Efeito das aplicações periódicas de verniz fluoretado na prevenção de cárie dentária em pré-escolares: revisão sistemática e meta-análise

• Autor(a) principal: Sousa, Fernanda Santos de Oliveira de
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/14094
• topic: Dental caries; Child, Preschool; Fluoride varnish; Fluorides, topical; Evidence-based dentistry; Systematic review; Cárie dentária; Pré-escolar; Verniz fluoretado; Fluoretos tópicos; Odontologia baseada em evidência; Revisão sistemática; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::ODONTOPEDIATRIA

The aim of theses systematic review and meta-analyses was to evaluate the effect of fluoride varnish applications on the prevention of dental caries in preschoolers. The electronic search was performed in seven databases, without language restriction, as well as in thesis database and registries of controlled clinical trials between October and November 2016. Handsearching was performed in eleven specialized journals, two of them from the medical area and also included abstracts presented at The International Association for Dental Research (IADR) and the European Organization for Caries Research (ORCA). Controlled randomized or quasi-randomized clinical trials with children ranging from zero to 71 months, evaluating the anticaries effect of the professional application of fluoride varnish versus placebo, no intervention or usual care were included. The risk of bias in the studies was assessed according to the Cochrane tool. The outcomes of interest were the incidence of dental caries in dentin, measured by the increase of caries lesions and the proportion of children who developed new caries lesions, and the number of hospital admissions due to dental caries, as well as adverse effects related to the use of the product. Data were synthesized and analyzed through meta-analysis. After exclusion of the duplicates, 2070 titles and abstracts were independently assessed by two evaluators previously trained to identify the studies that meet the inclusion criteria. Of these, 77 articles were selected to be read in full. This review included 19 studies that fulfilled the inclusion criteria. The risk of bias assessment identified one study with low risk. Meta-analyses showed that the use of fluoride varnish did not present a statistically significant difference when compared to the use of placebo or no intervention in the increase of caries at the tooth level (-0.31; 95% CI -1.67 to 1.06) and showed a statistically significant difference between these groups, with little clinical importance, at surface level (-0.68; 95% CI -1.01 to -0.35). The pooled relative risk in studies using placebo also showed no statistically significant difference (0.87; 95%CI 0.74 to 1.03). On the other hand, the overall relative risk pointed to the benefit of using the varnish and a 12% protection (0.88; 95% CI 0.81 to 0.96). According to the results observed in the Funnel Plot and Egger regression, the publication bias cannot be dismissed. Thus, better quality clinical trials are still needed to reach conclusive evidence on this issue.