Treatment of Initial Caries Lesions on Proximal Surfaces of Primary and Permanent Posterior Teeth - Full Text View

Purpose

This study aims to evaluate the effectiveness of 30% silver diamine fluoride in the treatment of clinically caries lesions in enamel, with radiographic image restricted to the enamel or the outer third of dentin on the proximal surfaces of primary and permanent posterior teeth. It also aims to compare it to the resin infiltration and to the control of proximal biofilm through the oral hygiene.

Condition	Intervention
Dental Caries Compliance Behavior	Procedure: Resin Infiltration Procedure: 30% Silver Diammine Fluoride Procedure: Dental Flossing Procedure: Resin Infiltration Placebo Procedure: 30% Silver Diammine Fluoride Placebo


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Treatment of Initial Caries Lesions on Proximal Surfaces of Primary and Permanent Posterior Teeth: a Randomized Placebo-controlled Study.

Resource links provided by NLM:

MedlinePlus related topics: Dental Health Tooth Decay

Drug Information available for: Fluorine Fluoride

U.S. FDA Resources

Further study details as provided by University of Sao Paulo:

Primary Outcome Measures:

progression of initial lesion caries [ Time Frame: 12 and 24 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

approximal plaque reduction [ Time Frame: 1, 3, 6, 12, 18 and 24 months ] [ Designated as safety issue: Yes ]


Estimated Enrollment:	183
Study Start Date:	January 2012
Estimated Study Completion Date:	October 2018
Estimated Primary Completion Date:	October 2018 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: Resin Infiltration Resin Infiltration 30% Silver Diammine Fluoride Placebo Dental Flossing	Procedure: Resin Infiltration After cleaning the proximal surface with caries lesion, it will be performed the local infiltration anesthesia and adaptation of the rubber dam. The adjacent tooth will be protected by plastic or metal strip. Hydrochloric acid 15% will be applied on the lesion, which will be washed and dried. The surface should be dried by applying 95% ethanol and air-way syringe. The resin infiltration (Icon, DMG) will be applied on the lesion. The resin will be polymerized and applied again and polymerized. Other Name: Icon Procedure: Dental Flossing In this group, the patient will perform only mechanical removal of biofilm to floss daily. Other Name: Oral hygiene Procedure: 30% Silver Diammine Fluoride Placebo Soft tissues will be protected with petroleum jelly. The patient will receive sterile water application with a disposable microbrush for 3m. Then the surface will be washed for 30s. Other Name: Cariestop Placebo
Experimental: 30% Silver Diammine Fluoride 30% Silver Diammine Fluoride Resin Infiltration Placebo Dental Flossing	Procedure: 30% Silver Diammine Fluoride It will be cleaned like group I. Soft tissues will be protected with petroleum jelly. The 30% silver diamine fluoride (Cariestop, Biodinamica) will be applied with a disposable microbrush for 3m. Then the surface will be washed for 30s. Other Name: Cariestop Procedure: Dental Flossing In this group, the patient will perform only mechanical removal of biofilm to floss daily. Other Name: Oral hygiene Procedure: Resin Infiltration Placebo In this group, the patient will be held only inserting the rubber dam and applied sterile water as a substitute for acid, ethanol and resin infiltration. Other Name: Icon Placebo
Active Comparator: Oral Hygiene Dental Flossing 30% Silver Diammine Fluoride Placebo Resin Infiltration Placebo	Procedure: Dental Flossing In this group, the patient will perform only mechanical removal of biofilm to floss daily. Other Name: Oral hygiene Procedure: Resin Infiltration Placebo In this group, the patient will be held only inserting the rubber dam and applied sterile water as a substitute for acid, ethanol and resin infiltration. Other Name: Icon Placebo Procedure: 30% Silver Diammine Fluoride Placebo Soft tissues will be protected with petroleum jelly. The patient will receive sterile water application with a disposable microbrush for 3m. Then the surface will be washed for 30s. Other Name: Cariestop Placebo

Detailed Description:

The sample will be comprised of 141 patients between 3 to 10 year-old and 504 proximal surfaces of 12-to-17-year-old adolescents, who present at least one proximal surface with initial caries lesion. Patients will be randomly allocated to treatments, according to the technique to be employed: (I) resin infiltration (II) 30% diamine silver fluoride, (III) just daily flossing by the patient. All subjects will receive placebo treatments performed in other groups. The teeth will be evaluated by clinical and radiographic exams at baseline and after 1, 3, 6, 12, 18 and 24 months. In 1, 3 and 18 months will just be evaluated aspects related to the biofilm.

Eligibility


Ages Eligible for Study:	3 Years to 17 Years (Child)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Primary teeth: distal surface of the first molar, mesial surface of the second molar and distal surface of the second molar (when the first permanent molar is present) with initial caries lesion (ICDAS 1, 2 or 3).
Permanent teeth: distal surface of the first premolar, mesial surface of the second premolar, distal surface of the second premolar, mesial surface of the first molar, distal surface of the first molar and mesial surface of the second molar with initial caries lesion (ICDAS 1, 2 or 3).

Exclusion Criteria:

Mesial surface of the first primary molar/premolar by the smaller contact with the distal surface of the canines. It will be also excluded the surfaces that show proximal restorations, sealants, cavities, defects, as well as intact teeth.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01477385

Contacts


Contact: Mariana M Braga, PhD	55 11 30917835	mmbraga@usp.br

Locations


Brazil
Universidade de São Paulo	Recruiting
São Paulo, Brazil, 05508-000
Contact: Mariana Braga, PhD 55 11 30917835 mmbraga@usp.br
Principal Investigator: Fausto Mendes, PhD
Sub-Investigator: Juliana Silveira, DDS
Sub-Investigator: Fernanda Ferreira, DDS

Sponsors and Collaborators

University of Sao Paulo

University of Copenhagen

Investigators


Principal Investigator:	Mariana M Braga, PhD	University of Sao Paulo

More Information

Publications:

Braga MM, Mendes FM, De Benedetto MS, Imparato JC. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child (Chic). 2009a;76(1):28-33. Braga MM, Morais CC, Nakama RC, Leamari VM, Siqueira WL, Mendes FM. In vitro performance of methods of approximal caries detection in primary molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009b;108(4):e35-41. Cagetti MG, Campus G, Sale S, Cocco F, Strohmenger L, Lingström P. Association between interdental plaque acidogenicity and caries risk at surface level: a cross sectional study in primary dentition. Int J Paediatr Dent. 2011;21(2):119-25. Ekstrand KR, Bakhshandeh A, Martignon S. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries Res. 2010;44(1):41-6.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Mattos-Silveira J, Floriano I, Ferreira FR, Viganó ME, Frizzo MA, Reyes A, Novaes TF, Moriyama CM, Raggio DP, Imparato JC, Mendes FM, Braga MM. New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial. Trials. 2014 Nov 19;15:448. doi: 10.1186/1745-6215-15-448.


Responsible Party:	Mariana Minatel Braga, Phd, University of Sao Paulo
ClinicalTrials.gov Identifier:	NCT01477385 History of Changes
Other Study ID Numbers:	SDFtrials-01
Study First Received:	November 16, 2011
Last Updated:	May 3, 2016
Health Authority:	Brazil: Ethics Committee

Keywords provided by University of Sao Paulo:


dental caries primary teeth permanent teeth silver diamine fluoride

Additional relevant MeSH terms:


Dental Caries Tooth Demineralization Tooth Diseases Stomatognathic Diseases	Fluorides Cariostatic Agents Protective Agents Physiological Effects of Drugs

ClinicalTrials.gov processed this record on September 23, 2016