Pediatric Dental Resident, Pediatric Dentistry Department, University of Nevada, Las Vegas (UNLV), 89106, USA.
Visiting Faculty, Biomedical and Clinical Research, University of Nevada, Las Vegas (UNLV), 89106, USA.
Sci Rep. 2019 Feb 14;9(1):2115. doi: 10.1038/s41598-019-38569-9.
Dental caries can compromise quality of life and is associated with demineralization of tooth structure by organic acids produced by microorganisms. This study systematically reviewed the dentine caries arrest capabilities of silver diamine fluoride (SDF) and sodium fluoride (NaF). A comprehensive search strategy was developed to identify the relevant publications in electronic databases and hand searched journals and reviews (to March 2018). By applying strict inclusion and exclusion criteria, only six papers (two randomized controlled trials, two follow-up articles and two secondary statistical analysis studies) were considered for full text qualitative and quantitative assessment. The included studies were critically appraised and statistically evaluated. Only four articles were considered for meta-analysis, as the other two were secondary analyses of included studies. When comparing the caries arrest lesions of SDF and NaF, SDF was found to be statistically more effective in dentine caries arrest of primary teeth during the 18 and 30 month clinical examinations. The weighted total effect size of the differences between SDF and NaF regarding arrested caries surfaces was calculated and showed nearly double the effectiveness of SDF to NaF at 30 months. Therefore, SDF is a more effective caries management reagent than NaF. Further clinical research is needed to consolidate the findings of this systematic review.
龋齿会降低生活质量，并且与微生物产生的有机酸导致牙体脱矿有关。本研究系统地综述了氟化银（SDF）和氟化钠（NaF）在牙本质龋抑制方面的能力。制定了全面的检索策略，以在电子数据库中确定相关的出版物，并对期刊和综述进行手工检索（截至 2018 年 3 月）。通过应用严格的纳入和排除标准，仅对 6 篇论文（2 项随机对照试验、2 项随访文章和 2 项二次统计分析研究）进行了全文定性和定量评估。纳入的研究进行了批判性评价和统计学评估。仅对 4 篇文章进行了荟萃分析，因为另外 2 篇是对纳入研究的二次分析。在比较 SDF 和 NaF 的龋齿抑制病变时，在 18 个月和 30 个月的临床检查中，SDF 在原发性牙齿牙本质龋抑制方面具有统计学上的优越性。计算了 SDF 和 NaF 之间在抑制龋面方面的差异的加权总效应大小，并显示 SDF 在 30 个月时的效果几乎是 NaF 的两倍。因此，SDF 是一种比 NaF 更有效的龋齿管理试剂。需要进一步的临床研究来巩固本系统评价的发现。
