Treatment of Initial Caries Lesions on Proximal Surfaces of Primary and Permanent Posterior Teeth

NCT ID: NCT01477385

Last Updated: 2016-05-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

183 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2018-10-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Dental Caries Compliance Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Resin Infiltration

Resin Infiltration 30% Silver Diammine Fluoride Placebo Dental Flossing

Group Type ACTIVE_COMPARATOR

Resin Infiltration

Intervention Type PROCEDURE

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.

Dental Flossing

Intervention Type PROCEDURE

In this group, the patient will perform only mechanical removal of biofilm to floss daily.

30% Silver Diammine Fluoride Placebo

Intervention Type PROCEDURE

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.

30% Silver Diammine Fluoride

30% Silver Diammine Fluoride Resin Infiltration Placebo Dental Flossing

Group Type EXPERIMENTAL

30% Silver Diammine Fluoride

Intervention Type PROCEDURE

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.

Dental Flossing

Intervention Type PROCEDURE

In this group, the patient will perform only mechanical removal of biofilm to floss daily.

Resin Infiltration Placebo

Intervention Type PROCEDURE

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.

Oral Hygiene

Dental Flossing 30% Silver Diammine Fluoride Placebo Resin Infiltration Placebo

Group Type ACTIVE_COMPARATOR

Dental Flossing

Intervention Type PROCEDURE

In this group, the patient will perform only mechanical removal of biofilm to floss daily.

Resin Infiltration Placebo

Intervention Type PROCEDURE

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.

30% Silver Diammine Fluoride Placebo

Intervention Type PROCEDURE

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.

Interventions

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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.

Intervention Type 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.

Intervention Type PROCEDURE

Dental Flossing

In this group, the patient will perform only mechanical removal of biofilm to floss daily.

Intervention Type 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.

Intervention Type 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.

Intervention Type PROCEDURE

Other Intervention Names

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Icon Cariestop Oral hygiene Icon Placebo Cariestop Placebo

Eligibility Criteria

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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.
Minimum Eligible Age

3 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Copenhagen

OTHER

Sponsor Role collaborator

University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Mariana Minatel Braga

Phd

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mariana M Braga, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Locations

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Universidade de São Paulo

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Mariana M Braga, PhD

Role: CONTACT

55 11 30917835

Facility Contacts

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Mariana Braga, PhD

Role: primary

55 11 30917835

References

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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.

Reference Type BACKGROUND

Mattos-Silveira J, Floriano I, Ferreira FR, Vigano 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.

Reference Type DERIVED
PMID: 25409545 (View on PubMed)

Other Identifiers

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SDFtrials-01

Identifier Type: -

Identifier Source: org_study_id

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