ABSTRACT
Aim:The purpose of this studywas to assess whether individuals with active caries lesions treated with professional topical application of fluoride at high concentrations show a lower incidence of caries than individuals who have not received professional treatment with fluoridated products. Literature review:Randomized clinical trials in which patients were followed up for at least 6 months were included. Studieswere identified with MEDLINE, Embase, LILACS, SCOPUS, and Cochrane Database of Systematic Reviews. Pairs of reviewers independently conducted study selection, data extraction, and risk-of-bias assessments. Eight trials, which included 5018 children and adolescents, were eligible. Results were evaluated by calculating the preventive fraction to standardize the outcomes.Results:Fluoride varnish yielded a better preventive fraction (90.18% to 14.6%) in both primary and permanent dentitions in comparison with methods using gel (22.3% to 6%) and foam (24%) after a mean follow-up period of 20.6 months. Regardless of the product used, increased frequency of application yielded greater benefit. Discussion:Theseresults do not agree with previous findings that, in 8 weeks periods, did not observe an additional effect of the professional use of fluorides over the control treatments(biofilm control). The presentreview indicatesthe need for long-term monitoring of the effect of treatment, whereby the effects of high fluoride concentrations may appear. Conclusion:Professional fluoride treatment proved to be effective in preventing new long-term injuries in both primary and permanent dentition, irrespective of the vehicle used (varnish, gel, or foam). (PROSPERO Register number CRD42021210740).
Objetivo:Avaliar se indivíduos com lesões ativas de cárie tratadas com aplicação tópica profissional de fluoretos em altas concentrações apresentam menor incidência de cárie do que indivíduos que não receberam este tratamento. Revisão da literatura:Ensaios clínicos randomizados, com acompanhamento de pelo menos 6 meses foram incluídos. Os estudos foram identificados nas bases de dados MEDLINE, Embase, LILACS, SCOPUS e Cochrane Database of Systematic Reviews. Pares de revisores conduziram de forma independente a seleção de estudos, extração de dados e avaliações de risco de viés. Oito estudos, que incluíram 5.018 crianças e adolescentes, foram elegíveis. Os resultados foram avaliados por meio do cálculo da fração preventiva. Resultados:O verniz fluoretado apresentou melhor fração preventiva (90,18% a 14,6%), tanto na dentição decídua quanto na permanente, em comparação com os métodos com gel (22,3% a 6%) e espuma (24%) após um período médio de seguimento de 20,6 meses. Independentemente do produto utilizado, o aumento da frequência de aplicação apresentou maior benefício. Discussão:Estes resultados diferem de achados anteriores em que, em períodos de 8 semanas, não houve efeito adicional do uso profissional de fluoretos em relação ao tratamento controle. A presente revisão indicou a necessidade de monitoramento a longo prazo do efeito do tratamento, quando os efeitos do fluoreto de alta concentração podem aparecer. Conclusão:O tratamento profissional com flúor mostrou-se eficaz na prevenção de novas lesões a longo prazo, tanto na dentição decídua quanto na permanente, independente do veículo utilizado (verniz, gel ou espuma). (Número de registro PROSPERO CRD42021210740).
Subject(s)
Fluorine , Randomized Controlled Trials as TopicABSTRACT
Abstract This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.