Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina.
Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina; Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR China.
Int Dent J. 2022 Dec;72(6):746-764. doi: 10.1016/j.identj.2022.06.022. Epub 2022 Jul 22.
Caries is the most prevalent chronic noncommunicable disease. Strategies to prevent its onset and early interventions to arrest the progression of early lesions have been emphasised throughout recent decades to avoid or delay the restorative spiral of the tooth. More individuals are retaining their natural teeth into old age, thereby necessitating ongoing restorative dentistry intervention for their maintenance. The aim of this systematic review was to update the state of the art regarding clinical studies reporting the effectiveness of different nonrestorative caries treatment options in the 5-year period from 2017 to 2022. Relevant articles were retrieved from 2 electronic databases, including randomised clinical trials (RCTs) published from January 2017 until April 2022, assessing effectiveness and secondary effects of at least one nonrestorative caries treatment option, carried out with adults and/or children with noncavitated or cavitated carious lesions on either primary or permanent teeth and diagnosed by radiographs or visual/tactile assessment. All 35 included articles presented the results of RCTs with a follow-up period ranging from 6 to 84 months. Most of these studies were considered high-quality articles with a low risk of bias. Sealants and fluoride gels and varnishes were mentioned in 12 studies as effective strategies to prevent the onset of caries lesions and to arrest them in the early stages. Resin infiltration reported high caries arresting rates in noncavitated proximal lesions in 10 publications. Silver diammine fluoride presented high caries-arresting rates in open dentin lesions, both in primary and permanent dentitions as well as in root caries lesions that were accessible for cleansing. New evidence has been published between 2017 and 2022 as the result of numerous clinical studies providing further evidence of the effectiveness of nonrestorative caries treatment options.
龋齿是最普遍的慢性非传染性疾病。近几十年来，人们一直强调预防龋齿的发生和早期干预以阻止早期病变的进展，以避免或延迟牙齿的修复循环。越来越多的人在老年时保留自己的天然牙齿，因此需要持续进行修复牙科干预来维护他们的牙齿。本系统评价的目的是更新 2017 年至 2022 年 5 年期间报告不同非修复性龋齿治疗选择有效性的临床研究现状。从 2 个电子数据库中检索到相关文章，包括 2017 年 1 月至 2022 年 4 月发表的随机临床试验（RCT），评估了至少一种非修复性龋齿治疗选择的有效性和次要效果，这些研究是在成年人和/或儿童中进行的，这些患者的非龋坏或龋坏病变位于乳牙或恒牙上，并且通过放射学或视觉/触觉评估进行诊断。所有 35 篇纳入的文章均报告了 RCT 的结果，随访时间从 6 个月到 84 个月不等。这些研究中大多数被认为是高质量的文章，具有较低的偏倚风险。在 12 项研究中，密封剂和氟化物凝胶和涂料被提及是预防龋齿病变发生和在早期阶段阻止它们的有效策略。10 项研究报告了树脂渗透在非龋近中面病变中具有较高的龋齿抑制率。在乳牙和恒牙以及可清洁的根面龋病变中，银氨溶液显示出较高的龋抑制率。2017 年至 2022 年期间发表了新的证据，这是由于大量临床研究提供了非修复性龋齿治疗选择有效性的进一步证据。
