Protective effect of fluorides on erosion and erosion/abrasion in enamel: a systematic review and meta-analysis of randomized in situ trials

Author(s)

Zanatta, Rayssa Ferreira ^{[1, 2]} ; Ferraz Caneppele, Taciana Marco ^[1] ; Scaramucci, Tais ^[3] ; El Dib, Regina ^{[4, 5, 6]} ; Maia, Lucianne Cople ^[7] ; Tavares Pereira Ferreira, Daniele Masterson ^[8] ; Borges, Alessandra Buhler ^[1]

Affiliation

^[1] Sao Paulo State Univ UNESP, Inst Sci & Technol, Dept Restorat Dent, Ave Engenheiro Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP - Brazil

^[2] Univ Taubate, UNITAU, Sch Dent, Dept Restorat Dent, Dept Dent, Rua Operarios 09, BR-12020270 Taubate, SP - Brazil

^[3] Univ Sao Paulo, Sch Dent, Dept Restorat Dent, Av Prof Lineu Prestes 2227, BR-05508000 Sao Paulo, SP - Brazil

^[4] Sao Paulo State Univ Unesp, Inst Sci & Technol, Dept Biosci & Oral Diag, Ave Engenheiro Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP - Brazil

^[5] Dalhousie Univ, Ctr Clin Res, Dept Community Hlth & Epidemiol, Room 404, 5790 Ave, University, NS B3H 1V7 - Canada

^[6] McMaster Univ, McMaster Inst Urol, St Josephs Healthcare, 1280 Main St West, Hamilton, ON L8S 4K1 - Canada

^[7] Fed Univ Rio de Janeiro UFRJ, Dept Pediat Dent & Orthodont, CCS, Postal Code 68066, Cidade Univ, BR-21941971 Rio De Janeiro, RJ - Brazil

^[8] Fed Univ Rio de Janeiro UFRJ, Ctr Ciencias Saude, Av Carlos Chagas Filho 373, Bloco L, BR-21941902 Rio De Janeiro, RJ - Brazil

• Document type: Review article
• Source: ARCHIVES OF ORAL BIOLOGY; v. 120, DEC 2020.
• Web of Science Citations: 0

Abstract

Objectives: To evaluate the effects of different fluoride types and vehicles when compared to water or placebo, on prevention of enamel erosion and erosive tooth wear progression. Design: A systematic review followed by meta-analysis of randomized in situ trials was conducted. PubMeb, Scopus, Web of Science, LILACS, BBO, Scielo, EMBASE and CENTRAL electronic databases were searched. Studies with fluoride compounds (NaF, AmF, Sn, TiF4) and vehicles (toothpaste, mouth rinse, gel, and varnishes) compared to control (water or placebo) for control of enamel loss progression were included. Reviewers independently screened potentially eligible articles, extracted data, and assessed risk of bias. GRADE approach was used to rate the overall certainty of evidence for toothpastes and rinses under erosive/abrasive challenges. Results: Thirty-two studies were elegible. Under erosive/abrasive challenges, enamel loss was significantly lower than control for NaF toothpastes {[}Mean difference(MD) -1.14; Confidence Interval(CI) -1.89 to -0.40] and Sn/associations {[}-6.02; -11.09 to -0.95], while no difference was found for AmF {[}-13.59; -39.7 to -12.52]. For mouth rinses, Sn/associations solutions were effective {[}-11.49; -16.62 to -6.37], but NaF showed no significant effect {[}-2.83; -8.04 to 2.38]. Conclusion: Overall, fluoride products are able to reduce enamel loss when compared to control, but results must be interpreted with caution. For toothpastes, NaF provided limited protection, with moderate evidence, while Sn/associations exhibited protective effect with low certainty of evidence. For rinses, NaF was not effective, with very low evidence, while the stannnous enriched fluorides offered higher protection regarding enamel erosion and erosive wear, with moderate certainty of evidence. (AU)

• FAPESP's process: 17/13799-8 - Antierosive potential of fluoridated solutions associated or not to film-forming polymers
• Grantee: Alessandra Buhler Borges
• Support Opportunities: Regular Research Grants