Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
J Evid Based Dent Pract. 2022 Mar;22(1):101682. doi: 10.1016/j.jebdp.2021.101682. Epub 2021 Dec 4.
This systematic review and meta-analyses aimed to evaluate the potential protective effect of titanium tetrafluoride (TiF) compound compared to sodium fluoride (NaF) on eroded enamel or dentin.
Two independent reviewers searched PubMed, Scopus, Web of Science, LILACS, Cochrane, EMBASE, and Open gray Literature up to June 2020. MeSH terms, supplementary concepts, synonyms, and free terms were applied based on PICOS strategy (P- population: eroded enamel or dentin; I- intervention: eroded teeth treated with solution or varnish of TiF; C- comparison: eroded teeth treated with a solution or varnish of NaF; O- outcome: mineral loss measurement; S- study design: in vitro studies). Seven distinct parameters evaluated the risk of bias, and all studies were submitted to 4 meta-analyses (first and second meta-analyses related to enamel loss treated with fluoride solution or varnish, respectively; third and fourth meta-analyses related to dentin loss treated with fluoride solution or varnish, respectively). A sensitivity test was performed by the RevMan software, based on standard mean difference calculation (P < .05).
A total of 10,260 studies were retrieved, from which 22 studies were included in systematic review through eligibility criteria, of which 1 study was classified as low risk of bias, 19 as medium, and 3 as high. Seventeen studies were included in 4 different meta-analyses, presenting considerable overall heterogeneity (I = 95; 92; 95; and 93%, respectively) with statistical significance for TiF on the first meta-analysis, and no statistical significance for second, third, and fourth meta-analyses.
Titanium tetrafluoride compound delivered as solution provided significant effective protection for erosion lesions on the enamel surface compared to sodium fluoride. However, when TiF or NaF were applied on enamel or dentin surfaces as varnish, both provided the same effective protection, based on in vitro studies with considerable heterogeneity.
本系统评价和荟萃分析旨在评估钛四氟化物（TiF）化合物与氟化钠（NaF）相比对脱矿釉质或牙本质的潜在保护作用。
两位独立的审查员检索了 PubMed、Scopus、Web of Science、LILACS、Cochrane、EMBASE 和 Open gray Literature，检索时间截至 2020 年 6 月。根据 PICOS 策略（P-研究人群：脱矿釉质或牙本质；I-干预措施：用 TiF 溶液或清漆处理的脱矿牙；C-比较：用 NaF 溶液或清漆处理的脱矿牙；O-结果：矿物质损失测量；S-研究设计：体外研究），使用了 MeSH 术语、补充概念、同义词和自由术语。对 7 个不同的参数进行了偏倚风险评估，所有研究均进行了 4 项荟萃分析（第一项和第二项荟萃分析分别与用氟化物溶液或清漆处理的釉质损失有关；第三项和第四项荟萃分析分别与用氟化物溶液或清漆处理的牙本质损失有关）。RevMan 软件基于标准均数差计算进行了敏感性测试（P＜0.05）。
共检索到 10260 项研究，其中 22 项研究通过纳入标准进行了系统评价，其中 1 项研究被归类为低偏倚风险，19 项为中偏倚风险，3 项为高偏倚风险。17 项研究被纳入 4 项不同的荟萃分析，结果显示存在较大的总体异质性（I分别为 95%、92%、95%和 93%），第一项荟萃分析中 TiF 具有统计学意义，第二项、第三项和第四项荟萃分析中则无统计学意义。
TiF 溶液在釉质表面提供了比 NaF 更有效的防龋保护，但在釉质或牙本质表面作为清漆使用时，两种氟化物提供了相同的有效保护，这是基于具有较大异质性的体外研究。
