Soeteman G D, Valkenburg C, Van der Weijden G A, Van Loveren C, Bakker Ewp, Slot D E
School for Dental Hygiene, University of Applied Sciences Utrecht, Utrecht, The Netherlands.
Dentist, Hoevelaken, The Netherlands.
Int J Dent Hyg. 2018 Feb;16(1):24-35. doi: 10.1111/idh.12289. Epub 2017 Jun 2.
The aim of this systematic review was to assess the effect of a whitening dentifrice (WDF) relative to a regular dentifrice (RDF) on the reduction of natural extrinsic tooth surface discoloration (ETD).
The MEDLINE-PubMed, Cochrane-CENTRAL and EBSCO-Dentistry and Oral Sciences databases were searched, up to April 2017. The inclusion criteria were as follows:(randomized)controlled clinical trials, healthy subjects ≥18 years of age, studies comparing WDF with RDF, a follow-up period of at least 6 weeks and studies scoring ETD as the stain area/extent, stain intensity or a composite score. Studies using an induced staining model were excluded.
Independent screening of 851 unique papers resulted in 21 eligible publications, which included 32 comparisons. The descriptive analysis illustrated that the majority of comparisons showed a significant effect on ETD, in favour of WDF over RDF. The meta-analysis substantiated this observation and revealed that the difference of means (diffM) comparing WDF and RDF was a reduction for stain area of -0.44 [(95% CI: -0.55; -0.339) (P<.00001)] according to the original Lobene Stain Index; this result is in favour of the WDF. For the modified Lobene Stain Index, the diffM was -0.41 [(95% CI: -0.71; -0.10) (P=.009)]. For overall stain intensity, the diffM was -0.35 [(95% CI: -0.44; -0.25) (P<.00001)], and the composite score was -0.39 [(95% CI: -0.57; -0.21) (P<.0001)] and -0.54 [(95% CI: -0.66; -0.43) (P<.00001)]. Subgroup analysis differentiating between products that contained added chemical antidiscoloration agents showed a similar pattern.
In this review, nearly all dentifrices that are specifically formulated for tooth whitening were shown to have a beneficial effect in reducing ETD, irrespective of whether or not a chemical discoloration agent was added.
本系统评价旨在评估美白牙膏（WDF）相对于普通牙膏（RDF）在减少天然外源性牙齿表面变色（ETD）方面的效果。
检索了截至2017年4月的MEDLINE-PubMed、Cochrane-CENTRAL和EBSCO-牙科学与口腔科学数据库。纳入标准如下：（随机）对照临床试验、年龄≥18岁的健康受试者、比较WDF与RDF的研究、至少6周的随访期以及将ETD作为染色面积/范围、染色强度或综合评分进行评分的研究。使用诱导染色模型的研究被排除。
对851篇独特论文进行独立筛选后，得到21篇符合条件的出版物，其中包括32项比较。描述性分析表明，大多数比较显示WDF在减少ETD方面相对于RDF具有显著效果。荟萃分析证实了这一观察结果，并显示根据原始Lobene染色指数，比较WDF和RDF的均值差异（diffM）为染色面积减少-0.44[（95%CI：-0.55；-0.339）（P<.00001）]；这一结果有利于WDF。对于改良的Lobene染色指数，diffM为-0.41[（95%CI：-0.71；-0.10）（P=.009）]。对于总体染色强度，diffM为-0.35[（95%CI：-0.44；-0.25）（P<.00001）]，综合评分为-0.39[（95%CI：-0.57；-0.21）（P<.0001）]和-0.54[（95%CI：-0.66；-0.43）（P<.00001）]。区分含有添加化学防变色剂产品的亚组分析显示出类似的模式。
在本综述中，几乎所有专门为牙齿美白配制的牙膏在减少ETD方面都显示出有益效果，无论是否添加了化学变色剂。
