Brazilian Dentistry Bibliography Research Articles

The role of phytotherapics for oral health promotion in primary care dentistry: a mini-review

This study sought to understand the use of herbal medicines as a therapeutic practice in dentistry in primary health care. A literature review was carried out using the databases National Library of Medicine - National Institutes of Health (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Brazilian Dentistry Bibliography (BBO), using the descriptors found in DeCS (Health Sciences Descriptors) and MeSH (National Center for Biotechnology Information): “dentistry,” “primary health care” and “phytotherapy.” The results showed that dentists have a deficient theoretical-practical basis for training on herbal medicines in dentistry, which leads to the reduced prescription of herbal medicines in health services as auxiliary therapies for treating oral pathologies. The lack of knowledge of dental professionals and the low financial incentive of managers to use herbal medicines reflect the low adherence to herbal medicine in pharmaceutical care in health units. Professional qualification and financial investment are essential for consolidating phytotherapy in primary health care.

Dental implants in large animal models with experimental systemic diseases: A systematic review.

This systematic review aims to identify and discuss the most used methodologies in pre-clinical studies for the evaluation of the implementation of dental implants in systemically compromised pigs and sheep. This study provides support and guidance for future research, as well as for the prevention of unnecessary animal wastage and sacrifice. Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) was used as a guideline; electronic searches were performed in PubMed, Scopus, Scielo, Web of Science, Embase, Science Direct, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Directory of Open Access Journals, Database of Abstracts of Reviews of Effects, and gray literature until January 2022 (PROSPERO/CRD42021270119). Sixty-eight articles were chosen from the 2439 results. Most studies were conducted in pigs, mainly the Göttinger and Domesticus breeds. Healthy animals with implants installed in the jaws were predominant among the pig studies. Of the studies evaluating the effect of systemic diseases on osseointegration, 42% were performed in osteoporotic sheep, 32% in diabetic sheep, and 26% in diabetic pigs. Osteoporosis was primarily induced by bilateral ovariectomy and mainly assessed by X-ray densitometry. Diabetes was induced predominantly by intravenous streptozotocin and was confirmed by blood glucose analysis. Histological and histomorphometric analyses were the most frequently employed in the evaluation of osseointegration. The animal models presented unique methodologies for each species in the studies that evaluated dental implants in the context of systemic diseases. Understanding the most commonly used techniques will help methodological choices and the performance of future studies in implantology.

The peri-implant ligament

The peri-implant ligament is formed from the interface of bone tissue, through the anchoring of proteins and the surface of the dental implant. In this sense, it is relevant to understand the extent to which this ligament is structured and biomimics the periodontal ligament functions. Aim: The goal of this scoping review is to present and analyze the peri-implant ligament composition and compare the extent to which this ligament is structured and biomimics the periodontal ligament functions. Methods: This scoping review was performed according to the Joanna Briggs Institute methodology for scoping reviews and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review. Two independent researchers searched Pubmed, Cochrane, Embase, Virtual Health Library, Scielo, Scopus, Web of Science, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Digital Library of Theses and Dissertations from the University of São Paulo and Portal Capes. Studies published in English, Portuguese and Spanish, over the last 21 years (2000-2021). Results: A total of 330 titles were identified and after applying inclusion and exclusion factors, 27 studies were included in this review. All proteins were identified regarding their tissue function and classified into 6 major protein groups. After that this new protein ligament was compared with the periodontal ligament regarding its function and composition. The main proteins associated with osseointegration, and thus, with the peri-implant ligament are recognized as belonging to the periodontal ligament. Conclusion: This scoping review results suggest evidence of the composition and function of the periimplant ligament. However, variations may still exist due to the existence of several modulants of the osseointegration process.

How is the quality of the available evidence on molar-incisor hypomineralization treatment? An overview of systematic reviews.

This overview analyzed the quality of the systematic reviews (SRs) available on treatments for molar-incisor hypomineralization (MIH). Six electronic databases were searched (PubMed/MEDLINE, Scopus, Web of Science, LILACS, Brazilian Bibliography of Dentistry and Cochrane Library) until March 2022. Two reviewers independently performed the selection, the quality assessment (Assessment of Multiple Systematic Reviews 2 - AMSTAR-2), and the risk of bias assessment of the SR (Risk of Bias in Systematic Reviews - ROBIS). Two hundred nine records were retrieved; after removing duplicates and applying the inclusion/exclusion criteria, 5 SRs remained. Three SRs were rated as showing critically low methodological quality and high risk of bias, and two were rated as moderate methodological quality and low risk of bias. The identified treatments that may be suitable for MIH were classified as (1) non-invasive - casein incorporated into toothpaste and sugar-free chewing gum, toothpaste containing arginine, 0.4% stannous fluoride gel; fluoride varnish; (2) micro-invasive - resin sealants for pits and fissures, microabrasion, dental whitening, resin infiltration; (3) invasive - ART restorations, indirect restorations (metal, composite, or ceramic); and (4) mixed intervention - stainless steel crowns. Despite the considerable number of published papers included in this set of systematic reviews, the evidence supporting the effectiveness of treatments for treating MIH is limited due to the methodological quality and risk of bias of the systematic reviews, as well as the quality of the primary studies (PROSPERO: CRD42020144831). Different treatments have been purposed for MIH treatment, but there is still not enough scientific evidence of good quality for the establishment of a definitive clinical protocol for the treatment of MIH.

Association between sense of coherence and oral clinical conditions in adults and the elderly: systematic review and meta-analysis.

This study systematically reviews the evidence on the relationship between sense of coherence (SOC) and oral clinical conditions in adults and elderly people. PubMed, Scopus, Web of Science, Latin American and Caribbean Literature in Health Sciences - Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Brazilian Dentistry Bibliography - Bibliografia Brasileira de Odontologia (BBO), Cochrane Library and grey literature were searched. Observational studies involving adults and elderly people that evaluated SOC with a valid instrument and investigated oral clinical measurements as outcomes were included. Two review authors independently assessed the studies for inclusion and extracted data. The quality of studies was assessed using the Downs and Black checklist. Meta-analysis used the random-effect inverse-variance method to obtain pooled odds ratios (OR) and 95% Confidence Intervals (CI) for each oral clinical condition. From a total of 872 identified studies, ten observational cross-sectional and one longitudinal study were included. Nine studies were judged of medium or high risk of bias. Meta-analyses showed that adults and elderly people with higher SOC were less likely to present dental caries (OR 0.84; 95%CI = 0.73-0.96), periodontal disease (OR 0.58; 95%CI = 0.30-0.85), gingivitis (OR 0.54; 95%CI = 0.18-0.90) or dental biofilm (OR 0.65; 95%CI = 0.43-0.86). Current evidence suggests that better SOC is positively related to better oral clinical status in adults and elderly people. Longitudinal and intervention studies are needed to confirm these findings.

Importance of occupational dentistry for companies - a literature review.

Due attention has not been given yet to workers’ health problems arising from oral diseases and to the impacts of not having an appropriate professional, i.e., dental surgeon, as part of the specialized service team of large companies, even acknowledging that the participation of these professionals is positive for improving workers’ quality of life and the productive performance of the company. Based on these premises, and through a literature review conducted from a search on the electronic portal of Brazilian Dentistry Bibliography, SciELO, and MEDLINE databases, the present study aimed to demonstrate factors that justify the integration of dental surgeons in occupational health programs of companies. The following advantages were mentioned: reduction in absenteeism and in the number of work accidents, productivity growth, and improvement in company image and in employees’ quality of life. In conclusion, the occupational health care model cannot be dissociated from oral health, considering the significant benefits both for employees and for companies themselves.

Removal of filling material in endodontic retreatment: a literature review

Removal of filling material from the root canal system is required when a previous endodontic treatment fails, what may result in the permanence of an unfavorable periapical condition. The intent is to completely remove the filling material from the root canal to achieve sufficient cleaning and shaping for successful retreatment. Objective: The aims of this article were to provide a systematic review of the different techniques of endodontic filling material associated or not with organic solvents and to analyze them critically in terms of advantages and disadvantages of each technique. Literature review: The descriptors used were “gutta-percha”, “obturation,” and “retreatment” in the following databases: PubMed, MEDLINE, Latin American and Caribbean Center on Health Sciences Information (Bireme), Latin-American and Caribbean Health Sciences (Lilacs), Brazilian Dentistry Bibliography (BBO), and Scientific Electronic Library Online (SciELO). Publications of in vitro/ex vivo and in vivo experiments without language restriction between the years 2010 and 2018 were selected. Conclusion: None of the techniques were capable of performing complete root canal cleaning, and the manual method was so effective as the automated method, although it requires longer working time. Furthermore, although this review confirmed that the solvent action did not allow a significant improvement in the removal of the filling material, ultrasound-activated irrigation proved to be an efficient adjunctive device as it could significantly reduce the volume of intracanal residuals.

Removal of obturation material in endodontic retreatment: a literature review

Introduction: Removal of filling material from the root canal system is required when a previous endodontic treatment fails, what may result in the permanence of an unfavorable periapical condition. The intent is to completely remove the filling material inside of the root canal to achieve sufficient cleaning and shaping for successful retreatment. Objective: The aims of this article were to provide asystematic review of the different techniques of endodontic filling material associated or not with organic solvents and to analyze them critically in terms of advantages and disadvantages of each technique. Literature review: The descriptors used were “guttapercha”, “obturation,” and “retreatment” in the following databases: PubMed, MEDLINE, Latin American and Caribbean Center on Health Sciences Information (Bireme), Latin-American and CaribbeanHealth Sciences (Lilacs), Brazilian Dentistry Bibliography (BBO), and Scientific Electronic Library Online (SciELO). Publications of in vitro/ ex vivo and in vivo experiments without language restriction between the years 2010 and 2018 were selected. Conclusion: None of the techniques were capable of performing complete root canal cleaning, and the manual method was so effective as the automated method, although it requires longer working time. Furthermore, although this review confirmed that the solvent action did not allow a significantimprovement in the removal of the filling material, ultrasoundactivated irrigation proved to be an efficient adjunctive device as it could significantly reduce the volume of intracanal residuals.

Odontologic atention on oncological practice

Introduction: According to the World Health Organization, cancer is a public health problem, especially among developing countries, where it is expected that in the coming decades, the impact of the disease on the population will correspond to 80% of the more than 20 million cases new estimates for 2025. Despite the advances in the technologies and drugs of antineoplastic therapy, several oral repercussions can be observed. Thus, dentistry plays a fundamental role in the restoration of general health and, consequently, the quality of life of these individuals. Objectives: To verify the dental assistance in the oncological practice. Methodology: Literature review where we searched for published articles available on the internet in the database systems: Medlars on line International Literature (Medline), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Brazilian Bibliography of Dentistry (BBO) present on the website of the Virtual Health Library (BVS). Results and Discussion: The literature evidences the need for oral-dental care and the inclusion of the dental surgeon in the multi and inter-transdisciplinary medical team required for good oncological practice. The literature is unanimous in indicating the need for medical intervention with the support of a multidisciplinary health team, including dental surgeon, in order to ensure adequate performance of antineoplastic therapies and specific care in the control of oral side effects and consequent general repercussions. Dentistry, for example, the prevention, treatment and control of diseases such as mucositis, xerostomia, cavities, dental infections and opportunistic mouth. Precariousness or even lack of adequate dental care may compromise oncological practice. Conclusion: The dentist incorporated into the oncological practice contributes to the quality of the care, favoring the integral care with attention to the oral condition and systemic repercussions.

Epidemiology of malocclusion in children and adolescents: a critic review

OBJECTIVES: The aim of this literature review about malocclusion was to identify epidemiologic instruments which are being used in Public Health, as well as to bring information regarding the occlusal alterations more prevalent in children and adolescents. METHODS: Information presented in previous studies was reviewed, in articles published in period 1997-2007, considering the production registered in the following databases: Latin American and Caribbean Health Sciences, Scientific Electronic Library Online, International Database for Medical Literature and Brazilian Dentistry Bibliography. RESULTS: The total of 191 identified references, 170 had been eliminated after the implementation of the exclusion criteria and 21 articles met the proposed inclusion criteria and had served of base for this work. The use of different criteria made difficult the comparison of studies in literature and did not offer parameters that can guide the scientific evidences. CONCLUSION: The most used epidemiologic indices were Dental Aesthetic Index and Index of Orthodontic Treatment Need and it was observed predominance of open bite in the deciduous dentition and crowding in the mixed and permanent dentitions.

Face‐bow transfer in prosthodontics: a systematic review of the literature

An extensive search for randomised controlled clinical trials was accomplished to compare dental prostheses and occlusal splints constructed with or without face-bow transfer, and question whether face-bow transfer may present better clinical results than simpler approaches. Studies were identified by searching electronic databases (PubMed/MEDLINE, Latin American and Caribbean Literature on the Health Science, and Brazilian Bibliography of Dentistry). The keywords 'dental articulator', 'semi-adjustable articulator', 'face-bow', 'jaw relation record' and 'occlusal splint therapy' were used. The minimum inclusion requirements were (i) randomised controlled trials with patients of any age, (ii) comparison between dental prostheses or occlusal splints constructed with or without face-bow transfer and (iii) assessment of clinician's time, number of occlusal contacts, patient satisfaction or masticatory function. The search resulted in the identification of 8779 articles. Subsequently, 8763 articles were excluded on the basis of title and abstract. By the end of the search phase, eight randomised controlled trials were considered eligible. Current scientific evidence suggests that face-bow transfer is not imperative to achieve better clinical results in prosthodontics. Randomised clinical trials suggest that simpler approaches for the construction of complete dentures and occlusal splints may present acceptable results, while no clinical study has investigated its use in fixed and removable partial dentures.

Alterações orais em crianças prematuras e de baixo peso ao nascer: a importância da relação entre pediatras e odontopediatras

OBJETIVO: Apresentar uma revisão de literatura sobre as alterações orais em crianças prematuras e de baixo peso ao nascer. FONTES DE DADOS: Foram selecionados artigos em inglês e português, desde 1976 até 2009, pesquisados no PubMed, Lilacs e na Bibliografia Brasileira de Odontologia (BBO), além de livros e consensos nacionais e internacionais. As palavras-chave utilizadas foram: "prematuro", "recém-nascido de baixo peso", "cárie dentária", "hipoplasia do esmalte dentário", "manifestações bucais e "dentição primária". Selecionaram-se artigos avaliando incidência, prevalência e etiologia das alterações orais, além de revisões de literatura e relatos de casos clínicos. SÍNTESE DOS DADOS: As alterações orais mais comuns em crianças prematuras e de baixo peso ao nascer são os defeitos no esmalte dentário (hipoplasias e hipocalcificações), a predisposição ao desenvolvimento de lesões de cárie dentária, as alterações na cronologia de erupção dentária e as alterações no palato com consequente aparecimento de maloclusão. Outras alterações também são relatadas, como diferenças nas dimensões das coroas dentárias e na espessura e porosidade do esmalte dentário. A interação entre pediatras e odontopediatras é fundamental no manejo dessas crianças. CONCLUSÕES: O conhecimento das alterações orais em crianças pré-termo e de baixo peso ao nascer por parte dos pediatras e odontopediatras favorece a atuação multidisciplinar com o objetivo de educar, prevenir e atenuar as possíveis mudanças físicas e dentárias nessas crianças.

Root resorption during orthodontic treatment

Medline, Embase, LILACS, The Cochrane Library (Cochrane Database of Systematic Reviews, CENTRAL, and Cochrane Oral Health Group Trials Register) Web of Science, EBM Reviews, Computer Retrieval of Information on Scientific Project (CRISP, www.crisp.cit.nih.gov), On-Line Computer Library Center (www.oclc.org), Google Index to Scientific and Technical Proceedings, PAHO (www.paho.org), WHOLis (www.who.int/library/databases/en), BBO (Brazilian Bibliography of Dentistry), CEPS (Chinese Electronic Periodical Services), Conference materials (www.bl.uk/services/bsds/dsc/conference.html), ProQuest Dissertation Abstracts and Thesis database, TrialCentral (www.trialscentral.org), National Research Register (www.controlled-trials.com), www.Clinicaltrials.gov and SIGLE (System for Information on Grey Literature in Europe). Randomised controlled trials including split mouth design, recording the presence or absence of external apical root resorption (EARR) by treatment group at the end of the treatment period. Data were extracted independently by two reviewers using specially designed and piloted forms. Quality was also assessed independently by the same reviewers. After evaluating titles and abstracts, 144 full articles were obtained of which 13 articles, describing 11 trials, fulfilled the criteria for inclusion. Differences in the methodological approaches and reporting results made quantitative statistical comparisons impossible. Evidence suggests that comprehensive orthodontic treatment causes increased incidence and severity of root resorption, and heavy forces might be particularly harmful. Orthodontically induced inflammatory root resorption is unaffected by archwire sequencing, bracket prescription, and self-ligation. Previous trauma and tooth morphology are unlikely causative factors. There is some evidence that a two- to three-month pause in treatment decreases total root resorption. The results were inconclusive in the clinical management of root resorption, but there is evidence to support the use of light forces, especially with incisor intrusion.

Childhood dental trauma and socioeconomic status

Brazilian Bibliography of Dentistry (BBO), Scientific Electronic Library online (SciELO), Latin American and Caribbean Health Sciences (LILACS), The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature (MEDLINE) and PubMed Central. The database of the Brazilian Coordination of Higher Education Personnel Improvement (CAPES) was searched as well as reference lists from included articles. Articles providing information on the correlation between traumatic injuries in permanent teeth and socioeconomic indicators were included. Data were extracted by two reviewers and disagreements resolved through discussion and a qualitative synthesis conducted. Nine studies were included (1 cohort, 8 cross-sectional). Seven of the surveys were carried out in Brazil and two in Thailand. The age of children was 9-14 years. Statistically significant associations between permanent tooth injuries and high economic status were found in four studies. There were few studies correlating traumatic injuries in permanent teeth and socioeconomic indicators and the majority found no such association. It is suggested that the association between traumatic dental injuries and socioeconomic factors may be related to the indicators used, considering differences in their individual components. Furthermore, the heterogeneity of the methodologies hinders the comparison of the studies.

Alterações periodontais associadas às doenças sistêmicas em crianças e adolescentes

OBJETIVO: O objetivo deste estuo foi revisar na literatura a inter-relação entre condições sistêmicas e a ocorrência de doenças periodontais em crianças e adolescentes, destacando-se as manifestações periodontais frequentemente encontradas. FONTES DE DADOS: Artigos indexados nas bases de dados Medline, Lilacs e Bibliografia Brasileira em Odontologia, nos últimos 20 anos, além de referências clássicas. As palavraschave utilizadas foram: "doença periodontal", "periodontite", "doenças sistêmicas", "criança" e "adolescente". SÍNTESE DOS DADOS: Doenças sistêmicas como hipofosfatasia, histiocitose X, síndrome de Down, síndrome de Papillon-Lefèvre, síndrome de Ehlers-Danlos, síndrome de Chédiak-Higashi, leucemias, Aids e as deficiências quantitativas e qualitativas dos neutrófilos estão associadas ao aparecimento de alterações periodontais graves em crianças e adolescentes. Os estudos demonstraram a ocorrência de alteração periodontal na forma de periodontite em crianças e adolescentes com doenças sistêmicas, podendo levar à perda precoce de dentes. CONCLUSÕES: A ocorrência de alterações periodontais é observada em crianças e adolescentes com alterações sistêmicas, que manifestam desde inflamação gengival até formas mais destrutivas, como periodontites e perda precoce dos dentes.

Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966- 2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa=0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4- 6.5]. Of the SRs, 57.1% had major flaws, scoring < or = 4. SR methodological quality is low; therefore, clinicians should critically appraise them prior to considering their recommendations to guide patient care.

Correlation between socioeconomic indicators and traumatic dental injuries: a qualitative critical literature review

Traumatic dental injuries are widespread and have become a serious dental public health problem in childhood. Despite its importance, very few studies have correlated the prevalence of permanent tooth injury and socioeconomic indicators. The aim of the present study was to evaluate just such a correlation. Electronic searches were performed in the following bibliographical databases: Brazilian Bibliography of Dentistry, Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature and PubMed Central. Reference lists from articles that fulfilled the inclusion criteria in this review were searched for additional relevant articles. The Brazilian Coordination of Higher Education Personnel Improvement Theses Databank was also included. Selection and analysis of the articles were performed independently by two authors of the present literature review. A total of 21 of 98 articles were eligible for inclusion in the review. However, only nine articles performed all the methodology criteria analyzed. Seven of the surveys were carried out in Brazil and two in Thailand. The age of children was 9-14 years. Statistically significant associations between permanent tooth injuries and high economic status were found in four studies. There were few studies correlating traumatic injuries in permanent teeth and socioeconomic indicators and the majority found no such association. It is suggested that the association between traumatic dental injuries and socioeconomic factors may be related to the indicators used, considering differences in their individual components. Furthermore, the heterogeneity of the methodologies hinders the comparison of the studies.

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

BackgroundTemporomandibular joint disorders (TMJD) are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1) identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2) evaluate their methodological quality, and (3) evaluate the evidence grade within the systematic reviews.MethodsA search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis) comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July). Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP) were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews.ResultsThe search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd). In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies.ConclusionThe results indicate that in spite of the widespread impact of TMJD, and the multitude of potential interventions, clinicians have expended sparse attention to systematically implementing clinical trial methodology that would improve validity and reliability of outcome measures. With some 20 years of knowledge of evidence-based healthcare, the meager attention to these issues begins to raise ethical issues about TMJD trial conduct and clinical care.

Fluoridated milk may be beneficial to schoolchildren by helping prevent caries

Data sources Data sources were the Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, Medline and OLDMedline, Embase, LILACS (Latin American and Caribbean Health Sciences Literature), BBO (Brazilian Bibliography of Dentistry), SIGLE (System for Information on Grey Literature in Europe) and Digital Dissertations. Bibliographies of relevant articles were searched and attempts were made to identify unpublished and ongoing studies. Several relevant journals were also searched by hand. Study selection There was no language restriction. Randomised controlled trials (RCT) or quasi-RCT were selected if they had an intervention or follow-up period of >3 years and compared fluoridated and nonfluoridated milk. Data extraction and synthesis Inclusion criteria, data extraction and quality assessment were carried out independently and in duplicate, with disagreements being resolved by discussion and agreement being assessed using Kappa. Mean differences and standard deviations were used to summarise data. Results Out of 144 articles identified by the searches, only two met the inclusion criteria. Since only one report was available as an abstract, unpublished information was requested from the authors and included in this review. A total of 353 children, who had baseline ages of 3–5.5 years, were involved in the studies. The fluoride levels in the two reports differed (2.5 or 7.5 mg/l) and therefore their results could not be combined. After consumption of fluoridated milk for 3 years there was a significant reduction in DMFT (78.4%, P<0.05) between test and control groups in one study. In the other study, although mean DMFT and DMFS were more favourable in the test group, no significant reductions in DMFT were observed until the fourth (35.5%, P<0.02) and fifth years (31.2%, P<0.05). For primary teeth there was a significant reduction in DMFT (31.3%, P<0.05) between the test and control groups after 3 years in one study but not the other. No intent-to-treat analysis could be carried out. Conclusions The two studies that were of sufficient quality to be included in this review suggested that fluoridated milk was beneficial to schoolchildren by helping prevent caries in the permanent dentition. There remains, however, a dearth of studies providing high-quality evidence of the effects of fluoridated milk.