Department of Integrated Dentistry, Medical University of Bialystok, 24A Maria Sklodowska-Curie, 15-276 Bialystok, Bialystok, Poland.
Department of Integrated Dentistry, Poznan University of Medical Sciences, 70 Bukowska, Poznan 60-812, Poland.
J Dent. 2024 Dec;151:105429. doi: 10.1016/j.jdent.2024.105429. Epub 2024 Oct 28.
A systematic review and meta-analysis were undertaken to update our 3-year-old meta-analysis to include RCTs, in vivo, and in situ clinical evidence that showed hydroxyapatite in oral care products can reduce dental caries.
Using the PICO guide, published clinical trials were searched where subjects (P) of all ages, with primary, mixed or permanent dentitions, using toothpastes, mouthwashes or gels containing hydroxyapatite as an active ingredient (I) were compared to subjects who used placebo or no intervention, or fluoride-containing positive controls (C), and the outcomes (O) were direct measurement of reduced dental caries or suitable proxy for reduced caries risk.
PubMed, Scopus, EMBASE, and Web of Science databases were searched using search terms from previous searches.
All authors collectively agreed which studies to include after applying the exclusion/inclusion criteria. Eighteen studies were retrieved and analyzed. The studies were graded according to a National Institutes of Health grading system. Three authors decided on the final list of publications suitable for meta-analysis, and the meta-analysis was carried out using the public domain R statistical program.
After applying more specific inclusion criteria and assessment, out of 18 retrieved studies, 5 clinical trials and 8 in situ trials were included in the meta-analysis.
The evidence for the effectiveness of fluoride-free, hydroxyapatite-containing oral care products in reducing dental caries, both from RCTs and in situ clinical trials, has expanded. More studies now show that hydroxyapatite is effective as an anti-caries active ingredient in the absence of fluoride.
As a sole active ingredient, considered safe if swallowed, hydroxyapatite is an ideal substitute for fluoride in toothpaste and mouthwash tailored for young children, and new data as presented in this review, demonstrated that hydroxyapatite-based oral care products can be used by people of all ages.
系统评价和荟萃分析旨在更新我们 3 年前的荟萃分析，纳入 RCT、体内和原位临床证据，表明口腔护理产品中的羟基磷灰石可减少龋齿。
使用 PICO 指南，搜索了已发表的临床试验，其中受试者（P）为所有年龄段，具有原发性、混合性或永久性牙列，使用含有羟基磷灰石作为活性成分的牙膏、漱口水或凝胶（I），与使用安慰剂或无干预或含氟阳性对照的受试者（C）进行比较，结果（O）是直接测量龋齿减少或适合龋齿风险降低的替代指标。
使用以前搜索的搜索词在 PubMed、Scopus、EMBASE 和 Web of Science 数据库中搜索。
所有作者在应用排除/纳入标准后共同商定纳入哪些研究。检索到 18 项研究并进行了分析。根据美国国立卫生研究院的分级系统对研究进行了分级。三位作者决定最终适合荟萃分析的出版物清单，并使用公共领域 R 统计程序进行荟萃分析。
在应用更具体的纳入标准和评估后，在检索到的 18 项研究中，有 5 项临床试验和 8 项原位试验被纳入荟萃分析。
关于无氟、含羟基磷灰石的口腔护理产品在减少龋齿方面有效性的证据，无论是来自 RCT 还是原位临床试验，都有所扩大。更多的研究现在表明，羟基磷灰石在没有氟化物的情况下作为一种抗龋活性成分是有效的。
作为单一的活性成分，如果被吞下被认为是安全的，羟基磷灰石是儿童牙膏和漱口水中氟化物的理想替代品，本综述中提出的新数据表明，基于羟基磷灰石的口腔护理产品可用于所有年龄段的人。
