Effect of fluoride group on dental erosion associated or not with abrasion in human enamel: A systematic review with network metanalysis.

Objectives: This systematic review evaluated the efficacy of monovalent and polyvalent fluoride group compared to the non-fluoride group on the prevention of enamel erosion associated or not with abrasion in in situ studies.

Design: This review was registered in the PROSPERO (CRD42017071118) and followed PRISMA 2020 guidelines. A systematic and comprehensive search was performed using PUBMED, WEB OF SCIENCE, SCOPUS, EMBASE, BBO, LILACS, SCIELO, and grey literature IBICT-BDTD. All in situ and ex vivo studies of erosion and erosion/abrasion tooth wear were included, with no language or date restrictions.

Results: 730 studies were obtained and after exclusion of duplicates, 311 were included for title and abstract reading. Two independent authors (kappa= 0.98) systematically conducted the selection phase. Considering the eligibility criteria and after full-text reading, 19 studies were included in qualitative and quantitative analysis.

Conclusion: Network metanalysis showed that polyvalent fluoride group, especially Sn-compounded, prevented enamel wear by erosion and erosion/abrasion compared to the non-fluoride group and monovalent fluoride group. Both low and high concentration monovalent fluoride group were not able to prevent erosion wear associated or not with abrasion. Sensitivity analysis of the network metanalysis was performed with the low risk of bias studies and the results were confirmed. There is robust evidence that stannous-compounded fluoridated and titanium tetrafluoride agents are effective in preventing erosion and erosion/abrasion compared to the non-fluoride group and other interventions.