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Lasers in Medical Science

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Open Access 01-12-2024 | Caries | Original Article

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs– a preliminary report

Authors: Lydia See, Sobia Zafar, David Fu, Diep H. Ha, Laurence J. Walsh, Claudia Lopez Silva

Published in: Lasers in Medical Science | Issue 1/2024

Abstract

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.

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Title: Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs– a preliminary report
Authors: Lydia See
Sobia Zafar
David Fu
Diep H. Ha
Laurence J. Walsh
Claudia Lopez Silva
Publication date: 01-12-2024
Publisher: Springer London
Keywords: Caries
Laser
Published in: Lasers in Medical Science / Issue 1/2024
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-024-04038-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laser fluorescence assessment of dental caries arrest with two silver fluoride agents in patients with special needs– a preliminary report

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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