Teixeira Liliana, Manarte-Monteiro Patrícia, Manso Maria Conceição
Conservative and Restorative Dentistry, Department of Medical Sciences, Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal.
Biostatistics, Faculty of Health Sciences, FP-ENAS, University Fernando Pessoa, Porto, Portugal.
J Dent Sci. 2016 Sep;11(3):215-224. doi: 10.1016/j.jds.2016.03.008. Epub 2016 May 24.
This study aims to perform a meta-analysis on the effect of prophylactic/therapeutic agents in enamel tissue loss due to erosion. A paper search was done on Medline, PubMed, Embase, and Cochrane Library, and 732 papers were identified. The inclusion criteria were very restrictive in order to be able to compare different protocols and methodologies used on those studies. Sixteen papers were eligible, grouped according to the measurement method of enamel tissue loss, and a meta-analysis was done for each type of fluoride- and casein-based agent applied. Standardized mean differences were pooled across studies. There was a significant difference between all the treatment groups and their respective control groups. The highest standardized mean difference on enamel tissue loss (mean; 95% confidence interval) was obtained by stannous fluoride (4.789 μm; 1.968-7.610; P < 0.001), followed by amine fluoride (2.485 μm; 0.746-4.225; P < 0.010), and titanium tetrafluoride (1.787 μm; 1.106-2.469; P < 0.001); the lowest difference was obtained by casein phosphopeptide-amorphous calcium phosphate (0.869 μm; 0.007-1.731; P < 0.050) and sodium fluoride (0.820 μm; 0.417-1.223; P < 0.001). Stannous fluoride as a fluoride-based prophylactic/therapeutic agent allowed the lowest enamel tissue loss in erosive conditions. Standardization among future study protocols will allow better comparison regarding the prophylactic/therapeutic agent with the best clinical efficacy.
本研究旨在对预防性/治疗性药物对因酸蚀导致牙釉质组织丧失的影响进行荟萃分析。在医学期刊数据库（Medline）、医学期刊数据库（PubMed）、荷兰医学文摘数据库（Embase）和考科蓝图书馆进行了文献检索，共识别出732篇论文。为了能够比较这些研究中使用的不同方案和方法，纳入标准非常严格。16篇论文符合要求，根据牙釉质组织丧失的测量方法进行分组，并对每种基于氟化物和酪蛋白的药物进行荟萃分析。对各项研究的标准化平均差进行汇总。所有治疗组与其各自的对照组之间存在显著差异。在牙釉质组织丧失方面，标准化平均差最高（均值；95%置信区间）的是氟化亚锡（4.789μm；1.968 - 7.610；P < 0.001），其次是四氟化钛（2.485μm；0.746 - 4.225；P < 0.010）和四氟化钛（1.787μm；1.106 - 2.469；P < 0.001）；差异最低的是酪蛋白磷酸肽 - 无定形磷酸钙（0.869μm；0.007 - 1.731；P < 0.050）和氟化钠（0.820μm；0.417 - 1.223；P < 0.001）。在酸蚀情况下，作为基于氟化物的预防性/治疗性药物，氟化亚锡导致的牙釉质组织丧失最少。未来研究方案之间的标准化将有助于更好地比较具有最佳临床疗效的预防性/治疗性药物。
