Topical fluoride-antibacterial agent combined therapy versus topical fluoride monotherapy in preventing dental caries: a
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SYSTEMATIC REVIEW
Topical fluoride‑antibacterial agent combined therapy versus topical fluoride monotherapy in preventing dental caries: a systematic review and meta‑analysis A. Gupta1 · S. Sharda1 · Nishant1 · N. Shafiq2 · A. Kumar1 · A. Goyal1 Received: 26 June 2020 / Accepted: 24 August 2020 © European Academy of Paediatric Dentistry 2020
Abstract Purpose To compare the effectiveness of topical fluoride—antibacterial agent combined therapy versus topical fluoride monotherapy in preventing dental caries among 1- to 16-year-old children. Methods PubMed, EbscoHost, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were searched for randomised controlled trials. The trials should have assessed the caries-preventive effectiveness of topical fluorideantibacterial agent (Povidone Iodine/Chlorhexidine/Xylitol/Triclosan/Cetylpyridinium Chloride) combined therapy versus topical fluoride monotherapy among children. Out of 3475 records that were screened, full text of 41 articles was assessed for potential inclusion. Sixteen trials that fulfilled the eligibility criteria were subjected to qualitative synthesis. The risk of bias was assessed using the Cochrane Collaboration’s tool. Continuous data from nine trials were pooled using Inverse Variance test in meta-analysis function of Review Manager (version 5.4). GRADE approach was used to analyse the certainty of evidence. Statistical heterogeneity was quantified using the I2 statistic. A p-value of 0.05 – Mean + SD of active carious lesions: Experimental group: Baseline = 6.55 ± 4.23 Final = 1.02±1.6 p < 0.05 Control group: Baseline = 6.49 ± 4.45 Final = 0.95 ± 1.79 p < 0.001 Caries Arrestment proportions: Experimental group = 85.3% Control group = 84.4% p > 0.05
Dental caries
Summary of findings
European Archives of Paediatric Dentistry
Martínez et al. (2012)
Pukallus et al. (2013)
4.
5.
N = 89 Tooth brushing twice daily with 304% F toothpaste
Incidence of dental caries; Prevalence of children with S mutans and Lactobacillus > 105 CFU/ Ml.
2 years
S mutans (CFU/ 1, 4 and 8 ml of saliva) weeks after final application
None reported.
Mean + SD caries increment: Experimental group = 3.3±3.2 Control group = 3.0±3.3 p > 0.05 Caries prevalence in control group = 5% Caries prevalence in experimental group = 7% p > 0.05
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Dental caries
Prevalence of children with high S mutans: Experimental group = 46% Control group = 47% p > 0.05 Prevalence of children with high Lactobacillus: Experimental group = 63% Control group = 66% p > 0.05
Post intervention salivary S mutans count (4 weeks) Experimental group: 5.42 + 0.64 Control group: 5.68 + 0.5 p > 0.05 Reduction in dental biofilm was greater in the experimental group. p > 0.05
Bacterial count
Summary of findings
S mutans (CFU/ 1 week after the Not addressed N = 37 final applicamg dental Weekly topical tion biofilm) application of 1.23% APF gel for four weeks
Adverse drug reaction
–
Follow-up
Not addressed
Outcome variControl group Number of sub- ables jects analysed (N); Inte
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