与非创伤性修复治疗相比，30%氟化亚锡在预防学龄前儿童牙本质龋损方面的疗效：一项随机临床试验

Efficacy of 30% silver diamine fluoride compared to atraumatic restorative treatment in arresting dentin caries lesions in preschoolers: a randomized clinical trial.

作者信息

Rodrigues Gabriella Fernandes, Vollú Ana Lúcia, Vargas Tamiris Ramos, Kamp Luana Mota Kort, da Cunha Costa Thuany, Cruz Lais Rueda, Luiz Ronir Raggio, Barja-Fidalgo Fernanda, Fonseca-Gonçalves Andréa

机构信息

Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

出版信息

Clin Oral Investig. 2024 Dec 6;29(1):3. doi: 10.1007/s00784-024-06081-8.

DOI:10.1007/s00784-024-06081-8

PMID:39641816

Abstract

OBJECTIVE

To compare the efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting caries lesions. Variables such as treatment time, adverse effects/parental aesthetic perception, anxiety and patients' behavior were also evaluated.

MATERIALS AND METHODS

Children (3.53 ± 1.03 years) with dentin caries lesions on the occlusal surface of primary molars were randomized into test (SDF) and control (ART) groups. To determine the presence of caries, dmf-t and ICDAS indexes were used. Caries lesions were also classified according to activity (active or inactive). The time required to perform treatments was recorded and the children's anxiety was assessed by a Facial Image Scale. The adverse events/aesthetic perception were registered by the operator and caregivers. The Frankl Behavioral Scale assessed patients' behavior. The chi-square/Fisher's exact and Mann-Whitney tests were used for comparisons between the groups.

RESULTS

Of the 118 participants who received treatment (SDF, n = 59; ART, n = 59), after 12-month follow-up, 91.5% (43/47) of caries lesions in the SDF and 90.2% (46/51) in the ART group were arrested (p = 1.000). After 24 months, 72% (18/25) were arrested in the SDF group and 95.2% (20/21) in the ART. The treatment times were 6.08 ± 1.72 and 13.58 ± 4.83, for SDF and ART, respectively (p < 0.001). No statistically significant difference of adverse effects, aesthetic perception, anxiety, and patients' behavior were found between the groups.

CONCLUSIONS

SDF was similar to ART in arresting caries lesion but required less time for treatment. The anxiety, adverse effects/aesthetic perception and patients' behavior were also similar between the groups. CLINICAL RELEVANCE: The use of SDF may be a faster and less invasive alternative for the treatment of caries lesions. Clinical trial registration number and date of registration: NCT03063307. September 2016.

摘要

目的

比较氟化亚锡（SDF）和非创伤性修复治疗（ART）在阻止龋损方面的疗效。还评估了治疗时间、不良反应/家长美学认知、焦虑和患者行为等变量。

材料与方法

将患有乳牙磨牙咬合面牙本质龋损的儿童（3.53±1.03岁）随机分为试验组（SDF）和对照组（ART）。使用dmf-t和国际龋病检测与评估系统（ICDAS）指数来确定龋病的存在情况。龋损还根据活动性（活动或静止）进行分类。记录治疗所需时间，并通过面部图像量表评估儿童的焦虑程度。由操作人员和护理人员记录不良事件/美学认知情况。使用弗兰克行为量表评估患者行为。采用卡方检验/费舍尔精确检验和曼-惠特尼检验进行组间比较。

结果

在接受治疗的118名参与者中（SDF组，n = 59；ART组，n = 59），12个月随访后，SDF组91.5%（43/47）的龋损和ART组90.2%（46/51）的龋损得到阻止（p = 1.000）。24个月后SDF组72%（18/25）的龋损得到阻止，ART组为95.2%（20/21）。SDF组和ART组的治疗时间分别为6.08±1.72和13.58±4.83（p < 0.001）。两组在不良反应情况、美学认知、焦虑和患者行为方面均未发现统计学上的显著差异。