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Propriedades físicas, químicas e biológicas do material biocerâmico nano-hidroxiapatite enquanto material restaurador: revisão sistemática
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| Projeto de pós-graduação_40133 | 1.32 MB | Adobe PDF |
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Abstract(s)
Introdução: Atualmente, encontram-se disponíveis no mercado materiais biocerâmicos capazes de promover a remineralização dos tecidos dentários duros. A nano-hidroxiapatite (nHA) é um dos materiais mais biocompatíveis e bioativos, podendo apresentar-se em diferentes formulações (dentífricos, selantes de fissuras, materiais de recobrimento pulpar e resinas compostas). No entanto, ainda não se verifica consenso na literatura a respeito da comprovada eficácia destes materiais. Assim, pretendeu-se com este trabalho realizar uma revisão sistemática da literatura, visando avaliar a eficácia dos diferentes materiais biocerâmicos contendo nHA atualmente disponíveis no mercado visando a remineralização do esmalte em lesões cariosas incipientes.
Metodologia: Pretendeu-se responder à seguinte questão: “Existe evidência científica suficiente que fundamente a eficácia e justifique a aplicação de materiais biocerâmicos do tipo nHA na reabilitação dentária?”. Os critérios de elegibilidade para a elaboração desta revisão seguiram a estratégia PICO: Participantes – lesões de cárie incipiente em dentição permanente humana; Intervenção – aplicação de materiais restauradores biocerâmicos (nHA); Controlo – comparação com outros materiais e/ou produtos que não sejam biocerâmicos; Outcome – remineralização de lesões de cárie incipiente. A pesquisa foi realizada em diferentes bases de dados: PubMed/MEDLINE, ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), com os artigos elegíveis a serem identificados e selecionados por dois revisores independentes, seguindo as guidelines PRISMA. A avaliação qualitativa da qualidade de cada estudo foi realizada através da aplicação da Consolidated Standards Of Reporting Trials (CONSORT) checklist para os ensaios clínicos, enquanto os estudos in vitro foram avaliados de acordo com o Quality Assessment Tool For In Vitro Studies (QUIN).
Resultados: Foram incluídos 12 artigos, sendo 9 deles estudos in vitro e 3 ensaios clínicos randomizados. O período de follow-up variou entre 7 dias até 18 meses, e foram comparados os efeitos da aplicação de dentífricos ou géis contendo nHA com outros produtos, incluindo produtos fluoretados. Os vários estudos analisaram a recuperação da superfície de cáries incipientes, através da sua remineralização, aplicando diversas metodologias experimentais e distintos métodos de reavaliação. Verificou-se que a nHA apresenta vários efeitos benéficos quando utilizada em dentífricos, incluindo o aumento da remineralização da superfície em lesões iniciais do esmalte, inibição do desenvolvimento de lesões cariosas e diminuição da desmineralização.
Conclusões: As evidências que apoiam a eficácia da aplicação de nHA na remineralização de lesões cariosas incipientes ainda são limitadas, pelo que é necessária a realização de estudos adicionais de longa duração com protocolos padronizados, de forma a avaliar o seu efeito a longo prazo na dentição humana.
Introduction: Currently, bioceramic materials capable of promoting the remineralization of hard dental tissues are available on the market. Nanohydroxyapatite (nHA) is one of the most biocompatible and bioactive materials, and can be presented in different formulations (toothpastes, fissure sealants, pulp coating materials and composite resins). However, there is still no consensus in the literature regarding the proven efficacy of these materials. Thus, the aim of this work was to carry out a systematic review of the literature, aiming to evaluate the efficacy of the different nHA-containing bioceramic materials currently available on the market for enamel remineralization in incipient carious lesions. Methodology: The aim was to answer the following question: "Is there sufficient scientific evidence to support the efficacy and justify the application of nHA-type bioceramic materials in dental rehabilitation?". The eligibility criteria for the elaboration of this review followed the PICO strategy: Participants – incipient caries lesions in human permanent dentition; Intervention – application of bioceramic restorative materials (nHA); Control – comparison with other materials and/or products that are not bioceramic; Outcome – remineralization of incipient caries lesions. The search was carried out in different databases: PubMed/MEDLINE, ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), with eligible articles being identified and selected by two independent reviewers, following the PRISMA guidelines. The qualitative evaluation of the quality of each study was carried out through the application of the Consolidated Standards Of Reporting Trials (CONSORT) checklist for clinical trials, while in vitro studies were evaluated according to the Quality Assessment Tool For In Vitro Studies (QUIN). Results: A total of 12 articles were included, 9 of which were in vitro studies and 3 were randomized controlled trials. The follow-up period ranged from 7 days to 18 months and the effects of applying nHA-containing toothpastes or gels were compared with other products, including fluoride products. The various studies analyzed the recovery of the surface of incipient caries, through its remineralization, applying different experimental methodologies and different methods of reevaluation. nHA has been found to have several beneficial effects when used on toothpastes, including increased surface remineralization in early enamel lesions, inhibition of the development of carious lesions, and decreased demineralization. Conclusions: The evidence supporting the efficacy of nHA application in the remineralization of incipient carious lesions is still limited, so additional long-term studies with standardized protocols are needed to evaluate its long-term effect on human dentition.
Introduction: Currently, bioceramic materials capable of promoting the remineralization of hard dental tissues are available on the market. Nanohydroxyapatite (nHA) is one of the most biocompatible and bioactive materials, and can be presented in different formulations (toothpastes, fissure sealants, pulp coating materials and composite resins). However, there is still no consensus in the literature regarding the proven efficacy of these materials. Thus, the aim of this work was to carry out a systematic review of the literature, aiming to evaluate the efficacy of the different nHA-containing bioceramic materials currently available on the market for enamel remineralization in incipient carious lesions. Methodology: The aim was to answer the following question: "Is there sufficient scientific evidence to support the efficacy and justify the application of nHA-type bioceramic materials in dental rehabilitation?". The eligibility criteria for the elaboration of this review followed the PICO strategy: Participants – incipient caries lesions in human permanent dentition; Intervention – application of bioceramic restorative materials (nHA); Control – comparison with other materials and/or products that are not bioceramic; Outcome – remineralization of incipient caries lesions. The search was carried out in different databases: PubMed/MEDLINE, ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), with eligible articles being identified and selected by two independent reviewers, following the PRISMA guidelines. The qualitative evaluation of the quality of each study was carried out through the application of the Consolidated Standards Of Reporting Trials (CONSORT) checklist for clinical trials, while in vitro studies were evaluated according to the Quality Assessment Tool For In Vitro Studies (QUIN). Results: A total of 12 articles were included, 9 of which were in vitro studies and 3 were randomized controlled trials. The follow-up period ranged from 7 days to 18 months and the effects of applying nHA-containing toothpastes or gels were compared with other products, including fluoride products. The various studies analyzed the recovery of the surface of incipient caries, through its remineralization, applying different experimental methodologies and different methods of reevaluation. nHA has been found to have several beneficial effects when used on toothpastes, including increased surface remineralization in early enamel lesions, inhibition of the development of carious lesions, and decreased demineralization. Conclusions: The evidence supporting the efficacy of nHA application in the remineralization of incipient carious lesions is still limited, so additional long-term studies with standardized protocols are needed to evaluate its long-term effect on human dentition.
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Keywords
Hidroxiapatite Remineralização dentária Propriedades biológicas Propriedades mecânicas Hydroxyapatite Tooth remineralization Biological properties Mechanical properties