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治疗儿童龋齿的新型“万灵药”——纳米氟化银:一项随机临床试验

A new "silver-bullet" to treat caries in children--nano silver fluoride: a randomised clinical trial.

作者信息

Santos Valdeci Elias dos, Vasconcelos Filho Arnoldo, Targino Andrea Gadelha Ribeiro, Flores Miguel Angel Pelagio, Galembeck André, Caldas Arnaldo França, Rosenblatt Aronita

机构信息

University of Pernambuco, Pediatric Dentistry, Brazil.

Department of Paediatric Dentistry, Faculty of Dentistry, University of Pernambuco, Brazil.

出版信息

J Dent. 2014 Aug;42(8):945-51. doi: 10.1016/j.jdent.2014.05.017. Epub 2014 Jun 12.

Abstract

BACKGROUND

Untreated dental caries in children remains a public health challenge in poor communities.

OBJECTIVES

This prospective controlled clinical trial investigated the effectiveness of a new anti-caries agent, Nano Silver Fluoride (NSF), applied once a year to arrest caries in children.

METHODS

One hundred thirty decayed primary teeth were randomly divided into two groups: NSF as the experimental agent and water as the control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at seven days and five and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's chi-square test was used to compare the groups during different follow-up exams.

RESULTS

At seven days, 81% of teeth in the NSF group exhibited arrested caries, whereas in controls, no teeth had arrested decay (p<0.001) [PF, prevented fraction=81%]. After five months, the NSF group had 72.7% with arrested decay, and the control group had 27.4% (p<0.001) [PF=62.5%]. At 12 months, 66.7% of the lesions treated with NSF were still arrested, while the control group had 34.7% remaining arrested (p=0.003) [PF=50%]. The number need to treat (NNT) at five months was two, and at 12 months, the number was three.

CLINICAL SIGNIFICANCE

The NSF formulation is effective to arrest active dentine caries and not stain teeth.

CONCLUSIONS

NSF was demonstrated to be effective in arresting caries in children in poor communities.

摘要

背景

儿童未经治疗的龋齿仍是贫困社区面临的一项公共卫生挑战。

目的

这项前瞻性对照临床试验研究了一种新型抗龋剂——纳米银氟化物(NSF)每年应用一次对儿童龋齿的防治效果。

方法

130颗龋坏乳牙被随机分为两组:NSF组作为试验组,水组作为对照组。由一名掩蔽身份的检查者进行临床诊断和治疗,另一名经过校准且对治疗类型不知情的检查者在7天、5个月和12个月时进行随访。遵循国际龋病检测与评估系统(ICDAS II)的标准来确定病变的活跃性和龋齿的诊断。在不同的随访检查中,使用Pearson卡方检验对两组进行比较。

结果

7天时,NSF组81%的牙齿龋齿得到控制,而对照组没有牙齿龋齿得到控制(p<0.001)[预防率(PF)=81%]。5个月后,NSF组72.7%的牙齿龋齿得到控制,对照组为27.4%(p<0.001)[PF=62.5%]。12个月时,用NSF治疗的病变中有66.7%仍处于控制状态,而对照组有34.7%仍处于控制状态(p=0.003)[PF=50%]。5个月时的需治疗人数(NNT)为2,12个月时为3。

临床意义

NSF制剂能够有效控制活跃的牙本质龋且不会使牙齿染色。

结论

NSF被证明对贫困社区儿童的龋齿防治有效。

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