Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China.
Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China.
J Dent Res. 2021 Jan;100(1):66-73. doi: 10.1177/0022034520952031. Epub 2020 Aug 31.
This 24-mo randomized controlled trial was based on a double-blind parallel design, and it compared the effectiveness of 2 fluoride application protocols in arresting dentine caries in primary teeth. Three-year-old children with active dentine caries were recruited and randomly allocated to 2 treatment groups. Children in group A received a semiannual application of a 25% silver nitrate (AgNO) solution followed by a commercially available varnish with 5% sodium fluoride (NaF) on the carious tooth surfaces. Children in group B received a semiannual application of a 25% AgNO solution followed by another commercially available varnish with 5% NaF containing functionalized tricalcium phosphate (fTCP). Carious tooth surfaces that were hard when probing were classified as arrested. Intention-to-treat analysis and a hierarchical generalized linear model were undertaken. A total of 408 children with 1,831 tooth surfaces with active dentine caries were recruited at baseline, and 356 children (87%) with 1,607 tooth surfaces (88%) were assessed after 24 mo. At the 24-mo evaluation, the mean (SD) number of arrested carious tooth surfaces per child were 1.8 (2.2) and 2.6 (3.3) for group A (without fTCP) and group B (with fTCP), respectively ( = 0.003). The arrest rates at the tooth surface level were 42% for group A and 57% for group B ( < 0.001). Results of the hierarchical generalized linear model indicated that protocol B (with fTCP) had a higher predicted probability (PP = 0.656) in arresting dentine caries than protocol A (without fTCP; PP = 0.500) when the carious lesions were on buccal/lingual surfaces, were on anterior teeth, had dental plaque coverage, and were in children from low-income families ( = 0.046). In conclusion, protocol B, which applied a 25% AgNO solution followed by a commercially available 5% NaF varnish with fTCP semiannually, is more effective in arresting dentine caries in primary teeth as compared with protocol A, which applied a 25% AgNO solution followed by another commercially available 5% NaF varnish without fTCP semiannually (ClinicalTrials.gov NCT03423797).
本 24 个月随机对照试验采用双盲平行设计，比较了两种氟化物应用方案在控制乳牙龋齿进展方面的有效性。招募了患有活动性牙本质龋的 3 岁儿童，并将其随机分配到 2 个治疗组。组 A 的儿童每半年接受一次 25%硝酸银（AgNO）溶液处理，然后在龋损牙面使用市售的含有 5%氟化钠（NaF）的漆；组 B 的儿童每半年接受一次 25%AgNO 溶液处理，然后在龋损牙面使用另一种市售的含有功能化磷酸三钙（fTCP）的 5%NaF 漆。当探诊时发现牙面坚硬时，将其分类为被抑制。进行意向治疗分析和分层广义线性模型分析。在基线时共招募了 408 名患有 1831 个活跃牙本质龋的儿童，其中 356 名（87%）儿童的 1607 个牙面（88%）在 24 个月后进行了评估。在 24 个月的评估中，组 A（无 fTCP）和组 B（有 fTCP）每个儿童的平均（SD）被抑制龋坏牙面数量分别为 1.8（2.2）和 2.6（3.3）（ = 0.003）。组 A 的牙面抑制率为 42%，组 B 为 57%（ < 0.001）。分层广义线性模型的结果表明，当龋损位于颊/舌面、位于前牙、有牙菌斑覆盖且来自低收入家庭时，方案 B（含 fTCP）比方案 A（无 fTCP）有更高的龋齿抑制概率（PP = 0.656）（PP = 0.500； = 0.046）。总之，与每半年应用 25%AgNO 溶液后应用另一种市售的不含 fTCP 的 5%NaF 漆相比，每半年应用 25%AgNO 溶液后应用市售的含有 fTCP 的 5%NaF 漆能更有效地抑制乳牙的牙本质龋进展（ClinicalTrials.gov NCT03423797）。
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