氟化亚银和纳米银对幼儿龋患儿唾液细菌计数的影响：一项随机对照临床试验。

Effect of silver diamine fluoride and nanosilver on salivary bacterial counts in children with early childhood caries: a randomized controlled clinical trial.

作者信息

Ammar Nour, El-Tekeya Magda M, Talat Dalia M, Essa Sara, Essawy Marwa M, Kühnisch Jan, Hamed Hams, Nabil Nouran, Achy Samar El, Tantawi Maha El

机构信息

Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21521, Egypt.

Department of Medical Microbiology and Immunology, Faculty of Medicine, Alexandria University, Alexandria, 21521, Egypt.

出版信息

BMC Oral Health. 2025 Jun 9;25(1):945. doi: 10.1186/s12903-025-06325-3.

DOI:10.1186/s12903-025-06325-3

PMID:40490725

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12150551/

Abstract

BACKGROUND

Silver diamine fluoride (SDF) is indicated for the management of early childhood caries (ECC). Similarly, nanosilver fluoride (NSF) is effective against caries. However, there are limited comparisons between both agents, especially regarding their antibacterial effect. This randomized controlled clinical trial aimed to compare the effects of SDF and NSF on salivary bacterial counts in children with ECC.

METHODS

Fifty 4-6-year-olds presenting with active dentin caries (ICDAS code 5) in primary teeth were randomly allocated to two groups. Streptococcus mutans (S. mutans) and Lactobacilli in unstimulated saliva were cultivated on differential media and counted as colony-forming units. Followed by the application of either 38% SDF or NSF. Saliva samples were recollected after one month. The legal guardians completed a detailed questionnaire assessing their child's dental hygiene habits, dental pain experience, and socioeconomic background. Multivariable binary logistic regression was used to assess the effects of both agents on bacterial counts while accounting for confounders.

RESULTS

The mean age of participants was 4.8 ± 0.8 years, with the majority (96%, N = 48) presenting with severe ECC. There were no statistically significant differences between the two groups regarding age, sex, dmft score, socioeconomic background, dental hygiene habits, or dental experience. After one month, within-group analysis showed a significant reduction in S. mutans only in the NSF group (p = 0.002) and significant decreases in Lactobacilli counts in both SDF and NSF groups (p < 0.05). However, between-group comparisons revealed no significant differences in the reduction of S. mutans (1.4% and 6.0%, respectively, p = 0.192) or Lactobacilli counts (6.0% and 6.0%, respectively, p = 0.754). Regression analyses revealed non-significant odds of reduced bacterial counts after NSF application compared to SDF.

CONCLUSION

After one application, children with ECC showed significant decrease in salivary bacteria, with no difference between the two agents regarding their antibacterial effect. NSF can serve as a viable option in ECC management in that it provides comparable antibacterial effects to 38% SDF without inducing tooth discoloration. This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT05221749 on 03/02/2022.

摘要

背景

氟化亚锡（SDF）适用于幼儿龋齿（ECC）的管理。同样，纳米氟化银（NSF）对龋齿也有效。然而，这两种药物之间的比较有限，尤其是在它们的抗菌效果方面。这项随机对照临床试验旨在比较SDF和NSF对ECC儿童唾液细菌计数的影响。

方法

50名4至6岁乳牙患有活动性牙本质龋（国际龋病检测与评估系统代码5）的儿童被随机分为两组。在鉴别培养基上培养未刺激唾液中的变形链球菌（S. mutans）和乳酸杆菌，并计为菌落形成单位。随后应用38%的SDF或NSF。一个月后收集唾液样本。法定监护人完成一份详细问卷，评估其孩子的口腔卫生习惯、牙痛经历和社会经济背景。多变量二元逻辑回归用于评估两种药物对细菌计数的影响，同时考虑混杂因素。

结果

参与者的平均年龄为4.8±0.8岁，大多数（96%，N = 48）患有严重的ECC。两组在年龄、性别、dmft评分、社会经济背景、口腔卫生习惯或牙科经历方面没有统计学上的显著差异。一个月后，组内分析显示仅NSF组的变形链球菌显著减少（p = 0.002），SDF组和NSF组的乳酸杆菌计数均显著减少（p < 0.05）。然而，组间比较显示变形链球菌减少量（分别为1.4%和6.0%，p = 0.192）或乳酸杆菌计数减少量（分别为6.0%和6.0%，p = 0.754）没有显著差异。回归分析显示，与SDF相比，应用NSF后细菌计数减少的几率无显著差异。