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      Adverse events on the use of interim therapeutic in schoolchildren: silver diamine fluoride × interim therapeutic restorative - a pilot study Translated title: Efeitos adversos de técnicas provisórias em crianças: diamino fluoreto de prata x tratamento restaurador provisório - um estudo piloto

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          Abstract

          PURPOSE: Silver diamine fluoride (SDF) is a caries prevention and arresting agent that is easy to apply clinically. Interim therapeutic restorations (IRT) are also known to be a simple and effective method for treating caries in children. This study examines whether treatment with 30% silver diamine fluoride (SDF) will cause fewer adverse events than the available interim therapeutic restorations in underprivileged schoolchildren with cavities. METHODS: We conducted a three-month pilot study comparing the adverse effects of IRT using glass ionomer cement (Fuji IX, GC America, Inc.) with those of 30% silver diamine fluoride (Cariostop Biodynamic®, Brazil) in 50 children aged 6 years. RESULTS: In the SDF group, all caries were arrested and no pain, abscess or fistula was reported. Of the children assigned to the Fuji IX group, 24% reported toothache (P < 0.05). There was no significant difference in the occurrence of fistula and abscess in the two groups. CONCLUSION: The authors suggest that for underprivileged schoolchildren with caries, the use of SDF when an appropriate clinical setting is not available resulted in fewer adverse effects than did treatment with an interim therapeutic restorative using FUJI IX.

          Translated abstract

          OBJETIVO: O Diamino fluoreto de prata, uma solução de fácil aplicação e que não precisa de um ambiente clínico para o seu uso, é um agente de notável capacidade de paralisar e prevenir cárie. Outro método simples e eficaz para o tratamento da cárie em crianças são Restaurações provisórias. Este estudo examinou o surgimento de efeitos adversos em escolares tratadas com Diamino fluoreto de prata (DFP) comparado com aquelas tratadas com o Tratamento Restaurador Provisório. METODOLOGIA: Foi realizado um estudo piloto de três meses comparando os efeitos adversos das restaurações provisórias, utilizando cimento de ionômero de vidro Fuji IX (GC America, Inc.), com o Diamino fluoreto de prata a 30% (Cariostop Biodinâmica®, Brasil), em 50 crianças com 6 anos de idade. RESULTADOS: O grupo DFP teve todas as suas cáries paralisadas e não apresentou dor, abscesso ou fístula. Das crianças tratadas com Fuji IX, 24% delas relataram dor de dente (P < 0,05). Para fístula e abscesso, não foi verificado diferença estatisticamente significativa. CONCLUSÃO: Os autores sugerem que, para crianças portadoras de cárie, sem acesso aos serviços de saúde, o DFP apresentou menos efeitos adversos do que o tratamento restaurador provisório utilizando FUJI IX.

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          Silver. I: Its antibacterial properties and mechanism of action.

          Silver products have two key advantages: they are broad-spectrum antibiotics and are not yet associated with drug resistance. This article, the first in a two-part series, describes the main mechanism of action of this metallic element.
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            Silver in health care: antimicrobial effects and safety in use.

            Silver has a long and intriguing history as an antibiotic in human health care. It has been developed for use in water purification, wound care, bone prostheses, reconstructive orthopaedic surgery, cardiac devices, catheters and surgical appliances. Advancing biotechnology has enabled incorporation of ionizable silver into fabrics for clinical use to reduce the risk of nosocomial infections and for personal hygiene. The antimicrobial action of silver or silver compounds is proportional to the bioactive silver ion (Ag(+)) released and its availability to interact with bacterial or fungal cell membranes. Silver metal and inorganic silver compounds ionize in the presence of water, body fluids or tissue exudates. The silver ion is biologically active and readily interacts with proteins, amino acid residues, free anions and receptors on mammalian and eukaryotic cell membranes. Bacterial (and probably fungal) sensitivity to silver is genetically determined and relates to the levels of intracellular silver uptake and its ability to interact and irreversibly denature key enzyme systems. Silver exhibits low toxicity in the human body, and minimal risk is expected due to clinical exposure by inhalation, ingestion, dermal application or through the urological or haematogenous route. Chronic ingestion or inhalation of silver preparations (especially colloidal silver) can lead to deposition of silver metal/silver sulphide particles in the skin (argyria), eye (argyrosis) and other organs. These are not life-threatening conditions but cosmetically undesirable. Silver is absorbed into the human body and enters the systemic circulation as a protein complex to be eliminated by the liver and kidneys. Silver metabolism is modulated by induction and binding to metallothioneins. This complex mitigates the cellular toxicity of silver and contributes to tissue repair. Silver allergy is a known contra-indication for using silver in medical devices or antibiotic textiles.
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              Silver diamine fluoride: a caries "silver-fluoride bullet".

              The antimicrobial use of silver compounds pivots on the 100-year-old application of silver nitrate, silver foil, and silver sutures for the prevention and treatment of ocular, surgical, and dental infections. Ag(+) kills pathogenic organisms at concentrations of <50 ppm, and current/potential anti-infective applications include: acute burn coverings, catheter linings, water purification systems, hospital gowns, and caries prevention. To distill the current best evidence relative to caries, this systematic review asked: Will silver diamine fluoride (SDF) more effectively prevent caries than fluoride varnish? A five-database search, reference review, and hand search identified 99 human clinical trials in three languages published between 1966 and 2006. Dual review for controlled clinical trials with the patient as the unit of observation, and excluding cross-sectional, animal, in vitro studies, and opinions, identified 2 studies meeting the inclusion criteria. The trials indicated that SDF's lowest prevented fractions for caries arrest and caries prevention were 96.1% and 70.3%, respectively. In contrast, fluoride varnish's highest prevented fractions for caries arrest and caries prevention were 21.3% and 55.7%, respectively. Similarly, SDF's highest numbers needed to treat for caries arrest and caries prevention were 0.8 (95% CI=0.5-1.0) and 0.9 (95% CI=0.4-1.1), respectively. For fluoride varnish, the lowest numbers needed to treat for caries arrest and prevention were 3.7 (95% CI=3.4-3.9) and 1.1 (95% CI=0.7-1.4), respectively. Adverse events were monitored, with no significant differences between control and experimental groups. These promising results suggest that SDF is more effective than fluoride varnish, and may be a valuable caries-preventive intervention. As well, the availability of a safe, effective, efficient, and equitable caries-preventive agent appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine's criteria for 21st century medical care.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                roc
                Revista Odonto Ciência
                Rev. odonto ciênc.
                Pontifícia Universidade Católica do Rio Grande do Sul (Porto Alegre )
                1980-6523
                2012
                : 27
                : 1
                : 26-30
                Affiliations
                [1 ] Pernambuco State University
                [2 ] Universidade Federal da Paraíba Brazil
                Article
                S1980-65232012000100005
                10.1590/S1980-65232012000100005
                64f73c9e-1458-4eab-a77c-2d9014c3e39a

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1980-6523&lng=en
                Categories
                DENTISTRY, ORAL SURGERY & MEDICINE

                Dentistry
                Dental caries,children,silver diamine fluoride,interim therapeutic restorative,Cárie,criança,diamino fluoreto de prata,restauração provisória

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