Dr. Polacek, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich., USA.
Dr. Malhi are pediatric dental residents, Pediatric Dentistry Graduate Program, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich., USA.
Pediatr Dent. 2021 Nov 15;43(6):475-480.
The purpose of this study was to evaluate the progression of incipient approximal caries lesions in permanent teeth of children and adolescents with and without silver diamine fluoride (SDF) application. A retrospective analysis of dental records and radiographs was performed. Baseline and follow-up bitewing radiographs were evaluated and scored using International Caries Classification and Management System (ICCMS) criteria to assess lesion progression. A total of 131 lesions from 68 subjects (mean age equals 9.6 years) were evaluated radiographically and followed for up to 41 months (mean time equals 13.61±6.8 months); 23.6 percent of lesions in the SDF group progressed compared to 38.1 percent in the control group (P<0.001). On average, lesions in the control group increased more per month compared to the study group (P<0.001). The odds of lesion progression in the control group were 2.76 times the odds of progression in the study group. There was a statistically significant difference in lesion progression based on application method; lesions where SDF was applied with Superfloss progressed more per month, on average, versus microbrush application. Silver diamine fluoride may be an effective therapy to slow caries progression of incipient approximal lesions in permanent teeth in high caries-risk populations. Future studies are needed to detect differences in application methods.
本研究旨在评估在应用和不应用银胺氟化物（SDF）的情况下，儿童和青少年恒前牙初期邻面龋损的进展情况。对牙科记录和射线照片进行了回顾性分析。使用国际龋分类和管理系统（ICCMS）标准评估基线和随访的翼片射线照片，并对病变进展进行评分。共评估了 68 名受试者（平均年龄为 9.6 岁）的 131 个病变，随访时间长达 41 个月（平均时间为 13.61±6.8 个月）；SDF 组中有 23.6%的病变进展，而对照组中有 38.1%的病变进展（P<0.001）。平均而言，对照组的病变每月增加的速度比研究组更快（P<0.001）。对照组病变进展的几率是研究组的 2.76 倍。根据应用方法，病变进展存在统计学差异；与微刷应用相比，使用 Superfloss 应用 SDF 的病变每月进展更多。银胺氟化物可能是一种有效的治疗方法，可减缓高龋风险人群恒前牙初期邻面龋损的进展。需要进一步研究来检测不同的应用方法。
