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Eficácia do material biocerâmico cálcio-fosfato amorfo na remineralização de lesões de mancha branca: revisão sistemática
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| Projeto de pós-graduação_40529 | 1.15 MB | Adobe PDF |
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Abstract(s)
Introdução: Encontram-se disponíveis no mercado diversos materiais biocerâmicos capazes de promover a remineralização dos tecidos dentários duros, como, por exemplo, o cálcio-fosfato amorfo (ACP). As lesões de mancha branca (WSL) representam um estado inicial de desmineralização do esmalte, sendo frequentemente encontradas em pacientes que utilizam aparelhos ortodônticos fixos ou em pacientes pediátricos com má higiene oral. A aplicação de produtos remineralizantes visa a prevenção e tratamento destas lesões, contudo, ainda não se verifica consenso entre autores a respeito da eficácia destes materiais.
Objetivo: Realizar uma revisão sistemática da literatura visando reunir e avaliar comparativamente resultados relacionados com o efeito remineralizante do CPP-ACP.
Materiais e métodos: Este trabalho foi registrado com o seguinte código (CRD42024540595) na base de dados PROSPERO. A pesquisa foi realizada nas bases de dados PubMed, Google Scholar e Cochrane Library. Foram incluídos estudos com aplicação clínica do CPP-ACP ou CPP-ACPF em pacientes humanos com lesões de mancha branca, e excluídos estudos com lesões artificiais, materiais não médico-dentários ou sem grupo controlo. A qualidade metodológica dos estudos foi avaliada com a checklist CONSORT.
Resultados: Foram incluídos 14 estudos, com diferentes metodologias e períodos de follow-up. A análise dos dados revelou que o CPP-ACP é geralmente eficaz na remineralização das WSLs, sobretudo em estudos de curta duração. A combinação com flúor (CPP-ACPF) aparenta potenciar o efeito remineralizante. No entanto, a comparação com o flúor isolado, placebo ou resina infiltrante apresenta resultados heterogéneos.
Conclusão: O CPP-ACP demonstra potencial como agente remineralizante de WSLs, especialmente quando associado ao flúor. Contudo, é necessária a realização de estudos clínicos padronizados e de longo prazo que validem a sua eficácia comparativa com outras terapias não invasivas.
Introduction: Several bioceramic materials are available on the market capable of promoting the remineralization of hard dental tissues, such as, for example, amorphous calcium-phosphate (ACP). White spot lesions (WSL) represent an early state of enamel demineralization and are frequently found in patients with fixed orthodontic appliances or pediatric patients with poor oral hygiene. The application of remineralizing products aims to prevent and treat these injuries. However, there is still no consensus among authors regarding the effectiveness of these materials. Objective: To carry out a systematic literature review aiming to gather and comparatively evaluate results related to the remineralizing effect of CPP-ACP. Materials and methods: This work was registered in the PROSPERO database under the code CRD42024540595. The bibliographic search was conducted using PubMed, Google Scholar and Cochrane Library databases. Inclusion criteria comprised clinical studies applying CPP-ACP or CPP-ACPF in human patients with white spot lesions. Exclusion criteria included artificial lesions, non-dental materials, or studies lacking a control group. Study quality was assessed using the CONSORT checklist. Results: Fourteen studies were included, with diverse methodologies and follow-up periods. The analysis showed that CPP-ACP is generally effective in the remineralization of WSLs, particularly in short-term studies. The combination with fluoride (CPP-ACPF) appears to enhance the effect. However, comparisons with isolated fluoride, placebo or resin infiltrant yielded variable outcomes. Conclusion: CPP-ACP shows promise as a remineralizing agent for WSLs, especially when combined with fluoride. Nevertheless, standardized long-term clinical studies are needed to confirm its comparative effectiveness against other non-invasive therapies.
Introduction: Several bioceramic materials are available on the market capable of promoting the remineralization of hard dental tissues, such as, for example, amorphous calcium-phosphate (ACP). White spot lesions (WSL) represent an early state of enamel demineralization and are frequently found in patients with fixed orthodontic appliances or pediatric patients with poor oral hygiene. The application of remineralizing products aims to prevent and treat these injuries. However, there is still no consensus among authors regarding the effectiveness of these materials. Objective: To carry out a systematic literature review aiming to gather and comparatively evaluate results related to the remineralizing effect of CPP-ACP. Materials and methods: This work was registered in the PROSPERO database under the code CRD42024540595. The bibliographic search was conducted using PubMed, Google Scholar and Cochrane Library databases. Inclusion criteria comprised clinical studies applying CPP-ACP or CPP-ACPF in human patients with white spot lesions. Exclusion criteria included artificial lesions, non-dental materials, or studies lacking a control group. Study quality was assessed using the CONSORT checklist. Results: Fourteen studies were included, with diverse methodologies and follow-up periods. The analysis showed that CPP-ACP is generally effective in the remineralization of WSLs, particularly in short-term studies. The combination with fluoride (CPP-ACPF) appears to enhance the effect. However, comparisons with isolated fluoride, placebo or resin infiltrant yielded variable outcomes. Conclusion: CPP-ACP shows promise as a remineralizing agent for WSLs, especially when combined with fluoride. Nevertheless, standardized long-term clinical studies are needed to confirm its comparative effectiveness against other non-invasive therapies.
Description
Keywords
Material biocerâmico Fosfato de cálcio amorfo de caseína Lesões de manchas brancas Remineralização dentária CPP-ACP Bioceramic material Casein amorphous calcium phosphate White spot lesions Tooth remineralization