Hayashi Mikako, Momoi Yasuko, Fujitani Morioki, Fukushima Masayoshi, Imazato Satoshi, Kitasako Yuichi, Kubo Shisei, Nakashima Shoji, Nikaido Toru, Shimizu Akihiko, Sugai Kenichi, Takahashi Rena, Unemori Masako, Yamaki Chinami
Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
Jpn Dent Sci Rev. 2020 Nov;56(1):155-163. doi: 10.1016/j.jdsr.2020.09.005. Epub 2020 Nov 25.
Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries. Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions.
再矿化治疗具有无创的优点，越来越多地被用作治疗早期釉质龋的微创治疗方法。本综述的目的是制定循证医学指南，以优化早期釉质龋的无创治疗策略。日本保守牙科学会（JSCD）指南委员会使用GRADE系统制定了治疗早期釉质龋的指南，该系统是全球指南制定的主流标准。委员会选择了治疗早期釉质龋时最常见的临床问题（CQs），并确定了评估治疗效果的重要临床结局。通过广泛的电子检索和手工检索，确定了相关的随机对照试验和对照临床试验。根据委员会制作的证据概要，专家小组讨论了所选治疗方法的效果、益处和缺点，以及它们的成本效益和可行性，以便就无创治疗早期釉质龋达成共识。在小组成员投票后，针对每个临床问题提出了建议。根据每个CQ的证据概要和专家小组讨论，专家们强烈建议应用局部氟化物来抑制早期釉质龋的空洞形成，并减少白斑病变。
