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Cost-efectiveness, children's and parental acceptability of using diammine silver fluoride in arresting enamel caries lesions: a series of randomized clinical trials

Grant number: 12/50716-0
Support type:Regular Research Grants
Duration: June 01, 2013 - June 30, 2015
Field of knowledge:Health Sciences - Dentistry - Pediatric Dentistry
Cooperation agreement: CNPq - First Projects Program
Principal researcher:Mariana Minatel Braga
Grantee:Mariana Minatel Braga
Home Institution: Faculdade de Odontologia (FO). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Although silver diammine fluoride has showed good results in arresting caries lesions, its application in Brazil has been diminished and nowadays, its potential can be underestimated in some clinical situations. Therefore, this study aims to verify the actual possibility of using silver diammine fluoride (SDF) in arresting enamel caries lesions, especially those in which it is difficult to remove local dental biofilm and whose control is complicated. Because of that, five parallel studies will investigate the cost-effectiveness and also children's and parental acceptability of using SDF in order to arrest enamel caries lesions. Ali these studies are focused on controlling caries on sites that present difficulties in controlling dental plaque, which could be a barrier to arresting these lesions only using fluoride toothpaste. Study 1 will verify parental acceptability of SDF using pictures and extracted teeth treated with cariostatic vs. other tooth conditions, as enamel and dentine caries and also sound surfaces. In the Study 2, the SDF will be compared to cross-toothbrushing technique for 1st erupting permanent molars, using a placebo solution for the groups in which the active comparator will be only toothbrushing. In Studies 3 and 4, the SDF will be tested, respectively, in approximal surfaces of primary and permanent molars in order to be compared to a caries lesion infiltrant and also, to the use of dental floss exclusively. Placebo will be also used in these studies. In the Study 5, enamel caries lesions on occlusal surface of primary molars will be treated with SDF in babies. The methodology and systematic will be standardized for all clinical studies. Subjects will be examined in the baseline and followed by 6, 12, 18 and 24 months. As primary outcome, we will consider the caries progression into dentine. Other outcomes will be also set. Visual inspection using ICDAS will be performed. For approximal surfaces, the radiographic examinations will be also done. Visible and mature plaque on the surfaces under evaluation will be assessed. We will evaluate the discomfort and the acceptability reported by children and their parents after treatments, the time and estimated money spent for treating in each situation. We will also collect social and biological data that could be related to effectiveness of techniques. Multilevel analyses will be performed to check which technique will be most effective and possible factors associated to its effectiveness. Discomfort, acceptability and costs will be compared between/among the approaches used to arrest enamel caries lesions. (AU)

Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
LADEWIG, NATHALIA MIRANDA; SAHIARA, CINTIA SAORI; YOSHIOKA, LAYSA; OLEGARIO, ISABEL CRISTINA; FLORIANO, ISABELA; TEDESCO, TAMARA KERBER; MENDES, FAUSTO MEDEIROS; BRAGA, MARIANA MINATEL; RAGGIO, DANIELA PROCIDA. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial. BMJ OPEN, v. 7, n. 7 JUL 2017. Web of Science Citations: 4.
MATTOS-SILVEIRA, J.; MATOS-LIMA, B. B.; OLIVEIRA, T. A.; JARROUG, K.; REGO, R. V.; REYES, A.; FERREIRA, F. R.; IMPARATO, J. C.; BRAGA, M. M. Why do children and adolescents neglect dental flossing?. EUROPEAN ARCHIVES OF PAEDIATRIC DENTISTRY, v. 18, n. 1, p. 45-50, FEB 2017. Web of Science Citations: 0.
MATTOS-SILVEIRA, JULIANA; FLORIANO, ISABELA; FERREIRA, FERNANDA R.; VIGANO, MARIA EDUARDA F.; MENDES, FAUSTO M.; BRAGA, MARIANA M. Children's discomfort may vary among different treatments for initial approximal caries lesions: preliminary findings of a randomized controlled clinical trial. International Journal of Paediatric Dentistry, v. 25, n. 4, p. 300-304, JUL 2015. Web of Science Citations: 9.
MATTOS-SILVEIRA, JULIANA; FLORIANO, ISABELA; FERREIRA, FERNANDA R.; VIGANO, MARIA E. F.; FRIZZO, M. A.; REYES, ALESSANDRA; NOVAES, TATIANE F.; MORIYAMA, CAROLINE M.; RAGGIO, DANIELA P.; IMPARATO, JOSE C. P.; MENDES, FAUSTO M.; BRAGA, MARIANA M. New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial. Trials, v. 15, NOV 19 2014. Web of Science Citations: 6.

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