Roseman University of Health Sciences, College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, UT, 84095, USA.
Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA, 98195-7475, USA.
J Dent. 2021 Feb;105:103561. doi: 10.1016/j.jdent.2020.103561. Epub 2020 Dec 24.
The authors conducted a case series to determine arrest of root surface caries lesions in older adults when teeth were treated topically with 38 % silver diamine fluoride (SDF).
The study was a prospective, single center case series. The patients were 62 older adults (age ≥55 years) who sought treatment at a dental school clinic. To be included, a patient needed to have at least one active root caries lesion. Lesions were rinsed and then dried with air, isolated, and then 38 % SDF was applied for two minutes with a microbrush. Treated lesions were re-evaluated at 2-3 weeks. Treatment was repeated every six months. Survival analysis methods for clustered data were used to estimate the caries lesion arrest probability over time separately for root surfaces and at crown margins.
Fifty-five participants returned for follow-up (44 % female, mean age (SD) 79.8 (7.4)). The probability of a lesion arresting with treatment ranged from 82.9 to 91.6%. Arrest rates at 18 months were slightly higher in root surfaces than around crown margins, 91.6 % (95 % CI 69.1-97.1) versus 89.8 % (95 % CI 71.6-96.3). All furcal lesions (n = 7) were arrested by 6 months, 100 % (95 % CI 59-100).
Repeated application of 38 % SDF at 6-month intervals was effective in arresting decay of root surface lesions and lesions around crowns in older adults. Study outcomes support SDF treatment for older adult patients who are frail and residing in nursing homes or dependent living facilities.
作者进行了一系列病例研究，以确定在老年人的根面龋损处局部使用 38%的氟化银（SDF）治疗时，这些龋损是否会停止发展。
这是一项前瞻性、单中心的病例系列研究。研究对象为在牙科学院诊所就诊的 62 名老年患者（年龄≥55 岁）。患者需要至少有一个活跃的根面龋损才能被纳入研究。对病变处进行冲洗、风干，隔湿后用微型牙刷将 38%SDF 涂抹于病变处 2 分钟。治疗后 2-3 周进行复查。每 6 个月重复治疗。采用聚集数据的生存分析方法分别估算根面和牙冠边缘的龋损停止发展的概率。
55 名参与者（44%为女性，平均年龄（标准差）79.8（7.4）岁）返回进行了随访。治疗后病变停止发展的概率为 82.9%-91.6%。18 个月时，根面的病变停止发展率略高于牙冠边缘，分别为 91.6%（95%CI 69.1-97.1）和 89.8%（95%CI 71.6-96.3）。所有根分叉处病变（n=7）在 6 个月时全部停止发展，停止发展率为 100%（95%CI 59-100）。
每隔 6 个月重复使用 38%SDF 可有效控制老年人根面病变和牙冠边缘病变的进展。研究结果支持对体弱、居住在疗养院或依赖生活设施的老年患者进行 SDF 治疗。
