Abstract：
Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ.
Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies\' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study.
The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings.
Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found.
Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.
Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies\' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study.
The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings.
Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found.
Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.
摘要：
目的：评估含纳米羟基磷灰石（nano-HA）+氟化物的牙科产品对体内或原位白斑病变（WSL）再矿化的影响。
方法：使用双管齐下的方法（干预/治疗）探索了七个数据库。筛选后,全文评估，和进一步的排斥，对5项研究(4项临床研究和1项原位研究)进行了定性综合.根据Cochrane协作指南收集并总结了研究的相关数据。使用Cochrane随机试验偏倚风险工具（RoB2.0）评估研究的方法学质量和GRADE指南评估其证据水平。RoB2.0域的偏倚风险(RoB)被评为低，高,或者有一些担忧，并对该工具进行了改编，用于现场研究。
结果：纳入的研究评估了151颗恒牙前牙的WSL，不同年龄的患者。协议应用程序，治疗长度（7d-12w），和对照组之间的研究差异很大，使得定量分析的表现不可行。临床研究的一般RoB被分类为低风险（n=2）或某些问题（n=2）。现场研究被认为是低风险的。证据水平适中。大多数研究发现了关于这种关联在临床环境中的优越性的中度证据。
结论：即使使用纳米HA+氟化物对WSL的再矿化治疗也有希望的结果，由于研究数量和产品种类有限，根据目前的系统审查，不能建议延长使用，特别是考虑到证据的中等水平。
方法：使用双管齐下的方法（干预/治疗）探索了七个数据库。筛选后,全文评估，和进一步的排斥，对5项研究(4项临床研究和1项原位研究)进行了定性综合.根据Cochrane协作指南收集并总结了研究的相关数据。使用Cochrane随机试验偏倚风险工具（RoB2.0）评估研究的方法学质量和GRADE指南评估其证据水平。RoB2.0域的偏倚风险(RoB)被评为低，高,或者有一些担忧，并对该工具进行了改编，用于现场研究。
结果：纳入的研究评估了151颗恒牙前牙的WSL，不同年龄的患者。协议应用程序，治疗长度（7d-12w），和对照组之间的研究差异很大，使得定量分析的表现不可行。临床研究的一般RoB被分类为低风险（n=2）或某些问题（n=2）。现场研究被认为是低风险的。证据水平适中。大多数研究发现了关于这种关联在临床环境中的优越性的中度证据。
结论：即使使用纳米HA+氟化物对WSL的再矿化治疗也有希望的结果，由于研究数量和产品种类有限，根据目前的系统审查，不能建议延长使用，特别是考虑到证据的中等水平。
