Table 1 A summary of included studies on non-surgical approaches in treating dentin caries in preschool children
From: Non-surgical treatment of dentin caries in preschool children – systematic review
Author/year | Study type/duration | Subjects | Intervention | Outcome assessment | Results/conclusion | Comment/quality assessment |
|---|---|---|---|---|---|---|
Zhi et al., 2012 [15] | RCT | 212 children | Gp 1: 38% SDF once a year | Clinical examination criteria: | At 1 year, the caries arrest rates of Gps 1, 2 and 3 were 37%, 53% and 29%, respectively. | Well-planned study design (random allocation, adequate sample size) Dropout rate was not high (15%). Confounding factors were taken into consideration. |
2 years | aged 3–4 years with active caries in primary teeth | Gp 2: 38% SDF twice a year | Active: lesion easily penetrated by probe | |||
Gp 3: Flowable GI filling once a year | Arrested: smooth, hard surfaces when probing | At 2 years, the caries arrest rates of three groups were 79%, 91% and 82%, respectively. | ||||
But for Gp 3 also lesions that were totally covered with GI | Effect of annual SDF and GI application on arresting caries did not differ significantly. | However, blinding of outcome assessment (between Gp 3 and Gp 1, 2) is impossible. | ||||
SDF application twice a year increased caries arrest rates. | Low risk of bias | |||||
Study quality (ADA): good | ||||||
dos Santos et al., 2012 [14] | RCT | 91 children aged 5–6 years with caries in primary teeth | Gp 1: interim restorative treatment with GI filling without caries removal | Clinical examination criteria: | At 12 months, the success rate of SDF was higher than interim restoration with GI filling (67% vs. 39%). | No details about the random allocation and attrition rate. Non-blinded study and duration of study was short. |
1 year | ||||||
Active: lesion easily penetrated by probe | ||||||
Gp 2: 30% SDF | Arrested: smooth, hard surfaces when probing | SDF was more effective than interim restoration with GI for arresting caries in primary teeth. | High risk of bias | |||
Study quality (ADA): poor | ||||||
Chu et al., 2002 [13] | RCT | 375 children | Gp 1: excavation plus 38% SDF once a year | Clinical examination criteria: | SDF groups (Gp 1, 2) had higher caries arrest rates than those of NaF groups (Gp 3, 4) and control. The respective mean numbers of arrested caries tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5 and 1.3, respectively. | Ethical concern regarding the negative control group (no treatment) |
30 months | (aged 3–5 years) | |||||
Upper anterior primary teeth | Gp 2: 38% SDF once a year | Arrested caries: cavity with hard floor and walls | ||||
Only anterior primary teeth were involved. The generalizability of the results to posterior teeth was limited. | ||||||
Gp 3: excavation plus 5% NaF 4 times a year | ||||||
Gp 4: 5% NaF 4 times a year | ||||||
Gp 5: Control (no treatment) | SDF was effective in arresting dentin caries. | Low risk of bias | ||||
Study quality (ADA): good | ||||||
Lo et al., 1998 [9] | Longitudinal study | 289 children aged 3–6 years | Gp 1: Regular oral health education session and daily tooth brushing with 1000 ppm fluoridated toothpaste | Clinical examination criteria: | Significant difference between the mean no. of arrested caries in Gp 1 and 2 which was 1.8 and 1.1, respectively. | Low attrition rate over 3 years. Potential confounders were evaluated. Although no random allocation was performed, comparable groups were assembled initially and maintained throughout the study. |
3 years | (168 children in intervention group, 121 children in the control group) | Arrested caries: dark brown to black in color with hard surface | ||||
At 3 years, 28% of the active dentin caries in Gp 1 children had become arrested while 12% of the caries were arrested in the control. | ||||||
Gp 2: Control (no intervention) | ||||||
Moderate risk of bias | ||||||
Study quality (ADA): good |