A Wider Scope of Analysis on 38% Silver Diamine Fluoride

This research was conducted to further support previous studies on the effectiveness of 38% silver diamine fluoride on caries arrest. In addition, the number of applications, time between subsequent applications, type of teeth (primary vs. permanent), final restoration following treatment, and the type of restoration, if any, were assessed. It is a retrospective longitudinal study that was conducted using a chart review technique for which a waiver of informed consent was obtained. The research participants’ privacy was ensured and protected. All participants’ identities remained anonymous and confidential. Furthermore, consent was collected from participants' sitters during their appointments as a protocol prior to applying 38% silver diamine fluoride (SDF). The current research was reviewed and approved by the Research Ethics Committee at King Faisal Specialist Hospital and Research Center (KFSH&RC). All investigators abided by the rules and regulations of the Government of Saudi Arabia, KFSH&RC, and the Research Advisory Council. A population of pediatric patients with primary and/or mixed dentition at a tertiary care hospital who were treated at the dental office between the period from March 2020 to December 2022 were recruited. A consecutive non-random sampling technique was used. The inclusion criteria include cavitated, asymptomatic, and teeth with no signs or symptoms of pulpal involvement. The sample size estimation was done by considering different percentages of success in arresting dental carries by using 38% SDF, with different levels of precision of 95% confidence intervals and with 0.05 level of significance. A 95% success was assumed in arresting dental carries by using 38% SDF, with a precision of ±5%, and with α=0.05, the required teeth sample size was 101. Anticipating some incomplete information and documentation, the sample size may be dynamic. Nighty-seven teeth both primary and permanent were included in this study. Data were analyzed using IBM SPSS Statistical software version 26.0 (Armonk, NY: IBM Corp.) for Windows. Descriptive statistics (mean standard deviation, frequencies, and percentages) were used to describe the quantitative and categorical outcome variables. Pearson’s chi-square test and Fisher’s exact test were used to compare the proportion success of 38% SDF in relation to the characteristics of study subjects. The odds ratios were used to quantify the measure of association between the success and other categorical study variables. A binary multiple logistic regression was used to identify the independent variables associated with the success of 38% SDF in arresting dental caries. A p-value of <0.05 and 95% confidence intervals were used to report the statistical significance and precision of results. Our current research concluded that different variables associated with 38% SDF, such as the number of applications and the time-lapse between applications, had no significant effect on the successful results of the application. Moreover, receiving a final restoration did not affect the success of the treatment when compared to treating with 38% SDF alone. Additionally, the type of final restoration had no impact on the prognosis. Further research using standardized protocols for study designs, detection criteria, outcomes, and statistical designs is needed to support findings and establish treatment guidelines.