Silver diamine fluoride for managing carious lesions: an umbrella review

Nassar Seifo, Heather Cassie, John R Radford, Nicola P T Innes, Nassar Seifo, Heather Cassie, John R Radford, Nicola P T Innes

Abstract

Background: This umbrella review comprehensively appraised evidence for silver diamine fluoride (SDF) to arrest and prevent root and coronal caries by summarizing systematic reviews. Adverse events were explored.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, PubMed, Embase, Cochrane Library, PROSPERO register and Joanna Briggs Institute Database of Systematic Reviews were searched for systematic reviews investigating SDF for caries prevention or arrest (1970-2018) without language restrictions. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers, in duplicate. Corrected covered area was calculated to quantify studies' overlap across reviews.

Results: Eleven systematic reviews were included; four focussing on SDF for root caries in adults and seven on coronal caries in children. These cited 30 studies (4 root caries; 26 coronal caries) appearing 63 times. Five systematic reviews were of "low", one "unclear" and five "high" risk of bias. Overlap of studies was very high (50% root caries; 17% coronal caries). High overlap and heterogeneity, mainly comparators and outcome measures, precluded meta-analysis. Results were grouped by aim and outcomes to present an overview of direction and magnitude of effect. SDF had a positive effect on prevention and arrest of coronal and root caries, consistently outperforming comparators (fluoride varnish, Atraumatic Restorative Treatment, placebo). For root caries prevention, the prevented fraction (PF) was 25-71% higher for SDF compared to placebo (two systematic reviews with three studies) and PF = 100-725% for root caries arrest (one systematic review with two studies). For coronal caries prevention, PF = 70-78% (two systematic reviews with two studies) and PF = 55-96% for coronal caries arrest (one systematic review with two studies) with arrest rates of 65-91% (four systematic reviews with six studies). Eight systematic reviews reported adverse events, seven of which reported arrested lesions black staining.

Conclusion: Systematic reviews consistently supported SDF's effectiveness for arresting coronal caries in the primary dentition and arresting and preventing root caries in older adults for all comparators. There is insufficient evidence to draw conclusions on SDF for prevention in primary teeth and prevention and arrest in permanent teeth in children. No serious adverse events were reported.

Keywords: Overview; Silver diamine fluoride; Systematic review; Umbrella review.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Citation matrix and calculation formulae. CA, covered area; CCA, corrected covered area. 0–5 = slight; 6–10 = moderate; 11–15 = high; over 15 = very high. (Reproduced with the author’s permission) [19]
Fig. 2
Fig. 2
Flow diagram of identification and reviews selection
Fig. 3
Fig. 3
Citation matrix for reviews assessed the effectiveness of SDF for root carious lesions management
Fig. 4
Fig. 4
Citation matrix for reviews assessed the effectiveness of SDF for coronal carious lesions management

References

    1. Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi M, Lopez A, Murray CJL. Global burden of Oral conditions in 1990-2010:a systematic analysis. J Dent Res. 2013;92(7):592–597. doi: 10.1177/0022034513490168.
    1. American Dental Association Council on Scientific A Professionally applied topical fluoride: evidence–based clinical recommendations. J Am Dent Assoc. 2006;137(8):1151–1159. doi: 10.14219/jada.archive.2006.0356.
    1. Sharma G, Puranik MP. K R S: approaches to arresting dental caries: an update. J Clin Diagn Res. 2015;9(5):ZE08–ZE11.
    1. Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc. 2016;44(1):16–28.
    1. Duangthip D, Jiang M, Chu CH, Lo ECM. Non-surgical treatment of dentin caries in preschool children–systematic review. BMC Oral Health. 2015;15(1):44. doi: 10.1186/s12903-015-0033-7.
    1. Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res. 2005;84(8):721–724. doi: 10.1177/154405910508400807.
    1. Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent. 2012;40(11):962–967. doi: 10.1016/j.jdent.2012.08.002.
    1. Zhao IS, Gao SS, Hiraishi N, Burrow MF, Duangthip D, Mei ML, Lo EC-M, Chu C-H. Mechanisms of silver diamine fluoride on arresting caries: a literature review. Int Dent J. 2018;68(2):67–76. doi: 10.1111/idj.12320.
    1. Jadad AR, Cook DJ, Jones A, Klassen TP, Tugwell P, Moher M, Moher D. Methodology and reports of systematic reviews and meta-analysesA comparison of Cochrane reviews with articles published in paper-based journals. JAMA. 1998;280(3):278–280. doi: 10.1001/jama.280.3.278.
    1. Lunny C, Brennan SE, McDonald S, McKenzie JE. Evidence map of studies evaluating methods for conducting, interpreting and reporting overviews of systematic reviews of interventions: rationale and design. Syst Rev. 2016;5(1):4. doi: 10.1186/s13643-015-0178-0.
    1. Pieper D, Antoine S-L, Morfeld J-C, Mathes T, Eikermann M. Methodological approaches in conducting overviews: current state in HTA agencies. Res Synth Methods. 2014;5(3):187–199. doi: 10.1002/jrsm.1107.
    1. Caird J, Sutcliffe K, Kwan I, Dickson K, Thomas J. Mediating policy-relevant evidence at speed: are systematic reviews of systematic reviews a useful approach. Evid Policy. 2015;11(1):81–97. doi: 10.1332/174426514X13988609036850.
    1. Hartling L, Chisholm A, Thomson D, Dryden DM. A descriptive analysis of overviews of reviews published between 2000 and 2011. PLoS One. 2012;7(11):e49667. doi: 10.1371/journal.pone.0049667.
    1. Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011;11(1):15. doi: 10.1186/1471-2288-11-15.
    1. Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc. 2015;13(3):132–140. doi: 10.1097/XEB.0000000000000055.
    1. Pollock A, Hunt H, Campbell P, Estcourt L, Brunton G. Cochrane overviews of reviews: exploring the methods and challenges. Birmingham: UK and Ireland Cochrane Symposium; 2016. p. 2016.
    1. Becker L, Oxman A. Overviews of reviews. In: Higgins J, Green S, editors. Cochrane handbook for systematic reviews of interventions. 5.1.0 edn. p. 2011.
    1. Uman LS. Systematic reviews and meta-analyses. J Can Acad Child Adolesc Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent. 2011;20(1):57–59.
    1. Pieper D, Antoine S-L, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol. 2014;67(4):368–375. doi: 10.1016/j.jclinepi.2013.11.007.
    1. Whiting P, Savović J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, Davies P, Kleijnen J, Churchill R. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol. 2016;69:225–234. doi: 10.1016/j.jclinepi.2015.06.005.
    1. Fung H, Wong MC, Lo EC, Chu C. Early childhood caries: a literature review. Oral Hyg Health. 2013;1:107.
    1. Gao SS, Zhao IS, Hiraishi N, Duangthip D, Mei ML, Lo ECM, Chu CH. Clinical trials of silver diamine fluoride in arresting caries among children: a systematic review. JDR Clin Transl Res. 2016;1(3):201–210. doi: 10.1177/2380084416661474.
    1. Weyant RJ, Tracy SL, Anselmo TT, Beltrán-Aguilar ED, Donly KJ, Frese WA, Hujoel PP, Iafolla T, Kohn W, Kumar J. Topical fluoride for caries prevention. J Am Dent Assoc. 2013;144(11):1279–1291. doi: 10.14219/jada.archive.2013.0057.
    1. Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. 2015;94(2):261–271. doi: 10.1177/0022034514557330.
    1. Chu C, Lo E. Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent. 2008;6(4).
    1. Schwendicke F, Göstemeyer G. Cost-effectiveness of root caries preventive treatments. J Dent. 2017;56:58–64. doi: 10.1016/j.jdent.2016.10.016.
    1. Twetman S, Dhar V. Evidence of effectiveness of current therapies to prevent and treat early childhood caries. Pediatr Dent. 2015;37(3):246–253.
    1. Peng J-Y, Botelho M, Matinlinna J. Silver compounds used in dentistry for caries management: a review. J Dent. 2012;40(7):531–541. doi: 10.1016/j.jdent.2012.03.009.
    1. Gluzman R, Katz RV, Frey BJ, McGowan R. Prevention of root caries: a literature review of primary and secondary preventive agents. Spec Care Dentist. 2013;33(3):133–140. doi: 10.1111/j.1754-4505.2012.00318.x.
    1. Hendre AD, Taylor GW, Chavez EM, Hyde S. A systematic review of silver diamine fluoride: effectiveness and application in older adults. Gerodontology. 2017;34(4):411–419. doi: 10.1111/ger.12294.
    1. Oliveira BH, Cunha-Cruz J, Rajendra A, Niederman R. Controlling caries in exposed root surfaces with silver diamine fluoride: a systematic review with meta-analysis. J Am Dent Assoc. 2018;149(8):671–679.e671. doi: 10.1016/j.adaj.2018.03.028.
    1. Chibinski AC, Wambier LM, Feltrin J, Loguercio AD, Wambier DS, Reis A. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: a systematic review and meta-analysis. Caries Res. 2017;51(5):527–541. doi: 10.1159/000478668.
    1. Contreras V, Toro MJ, Elías-Boneta AR, Encarnación-Burgos MA. Effectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review. Gen Dent. 2017;65(3):22.
    1. Gao SS, Zhang S, Mei ML, Lo EC, Chu CH. Caries remineralisation and arresting effect in children by professionally applied fluoride treatment–a systematic review. BMC Oral Health. 2016;16(1):12. doi: 10.1186/s12903-016-0171-6.
    1. Oliveira BH, Rajendra A, Veitz-Keenan A, Niederman R. The effect of silver diamine fluoride in preventing caries in the primary dentition: a systematic review and meta-analysis. Caries Res. 2019;53(1):24–32. doi: 10.1159/000488686.
    1. Rosenblatt A, Stamford TCM, Niederman R. Silver Diamine Fluoride: A Caries “Silver-Fluoride Bullet”. J Dent Res. 2009;88(2):116–125. doi: 10.1177/0022034508329406.
    1. Nishino M. Effect of topically applied ammoniacal silver fluoride on dental caries in children. J Osaka Univ Dent Sch. 1969;9:149–155.
    1. Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G. An introduction to overviews of reviews: planning a relevant research question and objective for an overview. Syst Rev. 2018;7(1):39. doi: 10.1186/s13643-018-0695-8.
    1. Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich A-B. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol. 201893:9–24.
    1. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res. 2002;81:767–770. doi: 10.1177/0810767.
    1. Food and Drug Administration: Code of Federal Regulations. . Accessed 1 Apr 2019.
    1. dos Santos VE, Jr, Vasconcelos Filho A, Targino AGR, Flores MAP, Galembeck A, Caldas AF, Jr, Rosenblatt A. A new “silver-bullet” to treat caries in children–Nano silver fluoride: a randomised clinical trial. J Dent. 2014;42(8):945–951. doi: 10.1016/j.jdent.2014.05.017.
    1. Braga MM, Mendes FM, De Benedetto MS, Imparato JCP. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. J Dent Child. 2009;76(1):28–33.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する