Li R, Lo E C M, Liu B Y, Wong M C M, Chu C H
1 Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
2 School of Stomatology, Shanghai Jiaotong University, Shanghai, China.
JDR Clin Trans Res. 2017 Jan;2(1):66-72. doi: 10.1177/2380084416668491. Epub 2016 Sep 28.
Dental root caries is a common disease among elders. More efforts on preventing this disease are needed. Silver diammine fluoride (SDF) is known to prevent dental caries in primary teeth. However, clinical evidence of its efficacy in preventing root surface caries is limited. This clinical trial aimed to compare the effectiveness of SDF in preventing root caries among elders in a water fluoridated area. A total of 323 elders who had at least 5 teeth with exposed root surfaces and who had self-care ability were randomly allocated into 3 intervention groups: group 1 (placebo control), annual application of tonic water; group 2, annual application of SDF solution; group 3, annual application of SDF solution, immediately followed by potassium iodide (KI) solution. Oral hygiene instructions and fluoride toothpaste were provided to all subjects. Status of dental root surface was assessed every 6 mo by the same independent examiner. After 30 mo, 257 (79.6%) elders were reviewed. The mean numbers of root surface with new caries experience in the control, SDF, and SDF/KI groups were 1.1, 0.4, and 0.5, respectively (analysis of variance, P < 0.001). Scheffe's multiple comparison showed that elders who received placebo developed more new root caries lesions ( P < 0.05), while the difference between the SDF and SDF/KI groups was not statistically significant ( P > 0.05). Moreover, elders who had higher visible plaque index scores at 30-mo examination (analysis of covariance, P < 0.001) and those who had higher baseline DMFT scores (analysis of covariance, P = 0.005) developed more new root caries. It is concluded that annual application of SDF or SDF/KI solution is effective in preventing root caries among community-dwelling elders in a fluoridated area ( ClinicalTrials.gov NCT02360124). Knowledge Transfer Statement: Annual topical application of silver diammine fluoride or silver diammine fluoride / potassium iodide solution is effective in preventing dental root surface caries among community-dwelling elders in a fluoridated area.
牙根龋是老年人中的一种常见疾病。需要在预防这种疾病方面做出更多努力。已知二胺银氟化物（SDF）可预防乳牙龋齿。然而，其预防根面龋疗效的临床证据有限。这项临床试验旨在比较SDF在水氟化地区预防老年人根龋的有效性。共有323名至少有5颗牙根面暴露且具备自我护理能力的老年人被随机分为3个干预组：第1组（安慰剂对照），每年使用滋补水；第2组，每年使用SDF溶液；第3组，每年使用SDF溶液，随后立即使用碘化钾（KI）溶液。向所有受试者提供口腔卫生指导和含氟牙膏。由同一位独立检查者每6个月评估一次牙根面状况。30个月后，对257名（79.6%）老年人进行了复查。对照组、SDF组和SDF/KI组有新龋经验的根面平均数量分别为1.1、(0.4)和(0.5)（方差分析，P < 0.001）。谢费多重比较显示，接受安慰剂的老年人出现了更多新的根龋病变（P < 0. 05），而SDF组和SDF/KI组之间的差异无统计学意义（P > 0.05）。此外，在30个月检查时可见菌斑指数得分较高的老年人（协方差分析，P < 0.001）以及基线DMFT得分较高的老年人（协方差分析，P = 0.005）出现了更多新的根龋。得出的结论是，每年使用SDF或SDF/KI溶液可有效预防氟化地区社区居住老年人的根龋（ClinicalTrials.gov NCT02360124）。知识转移声明：每年局部应用二胺银氟化物或二胺银氟化物/碘化钾溶液可有效预防氟化地区社区居住老年人的牙根面龋。
