Efficacy of 38% Silver Diamine Fluoride (SDF) versus Atraumatic Restorative Treatment (ART) in Arresting Dental Caries in Paediatric Patients: A Systematic Review and Meta-Analysis

Authors:

ABSTRACT

Aim

To evaluate the clinical efficacy of 38% Silver Diamine Fluoride (SDF) in arresting dental caries in paediatric patients in comparison to Atraumatic Restorative Treatment (ART) or placebo.

Material and methods

This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (ID: 596949). A thorough search of PubMed, Scopus, and Cochrane databases was conducted, retrieving 1366 studies. Duplicates were removed, yielding 892 unique records. Screening by title and abstract reduced this number to 96 studies, and after full-text review, 6 RCTS met the inclusion criteria. Data extraction and risk of bias assessment were performed using the Cochrane Risk of Bias Tool. Meta-analysis was conducted using Review Manager (RevMan) software 8.7.0, applying a random-effects model to account for variability across studies, and a sensitivity analysis was performed.

Results

The meta-analysis included 6 RCTS with 461 paediatric patients. The pooled results indicated that 38% SDF was more effective in arresting dental caries than placebo (RR=5.95%; [95% CI: 1.66,21.38], P=0.006). The pooled risk difference (RD) from sensitivity analysis was 0.64 (95% [CI: 0.49,0.78], p<0.00001), indicating that the use of 38% SDF is 64% more effective than placebo. Additionally, the pooled results showed that 38% SDF was more effective in arresting dental caries than ART, with a mean difference of 2.22 ([95% CI 0.080, 3.02], p=0.20). Sensitivity analysis revealed uniform outcomes favouring 38% SDF, with a pooled risk difference (RD) of 0.06 ([95% CI: 0.01,0.10], p=0.02), suggesting that 38% SDF is 6% more effective than ART in caries arrest.

Conclusion

38% SDF is an effective intervention for halting dental caries in paediatric patients, slightly outperforming ART. Both interventions may be considered for paediatric patients. Further standardised research with extended follow-up is needed.

PLUMX METRICS