Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
J Dent. 2024 Aug;147:104904. doi: 10.1016/j.jdent.2024.104904. Epub 2024 Mar 3.
The objective of this systematic review was to assess the efficacy of topical applications containing surface pre-reacted glass-ionomer filler on dental hard tissues.
A comprehensive literature search was conducted in PubMed, MEDLINE, Embase, Scopus, ClinicalTrials.gov, Lilacs and Cochrane Central Register of Controlled Trials (until 15.08.2022). Google and Open Grey were used to search for grey literature and handsearching was conducted.
Clinical and in vitro studies conducted on human adult teeth were considered eligible without date and language restrictions. The electronic database generated 2,488 results. In total, 227 studies were found to be relevant from which 71 duplicates were removed. Title and abstract screening were then conducted, and a total of 33 studies met the inclusion criteria were assessed for full text screening. Two authors concluded that 11 studies satisfied the eligibility criteria. In vitro studies were evaluated using an accepted quality assessment tool for dental studies. Cochrane risk of bias tool was used for quality assessment of clinical randomised studies, whilst ROBINS-I tool was used for non-randomised studies.
Nine in vitro and only two non-randomised clinical trials were reported to meet the eligibility criteria. Results were grouped and analysed separately according to the study design. Different modes of surface pre-reacted glass-ionomer filler delivery were reported in the included studies. Three studies tested the effect of surface pre-reacted glass-ionomer filler containing toothpastes, whilst three studies investigated the effect of polishing pastes with surface pre-reacted glass-ionomer filler, three studies used eluates as surface pre-reacted glass-ionomer filler delivery method and two studies reported the effect of the coatings. The effect of those vehicles was tested on enamel, dentine or oral biofilm. Each study was analysed individually, and heterogeneity was detected among in vitro and clinical studies. Half of the in vitro studies were medium risk, whilst three were low and two studies presented with high risk. In clinical trials, outcome, confounding, selection biases were reported. Meta-analysis was therefore unable to be carried out.
Regardless of the mode of delivery and type of studies, all included studies demonstrated the efficacy of surface pre-reacted glass-ionomer filler containing topical applications to inhibit demineralisation of dental hard tissues at a dose dependant manner. Antimicrobial properties towards cariogenic species were also reported.
Surface pre-reacted glass-ionomer filler containing topical applications may serve as potential caries preventive and cariostatic tools. The systematic review registered in PROSPERO, International prospective register of systematic reviews, No. CRD42022347130.
本系统评价的目的是评估含有表面预反应玻璃离子填充物的局部应用在牙体硬组织中的疗效。
在 PubMed、MEDLINE、Embase、Scopus、ClinicalTrials.gov、Lilacs 和 Cochrane 对照试验中心注册库（截至 2022 年 8 月 15 日）进行了全面的文献检索。使用 Google 和 Open Grey 搜索灰色文献，并进行手工检索。
纳入无日期和语言限制的成人牙齿的临床和体外研究。电子数据库生成了 2488 项结果。共发现 227 项相关研究，其中 71 项重复。然后进行标题和摘要筛选，共有 33 项研究符合纳入标准，进行全文筛选。两名作者认为 11 项研究符合入选标准。体外研究采用公认的牙科研究质量评估工具进行评估。临床随机研究的质量评估采用 Cochrane 偏倚风险工具，非随机研究采用 ROBINS-I 工具。
报告了 9 项体外研究和仅 2 项非随机临床研究符合纳入标准。根据研究设计对结果进行分组和单独分析。纳入研究报告了不同模式的表面预反应玻璃离子填充物的输送方式。三项研究测试了含表面预反应玻璃离子填充物牙膏的效果，三项研究研究了含有表面预反应玻璃离子填充物的抛光膏的效果，三项研究使用洗脱液作为表面预反应玻璃离子填充物的输送方法，两项研究报告了涂层的效果。这些载体的作用分别在牙釉质、牙本质或口腔生物膜上进行了测试。每项研究都单独进行了分析，并且在体外和临床研究中都发现了异质性。一半的体外研究为中度风险，而三项研究为低度风险，两项研究为高度风险。临床试验报告了结果、混杂、选择偏倚。因此，无法进行荟萃分析。
无论输送方式和研究类型如何，所有纳入的研究都表明，含有表面预反应玻璃离子填充物的局部应用在剂量依赖性方式下抑制牙体硬组织脱矿是有效的。也报告了对致龋物种的抗菌性能。
含有表面预反应玻璃离子填充物的局部应用可能成为潜在的防龋和抗龋工具。本系统评价已在 PROSPERO 注册，国际前瞻性系统评价注册库，编号 CRD42022347130。
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