Sihra Rena, Schroth Robert J, Bertone Mary, Martin Heather, Patterson Brayden, Mittermuller Betty-Ann, Lee Victor, Patterson Brayden, Moffatt Michael Ek, Klus Bradley, Fontana Margherita, Robertson Lawrence
J Can Dent Assoc. 2020 Jun;86:k9.
To investigate the efficacy of silver diamine fluoride (SDF) with 5% fluoride varnish (FV) in treating cavitated caries in young children and to explore the association between SDF treatment and oral-health-related quality of life (OHRQoL).
Children with active dentinal caries in primary teeth underwent treatment with 38% SDF and 5% FV at baseline and 4 months later. Treated lesions were assessed 4 and 8 months after baseline. Child-level analysis focused on classifying SDF treatment as completely successful if all of a child's treated lesions were arrested or incompletely successful if at least 1 lesion was not arrested. The Early Childhood Oral Health Impact Scale questionnaire was completed at second and third visits. Statistical analyses included descriptive and bivariate methods. A p value ≤ 0.05 was considered significant.
This pilot study enrolled 40 children with 239 caries lesions; mean age 40.2 ± 14.9 months and 45% male. Lesion arrest rates after 1 and 2 applications of SDF were 74.1% and 96.2%, respectively. Children who reportedly brushed twice daily were more likely to be in the completely successful group compared with those who brushed less (p = 0.006). Those in the completely successful group had a significantly lower mean baseline dmft score than those in the incompletely successful group (p = 0.048). No significant difference in OHRQoL was observed between the 2 groups.
SDF with 5% FV is an effective approach to the management of early childhood caries; more than 1 application is recommended, along with regular follow up of patients and twice daily brushing. OHRQoL was not found to be affected by the level of success of SDF treatment.
探讨含5%氟化物的氟化银（SDF）与氟化物漆（FV）联合治疗幼儿龋洞型龋齿的疗效，并探究SDF治疗与口腔健康相关生活质量（OHRQoL）之间的关联。
患有乳牙活动性牙本质龋的儿童在基线时以及4个月后接受38% SDF和5% FV治疗。在基线后的4个月和8个月对治疗后的病变进行评估。儿童层面的分析重点在于，如果儿童所有治疗的病变均得到控制，则将SDF治疗分类为完全成功；如果至少有1个病变未得到控制，则分类为不完全成功。在第二次和第三次就诊时完成幼儿口腔健康影响量表问卷调查。统计分析包括描述性和双变量方法。p值≤0.05被认为具有统计学意义。
这项前瞻性研究纳入了40名患有239颗龋损的儿童；平均年龄为40.2±14.9个月，男性占45%。SDF应用1次和2次后的病变控制率分别为74.1%和96.2%。据报道，每天刷牙两次的儿童比刷牙次数较少的儿童更有可能处于完全成功组（p = 0.006）。完全成功组的平均基线dmft评分显著低于不完全成功组（p = 0.048）。两组之间在OHRQoL方面未观察到显著差异。
含5% FV的SDF是治疗幼儿龋齿的有效方法；建议进行1次以上的治疗，并对患者进行定期随访以及每天刷牙两次。未发现OHRQoL受SDF治疗成功程度的影响。
