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Review
. 2016 Sep;11(3):215-224.
doi: 10.1016/j.jds.2016.03.008. Epub 2016 May 24.

Enamel lesions: Meta-analysis on effect of prophylactic/therapeutic agents in erosive tissue loss

Liliana Teixeira  1 , Patrícia Manarte-Monteiro  1 , Maria Conceição Manso  2   3
Affiliations
Review

Enamel lesions: Meta-analysis on effect of prophylactic/therapeutic agents in erosive tissue loss

Liliana Teixeira et al. J Dent Sci. 2016 Sep.

Abstract

This study aims to perform a meta-analysis on the effect of prophylactic/therapeutic agents in enamel tissue loss due to erosion. A paper search was done on Medline, PubMed, Embase, and Cochrane Library, and 732 papers were identified. The inclusion criteria were very restrictive in order to be able to compare different protocols and methodologies used on those studies. Sixteen papers were eligible, grouped according to the measurement method of enamel tissue loss, and a meta-analysis was done for each type of fluoride- and casein-based agent applied. Standardized mean differences were pooled across studies. There was a significant difference between all the treatment groups and their respective control groups. The highest standardized mean difference on enamel tissue loss (mean; 95% confidence interval) was obtained by stannous fluoride (4.789 μm; 1.968-7.610; P < 0.001), followed by amine fluoride (2.485 μm; 0.746-4.225; P < 0.010), and titanium tetrafluoride (1.787 μm; 1.106-2.469; P < 0.001); the lowest difference was obtained by casein phosphopeptide-amorphous calcium phosphate (0.869 μm; 0.007-1.731; P < 0.050) and sodium fluoride (0.820 μm; 0.417-1.223; P < 0.001). Stannous fluoride as a fluoride-based prophylactic/therapeutic agent allowed the lowest enamel tissue loss in erosive conditions. Standardization among future study protocols will allow better comparison regarding the prophylactic/therapeutic agent with the best clinical efficacy.

Keywords: caseins; demineralization; enamel; erosion; fluorides.

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Figures

Figure 1
Figure 1
Summary of article selection process.
Figure 2
Figure 2
Forest plot: control group versus TiF4 group.
Figure 3
Figure 3
Forest plot: Control group versus amine fluoride group.
Figure 4
Figure 4
Forest plot: Control group versus NaF.
Figure 5
Figure 5
Forest plot: Control group versus casein phosphopeptide–amorphous calcium phosphate group.
Figure 6
Figure 6
Forest plot: control group versus SnF2 group.
Figure 7
Figure 7
Forest plot: individual and pooled results of control group versus TiF4.
Figure 8
Figure 8
Forest plot: individual and pooled results of control group versus NaF group.
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