Clin Oral Investig:纳米羟基磷灰石能预防龋齿吗?

2022-06-14 MedSci原创 MedSci原创

龋齿是一种常见病,近些年由于加大了预防力度,可以看到龋齿发病率有所下降。但是早期龋齿发病率仍很高。有学者推荐使用纳米羟基磷灰石(nHA)来减少龋齿早期病变的发生,促进其再矿化。

龋齿是一种常见病,近些年由于加大了预防力度,可以看到龋齿发病率有所下降。但是早期龋齿发病率仍很高。有学者推荐使用纳米羟基磷灰石(nHA)来减少龋齿早期病变的发生,促进其再矿化。一些体内或原位研究集中在nHA的临床使用上,但到目前为止,还没有发表侧重于含有(无氟)nHA的药剂疗效的定量数据综合。发表于Clin Oral Investig的一项系统回顾和荟萃分析纳入了相关的前瞻性对照(非)随机临床试验,探究了nHA与其他(安慰剂)治疗或未治疗/标准对照的疗效。

研究人员筛选了三个电子数据库(Central Cochrane, PubMed-MEDLINE, Ovid EMBASE)。结果是包括ICDAS评分、釉质再矿化率、矿物质流失和病变深度等。使用偏倚风险2.0工具和GRADE分析器对偏倚风险和证据水平进行了分级。

 

结果,纳入了5项体内(和5项原位)研究,至少评估了633颗牙齿(1031个标本),超过420(95)名患者。由于研究设计的高度异质性和结果的多样性,无法对体内研究进行meta分析。原位研究表明,在脱矿条件下,NaF能够阻碍脱矿,而nHA不能;同时,nHA与无氟对照组没有区别。相反,在再矿化条件下,nHA和NaF显示出相同的再矿化潜力。然而,证据水平非常低。此外,有6项研究显示出较高的偏倚风险,而且有6项研究是由被测产品的制造商资助/发表的。

综上所述,该研究结果显示,有限的临床研究证据、相对较短的随访期、高偏倚风险和有限的证据等级并不能为nHA的疗效提供结论性的证据。

原始出处:

Richard Johannes Wierichs, et al., Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis. Clin Oral Investig. 2022 Apr;26(4):3373-3381. doi: 10.1007/s00784-022-04390-4.  

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    2023-03-05 小几洁
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