São Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, ZIP code: 12245-000, SP, Brazil; Department of Restorative Dentistry, School of Dentistry, Taubaté University, UNITAU, Department of Dentistry, Rua dos Operários, 09, Centro, Taubaté, São Paulo, Zip Code: 12020-270, Brazil.
São Paulo State University - UNESP, Institute of Science and Technology, Department of Restorative Dentistry, Avenida Engenheiro Francisco José Longo, 777, Jardim São Dimas, São José dos Campos, ZIP code: 12245-000, SP, Brazil.
Arch Oral Biol. 2020 Dec;120:104945. doi: 10.1016/j.archoralbio.2020.104945. Epub 2020 Oct 16.
To evaluate the effects of different fluoride types and vehicles when compared to water or placebo, on prevention of enamel erosion and erosive tooth wear progression.
A systematic review followed by meta-analysis of randomized in situ trials was conducted. PubMeb, Scopus, Web of Science, LILACS, BBO, Scielo, EMBASE and CENTRAL electronic databases were searched. Studies with fluoride compounds (NaF, AmF, Sn, TiF) and vehicles (toothpaste, mouth rinse, gel, and varnishes) compared to control (water or placebo) for control of enamel loss progression were included. Reviewers independently screened potentially eligible articles, extracted data, and assessed risk of bias. GRADE approach was used to rate the overall certainty of evidence for toothpastes and rinses under erosive/abrasive challenges.
Thirty-two studies were elegible. Under erosive/abrasive challenges, enamel loss was significantly lower than control for NaF toothpastes [Mean difference(MD) -1.14; Confidence Interval(CI) -1.89 to -0.40] and Sn/associations [-6.02; -11.09 to -0.95], while no difference was found for AmF [-13.59; -39.7 to -12.52]. For mouth rinses, Sn/associations solutions were effective [-11.49; -16.62 to -6.37], but NaF showed no significant effect [-2.83; -8.04 to 2.38].
Overall, fluoride products are able to reduce enamel loss when compared to control, but results must be interpreted with caution. For toothpastes, NaF provided limited protection, with moderate evidence, while Sn/associations exhibited protective effect with low certainty of evidence. For rinses, NaF was not effective, with very low evidence, while the stannnous enriched fluorides offered higher protection regarding enamel erosion and erosive wear, with moderate certainty of evidence.
评估不同类型和载体的氟化物与水或安慰剂相比，对预防牙釉质侵蚀和侵蚀性牙齿磨损进展的影响。
进行了系统评价和随机在位试验的荟萃分析。检索了 PubMeb、Scopus、Web of Science、LILACS、BBO、Scielo、EMBASE 和 CENTRAL 电子数据库。纳入了比较氟化物化合物（NaF、AmF、Sn、TiF）和载体（牙膏、漱口液、凝胶和涂料）与对照（水或安慰剂）对牙釉质丧失进展的控制的研究。审查员独立筛选了潜在合格的文章，提取了数据，并评估了偏倚风险。使用 GRADE 方法对在侵蚀/磨损挑战下使用牙膏和漱口液的总体证据确定性进行了评级。
32 项研究合格。在侵蚀/磨损挑战下，与对照相比，NaF 牙膏[平均差异（MD）-1.14；置信区间（CI）-1.89 至-0.40]和 Sn/混合物[-6.02；-11.09 至-0.95]牙釉质损失明显较低，而 AmF 则无差异[-13.59；-39.7 至-12.52]。对于漱口液，Sn/混合物溶液有效[-11.49；-16.62 至-6.37]，但 NaF 没有显著效果[-2.83；-8.04 至 2.38]。
总体而言，与对照相比，氟化物产品能够减少牙釉质的丧失，但结果必须谨慎解释。对于牙膏，NaF 提供了有限的保护，具有中等证据，而 Sn/混合物则表现出保护作用，但证据确定性较低。对于漱口液，NaF 无效，证据极低，而富含锡的氟化物在预防牙釉质侵蚀和侵蚀性磨损方面提供了更高的保护，证据确定性为中等。
