Insufficient evidence that slow-release XXXX devices reduce caries.

@entity1 @entity1388
UNASSIGNED: Data sourcesCochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, US National Institutes of Health Trials Register and World Health Organisation (WHO) International Clinical Trials Registry Platform.Study selectionParallel randomised controlled trials (RCTs) of any type of slow-release @entity1388 device irrespective of publication status, language or blinding were considered. Split mouth studies were excluded.Data extraction and synthesisStandard Cochrane methods were followed with at least two reviewers independently undertaking all the key steps.ResultsOnly one trial which was considered to be at high risk of bias was included. The trial included 174 @entity1 with 132 available for two year examination. However statistical analysis was performed on only the 63 @entity1 (31 in intervention group, 32 in control group) who had retained the beads (retention rate was 47.7% at two years). Among these 63 @entity1 , caries increment was reported to be statistically significantly lower in the intervention group than in the control group (DMFT: mean difference -0.72, 95% confidence interval (CI) -1.23 to -0.21; DMFS: mean difference -1.52, 95% CI -2.68 to -0.36 (very low quality evidence)). Although this difference was clinically significant, it only holds true for those @entity1 who retained the @entity1388 beads; over 50% of the @entity1 did not retain the beads. Adverse effects were not reported.ConclusionsThere is insufficient evidence to determine the caries-inhibiting effect of slow-release @entity1388 glass beads. The body of evidence available is of very low quality and there is a potential overestimation of benefit to the average @entity1 . The applicability of the findings to the wider population is unclear; the study had included @entity1 from a deprived area that had low levels of @entity1388 in drinking water, and were considered at high risk of carries. In addition, the evidence was only obtained from @entity1 who still had the bead attached at two years (48% of all available @entity1 ); @entity1 who had lost their slow-release @entity1388 devices earlier might not have benefited as much from the devices.
