AlKhodier Haifa, Molla Ghadeer, AlAjaji Nouf, Alkanhal Nuha A, AlSaykhan Mona
Pediatric Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU.
General Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, SAU.
Cureus. 2023 Aug 23;15(8):e44010. doi: 10.7759/cureus.44010. eCollection 2023 Aug.
This research was conducted to further support previous studies on the effectiveness of 38% silver diamine fluoride on caries arrest. In addition, the number of applications, time between subsequent applications, type of teeth (primary vs. permanent), final restoration following treatment, and the type of restoration, if any, were assessed. It is a retrospective longitudinal study that was conducted using a chart review technique for which a waiver of informed consent was obtained. The research participants' privacy was ensured and protected. All participants' identities remained anonymous and confidential. Furthermore, consent was collected from participants' sitters during their appointments as a protocol prior to applying 38% silver diamine fluoride (SDF). The current research was reviewed and approved by the Research Ethics Committee at King Faisal Specialist Hospital and Research Center (KFSH&RC). All investigators abided by the rules and regulations of the Government of Saudi Arabia, KFSH&RC, and the Research Advisory Council. A population of pediatric patients with primary and/or mixed dentition at a tertiary care hospital who were treated at the dental office between the period from March 2020 to December 2022 were recruited. A consecutive non-random sampling technique was used. The inclusion criteria include cavitated, asymptomatic, and teeth with no signs or symptoms of pulpal involvement. The sample size estimation was done by considering different percentages of success in arresting dental carries by using 38% SDF, with different levels of precision of 95% confidence intervals and with 0.05 level of significance. A 95% success was assumed in arresting dental carries by using 38% SDF, with a precision of ±5%, and with α=0.05, the required teeth sample size was 101. Anticipating some incomplete information and documentation, the sample size may be dynamic. Nighty-seven teeth both primary and permanent were included in this study. Data were analyzed using IBM SPSS Statistical software version 26.0 (Armonk, NY: IBM Corp.) for Windows. Descriptive statistics (mean standard deviation, frequencies, and percentages) were used to describe the quantitative and categorical outcome variables. Pearson's chi-square test and Fisher's exact test were used to compare the proportion success of 38% SDF in relation to the characteristics of study subjects. The odds ratios were used to quantify the measure of association between the success and other categorical study variables. A binary multiple logistic regression was used to identify the independent variables associated with the success of 38% SDF in arresting dental caries. A p-value of <0.05 and 95% confidence intervals were used to report the statistical significance and precision of results. Our current research concluded that different variables associated with 38% SDF, such as the number of applications and the time-lapse between applications, had no significant effect on the successful results of the application. Moreover, receiving a final restoration did not affect the success of the treatment when compared to treating with 38% SDF alone. Additionally, the type of final restoration had no impact on the prognosis. Further research using standardized protocols for study designs, detection criteria, outcomes, and statistical designs is needed to support findings and establish treatment guidelines.
本研究旨在进一步支持先前关于38%氟化银氨对龋齿抑制效果的研究。此外,还评估了应用次数、后续应用之间的时间间隔、牙齿类型(乳牙与恒牙)、治疗后的最终修复情况以及修复类型(如有)。这是一项回顾性纵向研究,采用图表回顾技术进行,已获得知情同意豁免。研究参与者的隐私得到了确保和保护。所有参与者的身份均保持匿名和保密。此外,作为在应用38%氟化银氨(SDF)之前的一项协议,在参与者就诊期间从其监护人处收集了同意书。本研究经法赫德国王专科医院及研究中心(KFSH&RC)的研究伦理委员会审查并批准。所有研究人员均遵守沙特阿拉伯政府、KFSH&RC和研究咨询委员会的规章制度。招募了2020年3月至2022年12月期间在一家三级护理医院牙科诊所接受治疗的患有乳牙和/或混合牙列的儿科患者群体。采用连续非随机抽样技术。纳入标准包括有龋洞、无症状且无牙髓受累迹象或症状的牙齿。通过考虑使用38% SDF抑制龋齿成功的不同百分比、95%置信区间的不同精度水平以及0.05的显著性水平来进行样本量估计。假设使用38% SDF抑制龋齿的成功率为95%,精度为±5%,α = 0.05,则所需牙齿样本量为101。考虑到可能存在一些不完整的信息和记录,样本量可能会有所变动。本研究纳入了97颗乳牙和恒牙。使用IBM SPSS统计软件26.0版(纽约州阿蒙克:IBM公司)对数据进行分析。描述性统计(均值标准差频率和百分比)用于描述定量和分类结局变量。使用Pearson卡方检验和Fisher精确检验来比较38% SDF相对于研究对象特征的成功比例。优势比用于量化成功与其他分类研究变量之间的关联程度。使用二元多元逻辑回归来确定与38% SDF抑制龋齿成功相关的独立变量。使用p值<0.05和95%置信区间来报告结果的统计学显著性和精度。我们目前的研究得出结论,与38% SDF相关的不同变量,如应用次数和应用之间的时间间隔,对应用的成功结果没有显著影响。此外,与单独使用38% SDF治疗相比,接受最终修复并不影响治疗的成功。此外,最终修复类型对预后没有影响。需要使用标准化方案进行研究设计、检测标准、结局和统计设计的进一步研究来支持研究结果并制定治疗指南。