摘要
目的系统评价我国局部用氟预防正畸治疗中牙釉质脱矿的效果。方法计算机检索The CochraneLibrary(2012年第9期)、MEDLINE(1996～2012.10)、EMbase(1974～2012.10)、CNKI(1994～2012.10)、VIP(1994～2012.10)、WanFang Data(1998～2012.10)和CBM(1978～2012.10),纳入关于我国局部用氟预防正畸治疗中牙釉质脱矿的随机和半随机对照试验,同时追溯纳入文献的参考文献。由2位研究者独立对纳入研究的质量进行严格评价和资料提取,而后采用RevMan 5.2软件进行Meta分析。结果共纳入19篇文献(20个研究),包括26 323颗牙齿。Meta分析结果显示:氟保护漆组的牙釉质脱矿率(8.4%)低于对照组(16.0%)[OR=0.44,95%CI(0.33,0.59),P<0.000 01];局部涂氟组的牙釉质脱矿率(8.3%)低于对照组(17.7%)[OR=0.46,95%CI(0.35,0.60),P<0.000 01];含氟牙膏组的牙釉质脱矿率(9.0%)低于对照组(14.5%)[OR=0.59,95%CI(0.49,0.71),P<0.000 01];含氟泡沫组的牙釉质脱矿率(11.6%)低于对照组(18.2%)[OR=0.48,95%CI(0.24,0.96),P=0.04];其他方式组的牙釉质脱矿率(12.0%)低于对照组(21.8%)[OR=0.43,95%CI(0.30,0.60),P<0.000 01]。2个结局的GRADE系统推荐分级为低等级,3个为极低等级。结论国内现有研究显示,局部用氟可以达到预防正畸治疗中牙釉质脱矿的效果,但由于纳入研究的方法学质量较低,本研究结果的可靠性尚需开展更多设计严谨的高质量、大样本的研究予以证实。
Objective To evaluate the effectiveness of topical fluoride on prevention of enamel demineralization during the orthodontic treatment in China.Methods The Cochrane Library（Issue 9,2012）,MEDLINE（1996 to 2012.10）,EMbase（1974 to 2012.10）,CNKI（1994 to 2012.10）,VIP（1994 to 2012.10）,WanFang data（1998 to 2012.10） and CBM（1978 to 2012.10） are searched for the randomized controlled trials（RCTs） and quasi-Randomized controlled trials（qRCTs） about topical fluoride preventing enamel demineralization during the orthodontic treatment.The bibliographies of the included studies were searched,too.Two reviewers evaluated the quality of the included studies and extracted data critically and independently,and then the extracted data were analyzed using RevMan 5.2 software.Results A total of 20 studies within 19 articles were included,which involved 26 323 teeth.The results of meta-analysis results show that,the rate of enamel demineralization of the fluoride varnish group（8.4%） was lower than that of the control group（16.0%）（OR=0.44,95%CI 0.33 to 0.59,P0.000 01）;the rate of enamel demineralization of the fluoride coating group（8.3%） was lower than that of the control group（17.7%）（OR=0.46,95%CI 0.35 to 0.60,P0.000 01）;the rate of enamel demineralization of the fluoride toothpaste group（9.0%） was lower than that of the control group（14.5%）（OR=0.59,95%CI 0.49 to 0.71,P0.000 01）;the rate of enamel demineralization of the fluoride foam group（11.6%） was lower than that of the control group（18.2%）（OR=0.48,95%CI 0.24 to 0.96,P=0.04）;the rate of enamel demineralization of other groups（12.0%） was lower than that of the control group（21.8%）（OR=0.43,95%CI 0.30 to 0.60,P0.000 01）.Two outcomes were low quality in the GRADE system and the other three are very low quality.Conclusion Current domestic evidence shows that topical fluoride is effective to prevent enamel demineralization during the orthodontic treatment.However,given the low methodological quality of most included studies,this conclusion still needs to be further proved by conducting more strictly-designed,high-quality and large-scale studies.
出处
《中国循证医学杂志》
CSCD
2013年第7期875-884,共10页
Chinese Journal of Evidence-based Medicine
关键词
局部用氟
预防
正畸
牙釉质脱矿
随机对照试验
半随机对照试验
Meta分析
Topical fluoride
Prevention
Orthodontic treatment
Enamel demineralization
Randomized controlled trial
Quasi-randomized controlled trial
Meta-analysis
作者简介
王曼，女（1991年～），本科在读。Email：wangman9168@126．com
通讯作者，Email：guoyi@whu．edu.cn
