Fluorided Solution on Human Enamel Erosion: Systematic Review and Meta-analysis

Objectives: Dental erosion is the loss of mineralized tissue from the tooth surface caused by acid substances. The use of fluoridated solution for prevention of erosion progression is increasing according to in situ/ex vivo studies, since there is the difficulty of performing randomized clinical trials in this field of knowledge. The objective of this systematic review was to analyze the efficacy of fluoride solutions on enamel wear in human teeth from in situ/ex vivo studies, compared to non - fluoridated solutions, in preventing and controlling the progression of dental erosion.
Methods: This review was registered in PROSPERO, and followed PRISMA guidelines. The electronic databases searched were: PUBMED, WEB OF SCIENCE, SCOPUS, EMBASE, BBO, LILACS, SCIELO, and the gray literature: IBICT-BDTD. The strategy was established for each base and a total of 533 references were obtained. Duplicates were removed with the help of the EndNote online tool, remaining 217 studies. Two authors independently followed the steps systematically (Kappa 0.98), finalizing with 14 studies for qualitative analysis and 7 studies for the meta-analysis. The 14 studies were divided into 31 fluoridated products and data from the test groups and control groups were collected for meta-analysis. The meta-analysis was grouped as follows: by study analysis (wear), substrate type (enamel), tooth type (human), type of agent (solution).
Results: We grouped 7 studies comparing 15 fluoride solution vs. non-fluoride solution. The Comprehensive Meta-analysis Software^® (Random Effect) was used and showed enamel treated with fluoridated solutions presented significant less wear when compared to non-fluorided solutions on enamel submited to erosive challenges in in situ/ex vivo studies (p = 0.00).
Conclusions: These results demonstrate good scientific evidence that fluoridated solution has a significant effect in the prevention of human enamel erosion.