目的:虽然二氟化银已被广泛用于龋齿阻滞和脱敏,在中性pH下的氟化银(AgF)也可具有作为微创龋齿治疗的价值。这项研究探讨了两种AgF产品(AgF/KI和AgF/SnF2)在患有高龋齿风险和唾液腺功能减退的成年患者中使用的有效性。
方法:这项裂口临床研究,两个约会相隔3个月,比较了单一应用AgF/KI(RivaStarAqua,SDI)和AgF/SnF2(Creighton牙科CSDS,Whiteley)在同一足弓上匹配的龋齿病变上,通过临床视觉触觉(cVT)评估龋齿状态和激光荧光(LF,诊断)评估病变中的细菌负荷,使用重复测量分析。
结果:研究招募了12名参与者。总共包括56颗牙齿(28对)。如通过cVT(P<0.0001)和LF(P=0.0027)测量的,两种AgF产物均给出龋齿活性的显著降低。两种AgF处理间无统计学差异,AgF/KI组活动性病变改善的反应率为92%,和96%的AgF/SnF2臂。牙齿类型没有影响,病变类型,拱形类型,斑块代谢和斑块面积在站点水平上的结果,在患者水平分析中也不存在站点的聚类效应.总的来说,LF优于cVT,用于检测尽管治疗仍进展的病变(P=0.0027)。
结论:单独应用AgF/KI或AgF/SnF2对于患有SN和高龋齿风险的成年患者的活动性龋齿病变停止具有很高的可预测性(超过90%)。临床评估应使用视觉触觉检查结合LF读数来检测仍在进展且需要额外治疗的病变。未来的研究应该将这些AgF模式与SDF进行比较,并探索应用之间的时间和重复应用的需要等因素。
背景:该研究于2021年8月23日在澳大利亚临床试验注册中心(ACTRN12621001139864p)注册。
OBJECTIVE: While silver diamine fluoride has been used extensively for caries arrest and desensitising, silver fluoride (AgF) at neutral pH may also have value as a minimally invasive dental caries treatment. This study explored the effectiveness of two AgF products (AgF/KI and AgF/SnF2) when used in adult patients with special needs (SN) who had high caries risk and salivary gland hypofunction.
METHODS: This split-mouth clinical study, over two appointments 3-months apart, compared the impact of a single application of AgF/KI (Riva Star Aqua, SDI) and AgF/SnF2 (Creighton Dental CSDS, Whiteley) on matched carious lesions in the same arch, by clinical visual-tactile (cVT) assessment of caries status and laser fluorescence (LF, DIAGNOdent) evaluation of bacterial load in the lesions, using repeated measures analysis.
RESULTS: Twelve participants were recruited in the study. A total of 56 teeth (28 pairs) were included. Both AgF products gave a significant decrease in caries activity as measured by cVT (P < 0.0001) and LF (P = 0.0027). There were no statistically significant differences between the two AgF treatments, with response rates for improvements in active lesions of 92% in the AgF/KI arm, and 96% in the AgF/SnF2 arm. There was no effect of tooth type, lesion type, arch type, plaque metabolism and plaque area at the site level on outcomes, nor was there a clustering effect of sites in a patient level analysis. Overall, LF was superior to cVT for detecting lesions that still progressed despite treatment (P = 0.0027).
CONCLUSIONS: A single application of AgF/KI or AgF/SnF2 has high predictability (over 90%) for achieving arrest in active caries lesions in adult patients with SN and high caries risk. Clinical assessment should use visual-tactile examination combined with LF readings to detect lesions that are still progressing and that require additional treatments. Future studies should compare these AgF modalities with SDF and explore factors such as time between applications and the need for repeated applications.
BACKGROUND: The study was registered with the Australian Clinical Trials Registry (ACTRN12621001139864p) on 23/08/2021.