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Effectiveness of Single and Dual Silver Fluoride Application

16. juni 2026 opdateret af: Nurfazlina binti Rosman, University of Malaya

The Effectiveness of Single and Dual Silver Fluoride (SF) Applications on Dentine Caries Among Malaysian Preschool Children: A Randomised Controlled Trial

This is a community-based, parallel-group, double-blinded randomised controlled trial aimed at evaluating the effectiveness of single and dual applications of 38% Silver Fluoride (SF) in arresting dentinal caries among Malaysian preschool children aged 4 to 6 years.

The main questions this study aims to answer are:

i) Does dual application of 38% Silver Fluoride differ from single application in arresting dentinal caries lesions after 6 months? ii) How does SF application influence oral health-related quality of life (OHRQoL) among preschool children, as measured by the Malay-ECOHIS questionnaire? iii) Is there a correlation between caries arrest and changes in Oral Health-Related Quality of Life (OHRQoL) measured using the Malay-ECOHIS questionnaire?

Researchers will compare children receiving a single application of 38% Silver Fluoride with those receiving dual applications to determine whether more frequent application improves caries arrest outcomes.

Participants will:

i) Undergo oral examination for assessment of dentinal caries using ICDAS criteria.

ii) Receive 38% Silver Fluoride application at baseline, with the dual-application group receiving an additional application at 3 months.

iii) Attend follow-up assessments at 3 and 6 months to evaluate caries arrest status.

iv) Have parents or guardians complete the Malay-ECOHIS questionnaire to assess changes in OHRQoL.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

138

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Nor Azlida Mohd Nor (Associate Prof), BDS, MSc, PhD
  • Telefonnummer: +6010-2716747
  • E-mail: azlida@um.edu.my

Undersøgelse Kontakt Backup

  • Navn: Dr. Tengku Nurfarhana Nadirah Tengku Hamzah(Dr), BDS, MClinDent
  • Telefonnummer: +6012-5250520
  • E-mail: tengkunurfarhana@um.edu.my

Studiesteder

  • Malaysia
    • Perak
      • Tapah, Perak, Malaysia, 35000
        • Preschools in Perak
        • Kontakt:
        • Ledende efterforsker:
          • Nurfazlina Rosman (Dr), DDS, MCOH
        • Underforsker:
          • Mohamad Noor Sairi (Dr), BDS, MCOH, Doctorate

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Children aged 4-6 years enrolled in selected preschools.
  2. Presence of at least one active dentinal caries lesion.
  3. Parental or guardian consent obtained.
  4. Asymptomatic cavitated dentine carious lesions in primary teeth.
  5. Parents/caregivers who understand the Malay language.

Exclusion Criteria:

  1. Clinical signs or symptoms of irreversible pulpitis or dental abscess/fistula.
  2. Systemic illness or medical contraindications for SF use.
  3. Developmental abnormalities of tooth structure, including amelogenesis imperfecta or dentinogenesis imperfecta.
  4. History of allergy or sensitivity to dental materials, including silver or fluoride contained in silver fluoride (SF).
  5. Children who have received professionally applied fluoride within the past six months at the time of recruitment.
  6. Arrested caries lesion.
  7. Children presenting with oral ulceration or mucositis.
  8. Uncooperative behaviour precluding oral examination.
  9. Children with pre-shedding tooth mobility

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Placebo komparator: Single Application of Silver Fluoride
Single applications of 38% silver fluoride will be applied to dentinal carious lesions at baseline and followed by placebo (normal saline) at 3 months
Medicin: 38% Silver Fluoride (Riva Star Aqua)
Topical application of 38% silver fluoride will be apply onto dentinal caries lesions using a micro-brush at baseline and 3 months follow up. One drop (0.05 mL) treats up to five surfaces. Maximum dose per visit does not exceed 260 µL.
Andet: Normal saline (palcebo)
Participants receive a single application of 38% silver fluoride at dentinal carious lesion at baseline and followed by placebo (normal saline) at 3 months
Eksperimentel: Dual Application of Silver Fluoride
Two applications of 38% silver fluoride will be applied to dentinal carious lesions at baseline and 3 months.
Medicin: 38% Silver Fluoride (Riva Star Aqua)
Topical application of 38% silver fluoride will be apply onto dentinal caries lesions using a micro-brush at baseline and 3 months follow up. One drop (0.05 mL) treats up to five surfaces. Maximum dose per visit does not exceed 260 µL.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Caries arrest at tooth surface level
Tidsramme: 6 months
Lesions are considered arrested if they are hard upon probing using WHO probe and have turned black in colour. Each tooth may contribute up to five surfaces, with analysis conducted at the lesion level.
6 months
Proportion of arrested lesions
Tidsramme: 6 months
Caries arrest will be assessed at the tooth surface level. The outcome is defined as the proportion of lesions classified as arrested out of the total treated lesions in each group. Comparisons will be made between single and dual application groups. Analyses will be conducted at both surface (lesion) level and participant level, accounting for clustering of lesions within individuals.
6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in OHRQoL (Malay-ECOHIS score)
Tidsramme: Baseline to 6 months
Change in total Malay-ECOHIS score from baseline to 6 months will be assessed. The Malay-ECOHIS is a validated parent-reported questionnaire measuring the impact of oral health on children and their families. Scores range from 0 to 52, with higher scores indicating worse oral health-related quality of life. A reduction in score reflects improvement in OHRQoL.
Baseline to 6 months
To determine correlation between caries arrest rate and change in total Malay-ECOHIS score
Tidsramme: 0-6 months

This outcome will assess the correlation between caries arrest rate at 6 months and change in total Malay-ECOHIS score from baseline to 6 months.

Caries arrest rate (%) will be assessed by clinical examination and calculated as the number of arrested treated dentinal caries lesions divided by the total number of treated dentinal caries lesions per participant, multiplied by 100. The unit of measure is percentage (%) of arrested treated dentinal caries lesions.

Change in total Malay-ECOHIS score will be assessed using the Malay-ECOHIS questionnaire. The change score will be calculated as the total score at 6 months minus the baseline total score. The unit of measure is change in total Malay-ECOHIS score. Pearson correlation will be used if normality assumptions are met; otherwise, Spearman rank correlation will be used.
0-6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Malaya

Efterforskere

  • Ledende efterforsker: Nor Azlida Mohd Nor (Associate Prof), BDS, MSc, PhD, Universiti Malaya

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. september 2027

Studieafslutning (Anslået)

1. februar 2028

Datoer for studieregistrering

Først indsendt

12. maj 2026

Først indsendt, der opfyldte QC-kriterier

16. juni 2026

Først opslået (Faktiske)

22. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • DF CO2505/0018 (P)

Plan for individuelle deltagerdata (IPD)

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INGEN

IPD-planbeskrivelse

Individual participant data will not be publicly shared due to participant confidentiality and ethical considerations

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Kliniske forsøg med Dentin Caries

Kliniske forsøg med 38% Silver Fluoride (Riva Star Aqua)

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