Efetividade anticárie de dentifrícios contendo diferentes sais fluoretados: revisão sistemática e meta-análises

Abstract

The aim of this study was to evaluate the anti-caries effectiveness of standard fluoride toothpastes (1000 to 1500 ppm) containing different types of fluoridated agents [Sodium Fluoride (NaF), Sodium Monofluorophosphate (MFP), Amine Fluoride (AmF) and Stannous Fluoride (SnF2)]. A systematic review was carried out through an electronic search in the databases MEDLINE, CENTRAL, EMBASE, WEB OF SCIENCE, SCOPUS, LILACS and BBO, without language restriction, followed by handsearch in conference abstracts of the International Association for Dental Research (IADR) and the European Organization for Caries Research (ORCA) and in the reference list of reviews and articles on the topic, in November 2018. The risk of bias was analyzed using the criteria from the Cochrane´s Risk of Bias 2 tool. Meta-analyzes were performed for the surface and tooth levels from subgroups of studies that compared the same fluoride salts. After removing duplicates, 3128 titles and abstracts were independently screened by two previously trained reviewers to identify studies that met the pre-defined inclusion criteria. Of these, 75 were selected for full reading and 14 articles with results from 13 studies that directly compared two fluoride salts were included for qualitative and quantitative analyses, all studies with high risk of bias. When comparing dentifrices with NaF and SnF2, there was a statistically significant difference only at the tooth level (-0.64; 95% CI -0.64 to -0.25) favoring the dentifrice with NaF, and when comparing AmF with MFP, the AmF was more effective both at the surface (-0.60; 95% CI -0.95 to -0.25) and at the tooth (-0.27; 95% CI -0.41 to -0.13) levels. For the other comparisons identified (NaF and MFP; AmF and MFP; SnF2 and MFP), no statistically significant differences were found at any of the levels evaluated. Finally, dentifrices containing AmF showed greater anti-caries effectiveness when compared with MFP and dentifrices with NaF had better results when compared with SnF2. However, this evidence is limited due to the high risk of bias and the small number of studies included in each comparison