Arresting Dentine Caries with Different Concentration and Periodicity of Silver Diamine Fluoride.
Arresting Dentine Caries with Different Concentration and Periodicity of Silver Diamine Fluoride.
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DOI：
10.1177/2380084416649150
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发表时间：
2016-07-01
影响因子：
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通讯作者：
Chu, C H
中科院分区：
文献类型：
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作者：
Fung, M H T;Duangthip, D;Chu, C H
银二胺氟化物（SDF）的不同方案已被用于管理幼儿龋齿。到目前为止，有关乳牙有效控制龋齿的浓度和应用频率的信息有限。本研究旨在比较两种市售SDF溶液（预制备浓度为38%和12%）在每年或每半年应用超过18个月时阻止乳牙牙本质龋的有效性。这项随机双盲临床试验招募了3至4岁的幼儿园儿童，他们至少有一颗牙齿患有牙本质龋。这些儿童被随机分配接受4种治疗方案：第1组，每年应用12% SDF;第2组，每年两次应用12% SDF;第3组，每年应用38% SDF;第4组，每年两次应用38% SDF。每隔6个月进行一次临床检查，以评估活动性龋损是否停止。在基线和随访检查时，通过父母问卷收集有关儿童背景和口腔卫生习惯的信息。共有888名儿童的4，220个牙本质龋面在基线时接受治疗。18个月后，831名儿童（94%）进行了检查。第1、2、3、4组的防龋率分别为50%、55%、64%、74%（P < 0.001）。与接受SDF每年一次应用的患者相比，接受SDF每年两次应用的患者有更高的机会被逮捕（比值比，1.33; 95%置信区间，1.04-1.71; P = 0.025）。浓度与病变部位的交互作用有统计学意义（P < 0.001）。与12%SDF相比，38%SDF的使用增加了阻塞的机会（P < 0.05），但咬合面上的病变除外。根据18个月的结果，SDF在38%浓度下比12%浓度下更有效地阻止学龄前儿童乳牙中的牙本质龋，并且每两年而不是每年施用一次。知识传授声明：本研究的结果可供临床医生和牙科公共卫生专业人员在决定应采用哪种浓度和频率的银二胺氟化物溶液来阻止牙本质龋时使用。考虑到使用银二胺氟化物的龋齿抑制治疗，这是无痛的，简单的，低成本的，这一信息可能会导致更适当的治疗决策，为幼儿或那些无法获得负担得起的传统牙科护理的龋齿控制。
Different regimens of silver diamine fluoride (SDF) have been used to manage early childhood caries. So far, there is limited information regarding the concentrations and frequency of applications for effective caries control in primary teeth. This study aimed to compare the efficacy of 2 commercially available SDF solutions at preprepared concentrations of 38% and 12% when applied annually or biannually over 18 mo in arresting dentine caries in primary teeth. This randomized double-blinded clinical trial recruited kindergarten children aged 3 to 4 y who had at least 1 tooth with dentine caries. The children were randomly allocated to receive 4 treatment protocols: group 1, annual application of 12% SDF; group 2, biannual application of 12% SDF; group 3, annual application of 38% SDF; and group 4, biannual application of 38% SDF. Clinical examinations at 6-mo intervals were conducted to assess whether active carious lesions became arrested. Information on the children's background and oral hygiene habits was collected through a parental questionnaire at baseline and follow-up examinations. A total of 888 children with 4,220 dentine carious tooth surfaces received treatment at baseline. After 18 mo, 831 children (94%) were examined. The caries arrest rates were 50%, 55%, 64%, and 74% for groups 1, 2, 3, and 4, respectively (P < 0.001). Lesions treated with SDF biannual application had a higher chance of becoming arrested compared with those receiving SDF annual application (odds ratio, 1.33; 95% confidence interval, 1.04-1.71; P = 0.025). The interaction between concentration and lesion site was statistically significant (P < 0.001). Compared with 12% SDF, the use of 38% SDF increased a chance of becoming arrested (P < 0.05), except lesions on occlusal surfaces. Based on the 18-mo results, SDF is more effective in arresting dentin caries in the primary teeth of preschool children at 38% concentration than 12% concentration and when applied biannually rather than annually. Knowledge Transfer Statement: The results of this study can be used by clinicians and dental public health professionals when deciding which concentrations and frequency of application of silver diamine fluoride solution should be adopted for arresting dentine caries. With consideration of caries arrest treatment with silver diamine fluoride, which is painless, simple, and low cost, this information could lead to more appropriate therapeutic decisions for caries control in young children or those who lack access to affordable conventional dental care.