Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 1;10(6):97.
doi: 10.3390/dj10060097.

CAMBRA Protocol Efficacy: A Systematic Review and Critical Appraisal

Ana Coelho  1   2   3 , Inês Amaro  1 , Tainá Iunes  1 , Anabela Paula  1   2   3 , Carlos Miguel Marto  2   3   4   5 , José Saraiva  1 , Manuel Marques Ferreira  2   3   6 , Eunice Carrilho  1   2   3
Affiliations
Review

CAMBRA Protocol Efficacy: A Systematic Review and Critical Appraisal

Ana Coelho et al. Dent J (Basel). .

Abstract

The Caries Management by Risk Assessment (CAMBRA) protocol consists of analyzing the patient's profile by assessing the risk and protective factors and assigning a risk level to the patient to allow an individualized treatment plan, which combines restorative treatments with a preventive chemical therapy. This systematic review and critical appraisal aim to evaluate the effectiveness of the CAMBRA protocol in reducing the incidence of caries lesions and oral bacterial load. An electronic search was carried out in the Cochrane Library, PubMed, Web of Science, Scopus, and Embase databases. Clinical studies evaluating the incidence of dental caries lesions and/or the reduction of cariogenic bacterial load (Streptococcus mutans and/or Lactobacilli spp.), with at least an intervention group that follows the CAMBRA protocol and a control group published up until January 2022, were included. The methodological quality assessment of the included clinical studies was assessed through the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The quality of the case-control study was evaluated according to the Methodological Index for Non-Randomized Studies (ROBINS-I). There is currently no scientific evidence to recommend the integration of the CAMBRA protocol into clinical practice. The results reported by the studies included in the systematic review do not suggest a decrease in the incidence of dental caries lesions and/or bacterial load. There is a clear need for the development of new clinical studies with an adequate methodology and follow-up, both for the CAMBRA protocol and for its components individually.

Keywords: cariogenic bacteria; dental caries; oral health; prevention.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of screening and selection processes.
Figure 2
Figure 2
Methodological quality assessment of the included randomized controlled trials [7,23] using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2).
Figure 3
Figure 3
Methodological quality assessment of the included case-control study [24] using the Methodological Index for Non-Randomized Studies (ROBINS-I).
See this image and copyright information in PMC

References

    1. Kutsch V.K. Dental caries: An update medical model of risk assessment. J. Prosthet. Dent. 2013;111:280–285. doi: 10.1016/j.prosdent.2013.07.014. - DOI - PubMed
    1. Lamont R.J., Koo H., Hajishengallis G. The oral microbiota: Dunamic communities and host interactions. Nat. Rev. Microbiol. 2018;16:745–759. doi: 10.1038/s41579-018-0089-x. - DOI - PMC - PubMed
    1. Marsh P.D. In Sickness and in Health-What Does the Oral Microbiome Mean to Us? An Ecological Perspective. Adv. Dent. Res. 2018;29:60–65. doi: 10.1177/0022034517735295. - DOI - PubMed
    1. Selwitz R.H., Ismail A.I., Pitts N.B. Dental caries. Lancet. 2007;6:51–59. doi: 10.1016/S0140-6736(07)60031-2. - DOI - PubMed
    1. Manji F., Dahlen G., Fejerskov O. Caries and Periodontitis: Contesting the Conventional Wisdom on Their Aetiology. Caries Res. 2018;52:548–564. doi: 10.1159/000488948. - DOI - PubMed

LinkOut - more resources