Purpose

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).

Conclusion

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.

Trial registration

The study was registered with the Australian Clinical Trials Registry (ACTRN12621001139864p) on 23/08/2021.

中文翻译：

---

激光荧光评估两种氟化银制剂对有特殊需要的患者的龋齿抑制效果——初步报告

目的

虽然二胺氟化银已广泛用于防龋和脱敏，但中性 pH 值的氟化银 (AgF) 也可能具有作为微创龋齿治疗的价值。本研究探讨了两种 AgF 产品（AgF/KI 和 AgF/SnF ₂）用于具有高龋齿风险和唾液腺功能低下的特殊需要 (SN) 成年患者的有效性。

方法

这项分口临床研究在相隔 3 个月的两次预约中进行，比较了单次应用 AgF/KI（Riva Star Aqua，SDI）和 AgF/SnF ₂（Creighton Dental CSDS，Whiteley）对匹配龋损的影响。同一牙弓，通过临床视觉触觉（cVT）评估龋齿状态和激光荧光（LF、DIAGNOdent）评估病变中的细菌载量，采用重复测量分析。

结果

该研究招募了十二名参与者。总共包括 56 颗牙齿（28 对）。根据 cVT ( P  < 0.0001) 和 LF ( P  = 0.0027) 测量，两种 AgF 产品均显着降低了龋齿活动。两种 AgF 治疗之间没有统计学上的显着差异，AgF/KI 组活动性病变改善的反应率为 92%，AgF/SnF ₂组为 96%。牙齿类型、病变类型、牙弓类型、牙菌斑代谢和位点水平的牙菌斑面积对结果没有影响，在患者水平分析中也没有位点的聚类效应。总体而言，在检测治疗后仍进展的病变方面，LF 优于 cVT（P  = 0.0027）。

结论

单次应用 AgF/KI 或 AgF/SnF ₂对于实现 SN 和高龋齿风险的成年患者活动性龋齿病变的阻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，并探索诸如应用之间的时间和重复应用的需要等因素。

试用注册

该研究于2021年8月23日在澳大利亚临床试验注册中心注册（ACTRN12621001139864p）。