Topical silver diamine fluoride for dental caries arrest in preschool children: A randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression.
نویسندگان
چکیده
OBJECTIVES The Stopping Cavities Trial investigated effectiveness and safety of 38% silver diamine fluoride in arresting caries lesions. MATERIALS AND METHODS The study was a double-blind randomized placebo-controlled superiority trial with 2 parallel groups. The sites were Oregon preschools. Sixty-six preschool children with ≥1 lesion were enrolled. Silver diamine fluoride (38%) or placebo (blue-tinted water), applied topically to the lesion. The primary endpoint was caries arrest (lesion inactivity, Nyvad criteria) 14-21days post intervention. Dental plaque was collected from all children, and microbial composition was assessed by RNA sequencing from 2 lesions and 1 unaffected surface before treatment and at follow-up for 3 children from each group. RESULTS AND CONCLUSION Average proportion of arrested caries lesions in the silver diamine fluoride group was higher (0.72; 95% CI; 0.55, 0.84) than in the placebo group (0.05; 95% CI; 0.00, 0.16). Confirmatory analysis using generalized estimating equation log-linear regression, based on the number of arrested lesions and accounting for the number of treated surfaces and length of follow-up, indicates the risk of arrested caries was significantly higher in the treatment group (relative risk, 17.3; 95% CI: 4.3 to 69.4). No harms were observed. RNA sequencing analysis identified no consistent changes in relative abundance of caries-associated microbes, nor emergence of antibiotic or metal resistance gene expression. Topical 38% silver diamine fluoride is effective and safe in arresting cavities in preschool children. CLINICAL SIGNIFICANCE The treatment is applicable to primary care practice and may reduce the burden of untreated tooth decay in the population.
منابع مشابه
مروری بر کاربردهای فلوئورید دی‌آمین نقره (Silver Diamine Fluoride) در دندانپزشکی
U ntreated caries are common findings in low-income communities. Treatment of dental caries in young children is challenging and requires a high skill and high cost of dental anesthesia for control ling patients and thus, chemical methods for arresting dental caries have been proposed. Silver Diamine Fluoride (SDF) is a material that is used to control and to arrest dental caries , especially...
متن کاملTopical Silver Diamine Fluoride for Dental Caries Arrest in Preschool Children: A Randomized Controlled Trial
Word Count: 235 (250 allowed) peer-reviewed) is the author/funder. All rights reserved. No reuse allowed without permission. The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/131870 doi: bioRxiv preprint first posted online Apr. 29, 2017;
متن کاملRandomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children.
OBJECTIVE To compare the effectiveness of annual topical application of silver diamine fluoride (SDF) solution, semi-annual topical application of SDF solution, and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth. METHODS A total of 212 children, aged 3-4 years, were randomly allocated to one of three groups for treatm...
متن کاملEffectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review.
This study aimed to evaluate the scientific evidence regarding the effectiveness of silver diamine fluoride (SDF) in preventing and arresting caries in the primary dentition and permanent first molars. A systematic review (SR) was performed by 2 independent reviewers using 3 electronic databases (PubMed, ScienceDirect, and Scopus). The database search employed the following key words: "topical ...
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ورودعنوان ژورنال:
- Journal of dentistry
دوره 68 شماره
صفحات -
تاریخ انتشار 2018