Campos Priscila H, Gimenez Thais, Rocha Rafael S, Caneppele Taciana M F, Guaré Renata O, Lussi Adrian, Bresciani Eduardo, Diniz Michele B
Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil.
Post-graduate Program in Dentistry, Ibirapuera University, São Paulo, Brazil.
Curr Pediatr Rev. 2022;18(1):33-46. doi: 10.2174/1573396317666211202090657.
The first clinically detectable stage of caries lesion is a non-cavitated white spot lesion (WSL). The detection of early stages of caries lesions allows non-invasive management by fluoride usage, oral hygiene and diet control. There is a lack of information in the literature regarding the prevalence of these caries lesions in preschool children, which is important especially for public health strategies.
The aim of this study was to conduct a systematic review with meta-analysis to verify the WSLs prevalence in primary teeth of preschool children.
A literature search with MEDLINE/PubMed, Scopus, Web of Science, and Open Gray databases was conducted. Included studies fulfilled the eligibility criteria. Meta-analyses were performed using random effects model, for prevalence of pooled WSLs and subgroups analyses.
The search strategy identified 4922 potentially relevant articles, with final inclusion of 16 studies. The pooled prevalence of WSLs in primary teeth was 14.0% (95% CI: 8.0-24.0), without publication bias (p=0.2668). For subgroup analyses, an increase in WSLs prevalence for children of low-income economy (24.0%; 95% CI: 20.0-28.0), for age >31 months (22.0%; 95% CI: 12.0-37.0), for validated visual criteria assessment (20.0%; 95% CI: 11.0-33.0), and for tactile assessment with ball-ended probe (26.0%; 95% CI: 11-50.0) were detected.
It is suggested that the prevalence of WSLs in primary teeth of preschool children increases in countries with low income economy, with age greater than 31 months or texture assessment with visual validated criteria or ball-ended probe. PROSPERO Registration: Protocol number #CDR42017078434.
龋损临床上可检测到的第一阶段是非龋洞型白斑病变（WSL）。龋损早期的检测有助于通过使用氟化物、口腔卫生和饮食控制进行非侵入性治疗。文献中缺乏关于学龄前儿童这些龋损患病率的信息，这对于公共卫生策略尤为重要。
本研究旨在进行一项系统评价并荟萃分析，以验证学龄前儿童乳牙中WSL的患病率。
使用MEDLINE/PubMed、Scopus、Web of Science和Open Gray数据库进行文献检索。纳入的研究符合纳入标准。采用随机效应模型进行荟萃分析，以分析合并的WSL患病率及亚组分析。
检索策略共识别出4922篇潜在相关文章，最终纳入16项研究。乳牙中WSL的合并患病率为14.0%（95%置信区间：8.0 - 24.0），无发表偏倚（p = 0.2668）。亚组分析发现，低收入经济体儿童（24.0%；95%置信区间：20.0 - 28.0）、年龄>31个月（22.0%；95%置信区间：12.0 - 37.0）、经验证的视觉标准评估（20.0%；95%置信区间：11.0 - 33.0）以及使用球端探针进行触觉评估（26.0%；95%置信区间：11 - 50.0）的WSL患病率有所增加。
建议在低收入经济体国家，年龄大于31个月，或采用经视觉验证标准或球端探针进行质地评估时，学龄前儿童乳牙中WSL的患病率会增加。PROSPERO注册号：协议编号#CDR42017078434。
