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Silver Diamine Fluoride Effectiveness Versus Atraumatic Restorative Treatment in Arresting ECC

Not Applicable
Completed
Conditions
Early Childhood Caries
Interventions
Procedure: ART
Registration Number
NCT04514094
Lead Sponsor
Hams Hamed Abdelrahman
Brief Summary

The study was conducted to evaluate the effectiveness of the biannual application of 38% silver diamine fluoride in arresting early childhood caries when compared to atraumatic restorative treatment.

Detailed Description

Owing to the virulent nature of early childhood caries (ECC) and its consequences if left untreated, immediate intervention is indicated to control the condition.

Barriers to intervention as young age, uncooperative patient behavior and lack of access to dental care are however, very common. The use of silver diamine fluoride as an anticaries agent is of growing popularity worldwide due to its promising results, safety of use, ease of application and relatively low cost. Further research is still required in order to provide evidence-based recommendations regarding the use of SDF in arresting early childhood caries. Purpose: To evaluate the effectiveness of biannual application of 38% silver diamine fluoride in arresting early childhood caries when compared to atraumatic restorative treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • For children:

    1. Healthy children.
    2. Age range 2-5 years.
    3. Informed consent (Appendix I)

For teeth:

  • Teeth with active dentin lesions corresponding to ICDAS II score 5 and 6.
  • Teeth having lesions that are considered active according to ICDAS II activity criteria for coronal primary caries.
Exclusion Criteria
  • For children:

    1. Children with systemic diseases.
    2. Children with reported allergy to silver or to any other component in the materials used.
    3. Children unable to return for recall visits.

For teeth:

  • Clinical or radiographic signs of pulpal involvement.(pain, abscess, sinus, obvious discoloration, premature hypermobility, internal or external root resorption).
  • Teeth with inactive lesions.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Atraumatic Restorative TreatmentARTCaries removal by hand instruments with care not to expose the pulp. * Maximum excavation from the periphery of lesions will be done, to minimize leakage at the restoration margins. * Cotton roll isolation will then be carried out. * Cavities will be restored by glass ionomer cement. * Hand pressure should be applied by a gloved and petroleum jelly coated finger, then, excess material will be removed.
Silver Diamine FluorideSDF* Gross debris will be removed with cotton pellets to allow better SDF contact with denatured dentin. * Cotton rolls will be used to protect surrounding gingival tissues and mucous membranes to avoid pigmentation or irritation. * Affected tooth surfaces will be dried with a gentle flow of air. * 1-2 drops only of SDF will be used for the whole visit. * SDF will then be directly applied to affected tooth surfaces only using a micro sponge brush. * At least one minute will be needed to allow drying of SDF. * Excess SDF will finally be removed with cotton rolls to minimize systemic absorption. * When possible, isolation will be continued for up to three minutes. * After 2-4 weeks: reapplication will be done only to lesions that do not appear arrested (dark and hard).
Primary Outcome Measures
NameTimeMethod
change in clinical success/failure rateat 6 and 12 months

Treated teeth in both groups will be evaluated for clinical success in each follow up appointment. The number of clinically successful/failed teeth will be recorded in

Secondary Outcome Measures
NameTimeMethod
Duration of the intervention visitDuring the procedure

time spent during each intervention appointment was calculated in seconds

Patient Satisfactionafter the 4th week

using a 4-item, 5-level, Likert-scale questionnaire o assess feelings about the application procedure.

Trial Locations

Locations (1)

Faculty of Dentistry, Alexandria University

🇪🇬

Alexandria, Egypt

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