Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil.
Caries Res. 2017;51(5):527-541. doi: 10.1159/000478668. Epub 2017 Oct 4.
A systematic review was performed to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in children when compared with active treatments or placebos. A search for randomized clinical trials that evaluate the effectiveness of SDF for caries control in children compared to active treatments or placebos with follow-ups longer than 6 months was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and grey literature. The risk of bias tool from the Cochrane Collaboration was used for quality assessment of the studies. The quality of the evidence was evaluated using the GRADE approach. Meta-analysis was performed on studies considered at low risk of bias. A total of 5,980 articles were identified. Eleven remained in the qualitative synthesis. Five studies were at "low," 2 at "unclear," and 4 studies at "high" risk of bias in the key domains. The studies from which the information could be extracted were included for meta-analysis. The arrestment of caries at 12 months promoted by SDF was 66% higher (95% CI 41-91%; p < 0.00001) than by other active material, but it was 154% higher (95% CI 67-85%; p < 0.00001) than by placebos. Overall, the caries arrestment was 89% higher (95% CI 49-138%; p < 0.00001) than using active materials/placebo. No heterogeneity was detected. The evidence was graded as high quality. The use of SDF is 89% more effective in controlling/arresting caries than other treatments or placebos. The quality of the evidence was graded as high.
系统评价评估了在比较活性治疗或安慰剂时，银氟化物（SDF）在控制儿童龋齿进展方面的疗效。在 PubMed、Scopus、Web of Science、LILACS、BBO、Cochrane 图书馆和灰色文献中，搜索了比较 SDF 对儿童龋齿控制效果的随机临床试验，随访时间超过 6 个月，以活性治疗或安慰剂作为对照。使用 Cochrane 协作的偏倚风险工具评估研究质量。使用 GRADE 方法评估证据质量。对被认为低偏倚风险的研究进行了荟萃分析。共确定了 5980 篇文章。11 篇文章进行了定性综合分析。5 项研究在关键领域的偏倚风险为“低”，2 项为“不确定”，4 项为“高”。可以从中提取信息的研究被纳入荟萃分析。SDF 在 12 个月时促进的龋齿静止率比其他活性材料高 66%（95%CI 41-91%；p < 0.00001），但比安慰剂高 154%（95%CI 67-85%；p < 0.00001）。总体而言，龋齿静止率比使用活性材料/安慰剂高 89%（95%CI 49-138%；p < 0.00001）。未检测到异质性。证据质量被评为高质量。与其他治疗或安慰剂相比，使用 SDF 控制/静止龋齿的效果提高了 89%。证据质量被评为高质量。
