Dublin Dental University Hospital, Trinity College Dublin, Dublin, Republic of Ireland.
Trinity College Dublin, Dublin, Republic of Ireland.
Evid Based Dent. 2024 Jun;25(2):89-90. doi: 10.1038/s41432-024-01018-2. Epub 2024 May 25.
Three electronic databases (Pubmed, Embase and the Cochrane Library) were searched in December 2022, and again for additional literature on 3-5th January 2023. Reference lists of relevant systematic reviews were hand searched for other eligible studies for inclusion.
Randomised controlled clinical trials and controlled clinical trials conducted on children (aged ≤ 18 years), conducted between 1974-2022 and available in English, were eligible for inclusion. Studies were excluded if caries was not an outcome, the control group was not sufficient, they were lab-based studies or studies where xylitol delivery was not a sweet or chewing gum and where the xylitol product contained a component such as fluoride which may influence the outcomes.
Four calibrated reviewers independently screened titles and abstracts, and disagreements were resolved via group discussion. Preventative effect was determined by comparing the mean caries increment in the control and intervention groups, producing a preventative fraction. A total of 617 titles were initially screened for relevance. After duplicate removal, 268 abstracts were screened and 16 full text articles reviewed, with one more study then excluded. 10 studies investigated xylitol-containing chewing gum, and six looked at xylitol candy (one did both). Eight included studies were randomised controlled trials. Data extraction was undertaken by two reviewers.
3466 participants were included in the 10 studies that investigated xylitol chewing gum, and all 10 studies reported a statistically significant preventive effect compared to a no chewing gum or placebo control. In 9 studies, the preventive fraction was clinically significant. The six studies investigating xylitol candies contained a total of 1023 participants, and only one study demonstrated a significant preventative effect.
There is some evidence that incorporating xylitol chewing gum daily has a caries-reducing effect in those with a moderate-to-high baseline caries level. This effect was not present for xylitol sweets.
2022 年 12 月检索了三个电子数据库（PubMed、Embase 和 Cochrane Library），并于 2023 年 1 月 3 日至 5 日再次检索以获取其他相关文献。手检了相关系统评价的参考文献列表，以纳入其他符合条件的研究。
纳入了在 1974 年至 2022 年间进行的、针对儿童（年龄≤18 岁）的随机对照临床试验和对照临床试验，且研究报告为英文。如果龋齿不是结局，对照组不充分，或者研究为实验室研究，或者木糖醇的给予方式不是甜味剂或咀嚼糖，并且其中的木糖醇产品含有可能影响结局的成分如氟化物，则排除研究。
四名经过校准的评审员独立筛选标题和摘要，如果有分歧，则通过小组讨论解决。通过比较对照组和干预组的平均龋齿增量来确定预防效果，得出预防分数。最初筛选了 617 个标题以确定相关性。去除重复项后，筛选了 268 个摘要，并审查了 16 篇全文文章，之后又排除了 1 项研究。10 项研究调查了含木糖醇的咀嚼糖，6 项研究调查了木糖醇糖果（其中 1 项同时进行了这两项研究）。8 项纳入研究为随机对照试验。由两名评审员进行数据提取。
10 项研究调查了含木糖醇的咀嚼糖，共有 3466 名参与者，与无咀嚼糖或安慰剂对照组相比，所有研究均报告了统计学上显著的预防效果。9 项研究中的预防分数具有临床意义。6 项研究调查了含木糖醇的糖果，共有 1023 名参与者，只有 1 项研究显示出显著的预防效果。
有证据表明，每天摄入木糖醇咀嚼糖可降低中重度基线龋齿水平患者的龋齿发生率。这种效果在木糖醇糖果中并不存在。
