Treatment for dental erosion: a systematic review of in vitro studies

PeerJ. 2022 Nov 8:10:e13864. doi: 10.7717/peerj.13864. eCollection 2022.

Abstract

Background: Dental erosion is a chemical loss of the mineralized dental tissue caused by exposure to nonbacterial acids. Different treatment protocols have been adopted with the use of fluoride compounds to promote the formation of a layer of mineral precipitation in eroded lesions.

Aim: This systematic review aimed to evaluate the main treatments for dental erosion.

Methodology: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recorded in the Open Science Framework database (OSF) under DOI 10.17605/OSF.IO/XMFNZ. The searches were conducted in six electronic databases (Pubmed, Embase, Web of Science, Cochrane, Scopus, Lilacs) and two grey literature sources (Google Scholar and OpenGrey). The eligibility criteria included in vitro studies that evaluated eroded teeth under treatment with some topical agent. Risk of bias assessment and qualitative synthesis were performed using the Cochrane collaboration's tool for assessing risk of bias modified for in vitro studies.

Results: A total of 522 studies were identified, and only four studies that fulfilled our eligibility criteria were included in this review. Among these studies, three were considered to have a low risk of bias, and one to have a high risk of bias. Two studies evaluated the anti-erosion effect of fluoride toothpaste, and the other two assessed the action of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the surface of human teeth. Among the products analyzed, CPP-ACP was the only one that promoted a significant increase in enamel microhardness and reduced tooth wear.

Conclusion: Based on the in vitro studies included in this review, there was no anti-erosion effect after using different fluoride toothpaste. However, it should be considered that one of these studies presented a high risk of bias. On the other hand, studies with CPP-ACP showed anti-erosion efficacy when applied before or after erosive wear.

Keywords: Systematic review; Tooth erosion; Treatment.

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fluorides* / therapeutic use
  • Humans
  • Minerals
  • Tooth Erosion* / drug therapy
  • Tooth Remineralization / methods
  • Toothpastes / therapeutic use

Substances

  • Fluorides
  • Toothpastes
  • Minerals

Grants and funding

This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brasil (CAPES), Financing Code 001. Rafael Rodrigues Lima is a researcher from Brazilian National Council for Scientific and Technological Development (CNPq) and received grant number 312275/2021-8. The APC was funded by the Pró-Reitoria de Pesquisa e Pós-Graduação from Federal University of Pará. There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.