Silver Diamine Fluoride Effectiveness in Arresting Early Approximal Carious Lesions

Objectives: Objectives: The aim of this study is to evaluate the effectiveness of Silver Diammine Fluoride (SDF) in arresting initial non-cavitated approximal carious lesion in adults utilizing subtraction radiography techniques.

Methods: Methods: This study is a randomized, double blinded, placebo-controlled clinical trial (ClinicalTrials.gov identifier-NCT02591147). The study population consists of adults aged 21-64 years old seeking care at the University of Iowa College of Dentistry. Eligible for the study included having at least one initial non-cavitated approximal posterior carious lesion (Radiologic scores RA1, RA2, or RA3 using the International Caries Classification and Management System (ICCMS) scoring system) (Figure 1) that is in contact with adjacent non-restored tooth surface.
Participants were randomly assigned to one of the two treatment groups and one randomly selected lesion received the following treatment: Group 1: conventional fluoride varnish application along with SDF every 6 month; Group 2: conventional fluoride varnish along with Placebo (water). Participants were prescribed Prevident® toothpaste. Participants completed a baseline diet and caries risk questionnaires.
The selected lesion will be followed up for 24 months every 6 months. Radiographic lesion progression is monitored by digital subtraction radiography.
Baseline measures and outcome data were assessed through direct reporting, clinical examination including blinded subtraction radiographic assessment, diet and caries risk questionnaires, and participant acceptability of the treatment

Results: Results: Results reported are from the ongoing two-year clinical trial still in enrollment. To date, 21 subjects have been enrolled. Fourteen were assigned to one group while seven were assigned to the other group. 16 subjects were females (64%). Mean age was 38.71±12.07 years. Mean Decayed, Missing, Filled Teeth (DMFT) was 15.33±1.52. No complaints were reported by the subjects so far.

Conclusions: Conclusions: Preliminary findings suggest that SDF is a reasonable option to treat initial approximal lesions. Future results will provide quantitative information on the progression of the lesions when SDF is used.