Objective: The study described the incidence of interproximal caries arrest following SDF and fluoride varnish application in the primary dentition. Study design: A retrospective analysis of dental records including radiographs was conducted for interproximal dental caries in pediatric patients treated with SDF applied with woven floss. Bitewing radiographs and ICCMS™ radiographic scoring criteria were used to assess caries depth in primary teeth at baseline and then at 12-month follow-up examination. Results: This study included 185 interproximal carious lesions in 131 patients treated with SDF. Mean baseline ICCMS™ score for all lesions was 1.50, with an average dmft of 2.9. The majority of carious lesions (n=155, 84.0%) showed radiographic evidence of non-progression at 12-month follow-up. There was no statistically significant difference in caries arrest among primary canines, primary first molars, and primary second molars (P=0.61). Furthermore, there was no statistically significant difference in caries arrest in patients with commercial insurance, Medicaid, or no insurance (P=0.27). Conclusions: SDF application with woven floss was associated with interproximal caries arrest in the primary dentition at 12-month follow-up in this sample of low caries risk children. Tooth type and insurance type were not associated with caries arrest.
Background: Dental caries remains a global problem that causes disproportionate suffering in underserved populations. Simple interventions are needed to improve patient experience, clinical and cost-effectiveness, and access to care. The self-assembling peptide P11-4 is a recently developed, non-invasive treatment that regenerates enamel in initial caries lesions.
Studies reviewed: We conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products CurodontTM Repair (CR) and CurodontTM Repair Fluoride Plus (CRFP) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System (ICDAS) score, Quantitative Light Fluorescence, esthetic appearance, and lesion size.
Results: Six clinical trials comparing CR to controls met the inclusion criteria. Results of this review represent two primary and two secondary outcomes. When compared to parallel groups, CR improved caries arrest (RR: 1.82; 95% CI: 1.32 to 2.50; 45% attributable risk; 95% CI: 24 to 60%) and decreased lesion size by 32% (Hedge g: -0.59; CI: -1.03 to -0.15). We observed positive trends for avoiding cavitation (RR: 0.32; CI: 0.10 to 1.06) and lowering merged ICDAS score (RR: 3.68; CI: 0.42 to 32.3). No studies used CRFP or reported adverse esthetic changes.
Practical implications: CR has a treatment effect on caries arrest and decreased lesion size. Two trials contributing to the caries arrest result had non-masked assessors, and all trials had elevated risks of bias. We recommend conducting longer trials. CR is a promising treatment for initial caries lesions.
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