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Preventive Effects of Silver Diamine Fluoride on Early Enamel Caries
Sponsor: National University of Malaysia
Summary
Fixed orthodontic patients are at risk of developing dental caries. Topical application of fluoride varnish (FV) around the orthodontic brackets and using fluoridated mouth rinses have been suggested to prevent the formation of white spot lesions (WSLs) on enamel. Recent studies have shown that silver diamine fluoride (SDF) demonstrated better outcomes in dental caries prevention as compared to FV. However, the caries preventive effects of SDF application around the orthodontic brackets have not been established yet. This study will be conducted to evaluate the effectiveness of SDF in preventing WSLs formation in patients undergoing fixed orthodontic treatment. This study will use a randomised-controlled double-blinded design with three parallel arms. Ninety-nine eligible participants will be recruited. Using their registration number, a random list of patients will be generated using computer software. Each patient will be assigned randomly to three groups: SDF, FV, or placebo. Digital photographs of upper anterior teeth (frontal view) will be taken as a baseline and repeated at every review appointment. The materials will be applied around the orthodontic bracket of upper incisors and canines every 6 months. The formation of WSLs around the bracket will be evaluated at 1, 3, 6, and 12 months using three parameters: the ICDAS scoring system, the laser fluorescence caries detector, and digital photographic analysis using the Gorelick score. The patients' perception of the colour changes of the enamel will be evaluated through patient-reported outcomes. The difference in ICDAS and Gorelick scores and the patients' perceptions will be reported through descriptive statistics. The Kruskal-Wallis or one-way ANOVA statistical test will be used to compare the changes in fluorescence intensity between treatment groups. The investigators believe that the results of this study will provide insight into the caries preventive protocol among fixed orthodontics patients and subsequently reduce the incidence of WSLs during orthodontic treatment.
Official title: The Effectiveness of Silver Diamine Fluoride (SDF) in the Prevention of Early Enamel Caries Among Patients With Fixed Orthodontic Appliances: A Randomised Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
99
Start Date
2025-01-31
Completion Date
2026-12-31
Last Updated
2025-01-30
Healthy Volunteers
Yes
Interventions
Silver diamine fluoride- potassium iodide
SDF , Riva Star, SDI Limited., Australia
Fluoride varnish
Duraphat varnish®, Colgate-Palmolive (UK) Ltd.
0.9 % saline
Standard oral hygiene instructions every 3 months and application of Normal Saline for every 6 months
Locations (1)
Faculty of Dentistry, UKM
Kuala Lumpur, Kuala Lumpur, Malaysia