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Randomized Clinical Trial on Sodium Fluoride with Tricalcium Phosphate.
K J Chen1, S S Gao1, D Duangthip1
1Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR, China.
Journal of Dental Research
|September 1, 2020
Summary
Adding functionalized tricalcium phosphate (fTCP) to a silver nitrate (AgNO3) and sodium fluoride (NaF) varnish significantly improves dentine caries arrest in primary teeth. This enhanced protocol offers a more effective solution for pediatric dental caries management.
Area of Science:
- Pediatric Dentistry
- Cariology
- Dental Materials Science
Background:
- Dentine caries in primary teeth is a prevalent issue requiring effective management strategies.
- Silver nitrate (AgNO3) and sodium fluoride (NaF) varnishes are commonly used for caries arrest.
- The potential benefit of incorporating functionalized tricalcium phosphate (fTCP) into these treatments is under investigation.
Purpose of the Study:
- To compare the effectiveness of two semiannual fluoride application protocols in arresting dentine caries in primary teeth.
- To evaluate the added benefit of functionalized tricalcium phosphate (fTCP) in a silver nitrate (AgNO3) and sodium fluoride (NaF) varnish regimen.
Main Methods:
- A 24-month, double-blind, randomized controlled trial involving 408 three-year-old children with active dentine caries.
- Group A received semiannual applications of 25% AgNO3 followed by 5% NaF varnish (without fTCP).
- Group B received semiannual applications of 25% AgNO3 followed by 5% NaF varnish with fTCP.
Main Results:
- The caries arrest rate at the tooth surface level was significantly higher in Group B (57%) compared to Group A (42%) (P < 0.001).
- The mean number of arrested carious tooth surfaces per child was greater in Group B (2.6) than in Group A (1.8) (P = 0.003).
- Protocol B demonstrated a higher predicted probability of caries arrest, particularly for lesions on buccal/lingual surfaces, anterior teeth, with plaque, and in children from low-income families (P = 0.046).
Conclusions:
- Semiannual application of 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish containing functionalized tricalcium phosphate (fTCP) is more effective in arresting dentine caries in primary teeth.
- The addition of fTCP to the NaF varnish enhances the caries arrest efficacy of the silver nitrate-based protocol.
- This optimized protocol (Protocol B) represents an improved therapeutic option for managing dentine caries in young children.
