Efficacy and acceptance of treatment for initial approximal caries lesions using silver diamine fluoride in adolescents: a randomized placebo-controlled study

Author(s)

Fernanda Rosche Ferreira

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia (FO/SDO)
• Defense date: 2016-06-15

Examining board members

Mariana Minatel Braga Fraga; Fausto Medeiros Mendes; Tatiane Fernandes de Novaes; Linda Wang

• Advisor: Mariana Minatel Braga Fraga

Abstract

Detecting caries lesion in earliest stages is a current proposal to early intervention and control of caries lesions in order to avoid its progression and to prevent the cavitation. Randomized clinical trials (RCT) are essential to test the efficacy of these products for this purpose. In this sense, a RCT to test the efficacy of silver diamine fluoride (SDF) compared to resin infiltration and the mechanical control of the biofilm through daily use floss (control group) on proximal surfaces of permanent posterior teeth in adolescents. Since the treatments present very different complexities and the patient may be influenced and neglect to flossing compliance because of that, we chose to carry out placebo treatments to help in blinding the patients. The first paragraph was written, to validate this methodology and verify if the discomfort reported by the patient during the placebo treatment influenced the discomfort related to the active treatment. In the second chapter, we performed some analyses focused on outcomes collected immediately after the treatments in order to very adolescent\'s discomfort and parental satisfaction with treatments and also an interim analysis, including approximately half of the sample (patients who had completed more than six months follow-up) to test the progression of caries lesions treated using nonsurgical techniques. Possible risks/benefits to participants were evaluated to check the possibility of concluding the study, since the primary outcome (caries progression) a long-term outcome, mainly in permanent teeth. This dissertation may contribute to showing differences regarding acceptability (reported discomfort) related to different options clinically available and, also, evidencing the impact of a new methodology to controlling the study, looking for similar patients\' compliance with flossing when therapies for proximal caries control are tested. Finally, we could predict our study should be probably extended to permit more realistic data about the efficacy of mentioned treatments. (AU)

• FAPESP's process: 14/00271-7 - Cost-efficacy and adolescents' acceptability in treating initial approximal caries lesions using diammine silver fluoride: a randomized controlled clinical trial
• Grantee: Fernanda Rosche Ferreira
• Support Opportunities: Scholarships in Brazil - Master