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Outcomes of Holding Care in Primary Teeth Treated with Silver Diamine Fluoride Versus Interim Therapeutic Restorations

Abstract

Abstract

Purpose: The purpose was to evaluate and compare the success, outcomes, and adverse events of two common holding care techniques used in pediatric dentistry, Silver diamine fluoride (SDF) and interim therapeutic restorations (ITR).

Methods: A retrospective chart review was conducted involving patients of record from January 2015 through October 2017 at the University of California San Francisco, Pediatric Dental Clinics. Children ages 0 to 6 years old, who had undergone treatment with Silver diamine fluoride or Interim Therapeutic Restorations, were evaluated during a time frame of up to 34 months. One treatment was considered successful if the tooth did not develop any symptoms or adverse events during the course of the holding care, nor was the tooth extracted prematurely. A generalized linear mixed effect model was used to evaluate the two holding care techniques for their success.

Results: Totally 57 out of 118 ITR patients and 185 out of 265 SDF patients were eligible to be included in the study. From these selected patients, 135 teeth treated with ITR and, 834 teeth treated with SDF were observed in the 34-month time frame. Of the 135 teeth treated with ITR, 127 teeth (94.1%) were successful, 3 teeth became symptomatic, and 5 teeth had to be extracted as premature loss. Of the 834 teeth treated with SDF, 815 teeth (97.7%) were successful, 3 teeth became symptomatic, 2 developed an abscess or fistula, and 14 teeth had to be extracted as premature loss. There was no statistically significant difference in success rate between the two treatments. Oral hygiene was the only variable that significantly impacted the success of the treatments.

Conclusion: The results demonstrate that both Silver diamine fluoride and Interim Therapeutic Restorations are reliable holding care techniques in pediatric dental patients, and produce few adverse events.

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