Topical Silver Diamine Fluoride for Dental Caries Arrest in Preschool Children: A Randomized Controlled Trial

摘要: Author(s): Milgrom, Peter; Horst, Jeremy; Ludwig, Sharity; Rothen, Marilynn; Chaffee, Benjamin; Lyalina, Svetlana; Pollard, Katherine; DeRisi, Joseph; Mancl, Lloyd | Abstract: Abstract Objectives: The Stopping Cavities Trial investigated effectiveness and safety of 38% silver diamine fluoride in arresting caries lesions. Materials Methods: Double-blind randomized placebo-controlled superiority trial with 2 parallel groups. Oregon preschools. 66 preschool children ≥1 lesion. or placebo (blue-tinted water), applied topically to the primary endpoint was arrest (lesion inactivity, Nyvad criteria) 14- 21 days post intervention. Dental plaque collected from all children, microbial composition assessed by RNA sequencing lesions 1 unaffected surface before treatment at follow-up for 3 each group. Results Conclusion: Mean fraction arrested group higher (0.72; 95% CI; 0.55, 0.84) than (0.05; 0.00, 0.16). Confirmatory analysis using generalized estimating equation log-linear regression, accounting number treated surfaces length follow-up, indicated significantly (relative risk, 17.3; CI: 4.3 69.4). No harms were observed. identified no consistent changes relative abundance caries-associated microbes, nor emergence antibiotic metal resistance gene expression. Topical effective safe cavities children. is applicable care practice may reduce burden untreated tooth decay population. Registration: ClinicalTrials.gov NCT02536040 . Clinical Significance In this clinical trial, 72% fluoride, harms. Contrary presumed antibacterial mechanism, lesion bacterial changed negligibly. This simple topical