O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/18611 |
Resumo: | Contemporary methods of diagnosing and treating caries advocate a distinction between cavitated and non-cavitated, active and inactive lesions and, when possible, minimally invasive interventions. The research question of this systematic review was: Is the treatment of non-cavitated caries lesions effective in preventing the appearance of dental cavity, restoration, toothache or tooth loss, in individuals with deciduous or permanent teeth?. A bibliographic search was carried out in the main databases until the year 2020. Two reviewers independently selected the studies and extracted the data. In cases where there was disagreement, a third reviewer was consulted and the dispute was resolved by consensus. Bias risk analysis was performed using the RoB2 tool and evidence certainty assessment using the GRADE system. A total of 4,108 titles were obtained, which after removing duplicate titles and applying the exclusion criteria, 19 studies were selected. No study presented the risk for the individual of developing at least one event related to the outcomes of interest, so it was not possible to perform a risk meta-analysis. Ten studies presented the results in terms of the average number of cavitated or restored dentin lesions per individual, allowing meta-analyses of differences in averages to be performed. Various combinations were made, as some studies had more than one intervention to be compared with placebo or oral hygiene. The results of the meta-analyses were similar, with the point estimate of the difference in the mean varying between -0.22 and -0.27 in the various meta-analyses performed. That is, on average, per individual, there were between 0.22 and 0.27 fewer teeth with dentin (or filled) carious cavity in the group that received treatment compared to the group that received the placebo or no treatment. The Higgins Index (I2) tells us the proportion of variability in effect estimates that can be attributed to heterogeneity across studies rather than chance. Based on this index, heterogeneity was substantial in all meta-analyses, ranging from 69% to 76%. Conclusion: no study has evaluated the effectiveness of non-invasive treatment of non-cavitated lesions (white spot) in preventing pain or tooth loss. Few studies have evaluated the effectiveness of the treatment in preventing cavities or restorations. Among these few studies, treatment had a relatively modest effect. The risk of bias in the included studies was generally high or moderate and the certainty of evidence was low. Research on dental caries must include true outcomes so that it is possible to know the effectiveness of different early interventions in preventing dentin cavities, restorations, pain and tooth loss. |
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Nadanovsky, PauloSantos, Ana Paula Pires dosVerly Junior, EliseuAndrade, Marcia Rejane Thomas CanabarroWeyne, Sergio de Carvalhohttp://lattes.cnpq.br/6974527937415816Bomfim, Alessandra Raymundoarbomfim@hotmail.com2022-11-07T14:21:09Z2022-03-30BOMFIM, Alessandra Raymundo. O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática. 2022. 278 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022 .http://www.bdtd.uerj.br/handle/1/18611Contemporary methods of diagnosing and treating caries advocate a distinction between cavitated and non-cavitated, active and inactive lesions and, when possible, minimally invasive interventions. The research question of this systematic review was: Is the treatment of non-cavitated caries lesions effective in preventing the appearance of dental cavity, restoration, toothache or tooth loss, in individuals with deciduous or permanent teeth?. A bibliographic search was carried out in the main databases until the year 2020. Two reviewers independently selected the studies and extracted the data. In cases where there was disagreement, a third reviewer was consulted and the dispute was resolved by consensus. Bias risk analysis was performed using the RoB2 tool and evidence certainty assessment using the GRADE system. A total of 4,108 titles were obtained, which after removing duplicate titles and applying the exclusion criteria, 19 studies were selected. No study presented the risk for the individual of developing at least one event related to the outcomes of interest, so it was not possible to perform a risk meta-analysis. Ten studies presented the results in terms of the average number of cavitated or restored dentin lesions per individual, allowing meta-analyses of differences in averages to be performed. Various combinations were made, as some studies had more than one intervention to be compared with placebo or oral hygiene. The results of the meta-analyses were similar, with the point estimate of the difference in the mean varying between -0.22 and -0.27 in the various meta-analyses performed. That is, on average, per individual, there were between 0.22 and 0.27 fewer teeth with dentin (or filled) carious cavity in the group that received treatment compared to the group that received the placebo or no treatment. The Higgins Index (I2) tells us the proportion of variability in effect estimates that can be attributed to heterogeneity across studies rather than chance. Based on this index, heterogeneity was substantial in all meta-analyses, ranging from 69% to 76%. Conclusion: no study has evaluated the effectiveness of non-invasive treatment of non-cavitated lesions (white spot) in preventing pain or tooth loss. Few studies have evaluated the effectiveness of the treatment in preventing cavities or restorations. Among these few studies, treatment had a relatively modest effect. The risk of bias in the included studies was generally high or moderate and the certainty of evidence was low. Research on dental caries must include true outcomes so that it is possible to know the effectiveness of different early interventions in preventing dentin cavities, restorations, pain and tooth loss.Os métodos contemporâneos de diagnóstico e tratamento de cárie preconizam uma distinção entre lesões cavitadas e não cavitadas, ativas e inativas e, quando possível, intervenções minimamente invasivas. A pergunta de pesquisa desta revisão sistemática foi: O tratamento de lesões não cavitadas de cárie é efetivo em impedir o aparecimento de cavidade dentária, restauração, dor de dente ou perda de dente, em indivíduos com dentes decíduos ou permanentes?. Foi feita uma busca bibliográfica nas principais bases de dados até o ano de 2020. Duas revisoras selecionaram os estudos e extraíram os dados independentemente. Nos casos em que houve discordância, uma terceira revisora foi consultada e a disputa foi resolvida por consenso. A análise de risco de viés foi executada utilizando-se a ferramenta RoB2 e avaliação de certeza da evidência utilizando o sistema GRADE. Foram obtidos 4.108 títulos, e após a remoção dos títulos duplicados e da aplicação dos critérios de exclusão, selecionou-se 19 estudos. Nenhum estudo apresentou o risco para o indivíduo de desenvolver pelo menos um evento relacionado aos desfechos de interesse, por isso não foi possível realizar metanálise de risco. Dez estudos apresentaram os resultados em número médio de lesões cavitadas em dentina ou restauradas por indivíduo, permitindo que fossem feitas metanálises de diferenças nas médias. Várias combinações foram feitas, uma vez que alguns estudos apresentavam mais de uma intervenção a ser comparada com placebo ou higiene bucal. Os resultados das metanálises foram semelhantes, com a estimativa pontual da diferença na média variando entre -0,22 e -0,27 nas diversas metanálises executadas. Ou seja, em média, por indivíduo, houve entre menos 0,22 e menos 0,27 dente com cavidade de cárie em dentina (ou com restauração) no grupo que recebeu tratamento em comparação com o grupo que recebeu o placebo ou nenhum tratamento. O Índice de Higgins (I2) nos diz a proporção da variabilidade nas estimativas de efeito que pode ser atribuída à heterogeneidade entre os estudos e não ao acaso. Com base neste índice, a heterogeneidade foi substancial em todas as metanálises, variando entre 69% e 76%. Conclusão: nenhum estudo avaliou a efetividade do tratamento não invasivo de lesões não cavitadas (mancha branca) em evitar dor ou perda de dente. Poucos estudos avaliaram a efetividade do tratamento em evitar cavidades ou restaurações. Dentre esses poucos estudos, o tratamento teve um efeito relativamente modesto. O risco de viés nos estudos incluídos foi, de uma forma geral, alto ou moderado e a certeza da evidência foi baixa. Pesquisas sobre cárie dentária devem incluir desfechos verdadeiros para que seja possível conhecer a efetividade das diferentes intervenções precoces em evitar cavidades em dentina, restaurações, dor e perda de dentes.Submitted by Marcia CB/C (marciagraziadio@yahoo.com.br) on 2022-11-07T14:21:09Z No. of bitstreams: 1 Tese - Alessandra Raymundo Bomfim - 2022 - Completa.pdf: 6415401 bytes, checksum: 7cde2a1bad50dc26e2f523c76d99c874 (MD5)Made available in DSpace on 2022-11-07T14:21:09Z (GMT). No. of bitstreams: 1 Tese - Alessandra Raymundo Bomfim - 2022 - Completa.pdf: 6415401 bytes, checksum: 7cde2a1bad50dc26e2f523c76d99c874 (MD5) Previous issue date: 2022-03-30application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBrasilCentro Biomédico::Instituto de Medicina Social Hesio CordeiroDental cariesTreatmentPrevention and controlSystematic reviewCárie dentáriaTratamentoPrevençãoRevisão sistemáticaCIENCIAS DA SAUDE::SAUDE COLETIVAO tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemáticaIs the treatment of non-cavitated dental caries lesion effective? A systematic reviewinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Alessandra Raymundo Bomfim - 2022 - Completa.pdfTese - Alessandra Raymundo Bomfim - 2022 - Completa.pdfapplication/pdf6415401http://www.bdtd.uerj.br/bitstream/1/18611/2/Tese+-+Alessandra+Raymundo+Bomfim+-+2022+-+Completa.pdf7cde2a1bad50dc26e2f523c76d99c874MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/18611/1/license.txte5502652da718045d7fcd832b79fca29MD511/186112024-02-26 20:20:37.982oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:20:37Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
dc.title.alternative.eng.fl_str_mv |
Is the treatment of non-cavitated dental caries lesion effective? A systematic review |
title |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
spellingShingle |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática Bomfim, Alessandra Raymundo Dental caries Treatment Prevention and control Systematic review Cárie dentária Tratamento Prevenção Revisão sistemática CIENCIAS DA SAUDE::SAUDE COLETIVA |
title_short |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
title_full |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
title_fullStr |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
title_full_unstemmed |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
title_sort |
O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática |
author |
Bomfim, Alessandra Raymundo |
author_facet |
Bomfim, Alessandra Raymundo arbomfim@hotmail.com |
author_role |
author |
author2 |
arbomfim@hotmail.com |
author2_role |
author |
dc.contributor.advisor1.fl_str_mv |
Nadanovsky, Paulo |
dc.contributor.referee1.fl_str_mv |
Santos, Ana Paula Pires dos |
dc.contributor.referee2.fl_str_mv |
Verly Junior, Eliseu |
dc.contributor.referee3.fl_str_mv |
Andrade, Marcia Rejane Thomas Canabarro |
dc.contributor.referee4.fl_str_mv |
Weyne, Sergio de Carvalho |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6974527937415816 |
dc.contributor.author.fl_str_mv |
Bomfim, Alessandra Raymundo arbomfim@hotmail.com |
contributor_str_mv |
Nadanovsky, Paulo Santos, Ana Paula Pires dos Verly Junior, Eliseu Andrade, Marcia Rejane Thomas Canabarro Weyne, Sergio de Carvalho |
dc.subject.eng.fl_str_mv |
Dental caries Treatment Prevention and control Systematic review |
topic |
Dental caries Treatment Prevention and control Systematic review Cárie dentária Tratamento Prevenção Revisão sistemática CIENCIAS DA SAUDE::SAUDE COLETIVA |
dc.subject.por.fl_str_mv |
Cárie dentária Tratamento Prevenção Revisão sistemática |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::SAUDE COLETIVA |
description |
Contemporary methods of diagnosing and treating caries advocate a distinction between cavitated and non-cavitated, active and inactive lesions and, when possible, minimally invasive interventions. The research question of this systematic review was: Is the treatment of non-cavitated caries lesions effective in preventing the appearance of dental cavity, restoration, toothache or tooth loss, in individuals with deciduous or permanent teeth?. A bibliographic search was carried out in the main databases until the year 2020. Two reviewers independently selected the studies and extracted the data. In cases where there was disagreement, a third reviewer was consulted and the dispute was resolved by consensus. Bias risk analysis was performed using the RoB2 tool and evidence certainty assessment using the GRADE system. A total of 4,108 titles were obtained, which after removing duplicate titles and applying the exclusion criteria, 19 studies were selected. No study presented the risk for the individual of developing at least one event related to the outcomes of interest, so it was not possible to perform a risk meta-analysis. Ten studies presented the results in terms of the average number of cavitated or restored dentin lesions per individual, allowing meta-analyses of differences in averages to be performed. Various combinations were made, as some studies had more than one intervention to be compared with placebo or oral hygiene. The results of the meta-analyses were similar, with the point estimate of the difference in the mean varying between -0.22 and -0.27 in the various meta-analyses performed. That is, on average, per individual, there were between 0.22 and 0.27 fewer teeth with dentin (or filled) carious cavity in the group that received treatment compared to the group that received the placebo or no treatment. The Higgins Index (I2) tells us the proportion of variability in effect estimates that can be attributed to heterogeneity across studies rather than chance. Based on this index, heterogeneity was substantial in all meta-analyses, ranging from 69% to 76%. Conclusion: no study has evaluated the effectiveness of non-invasive treatment of non-cavitated lesions (white spot) in preventing pain or tooth loss. Few studies have evaluated the effectiveness of the treatment in preventing cavities or restorations. Among these few studies, treatment had a relatively modest effect. The risk of bias in the included studies was generally high or moderate and the certainty of evidence was low. Research on dental caries must include true outcomes so that it is possible to know the effectiveness of different early interventions in preventing dentin cavities, restorations, pain and tooth loss. |
publishDate |
2022 |
dc.date.accessioned.fl_str_mv |
2022-11-07T14:21:09Z |
dc.date.issued.fl_str_mv |
2022-03-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
BOMFIM, Alessandra Raymundo. O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática. 2022. 278 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022 . |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/18611 |
identifier_str_mv |
BOMFIM, Alessandra Raymundo. O tratamento da lesão de cárie dentária não cavitada é efetivo? Uma revisão sistemática. 2022. 278 f. Tese (Doutorado em Saúde Coletiva) - Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2022 . |
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http://www.bdtd.uerj.br/handle/1/18611 |
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por |
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UERJ |
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Brasil |
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Centro Biomédico::Instituto de Medicina Social Hesio Cordeiro |
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Universidade do Estado do Rio de Janeiro |
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