A Randomized Clinical Trial to Assess Caries Arrest by Using Silver Diamine Fluoride in U.S. Children: Interim Findings.

Pediatric dentistry Pub Date : 2024-01-15
Margherita Fontana, Divya Khera, Steven Levy, George Eckert, Barry Katz, Emily Yanca, Carlos González-Cabezas, Amr Moursi
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Abstract

Purpose: To assess the effectiveness of 38 percent silver diamine fluoride (SDF) in arresting cavitated caries lesions in young U.S. children. Methods: Children 12 to 71 months of age with severe early childhood caries participated in this phase three, multicenter, randomized, placebocontrolled trial. SDF was applied twice (at baseline and six months), and children were followed for eight months. A planned interim analysis of only the six-month primary outcome caries arrest data, for approximately half of the cohort (680 of 1,144 children), was conducted using a generalized estimating equation model, accounting for non-independence among carious lesions within a patient. Results: Five hundred ninety-nine of the 680 participants, with 1,413 lesions, completed the six-month exam. Lesions in the SDF group demonstrated 54 percent arrest versus 21 percent in the placebo (P<0.001). Conclusions: Silver diamine fluoride was effective at arresting active cavitated lesions in this population, leading to the early stop of the trial. Final analyses of all data and other outcomes are currently underway.

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评估美国儿童使用二胺氟化银预防龋齿的随机临床试验:中期研究结果。
目的:评估浓度为 38% 的二胺氟化银 (SDF) 在抑制美国幼儿龋齿病变方面的效果。方法:对 12 到 71 个月大的患有严重早期龋齿的儿童进行这项研究:年龄在 12 到 71 个月之间、患有严重早期龋齿的儿童参加了这项第三阶段多中心、随机、安慰剂对照试验。SDF 应用两次(基线期和六个月期),对儿童进行为期八个月的随访。计划中的中期分析只针对6个月的主要结果龋齿抑制数据进行,分析对象为大约一半的群体(1,144名儿童中的680名),分析采用了广义估计方程模型,考虑到了患者体内龋齿病变之间的非独立性。研究结果680 名参与者中有 599 人完成了为期 6 个月的检查,共发现 1,413 个病变。二胺氟化银组的病变停止率为 54%,而安慰剂组为 21%(结论:二胺氟化银能有效抑制龋齿的形成:二胺氟化银能有效抑制该人群中的活动性龋损,因此试验提前结束。目前正在对所有数据和其他结果进行最终分析。
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