用氨化银氟化物阻止幼儿牙本质龋的随机临床试验。

A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride.

机构信息

Faculty of Dentistry, Mahidol University, Bangkok, Thailand.

Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.

出版信息

J Dent. 2020 Aug;99:103375. doi: 10.1016/j.jdent.2020.103375. Epub 2020 May 16.

DOI:10.1016/j.jdent.2020.103375

PMID:32428523

Abstract

OBJECTIVES

The study aimed to compare the effectiveness of 38% silver diamine fluoride (SDF) solution, and 5% sodium fluoride (NaF) varnish applied semiannually in arresting dentin caries in young children with high caries risk.

METHODS

Children aged 1-3 years who had at least one active dentin carious lesion were randomly allocated into 2 groups as follows: Group 1 = 38% SDF (Topamine), and Group 2 = 5% NaF varnish (Duraphat). Both agents were applied every 6 months onto the carious surface. Lesion activity was assessed by the visual-tactile examination. Baseline and follow-up examinations were conducted by the same examiner. The children's demographic background, oral health-related habits, and oral hygiene practices, as well as parental satisfaction with children's dental appearance were collected at baseline and the 12-month follow-up.

RESULTS

At baseline, 153 and 149 children were recruited in Group 1 and Group 2, respectively. The mean dmfs scores in Groups 1 and 2 were 8.89 and 9.79, respectively. After 12 months, 87.1% remained in the study. The caries arrest rate of Group 1 (35.7%) was significantly higher than that of Group 2 (20.9%) (p < 0.001). The results of the multilevel logistic regression analysis confirmed that the treatment in Group 1 was more effective in arresting dentin carious lesions than that of Group 2 (OR = 2.04; 95% CI, 1.41-2.96). The presence of plaque on caries lesions, tooth type, tooth surface type, frequency of milk feeding, snack taking, and family income influenced on caries activity. Regardless of the intervention groups, there were no differences in parental satisfaction with on the child's dental appearance before and after receiving the intervention.

CONCLUSION

Based on the 12-month results, 38% SDF is more effective than 5% NaF varnish in arresting dentin carious lesions in young children. SDF has no negative impact on parental satisfaction with the child's dental appearance.

CLINICAL SIGNIFICANCE

To control dentin carious lesions in young children with high caries risk, 38% SDF is more effective than 5% NaF varnish.

摘要

目的

本研究旨在比较 38% 氟化银（SDF）溶液和 5% 氟化钠（NaF）涂料每半年应用于高龋风险幼儿的窝沟龋的疗效。

方法

纳入至少有一个活跃的牙本质龋损的 1-3 岁儿童，随机分为 2 组：组 1=38% SDF（Topamine），组 2=5% NaF 涂料（Duraphat）。两组均将药物每 6 个月涂在龋损表面。通过视觉-触觉检查评估病变活动度。基线和随访检查由同一名检查者进行。在基线和 12 个月随访时收集儿童的人口统计学背景、口腔健康相关习惯、口腔卫生习惯以及家长对儿童牙齿外观的满意度。

结果

基线时，组 1 和组 2 分别纳入 153 名和 149 名儿童。组 1 和组 2 的平均 dmfs 评分分别为 8.89 和 9.79。12 个月后，87.1%的儿童仍在研究中。组 1（35.7%）的龋齿抑制率明显高于组 2（20.9%）（p<0.001）。多水平逻辑回归分析结果证实，组 1 的治疗在抑制牙本质龋损方面比组 2 更有效（OR=2.04；95%CI，1.41-2.96）。菌斑在龋损上的存在、牙齿类型、牙齿表面类型、喂奶频率、吃零食频率和家庭收入影响龋病的活动。无论干预组如何，在接受干预前后，家长对孩子牙齿外观的满意度没有差异。