Systematic Review of Controlled Trials on the Effectiveness of Fluoride Gels for the Prevention of Dental Caries in Children

摘要: Fluoride gels have been widely used since the 1970s. The aim of this review was to assess effectiveness and safety fluoride in prevention dental caries children examine factors potentially modifying their effectiveness. Relevant randomized or quasi-randomized trials were identified without language restrictions by searching multiple databases, reference lists articles, journals contacting selected authors manufacturers. Trials with blind outcome assessment comparing gel placebo no treatment for at least one year involving under seventeen years age selected. Inclusion decisions, quality assessment, data extraction duplicated a random sample third studies, consensus achieved discussion party. Random effects meta-analyses performed where could be pooled. Potential sources heterogeneity examined meta-regression analyses. main increment measured change decayed, missing, filled permanent tooth surfaces (D(M)FS). primary measure effect prevented fraction (PF) that is difference mean between control groups expressed as percentage group. adverse unacceptability also recorded. Twenty-five studies included, 7,747 children. For twenty-three contributed meta-analysis, D(M)FS pooled estimate 28 percent (95 CI, 19 37 percent; p < 0.0001). There clear heterogeneity, confirmed statistically (p varied according type group used, PF on average being 5 33 0.009) higher non-placebo controlled trials. Only two reported events. evidence caries-inhibiting gel. best magnitude effect, based fourteen placebo-controlled trials, 21 reduction 14 percent) D(M)FS. This corresponds an NNT 1 3) avoid population 2.2 D(M)FS/year, twenty-four 18 36) 0.2 D(M)FS/year. However, further work needed identify quantify potential harmful gels.