Topical agents for root caries prevention.
Topical agents for root caries prevention.
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DOI：
10.1038/sj.ebd.6401074
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发表时间：
2015-03-01
影响因子：
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通讯作者：
Hayes, Martina
中科院分区：
文献类型：
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作者：
Hayes, Martina
数据来源：PubMed，EMBASE和科克伦对照试验中心注册。研究选择：随机和非随机，对照和前瞻性研究比较预防制度的根龋被认为是。只有英语或德语的语言研究被认为是。数据提取和综合：标准数据项提取。平均差异（MD）和标准平均差异（SMD）是主要的效应指标。计算DMFRS/DFRS（龋坏、缺失、充填根面）和RCI（根龋指数）的变化。进行了随机效应荟萃分析。采用科克伦偏倚风险工具评价研究质量，并根据GRADE进行证据分级。结果：纳入34项研究中的30个试验，涉及10，126例患者。29项为RCT，另一项为对照试验。仅5项研究的偏倚风险被认为较低。共检测了28种化学制剂。11项研究评估了牙膏; 10次冲洗; 8次清漆; 3次氟化物溶液; 3次凝胶; 2次臭氧应用; 1次预防性牙科治疗方案。荟萃分析显示，含5，000 ppm F-（RR = 0.49; 95% CI= 0.42，0.57;高证据水平）或1.5%精氨酸+1，450 ppm F-（RR = 0.79; 95% CI = 0.64，0.98;极低水平）在灭活RCL方面比含1，100至1，450 ppm F-的农药更有效。与NaF产品相比，自施用的含AmF/SnF 2的洗涤剂和冲洗剂降低了RCL的引发（SMD = 0.15; 95%CI =-0.22，0.52;低水平证据）。与安慰剂漱口液相比，含225 - 900 ppm F-的漱口液显示DMFRS/DFRS显著降低（MD = -0.18; 95% CI =-0.35，-0.01;低水平）。氯己定的RCI显著降低（MD = -0.67; 95% CI =-1.01，-0.32;极低水平证据）以及SDF（MD = -0.33; 95% CI =-0.39，-0.28;非常低水平）。结论：基于荟萃分析，含5，000 ppm F-和专业应用的CHX或SDF清漆的涂料可能会抑制现有的RCL和/或减少RCL的发生。然而，由于每种药物的临床试验数量少，研究中偏倚的风险高，证据等级有限，因此应谨慎解释结果。
DATA SOURCES: PubMed, EMBASE and Cochrane Central Register of Controlled Trials.STUDY SELECTION: Randomised and nonrandomised, controlled, and prospective studies comparing preventive regimes for root caries were considered. Only English or German language studies were considered.DATA EXTRACTION AND SYNTHESIS: Standard data items were extracted. Mean differences (MD) and standard mean differences (SMD) were primary effect measures. Changes were calculated for DMFRS/DFRS (decayed, missing, filled root surfaces), and RCI (root caries index). Random-effects meta-analysis was conducted. Study quality was assessed using the Cochrane risk of bias tool and grading of evidence was performed according to the GRADE.RESULTS: Thirty trials reported in 34 studies involving 10,126 patients were included. Twenty-nine were RCTs, the other a controlled trial. Risk of bias was considered low for only five studies. In all 28 chemical agents were tested. Eleven studies assessed dentifrices; ten rinses; eight varnishes; three fluoride solutions; three gels; two ozone applications; one preventive dental regimen. Meta-analyses revealed that dentifrices containing 5,000 ppm F- (RR = 0.49; 95% CI= 0.42, 0.57; high level of evidence) or 1.5% arginine plus 1,450 ppm F- (RR = 0.79; 95% CI = 0.64, 0.98; very low level) are more effective in inactivating RCLs than dentifrices containing 1,100 to 1,450 ppm F-. Self-applied AmF/SnF2-containing dentifrice and rinse decreased the initiation of RCLs when compared with NaF products (SMD = 0.15; 95% CI = -0.22, 0.52; low level evidence). Mouth rinse containing 225 to 900 ppm F- revealed a significantly reduced DMFRS/DFRS (MD = -0.18; 95% CI = -0.35, -0.01; low level) when compared with a placebo rinse. Significantly reduced RCI was found for Chlorhexidine (MD = -0.67; 95% CI = -1.01, -0.32; very low level evidence) as well as SDF (MD = -0.33; 95% CI = -0.39, -0.28; very low level) when compared with placebo varnish.CONCLUSIONS: Based on meta-analysis, dentifrice containing 5,000 ppm F- and professionally applied CHX or SDF varnish may inactivate existing and/or reduce the initiation of RCLs. However, results should be interpreted with caution due to the low numbers of clinical trials for each agent, the high risk of bias within studies, and the limiting grade of evidence.