spot regression. Two trials in non-orthodontic patients showed statistically significant remineralising potential of Tooth Mousse(®) over fluoride mouthrinse or the regular use of fluoride toothpaste in 14-30 days.ConclusionsThe authors found no evidence to support the use of Tooth Mousse(®) over brushing with a fluoride toothpaste for the prevention of early caries. ToothMousse(®) appeared to benefit regression of white spot lesions associated with orthodontic treatment but the evidence is limited. Effectiveness of Tooth Mousse(®) was not significantly increased by the addition of fluoride in Tooth Mousse Plus(®) and evidence is still lacking to support the use of one over another. High quality randomised clinical trials are needed before these products can be recommended for the prevention and treatment of early carious lesions in the general population.Source of fundingThe publication was funded by Colgate Palmolive, Australia.
数据来源
医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、医学预印本数据库（PreMedline）和考克兰系统评价数据库（Cochrane Central Register of Controlled Trials）。
研究选择
临床试验，仅调查任何年龄参与者的临床龋齿结果，比较使用含酪蛋白磷酸肽 - 无定形磷酸钙（CCP - ACP）的齿优护（Tooth Mousse®）或齿优护加强版（Tooth Mousse Plus®）与常规口腔护理方案预防龋齿的效果，无论是否与其他预防产品进行比较。使用CCP - ACP其他配方的研究被排除。采用半口设计的试验也被排除。仅考虑英文论文。
数据提取与综合
两位作者使用考克兰协作组织用于评估随机试验偏倚风险的工具独立评估论文。由于研究异质性，无法进行荟萃分析。
结果
最终纳入12项研究进行综述；3项关于龋齿预防的研究被评估为低偏倚风险。其余9项高偏倚风险的研究报告了早期龋损的治疗或消退情况。两项随机对照试验（RCT）报告称，使用齿优护（Tooth Mousse®）相比使用含氟牙膏刷牙没有显著益处，第三项研究表明，与对照组相比，齿优护（Tooth Mousse®）组的牙釉质微硬度有统计学显著增加，但与接受氟凝胶治疗的组相比无差异。总体而言，作者得出结论，在预防龋损方面，齿优护（Tooth Mousse®）的效果不优于氟化物。
9项研究中的7项评估了正畸患者的龋损严重程度，其中4项显示有统计学显著的白斑消退。两项针对非正畸患者的试验表明，在14 - 30天内，齿优护（Tooth Mousse®）相比氟化物漱口水或定期使用含氟牙膏具有统计学显著的再矿化潜力。
结论
作者未发现证据支持使用齿优护（Tooth Mousse®）优于使用含氟牙膏刷牙来预防早期龋齿。齿优护（Tooth Mousse®）似乎对正畸治疗相关的白斑病变消退有益，但证据有限。在齿优护加强版（Tooth Mousse Plus®）中添加氟化物并未显著提高齿优护（Tooth Mousse®）的有效性，且仍缺乏支持使用其中一种而非另一种的证据。在这些产品可被推荐用于普通人群早期龋损的预防和治疗之前，需要高质量的随机临床试验。
资金来源
本出版物由澳大利亚高露洁棕榄公司资助。
