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Abstract：
BACKGROUND: Dental fluorosis (DF) is caused by excessive exposure to fluoride during odontogenesis and leads to various changes in the development of tooth enamel. Some regions in Mexico are considered endemic fluorosis zones due to the high fluoride content in drinking water. The objective of this study was to perform a systematic review and meta-analysis to identify the association between the concentration of fluoride in drinking water and the severity of dental fluorosis in northern and western Mexico.
METHODS: This protocol was registered in the PROSPERO database (ID: CRD42023401519). The search for information was carried out in the PubMed/Medline, Scopus, SpringerLink, and Google Scholar databases between January 2015 and October 2023. The overall relative risk was calculated using the inverse of variance approach with the random effects method. The RoB 2.0 tool was used to construct risk plots.
RESULTS: Eleven articles were analyzed qualitatively, and most of the included studies presented at least one level of DF severity; six articles were analyzed quantitatively, dividing them into two regions. In North region it was observed a higher prevalence of severe TF cases, corresponding to ≥ TF 5 category (4.78) [3.55, 6.42]. In the West region, most of the included studies presented a higher prevalence of less severe cases, corresponding to ≤ TF 4, in comparison with the North region (0.01) [0.00, 0.52], interpreted as a protective effect.
CONCLUSIONS: The concentrations of fluorides in drinking water are reportedly high in these regions and are directly related to the severity of dental fluorosis experienced by the inhabitants. In the Northern region exists a major concentration of fluoride in drinking water compared with the Western region as well as a prevalence of higher severity cases of dental fluorosis.
METHODS: This protocol was registered in the PROSPERO database (ID: CRD42023401519). The search for information was carried out in the PubMed/Medline, Scopus, SpringerLink, and Google Scholar databases between January 2015 and October 2023. The overall relative risk was calculated using the inverse of variance approach with the random effects method. The RoB 2.0 tool was used to construct risk plots.
RESULTS: Eleven articles were analyzed qualitatively, and most of the included studies presented at least one level of DF severity; six articles were analyzed quantitatively, dividing them into two regions. In North region it was observed a higher prevalence of severe TF cases, corresponding to ≥ TF 5 category (4.78) [3.55, 6.42]. In the West region, most of the included studies presented a higher prevalence of less severe cases, corresponding to ≤ TF 4, in comparison with the North region (0.01) [0.00, 0.52], interpreted as a protective effect.
CONCLUSIONS: The concentrations of fluorides in drinking water are reportedly high in these regions and are directly related to the severity of dental fluorosis experienced by the inhabitants. In the Northern region exists a major concentration of fluoride in drinking water compared with the Western region as well as a prevalence of higher severity cases of dental fluorosis.
摘要：
背景：氟斑牙（DF）是由牙本质发育过程中过度暴露于氟化物引起的，并导致牙釉质发育的各种变化。由于饮用水中的氟化物含量高，墨西哥的某些地区被认为是地方性氟中毒区。这项研究的目的是进行系统评价和荟萃分析，以确定饮用水中氟化物的浓度与墨西哥北部和西部氟斑牙严重程度之间的关系。
方法：该方案已在PROSPERO数据库（ID：CRD42023401519）中注册。信息搜索是在PubMed/Medline中进行的，Scopus,SpringerLink,以及2015年1月至2023年10月之间的GoogleScholar数据库。使用随机效应方法的方差逆方法计算总体相对风险。使用RoB2.0工具构建风险图。
结果：对11篇文章进行了定性分析，大多数纳入的研究至少呈现一个DF严重程度；六篇文章进行了定量分析，把它们分成两个区域。在北部地区，观察到严重TF病例的患病率较高。对应于≥TF5类别（4.78）[3.55，6.42]。在西部地区,大多数纳入的研究表明，不太严重的病例的患病率较高，对应于≤TF4，与北部地区(0.01)[0.00，0.52]相比，解释为保护作用。
结论：据报道，这些地区饮用水中的氟化物浓度很高，与居民氟斑牙的严重程度直接相关。与西部地区相比，北部地区的饮用水中氟化物浓度较高，并且氟斑牙的患病率更高。
方法：该方案已在PROSPERO数据库（ID：CRD42023401519）中注册。信息搜索是在PubMed/Medline中进行的，Scopus,SpringerLink,以及2015年1月至2023年10月之间的GoogleScholar数据库。使用随机效应方法的方差逆方法计算总体相对风险。使用RoB2.0工具构建风险图。
结果：对11篇文章进行了定性分析，大多数纳入的研究至少呈现一个DF严重程度；六篇文章进行了定量分析，把它们分成两个区域。在北部地区，观察到严重TF病例的患病率较高。对应于≥TF5类别（4.78）[3.55，6.42]。在西部地区,大多数纳入的研究表明，不太严重的病例的患病率较高，对应于≤TF4，与北部地区(0.01)[0.00，0.52]相比，解释为保护作用。
结论：据报道，这些地区饮用水中的氟化物浓度很高，与居民氟斑牙的严重程度直接相关。与西部地区相比，北部地区的饮用水中氟化物浓度较高，并且氟斑牙的患病率更高。
