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Maldupa I, Innes N, Viduskalne I, Brinkmane A, Senakola E, Krumina K, Uribe SE. Clinical effectiveness/child-patient and parent satisfaction of two topical fluoride treatments for caries: a randomised clinical trial. Sci Rep 2024; 14:8123. [PMID: 38582806 PMCID: PMC10998894 DOI: 10.1038/s41598-024-58850-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 04/08/2024] Open
Abstract
Knowledge gaps exist regarding optimal silver diammine fluoride (SDF) regimens and the efficacy of new products for arresting dental caries in young children. We evaluated the effectiveness of 38%-SDF (SDI-RivaStar), Tiefenfluorid (TF) comparing with Placebo (P), all in conjunction with behavioural modification (BM), in preventing major complications (endodontic/extractions/pain)-a patient-centred outcome-due to early childhood caries over 12 months in children under 71-months. A six-arm, patient/parent-blinded, superiority, placebo-controlled randomised control trial at the university clinic in Riga, Latvia, from 1/9/20-31/8/22 (Protocol registration ISRCTN17005348). The trial tested six protocols, using three compounds (P/SDF/TF) under two regimes: annual and biannual (P1/P2/TF1/TF2/SDF1/SDF2) for major complications. Secondary outcomes included minor complications and parental satisfaction. All groups received BM. 373/427 randomised children (87.3%) completed the study. SDF2 had a significantly lower rate and risk of major (21.5%, OR = 0.28, 95%CI [0.11, 0.72], p < 0.05) and minor complications (OR = 0.16 (95%CI [0.05, 0.50], p = 0.002). Overall satisfaction was 96% (p > 0.05). SDF biannual application with BM effectively prevented major complications of early childhood caries and was well accepted by children and their parents. Trial registration number: ISRCTN17005348, principal investigator: Ilze Maldupa, registration date: 30/06/2021.Clinical trial registration number: ISRCTN registry: ISRCTN17005348, https://doi.org/10.1186/ISRCTN17005348 , registration date: 30/06/2021.
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Affiliation(s)
- Ilze Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia.
| | - Nicola Innes
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK
| | - Ilona Viduskalne
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia
| | - Anda Brinkmane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia
| | - Egita Senakola
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia
| | - Karina Krumina
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia
| | - Sergio E Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Dzirciema str. 20, Riga, 1007, Latvia
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
- Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
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Xu GY, Zhao IS, Lung CYK, Yin IX, Lo ECM, Chu CH. Silver Compounds for Caries Management. Int Dent J 2024; 74:179-186. [PMID: 38008704 PMCID: PMC10988255 DOI: 10.1016/j.identj.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/28/2023] Open
Abstract
Silver metal and compounds have antibacterial properties, although their action's mechanisms are not fully understood. Scientists generally consider that silver disrupts the bacterial cell wall. It causes a structural change in the bacterial cell membrane and cytoplasm. It also stops deoxyribonucleic acid replication, resulting in inactivating enzymatic activity and cell death. The antimicrobial effect of silver-containing compounds relies on the release of bioactive silver ions. Hence, silver metal and compounds have been used in medicine to prevent infection for hundreds of years. Silver metal and compounds are also used as antibacterial agents in dentistry. Studies have shown that silver compounds are effective in the management of dental caries. Fluoride-containing silver compounds have been found in experiments to be beneficial at remineralising dental cavities. Silver diamine fluoride (SDF) can assist in preventing and arresting tooth cavities. The World Health Organization included SDF in its Model List of Essential Medicine for both adults and children in 2021. Clinicians also use SDF to manage dentine hypersensitivity as well as to inhibit growth of periodontal pathogens. However, traditional silver compounds cause tooth discolouration because of the silver-staining effect. These side effects of their applications depend on the amount applied and the frequency of application. Researchers are developing nanosilver fluoride and silver nanoparticles to overcome the staining. This review gives an overview of the antibacterial mechanism of silver compounds, namely silver nitrate, silver fluoride, SDF, silver nanoparticles, and nano silver fluoride for caries management. The outlook for the future development of silver compounds will be discussed.
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Affiliation(s)
- Grace Y Xu
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China; Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Irene S Zhao
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China; Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Christie Y K Lung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Iris X Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Chan AKY, Tsang YC, Yu OY, Lo ECM, Leung KCM, Chu CH. Clinical evidence for silver diamine fluoride to reduce dentine hypersensitivity: A systematic review. J Dent 2024; 142:104868. [PMID: 38301767 DOI: 10.1016/j.jdent.2024.104868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To assess the clinical evidence for silver diamine fluoride (SDF) to reduce dentine hypersensitivity in adults. METHODS Two independent researchers searched the English literature in five databases (Scopus, PubMed, Web of Science, EMBASE and the Cochrane Library) up to 15th July 2023 for clinical trials investigating the desensitising effect of professionally applied SDF to manage dentine hypersensitivity in adults aged 18 or above at any follow-up period. The primary outcome was the change in dentine hypersensitivity between baseline and follow-up visits after SDF application regarding any validated pain outcome measures. The Cochrane guidelines were used for the risk of bias assessment. RESULTS Three hundred and thirty-one studies were identified, and four of them were finally included. Three of the included studies were rated as having a 'low risk' of bias. The SDF solution reduced dentine hypersensitivity in adults. The percentage reduction in dentine hypersensitivity ranged from 23 % to 56 % after a single application of SDF solution. Moreover, the SDF solution was more effective than potassium nitrate, potassium oxalate and glutaraldehyde plus hydroxyethyl methacrylate in reducing dentine hypersensitivity. Meta-analysis indicated a more significant reduction in visual analogue scales (1-10) by 1.35 (95 % CI:0.9-1.8; p<0.00001) after receiving the SDF application than controls. CONCLUSION The included clinical trials showed that SDF solution reduced dentine hypersensitivity in adults. However, clinical trials are few, and their protocol varied from one another. Further well-designed clinical trials should be conducted to provide more evidence on its use to manage dentine hypersensitivity. CLINICAL SIGNIFICANCE SDF is cleared as desensitizing agents by the US Food and Drug Administration to manage dentine hypersensitivity, which induces pain, limits food choice, and impacts the quality of life. Evidence from this systematic review informs clinicians and provides researchers insight for future research on SDF use for dentine hypersensitivity. THE INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO) REGISTRATION NUMBER: CRD42023462613.
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Affiliation(s)
- Alice Kit Ying Chan
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Yiu Cheung Tsang
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China.
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Quritum M, Abdella A, Amer H, El Tantawi M. Effect of silver diamine fluoride and nano silver fluoride on oral health-related quality of life of children with early childhood caries: A randomized clinical trial. J Dent 2024; 142:104878. [PMID: 38311016 DOI: 10.1016/j.jdent.2024.104878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVES Untreated caries in primary teeth is one of the most prevalent health problems in children worldwide. Silver diamine fluoride (SDF) non-invasively arrests caries but causes staining unlike Nano Silver Fluoride (NSF) which causes no stains. This study compared the effect of NSF and 38 % SDF on the oral health related quality of life (OHRQoL) of preschool children after 6 months. METHODS Children were included if they were younger than 4 years, with at least one active lesion, ICDAS score ≥3, attending nurseries in a rural area in Alexandria, Egypt. They were randomly assigned to receive NSF once at baseline, or SDF at baseline and after 6 months. The Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) was used to assess the OHRQoL. The groups were compared using chi-square test and the effect of the intervention on OHRQoL was assessed using multiple linear regression. RESULTS 360 children were included, mean (SD) age = 42.3 (8.2) months. After 6 months, NSF had significantly lower A-ECOHIS scores than SDF in bivariate analysis (p< 0.05) and in regression analysis (B= -5.02, p = 0.001) after adjusting for confounders. There were significant reductions in the A-ECOHIS total and domains' scores in both study groups, except for the social interaction domain in the SDF group. CONCLUSION After 6-month, both agents significantly improved children's OHRQoL although NSF had a significantly better impact on OHRQoL than SDF. CLINICAL SIGNIFICANCE Patient-reported outcomes support the inclusion of the two agents among the options for ECC management with better effect on quality of life after NSF. TRIAL REGISTRATION The trial was registered in the clinicaltrials.gov registry (#NCT05255913).
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Affiliation(s)
- Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ahmed Abdella
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hala Amer
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Palankalieva A, Belcheva-Krivorova A. Silver compounds used in pediatric dentistry for caries arrest: A review of current materials and new technologies. Folia Med (Plovdiv) 2024; 66:19-25. [PMID: 38426461 DOI: 10.3897/folmed.66.e115790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 03/02/2024] Open
Abstract
Silver compounds have been used in medicine and dentistry for centuries. Their use in pediatric dentistry has long been restricted because of some drawbacks, chief among them being the discoloration of teeth with black stains. However, recent advances in technology have resulted in the development of new silver agents that do not have the limitations of previously used ones. This led to the reintroduction of silver compounds in pediatric dentistry. The aim of the present review was to examine the evidence supporting the therapeutic use of silver compounds in pediatric dentistry for caries arrest, as well as the mode of action and biocompatibility, characteristics, advantages, and disadvantages of different silver-containing agents.
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Al-Nerabieah Z, AlKhouli M, Dashash M. Parental satisfaction and acceptance of silver diamine fluoride treatment for molar incisor hypomineralisation in pediatric dentistry: a cross-sectional study. Sci Rep 2024; 14:4544. [PMID: 38402306 PMCID: PMC10894263 DOI: 10.1038/s41598-024-55456-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/23/2024] [Indexed: 02/26/2024] Open
Abstract
The study aimed to investigate parental satisfaction and acceptance of silver diamine fluoride (SDF) treatment for permanent molars affected by molar incisor hypomineralisation (MIH). This study was conducted in the pediatric dental department at Damascus University, Syria. This study was performed at the period from Jan 2023 to April 2023. In this cross-sectional study, a validated questionnaire employing a 5-point Likert scale was used to evaluate esthetics, ease of application, pain perception, and taste acceptability. Participants included 100 parents or guardians of children aged 6-9 years who had received SDF treatment in the past year. The findings of this study revealed high satisfaction levels (77.5%) with the treatment. Parents expressed contentment with the appearance of their child's molars after SDF application (58% agreed or strongly agreed) and found the application process easy and pain-free (100% agreed or strongly agreed). However, taste acceptability posed a challenge, with over half of the parents (53%) finding it unacceptable. Regression analysis underscored the significant impact of esthetics, ease of application, pain perception, and taste on parental satisfaction. Moreover, parents with higher education levels (graduate or postgraduate) exhibited higher acceptance rates compared to those with lower education levels (63.1% vs. 33.6%). Notably, parental gender and age did not significantly influence SDF treatment acceptance. This study provides critical insights into parental satisfaction and acceptance of SDF treatment for MIH-affected permanent molars. Despite concerns about tooth discoloration, the high satisfaction levels suggest that SDF holds promise as an effective treatment option. Parental education significantly influenced acceptance rates. This research highlights the importance of considering parental perspectives and tailoring communication strategies in pediatric dentistry, ultimately contributing to improved care for young patients with MIH.
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Affiliation(s)
- Zuhair Al-Nerabieah
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Muaaz AlKhouli
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Mayssoon Dashash
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria
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Lee GKY, Tan MN, Gao X, Wee HL, Lai BWP, Hong CHL, Hu S. Acceptance of silver diamine fluoride use in community dwelling older adults, nursing home residents, and caregivers. J Dent 2024; 141:104819. [PMID: 38128821 DOI: 10.1016/j.jdent.2023.104819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES To compare the level of acceptance of silver diamine fluoride (SDF) treatment between different functional groups of older adults aged 65-years-old and above. METHODS Three groups were recruited representing functionally-independent ("Community dwelling"), frail ("Nursing home"), and functionally-dependent older adults ("Caregiver": proxy respondent involved in caring for an older adult of all functional levels). Participants viewed a video on SDF and an interviewer-led questionnaire collected demographics, dental experience and perception on SDF use. RESULTS The study recruited 201 participants (100 "Community dwelling", 51 "Nursing home", 50 "Caregiver"). Overall, 73 % of participants were accepting of SDF treatment. Those in the "Community dwelling" group were most accepting (85 %), followed by the "Nursing home" group (61 %) and "Caregiver" group (60 %) (p<0.001). Participants were more accepting of SDF use on posterior (73 %) compared to anterior teeth (46 %). They were more accepting when SDF was presented as a treatment to avoid infection and pain (87 %), and general anesthesia (78 %). In a regression analysis, "Nursing home" and "Caregiver" participants were three times less likely to accept SDF (OR 0.27 [95 % CI: 0.13 to 0.60], and OR 0.27 [95 % CI: 0.12 to 0.58] respectively) compared to "Community dwelling" participants. After adjusting for other factors, only the "Caregiver" group remained significant (Adjusted OR 0.32 [95 % CI: 0.13 to 0.78]). CONCLUSIONS Older adults were accepting of SDF and this treatment modality has the potential to be a routine treatment option in dental caries management in this population. However, this was less certain among frail and functionally dependent older adults. CLINICAL SIGNIFICANCE An SDF program to manage caries is likely to be well-received by functionally-independent older adults. However, the acceptance among frail and functionally-dependent older adults were lower even though SDF is mostly likely to benefit these populations. There is a need to investigate this relatively lower levels of acceptance.
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Affiliation(s)
| | - Mei Na Tan
- National University Centre for Oral Health Singapore, National University Health System, Singapore
| | - Xiaoli Gao
- Faculty of Dentistry, National University of Singapore, Singapore; Saw Swee Hock School of Public Heath, National University of Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Heath, National University of Singapore, Singapore
| | - Bien Wen Pui Lai
- Paediatric Dentistry Unit, National Dental Centre Singapore, Singapore
| | | | - Shijia Hu
- Faculty of Dentistry, National University of Singapore, Singapore.
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Phan D, Wen ZT, Fidel PL, Chapple AG, Collins A, Johnson JT. Silver Diammine Fluoride Usage in General Dentistry Offices in Louisiana. J Dent Child (Chic) 2024; 91:3-9. [PMID: 38671573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Purpose: To evaluate the current knowledge and usage of silver diammine fluoride (SDF) by general dentists in Louisiana and to identify primary barriers to the imple- mentation of SDF. Methods: A 16-item survey was emailed to 1719 Louisiana Dental Association members to identify factors influencing general dentists' usage of SDF. Results: Eighty-two surveys were completed with a response rate of 4.8 percent, with 69 identified as general dentists. Over half of the respondents were male (53.6%) and their practice experience ranged from less than one year to 48 years. The majority were solo owners (43.5%) while 7.3 percent had jobs in the corporate setting. Most agreed/strongly agreed that their knowledge of SDF was from either dental journals or online resources, while fewer stated they were taught about SDF (25%) or used SDF (8%) in dental school. The majority knew the advantages and off-label usage of SDF. However, only 40 percent recognized that SDF was officially approved for tooth hypersensitivity only. The most reported perceived barrier to SDF implementation was not learning about SDF in dental school (36%). Conclusion: There is a lack of understanding of SDF usage among Louisiana general dentists. The main reason for not incorporating SDF into their practice is the lack of training in their dental education.
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Affiliation(s)
- Dean Phan
- Private practice, Corinth, Texas, USA;,
| | - Zezhang Tom Wen
- Department of Oral and Craniofacial Biology, School of Dentistry
| | - Paul L Fidel
- Department of Oral and Craniofacial Biology, School of Dentistry
| | - Andrew G Chapple
- Stanley S. Scott Cancer Center, School of Medicine, LSU Health Sciences Center, New Orleans, La., USA
| | - Alexa Collins
- Department of Oral and Craniofacial Biology, all at the School of Dentistry
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Fontana M, Khera D, Levy S, Eckert G, Katz B, Yanca E, González-Cabezas C, Moursi A. A Randomized Clinical Trial to Assess Caries Arrest by Using Silver Diamine Fluoride in U.S. Children: Interim Findings. Pediatr Dent 2024; 46:8-12. [PMID: 38449039 PMCID: PMC10921985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Purpose: To assess the effectiveness of 38 percent silver diamine fluoride (SDF) in arresting cavitated caries lesions in young U.S. children. Methods: Children 12 to 71 months of age with severe early childhood caries participated in this phase three, multicenter, randomized, placebocontrolled trial. SDF was applied twice (at baseline and six months), and children were followed for eight months. A planned interim analysis of only the six-month primary outcome caries arrest data, for approximately half of the cohort (680 of 1,144 children), was conducted using a generalized estimating equation model, accounting for non-independence among carious lesions within a patient. Results: Five hundred ninety-nine of the 680 participants, with 1,413 lesions, completed the six-month exam. Lesions in the SDF group demonstrated 54 percent arrest versus 21 percent in the placebo (P<0.001). Conclusions: Silver diamine fluoride was effective at arresting active cavitated lesions in this population, leading to the early stop of the trial. Final analyses of all data and other outcomes are currently underway.
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Affiliation(s)
- Margherita Fontana
- Clifford Nelson Endowed Professor of Dentistry, Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich., USA
| | - Divya Khera
- Clinical Assistant Professor, Department of Pediatric Dentistry, College of Dentistry, New York University, New York, NY, USA
| | - Steven Levy
- Wright-Bush-Shreves Endowed Professor of Research, Department of Preventive and Community Dentistry, College of Dentistry, and professor, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - George Eckert
- Biostatistician, Department of Biostatistics and Health Data Science, School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Ind., USA
| | - Barry Katz
- Professor Emeritus, Department of Biostatistics and Health Data Science, School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Ind., USA
| | - Emily Yanca
- Clinical Research Project Manager, Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich., USA
| | - Carlos González-Cabezas
- Richard Christiansen Collegiate Professor, Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Mich., USA
| | - Amr Moursi
- Professor and Chair, Department of Pediatric Dentistry, College of Dentistry, New York University, New York, NY, USA
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Abdellatif EB, El Kashlan MK, El Tantawi M. Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial. BMC Oral Health 2023; 23:875. [PMID: 37978488 PMCID: PMC10656986 DOI: 10.1186/s12903-023-03597-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. METHODS Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents' satisfaction with their children's appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. RESULTS The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children's appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). CONCLUSION SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. TRIAL REGISTRATION This trial was registered in the clinicaltrials.gov registry (#NCT05642494).
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Affiliation(s)
- Enas B Abdellatif
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt.
| | - Mona K El Kashlan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
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He S, Wu S, Duangthip D, Chu CH, Lo ECM. Teaching of silver diamine fluoride for the management of dental caries and hypersensitivity - situation in the Southeast Asia dental schools. BMC Oral Health 2023; 23:815. [PMID: 37898744 PMCID: PMC10613390 DOI: 10.1186/s12903-023-03502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/07/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Using silver diamine fluoride (SDF) for caries management has raised dentists' interests in Southeast Asia (SEA). However, information about the teaching of SDF in dental schools in SEA is limited. Therefore, this survey aimed to describe the extent to which SDF had been introduced into the education of undergraduate students in the dental schools in SEA. METHODS An online questionnaire survey was conducted on the duration, method, contents, and barriers regarding the teaching of SDF. Teachers in charge of undergraduate program in pediatric dentistry and those in community dentistry in all the 90 dental schools in SEA were approached and we required each department to reply once only. Descriptive statistics and Chi-square test were used to describe and assess the differences between the two departments in the teaching of SDF. RESULTS A total of 81 responses from the departments of 49 schools were received, giving a school-level response rate of 54% (49/90). SDF was taught in the undergraduate program in 86% (42/49) of the respondent schools, and 50% (21/42) of these schools had included SDF in the teaching for five or more years. Almost all (98%) of the departments taught SDF through lectures. Furthermore, 55% of them adopted SDF in clinical practice. Regarding the teaching content, the use of SDF for arresting cavitated caries lesion was the most commonly covered (82-97%), followed by for arresting early noncavitated lesions (69-82%), for preventing new caries development (66-79%) and for treating dental hypersensitivity (77%). There were variations in the post-treatment instruction taught. For the departments not teaching SDF, the most common reason (10/19, 53%) was that SDF was not available. CONCLUSION SDF is covered in the undergraduate program in most of the dental schools in SEA. The use of SDF to arrest cavitated caries lesions in primary teeth is usually taught. However, other applications of SDF, such as for prevention of caries and treatment of dental hypersensitivity, are less commonly mentioned in the teaching.
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Affiliation(s)
- Shuyang He
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Rd, Sai Wan Hong Kong, China
| | - Sicheng Wu
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Rd, Sai Wan Hong Kong, China
| | - Duangporn Duangthip
- Restorative Dental Sciences, Faculty of Dentistry, The Universitry of Hong Kong, 34 Hospital Rd, Hong Kong, Sai Wan, China
| | - Chun Hung Chu
- Restorative Dental Sciences, Faculty of Dentistry, The Universitry of Hong Kong, 34 Hospital Rd, Hong Kong, Sai Wan, China
| | - Edward Chin Man Lo
- Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Rd, Sai Wan Hong Kong, China.
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Yassin R, Amer H, Tantawi ME. Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother's motivational interviewing for arresting early childhood caries: a randomized clinical trial. BMC Oral Health 2023; 23:710. [PMID: 37789300 PMCID: PMC10548636 DOI: 10.1186/s12903-023-03456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Silver Diamine Fluoride (SDF) has gained attention as one of the minimally invasive modalities to manage ECC although it causes black staining of treated carious lesions. A possible affordable alternative may be Sodium Fluoride (NaF) varnish combined with good oral hygiene promoted by parental Motivational Interviewing (MI). The study compared the effectiveness of 38% SDF solution and 5% NaF varnish supported by parental MI in arresting ECC. MATERIALS AND METHODS Children aged ≤ 4 years old with at least one active carious lesion (ICDAS score ≥ 3) were randomly assigned to treatment by a single application of 38% SDF solution or a single application of 5% NaF varnish supported by two MI sessions for mothers at baseline and after three months. Chi-Squared test was used to compare groups and multilevel logistic regression analysis was used to assess the effect of the interventions on ECC arrest adjusting for confounders. The interaction between the type of intervention and baseline lesion severity, moderate (ICDAS 3/4) or advanced (ICDAS 5/6), was also assessed. RESULTS The study included 165 children with 949 active lesions. After 6 months, there were no significant differences between SDF and NaF/MI groups in overall caries arrest (63.7% and 58.1%, p = 0.08), and in moderate lesions (72.9% and 69.6%, p = 0.52). However, in advanced lesions, the arrest rate was significantly higher in the SDF than the NaF/ MI group (60.3% and 50.0%, P = 0.01). Multilevel multiple logistic regression showed no significant differences between the interventions (AOR = 1.56, P = 0.27) with significant interaction between the intervention and baseline lesion severity (p < 0.001). Moderate lesions treated with SDF (AOR = 3.69, P = 0.008) or NaF/MI (AOR = 3.32, P < 0.001) had significantly higher odds of arrest than advanced lesions treated with NaF/ MI with no difference between advanced lesions treated with SDF or NaF/ MI (AOR = 1.85, P = 0.155) in arrest rate. CONCLUSION NaF/ MI can be an alternative to SDF in arresting advanced and moderate ECC lesions without staining with stronger effect on moderate lesions (ICDAS 3/4). TRIAL REGISTRATION The trial was retrospectively registered at clinicaltrial.gov registry (#NCT05761041) on 9/3/2023.
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Affiliation(s)
- Randa Yassin
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Hala Amer
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Chan AKY, Tsang YC, Jiang CM, Leung KCM, Lo ECM, Chu CH. Treating hypersensitivity in older adults with silver diamine fluoride: A randomised clinical trial. J Dent 2023; 136:104616. [PMID: 37454789 DOI: 10.1016/j.jdent.2023.104616] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the desensitizing effect of topically applied 38% silver diamine fluoride (SDF) solution on the exposed root surface of hypersensitive teeth in older adults. METHOD This double-blind randomised clinical trial recruited healthy older adults with dentine hypersensitivity. A trained examiner tested the most hypersensitive tooth root surface with a blast of compressed cold air from a three-in-one syringe. The participants gave a sensitivity score (SS) in visual analogue scale from 0 (no pain) to 10 (agonizing) at the baseline visit. Then, they received 38% SDF or 5% potassium nitrate solution (control) as intervention on the root surface. After the intervention, they received a compressed cold air test and reported the SS again. The compressed cold air test followed by intervention was repeated at 4- and 8-week follow ups. The primary outcome was the reduction in SS at 8-week follow-up with reference to the SS at baseline before intervention. Shapiro-Wilk and Mann-Whitney U tests were performed for data analysis following a normality test of SS. RESULTS This trial recruited 148 participants, and 139 (94%) participants completed the trial. The median percentage reductions in SS in the SDF and potassium nitrate groups were 60% and 50%, respectively (p < 0.001). CONCLUSION According to the results, 38% SDF solution reduced hypersensitivity on the exposed root surface of older adults. In addition, 38% SDF was more effective than 5% potassium nitrate solution to reduce hypersensitivity on the exposed root surface of older adults. CLINICAL SIGNIFICANCE Dentin hypersensitivity is common amongst older adults and negatively affects their quality of life. To date, there is no gold standard professionally applied desensitizing therapy in treating hypersensitivity. Evidence from this clinical trial could aid clinical practice and improve oral health in older adults. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov (NCT05392868).
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Affiliation(s)
- Alice Kit Ying Chan
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Yiu Cheung Tsang
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chloe Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Postal address: 3/F, The Prince Philip Dental Hospital, 34, Hospital Road, Sai Ying Pun, Hong Kong, China.
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Rinsathon J, Wiriyasuebpong S, Thariya K, Jiradechochai P, Phetsuk P, Bouanil S, Saikaew P, Pawaputanon Na Mahasarakham C. Bonding performance of glass ionomer cement to carious dentin treated with different surface treatment protocols using silver diamine fluoride. Sci Rep 2023; 13:14233. [PMID: 37648840 PMCID: PMC10468524 DOI: 10.1038/s41598-023-41511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023] Open
Abstract
This study investigated the influence of silver diamine fluoride (SDF) on the shear bond strength (SBS) to artificial carious dentin and GIC restorations with various SDF application protocols. Artificial caries were prepared on human dentin discs using bacteria model. These samples were randomly allocated to five groups (n = 10/group) according to the following treatment: (1) control group (CD): no treatment (2) CSR: dentin conditioner, SDF, and rinsing (3) CS: dentin conditioner and SDF (4) SRC: SDF, rinsing and dentin conditioner, and (5) SC: SDF and dentin conditioner. The treated-dentin surface was bonded with GIC and subjected to SBS test. Mean SBS was analyzed using one-way ANOVA. Surface morphology and elemental contents after surface treatment were examined (n = 3/group) by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX). There was no significant difference in the mean SBS among CD (2.45 ± 0.99 MPa), CSR (1.76 ± 0.65 MPa), and SRC (2.64 ± 0.95 MPa). Meanwhile, the mean SBS of CS (0.35 ± 0.21 MPa) was significantly lower than the control and SRC group. SEM/EDX demonstrated deeper silver penetration in CSR and CS groups when compared to SRC and SC groups. SDF-modified GIC restorations resulted in significantly lower bond strength in CS and SC groups. The findings suggested treating the carious dentin surface with CSR and SRC protocol. SDF-treated carious dentin should be rinsed off prior to restore with GIC.
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Affiliation(s)
| | - Suthinee Wiriyasuebpong
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Kunwara Thariya
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Panupong Jiradechochai
- Department of Restorative Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Porada Phetsuk
- Research Unit, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Sanit Bouanil
- Research Unit, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pipop Saikaew
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Timms L, Bux S, Maybin L, Rogers H, Horisk K, Fraser J, Large J, Deery C, Ashley P, Keightley A, Sumner O. A multi-site service evaluation of silver diamine fluoride use for children. Br Dent J 2023; 235:269-272. [PMID: 37620483 PMCID: PMC10449624 DOI: 10.1038/s41415-023-6175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 08/26/2023]
Abstract
Introduction The use of silver diamine fluoride (SDF) is relatively new to the UK. It is unknown how it is being used and for what indications in UK paediatric dental services.Aim To: 1) establish how SDF is being used across different paediatric dental settings in the UK; and 2) consider parental and patient views on the treatment experience and side effect of discolouration.Method A multi-site service evaluation was carried out across six paediatric dentistry units covering hospital and community services. Data were collected prospectively from 17/02/2020 to 02/03/2022. Simple descriptive statistics were used to analyse the data.Results Data were collected for 54 patients. The included patients had an age range of 2-13 years, with a mean of 4.9 years. The reason SDF was chosen was reported as: to avoid general anaesthetic (n = 25); to avoid extractions (n = 8); stabilisation (n = 25); acclimatisation (n = 24); and insufficient cooperation for other treatment (n = 17). In total, 42 cases had SDF applied to the primary dentition. This was in the anterior dentition for 18 patients and the posterior dentition for 15, with nine patients having SDF applied both anteriorly and posteriorly. The majority of children and parents were accepting of the technique and immediate aesthetic outcome.Conclusion In the services involved in this multi-site service evaluation, SDF is used for young patients in the primary dentition for the purpose of caries arrest. The technique was viewed positively by the majority of parents and children.
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Affiliation(s)
- Laura Timms
- Doctoral Fellow, Paediatric Dentistry, University of Sheffield, United Kingdom.
| | - Sara Bux
- Dental Officer, Central London Community Health, United Kingdom
| | - Linzi Maybin
- Senior Dental Officer, Bradford District Care NHS Foundation Trust, United Kingdom
| | - Helen Rogers
- Clinical Lecturer, Paediatric Dentistry, University of Newcastle, United Kingdom
| | - Katie Horisk
- Paediatric Dentistry Registrar, Eastman Dental Hospital, United Kingdom
| | - Jacqueline Fraser
- Dental Core Trainee 2 in Oral and Maxillofacial Surgery, Crosshouse Hospital, United Kingdom
| | - Jessica Large
- Paediatric Dentistry Registrar, Charles Clifford Dental Hospital, Sheffield, United Kingdom
| | - Chris Deery
- Professor in Paediatric Dentistry, University of Sheffield, United Kingdom
| | - Paul Ashley
- Professor in Paediatric Dentistry, University College London, United Kingdom
| | - Alex Keightley
- Consultant in Paediatric Dentistry, Edinburgh Dental Institute, United Kingdom
| | - Oliver Sumner
- Consultant in Paediatric Dentistry, Newcastle Dental Hospital, United Kingdom
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Sommerfeldt W, Gellert P, Müller A, Götze N, Göstemeyer G. Older patients' perception of treating root caries with silver diamine fluoride - a qualitative study based on the Theoretical Domains Framework. J Dent 2023; 130:104408. [PMID: 36626976 DOI: 10.1016/j.jdent.2022.104408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Caries treatment with silver diamine fluoride (SDF) is effective, but often leads to irreversible tooth discoloration. This study aimed to investigate older patients' perceptions of root caries treatment with SDF and to identify factors that influence their decision process. METHODS Fifteen interviews were conducted in older patients (mean, min/max: 83, 71/92 years) with root caries experience, following a semi-structured interview-guide based on the domains of the Theoretical Domains Framework (TDF) including three case vignettes of SDF treatment. Transcripts of the interviews were used to perform deductive and inductive content analysis along the TDF and Capability-Opportunity-Motivation-Behavior model (COM-B) to assess influential factors. RESULTS All TDF domains and behavior determinants of the COM-B were covered, identifying twenty-two barriers, facilitators and conflicting themes. Main barriers for consenting to SDF treatment were patients' perceptions of permanent staining of visible root caries lesions, as well as preconceptions about those of others and lack of knowledge about root caries and SDF. Main facilitators were trust in advice given by dentists, especially regarding new treatment options, that aesthetics were less important in non-visible areas and the importance of tooth preservation and feasibility of treatments when immobile or in need of care. CONCLUSION Permanent discoloration is an important barrier to older patients' acceptance of SDF treatment for visible root caries. However, patients appear to accept SDF treatment under certain conditions, including less visible lesions or in comparison to more invasive treatment options. CLINICAL SIGNIFICANCE Our findings contribute to understanding both barriers and facilitators when treating root caries in older patients with SDF.
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Affiliation(s)
- Wiebke Sommerfeldt
- Department of Operative, Preventive and Pediatric Dentistry, Charité Centre for Dental Medicine, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Müller
- Department of Oral Diagnostics, Digital Health and Health Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nirina Götze
- Department of Operative, Preventive and Pediatric Dentistry, Charité Centre for Dental Medicine, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Gerd Göstemeyer
- Department of Operative, Preventive and Pediatric Dentistry, Charité Centre for Dental Medicine, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
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Brunet‐Llobet L, Auría‐Martín B, González‐Chópite Y, Cahuana‐Bartra P, Mashala EI, Miranda‐Rius J. The use of silver diamine fluoride in a children's hospital: Critical analysis and action protocol. Clin Exp Dent Res 2022; 8:1175-1184. [PMID: 35869630 PMCID: PMC9562575 DOI: 10.1002/cre2.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives The present critical analysis aims to propose an action protocol for the use of silver diamine fluoride (SDF) in pediatric patients in a hospital setting, especially for those who are currently awaiting hospital dental treatment under general anesthesia. Material and Methods A literature search was performed in the PubMed/MEDLINE from 2009 to 2021 using the search terms “silver diamine fluoride”, “pediatrics silver diamine fluoride”, “application silver diamine fluoride”, and “AND” ‐ combined with terms: “potassium iodide”, “properties”, “adverse effects”, “early childhood caries”, “patient with disability”, “management”, “special health care needs patient”. Articles that recorded the type of teeth, application protocol, the concentration of the product, and possible complications of the treatment were selected. Results Four hundred and sixteen related articles were obtained, of which 13 were finally chosen on the basis of the search criteria. The age at which the use of SDF was recommended ranged from the first year of life to 12 years, in most cases in primary teeth. The study populations varied in size from 53 to 799 patients. An analysis of the characteristics of SDF and its use in pediatric patients with dental caries was performed. The recommended concentration was 38% SDF, applied twice yearly. The main complication reported was staining. A decision algorithm was designed including SDF as an agent for caries control in patients attending the specific population of our hospital (divided into two groups: healthy children aged 0−4 years and patients with special health care needs (SHCNs) aged 0−18 years). Conclusions SDF therapy appears to be effective in the control of caries in pediatric patients. We propose an action protocol for patients with early childhood caries to reduce risk, complications, and the progression of lesions. The protocol is aimed especially at pediatric patients who also have some systemic pathology, disability, SHCNs, and/or behavioral difficulties.
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Affiliation(s)
- Lluís Brunet‐Llobet
- Department of Pediatric Dentistry, Hospital Sant Joan de DéuUniversity of BarcelonaBarcelonaSpain
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD)BarcelonaSpain
| | - Beatriz Auría‐Martín
- Department of Pediatric Dentistry, Hospital Sant Joan de DéuUniversity of BarcelonaBarcelonaSpain
| | - Yndira González‐Chópite
- Department of Pediatric Dentistry, Hospital Sant Joan de DéuUniversity of BarcelonaBarcelonaSpain
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD)BarcelonaSpain
| | - Pau Cahuana‐Bartra
- Department of Pediatric Dentistry, Hospital Sant Joan de DéuUniversity of BarcelonaBarcelonaSpain
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD)BarcelonaSpain
- Department of Odontostomatology, Faculty of Medicine and Health SciencesUniversity of BarcelonaBarcelonaSpain
| | - Elias Isaack Mashala
- Doctoral Programme in Medicine and Translational Research, Line of Odontostomatology. Faculty of Medicine and Health Sciences, Hospital Sant Joan de DéuUniversity of BarcelonaBarcelonaSpain
| | - Jaume Miranda‐Rius
- Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg)Institut de Recerca Sant Joan de Déu (IRSJD)BarcelonaSpain
- Department of Odontostomatology, Faculty of Medicine and Health SciencesUniversity of BarcelonaBarcelonaSpain
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Chai HH, Kiuchi S, Osaka K, Aida J, Chu CH, Gao S(S. Knowledge, Practices and Attitudes towards Silver Diamine Fluoride Therapy among Dentists in Japan: A Mixed Methods Study. Int J Environ Res Public Health 2022; 19:ijerph19148705. [PMID: 35886557 PMCID: PMC9319621 DOI: 10.3390/ijerph19148705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/23/2022] [Accepted: 07/14/2022] [Indexed: 12/24/2022]
Abstract
In 2021, the World Health Organization included silver diamine fluoride (SDF) as an essential medicine to manage caries in adults and children. SDF was developed in the 1960s, but its use for children became unpopular in Japan because of the decline and low prevalence of early childhood caries. This mixed methods study explored the knowledge, practices and attitudes towards SDF therapy among dentists promoting fluoride use in Japan. It also investigated senior dentists’ perceptions of SDF therapy in Japan. The quantitative study invited all 173 members of the largest organisation promoting fluoride use in Japan to complete a web-based questionnaire survey. Sixty (60/173; 35%) dentists promoting fluoride use in Japan completed the questionnaire survey. All dentists knew of SDF treatment, and 50 (50/60; 83%) used SDF for dental care. Fifty-nine dentists (59/60; 98%) agreed that SDF therapy was simple and quick. All 60 dentists agreed that SDF was effective to arrest caries; 51 dentists (51/60; 85%) agreed that SDF was effective to prevent caries. Most dentists (51/60; 85%) were concerned about SDF’s unaesthetic staining. Fifty-seven dentists (57/60; 95%) used SDF to arrest primary posterior teeth, and 52 dentists (52/60; 87%) used SDF to arrest root caries. However, 25 dentists (25/60; 42%) did not use SDF to prevent caries in permanent teeth. The qualitative study interviewed 12 senior dentists using snowball sampling and achieved data saturation. The dentists opined that SDF therapy was effective, simple, painless, non-invasive and inexpensive. SDF is seldom used in Japan at present because of the unaesthetic black staining and the low prevalence of early childhood caries; however, it can regain popularity by arresting root caries in the aging population.
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Affiliation(s)
- Hollis Haotian Chai
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China;
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
| | - Sakura Kiuchi
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
| | - Ken Osaka
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
| | - Jun Aida
- Graduate School of Dentistry, Tohoku University, Sendai 980-8577, Japan; (S.K.); (K.O.); (J.A.)
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
| | - Shiqian (Sherry) Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361005, China;
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
- Correspondence:
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Ruff RR, Whittemore R, Grochecki M, Bateson J, Barry Godín TJ. Silver diamine fluoride and oral health-related quality of life: A review and network meta-analysis. PLoS One 2022; 17:e0261627. [PMID: 35104291 PMCID: PMC8806055 DOI: 10.1371/journal.pone.0261627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/06/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Silver diamine fluoride (SDF) is an effective non-surgical treatment for dental caries which may also impact oral health-related quality of life (OHRQoL). The objective of this study was to conduct a network meta-analysis of SDF versus other standard of care therapies on OHRQoL. DATA SOURCES Studies published in PubMed/MEDLINE, Scopus, or Web of Science through July 2021 with no date or language restrictions. STUDY SELECTION Any randomized controlled trial, cohort, or case-control study that included silver diamine fluoride as either a single or combinative treatment for dental caries and a quantitatively measured outcome for oral health-related quality of life was included. DATA EXTRACTION AND SYNTHESIS Potentially eligible studies were screened by two independent reviewers trained in conducting systematic reviews. Studies meeting inclusion criteria underwent a full-text review with data being extracted using a standardized form, including publication details, study methodology, outcomes, assessors, and sample information. Studies underwent a risk of bias assessment. Quantitative synthesis was performed using fixed effects meta-analysis and individual comparisons were assessed via network meta-analysis. MAIN OUTCOME(S) AND MEASURE(S) Oral health-related quality of life. RESULTS 19 articles were returned following search strategies. Following screening, ten studies were evaluated for full-text eligibility and five were retained for meta-analyses. Results across all treatments indicate no differences in OHRQoL when compared to SDF (SMD = -0.06, 95% CI = -0.20, 0.08). Direct and indirect estimates from network meta-analysis indicated that OHRQoL in children was not significantly different when treated with SDF versus atraumatic restorations (d = 0.02, 95% CI = -0.32, 0.36) or placebo (d = 0.03, 95% CI = -0.16, 0.22). CONCLUSIONS Evidence from the literature consistently shows no discernible impact on OHRQoL across various non-surgical treatments for dental caries. Overall oral health-related quality of life may increase regardless of treatment protocol due to treatment of the underlying disease. Concerns over the staining of dental decay and oral mucosa resulting from treatment with silver diamine fluoride do not seem to affect OHRQoL.
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Affiliation(s)
- Ryan Richard Ruff
- Department of Epidemiology & Health Promotion, New York College of Dentistry, New York, New York, United States of America
| | - Rachel Whittemore
- Department of Epidemiology & Health Promotion, New York College of Dentistry, New York, New York, United States of America
| | - Martyna Grochecki
- Department of Epidemiology & Health Promotion, New York College of Dentistry, New York, New York, United States of America
| | - Jillian Bateson
- Department of Epidemiology & Health Promotion, New York College of Dentistry, New York, New York, United States of America
| | - Tamarinda J. Barry Godín
- Department of Epidemiology & Health Promotion, New York College of Dentistry, New York, New York, United States of America
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Liu S, Chai J, Sun S, Zhang L, Yang J, Fu X, Hai J, Jing YH, Wang B. Site-Selective Photosynthesis of Ag-AgCl@Au Nanomushrooms for NIR-II Light-Driven O 2- and O 2•--Evolving Synergistic Photothermal Therapy against Deep Hypoxic Tumors. ACS Appl Mater Interfaces 2021; 13:46451-46463. [PMID: 34570459 DOI: 10.1021/acsami.1c16999] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Light-driven endogenous water oxidation has been considered as an attractive and desirable way to obtain O2 and reactive oxygen species (ROS) in the hypoxic tumor microenvironment. However, the use of a second near-infrared (NIR-II) light to achieve endogenous H2O oxidation to alleviate tumor hypoxia and realize deep hypoxic tumor phototherapy is still a challenge. Herein, novel plasmonic Ag-AgCl@Au core-shell nanomushrooms (NMs) were synthesized by the selective photodeposition of plasmonic Au at the bulge sites of the Ag-AgCl nanocubes (NCs) under visible light irradiation. Upon NIR-II light irradiation, the resulting Ag-AgCl@Au NMs could oxidize endogenous H2O to produce O2 to alleviate tumor hypoxia. Almost synchronously, O2 could react with electrons on the conduction band of the AgCl core to generate superoxide radicals (O2•-)for photodynamic therapy. Moreover, Ag-AgCl@Au NMs with an excellent photothermal performance could further promote the phototherapy effect. In vitro and in vivo experimental results show that the resulting Ag-AgCl@Au NMs could significantly improve tumor hypoxia and enhance phototherapy against a hypoxic tumor. The present study provides a new strategy to design H2O-activatable, O2- and ROS-evolving NIR II light-response nanoagents for the highly efficient and synergistic treatment of deep O2-deprived tumor tissue.
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Affiliation(s)
- Sha Liu
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
| | - Jian Chai
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
| | - Shihao Sun
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
| | - Lang Zhang
- Institute of Anatomy and Histology & Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China
| | - Jiayue Yang
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
| | - Xu Fu
- Laboratory of Emergency Medicine, Lanzhou University Second Hospital, Lanzhou 730000, P. R. China
| | - Jun Hai
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
| | - Yu-Hong Jing
- Institute of Anatomy and Histology & Embryology, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China
| | - Baodui Wang
- Key Laboratory of Nonferrous Metal Chemistry and Resources Utilization of Gansu Province, State Key Laboratory of Applied Organic Chemistry, College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou 730000, P. R. China
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Eldebany N, Abd Elkodous M, Tohamy H, Abdelwahed R, El-Kammar M, Abou-Ahmed H, Elkhenany H. Gelatin Loaded Titanium Dioxide and Silver Oxide Nanoparticles: Implication for Skin Tissue Regeneration. Biol Trace Elem Res 2021; 199:3688-3699. [PMID: 33200397 DOI: 10.1007/s12011-020-02489-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/09/2020] [Indexed: 10/23/2022]
Abstract
Treatment of burn wounds has many requirements to ensure wound closure with healthy tissue, increased vascularization, guarantee edema resolution, and control bacterial infection. We propose that titanium oxide (TiO2) nanoparticles (NPs) will be more efficient than silver dioxide (Ag2O) in the treatment of burn wounds. Herein, gelatin loaded NPs (GLT-NPs) were evaluated for their efficacy to regenerate second-degree burn wound in rabbit skin. TEM results revealed that the average particle sizes were ⁓ 7.5 and 17 nm for Ag2O and TiO2 NPs, respectively. The results of the in vivo application of GLT-NPs on burn wound in the rabbit revealed that both Ag2O and TiO2 NPs were efficient than the control none treated (CTRL) and GLT group. In terms of the healing rate, the GLT-TiO2 did not show any significant difference than GLT-Ag2O (99.57% vs. 99.85%, p = 0.2). Meanwhile, the healing rate was significantly higher in both NPs' treated groups than CTRL (94.16%, p < 0.01) and GLT group (95.07%, p < 0.05). Also, the histological analysis using H&E staining showed re-epithelization, less edema, and enhanced vascularization in both GLT-NPs than CTRL and GLT groups. Furthermore, immunohistochemical analysis of TGF-β1 and α-SMA revealed significantly a higher expression in both GLT-NPs groups than CTRL and GLT groups at weeks 1 and 2 (p < 0.05). Interestingly, TGF-β1 and α-SMA were substantially higher in GLT- TiO2 than GLT-Ag2O at weeks 1 and 2 (p < 0.05), but the expression was not significant at week 3. In conclusion, GLT-NPs showed higher regenerative capacity and enhanced the healing quality after burn wound compared to CTRL and GLT. Graphical abstract.
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Affiliation(s)
- Nermeen Eldebany
- Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt
| | - Mohamed Abd Elkodous
- Department of Electrical and Electronic Information Engineering, Toyohashi University of Technology, 1-1 Hibarigaoka, Tempaku-cho, Toyohashi, Aichi, 441-8580, Japan
- Center for Nanotechnology (CNT), School of Engineering and Applied Sciences, Nile University, Giza, Egypt
| | - Hossam Tohamy
- Department of Pathology, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt
| | - Ramadan Abdelwahed
- Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt
| | - Mahmoud El-Kammar
- Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt
| | - Howaida Abou-Ahmed
- Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt
| | - Hoda Elkhenany
- Department of Surgery, Faculty of Veterinary Medicine, Alexandria University, Alexandria, 21944, Egypt.
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Haiat A, Ngo HC, Samaranayake LP, Fakhruddin KS. The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: A systematic review. PLoS One 2021; 16:e0252734. [PMID: 34115788 PMCID: PMC8195348 DOI: 10.1371/journal.pone.0252734] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
Silver diamine fluoride (SDF) is used in minimally invasive dentistry for arresting dental caries. However, discoloration of teeth is a significant side effect that has limited the use of SDF. Hence, the application of potassium iodide (KI) following SDF has been proposed to ameliorate the staining. Although antimicrobial activity is one of the major mechanisms of the caries-arresting effect of SDF, the antimicrobial potency of SDF/KI combination is unclear. Thus, the primary objective of this systematic review was to appraise the studies on the antimicrobial efficacy of SDF/KI combination on cariogenic microbes. The secondary objective was to summarize the evidence on the potential of KI in reducing the discoloration associated with the application of SDF. Electronic databases of Medline via PubMed, Cochrane Library, Web of Science, and EBSCO host were searched for English language manuscripts from January 2005 to 15th November 2020. The reference lists of these manuscripts were manually searched for additional studies. Twelve studies were included in the final analysis, seven of which have investigated the antimicrobial efficacy of SDF/KI, and the rest have examined the anti-staining potential of KI. The exploratory findings from the reviewed articles revealed the promising antimicrobial potential of SDF/KI on cariogenic microbes associated with dentine caries. There is, however, contradictory evidence on the effect of SDF/KI on tooth color. The reviewed in-vitro studies indicated significant effectiveness of KI in preventing staining. A clinical trial on primary dentition showed 25% reduction in the incidence of staining by SDF after applying KI, while a clinical study on root caries in adults showed no significant effect. Within the methodological limitations of this review, we conclude that for arresting dental caries, SDF could be combined with KI, as there may be a lower likelihood of staining. Further, well-designed clinical trials on the antimicrobial and anti-staining effect of SDF/KI are needed to obtain more robust evidence.
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Affiliation(s)
- Anahita Haiat
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - Hien Chi Ngo
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - Lakshman Perera Samaranayake
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
- Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong
| | - Kausar Sadia Fakhruddin
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Paul B, Sierra MA, Xu F, Crystal YO, Li X, Saxena D, Ruff RR. Microbial population shift and metabolic characterization of silver diamine fluoride treatment failure on dental caries. PLoS One 2021; 16:e0242396. [PMID: 33720954 PMCID: PMC7959385 DOI: 10.1371/journal.pone.0242396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/22/2021] [Indexed: 11/25/2022] Open
Abstract
The objective of this pilot study was to describe the microbial profiles present in the plaque and saliva of children who continued to develop new carious lesions following treatment with silver diamine fluoride ("nonresponders") compared to caries active, caries-free, and children immediately receiving SDF treatment for untreated caries in order to identify potential microbial differences that may relate to a re-incidence of caries. Saliva and plaque samples from infected and contralateral sites were obtained from twenty children who were either caries free, had active carious lesions, were caries active and received SDF treatment immediately before sampling, or had previously received SDF treatment and developed new caries. In total, 8,057,899 Illumina-generated sequence reads from 60 samples were obtained. Reads were processed using the Quantitative Insights Into Microbial Ecology pipeline. Group differences were assessed using Analysis of Variance Models and Tukey Honest Significant Differences. To identify significant taxa between treatment groups, Linear discriminant analysis Effect Size (LefSe) and Analysis of Differential Abundance Taking Sample Variation Into Account were used. Differential abundant analysis indicated that members of the Lachnospiraceae family were significantly enriched in non-responders and the genus Tannerella and species Granulicatella adiances were also highly abundant in this group. LefSe analysis between non-responders and SDF-treated groups revealed that genera Leptotrichia and Granulicatella were enriched in non-responders. We observed the highest abundance of phosphotransferase system and lowest abundance of lipopolysaccharide synthesis in non-responders. The microbiome in dental biofilms is responsible for initiation and progression of dental caries. SDF has been shown to be effective in arresting the progression carious lesions, in part due to its antimicrobial properties. Findings suggest that the differential abundance of select microbiota and specific pathway functioning in individuals that present with recurrent decay after SDF treatment may contribute to a potential failure of silver diamine fluoride to arrest dental caries. However, the short duration of sample collection following SDF application and the small sample size emphasize the need for further data and additional analysis.
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Affiliation(s)
- Bidisha Paul
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, United States of America
| | - Maria A. Sierra
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, United States of America
| | - Fangxi Xu
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, United States of America
| | - Yasmi O. Crystal
- Department of Pediatric Dentistry, New York University College of Dentistry, New York, New York, United States of America
| | - Xin Li
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, United States of America
| | - Deepak Saxena
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, United States of America
| | - Ryan Richard Ruff
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, New York, United States of America
- New York University College of Global Public Health, New York, New York, United States of America
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Rao BR, Kumar R, Haque S, Kumar JM, Rao TN, Kothapalli RVSN, Patra CR. Ag 2[Fe(CN) 5NO]-Fabricated Hydrophobic Cotton as a Potential Wound Healing Dressing: An In Vivo Approach. ACS Appl Mater Interfaces 2021; 13:10689-10704. [PMID: 33621045 DOI: 10.1021/acsami.0c19904] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
There have been reports of different types of wound dressings for various functions and purposes. Cotton being one of the most widely used wound dressing material due to its non-toxic, biodegradable, and other properties is used for fabrication as well as in the form of scaffolds for faster and effective wound closure. Our research team has already demonstrated the role of silver nitroprusside nanoparticles (SNPNPs) for wound healing and antibacterial activity. In the current study, we have developed cotton fabric impregnated with SNPNPs (SNPCFs) which remain photo inert and displayed long-term antimicrobial activity due to the surface modification with the silver nitroprusside complex. These SNPCFs were characterized by various analytical techniques (XRD, FTIR, UV spectroscopy, TGA, TEM, FESEM, EDAX, ICP-OES). The fabricated cotton dressings with nanoparticles showed an improved water contact angle (113-130°) than that of bare cotton gauze (60°) and exhibited more antibacterial property in case of both Gram-negative bacteria (Klebsiella aerogenes and Escherichia coli) and Gram-positive bacteria (Pseudomonas aeruginosa and Bacillus subtilis) even after several washings. The biocompatible nature of SNPCFs was assessed by in vivo chorioallantoic membrane assay that showed no obstruction in the formation of blood vessels. The SNPCFs exhibited better wound healing activity compared to the bare cotton and AgCFs as observed in the C57BL6/J mouse. The histopathological investigation reveals increase in re-epithelialization and deposition of connective tissue. The macrophage (M2) counts in SNPCF-treated skin tissues were supportive of more wound healing activity than mice treated with cotton fabric impregnated with chemically synthesized silver nanoparticles. Based on biodistribution analysis using ICP-OES, the data illustrated that a significant amount of silver is absorbed in the skin tissues of mice as compared to the blood and kidney. Furthermore, the absence of silver from the vital organs (heart, liver, and kidney) corroborates our hypothesis that the SNPCFs can act excellently in treating wounds when topically applied over skin. Thereafter, all these results highlight a strong possibility that SNPCFs exemplify the potential as a new antimicrobial and wound healing agent in future times.
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Affiliation(s)
- Bonda Rama Rao
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Rajnish Kumar
- Polymers & Functional Materials Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Shagufta Haque
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
| | - Jerald Mahesh Kumar
- Animal House, CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad, Uppal Road, Tarnaka, Hyderabad 500007, India
| | - T Nageswara Rao
- Department of Analytical, CSIR-Indian Institute of Chemical Technology, Hyderabad 500007, India
| | - Raju V S N Kothapalli
- Polymers & Functional Materials Division, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, India
| | - Chitta Ranjan Patra
- Department of Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, Uttar Pradesh, India
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Huang C, Wang R, Yan Z. Silver dressing in the treatment of diabetic foot: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24876. [PMID: 33607864 PMCID: PMC7899903 DOI: 10.1097/md.0000000000024876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Diabetic foot (DF) is one of the most common and serious chronic complications of diabetes. At present, there are many dressings used in the treatment of the diabetic foot. Among them, silver dressings are widely used, but the conclusion has not yet been formed. The purpose of this study is to search for relevant studies on the treatment of DF with silver dressings through evidence-based medicine methods and to draw conclusions with higher levels of evidence to provide a basis for the clinical treatment of DF. METHODS Computer search of databases such as CNKI, SinoMed, VIP, Wanfang, PubMed, Embase, and Cochrane Library. The search time is from the establishment of the database to January 23, 2021. Two researchers will independently select studies, collect data, and assess the methodology quality by the Cochrane risk of bias tool. The meta-analysis will be completed by RevMan 5.3 software. RESULTS This systematic review will provide an assessment of the current state of DF, aiming to assess the efficacy of silver dressings for patients with DF. CONCLUSION This systematic review will provide a credible evidence-based for the clinical treatment of DF with silver dressings.
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Affiliation(s)
- Chunhua Huang
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Ruiqi Wang
- Jiangxi University of Traditional Chinese Medicine Nanchang, Jiangxi Province, China
| | - Zhangren Yan
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
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Zheng Z, Chen Q, Dai R, Jia Z, Yang C, Peng X, Zhang R. A continuous stimuli-responsive system for NIR-II fluorescence/photoacoustic imaging guided photothermal/gas synergistic therapy. Nanoscale 2020; 12:11562-11572. [PMID: 32432283 DOI: 10.1039/d0nr02543g] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Nanosystems responsive to a tumor microenvironment (TME) have recently attracted great attention due to their potential in precision cancer theranostics. However, theranostic nanosystems with a TME-activated consecutive cascade for the accurate diagnosis and treatment of cancer have rarely been exploited. Herein, an activatable theranostic nanosystem (Bi2S3-Ag2S-DATS@BSA-N3 NYs) is designed and constructed on the basis of a one-pot biomineralization method and surface functional modification to improve second near-infrared (NIR-II) fluorescence/photoacoustic (PA) imaging-guided photothermal therapy (PTT)/gas therapy (GT). Based on enhanced penetration and retention (EPR) effect-mediated tumor accumulation, the tumor-overexpressed glutathione (GSH) can accelerate hydrogen sulfide (H2S) generation from the nanoparticles by reacting with the encapsulated diallyl trisulfide (DATS). Meanwhile, the in situ released H2S can be used not only for gas therapy, but also to start the reduction of -N3(-) to -NH2(+), thereby enhancing the tumor-specific aggregation of NYs. As a result, the activatable nanosystems with excellent tumor accumulation and biodistribution could achieve an accurate NIR-II/PA dual-modality imaging for guiding the synergistic anticancer efficacy (PTT/GT). Thus, this work provides a promising TME-mediated continuously responsive strategy for efficient anticancer therapy.
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Affiliation(s)
- Ziliang Zheng
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, China and The Affiliated Da Yi Hospital of Shanxi Medical University, Taiyuan 030032, China.
| | - Qi Chen
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, China and The Affiliated Da Yi Hospital of Shanxi Medical University, Taiyuan 030032, China.
| | - Rong Dai
- College of Chemistry and Chemical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Zhuo Jia
- College of Chemistry and Chemical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Chenhua Yang
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, China
| | - Xiaoyang Peng
- Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan 030001, China
| | - Ruiping Zhang
- The Affiliated Da Yi Hospital of Shanxi Medical University, Taiyuan 030032, China.
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27
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Gao SS, Chen KJ, Duangthip D, Wong MCM, Lo ECM, Chu CH. Preventing early childhood caries with silver diamine fluoride: study protocol for a randomised clinical trial. Trials 2020; 21:140. [PMID: 32019596 PMCID: PMC7001262 DOI: 10.1186/s13063-020-4088-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/18/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Silver diamine fluoride (SDF) solution is effective in arresting early childhood caries (ECC). Previous studies have suggested that it might exert a preventive effect in managing ECC. However, no well-designed clinical trials have yet been performed to study the effect of SDF on caries prevention. The objective of this randomised clinical trial is to determine whether 38% SDF solution is superior to 5% sodium fluoride (NaF) varnish in preventing new carious lesions in primary anterior teeth. METHODS/DESIGN This is a phase II, single-centre, randomised, double-blind, active-controlled, parallel-group pragmatic trial. The hypothesis tested is that 38% SDF would be more effective than 5% NaF in preventing new caries development in primary anterior teeth. Approximately 730 3-year-old children who are generally healthy and with parental consent will be recruited from Hong Kong kindergartens. This sample size will be sufficient for appropriate statistical analysis of a superiority trial with 90% power, allowing for a 20% drop-out rate. Stratified randomisation will be adopted for allocating the intervention. The intervention will either be 38% SDF or 5% NaF (as a positive control) therapy on primary upper anterior teeth. A single trained examiner will conduct a dental examination every 6 months until 30 months in kindergarten. Another operator will provide fluoride therapy immediately after each dental examination. The examiner, children and children's parents will be blinded to the treatment allocation. A questionnaire survey will be conducted to study the children's oral health-related behaviours and socioeconomic backgrounds. Chi-square tests, t tests, regression analyses and survival analyses will be adopted for data analysis. DISCUSSION The effectiveness of 38% SDF in preventing ECC remains uncertain. If the results are as anticipated, care standards using 5% NaF for ECC prevention will be changed. In addition, the results will be widely available and increase the adoption of SDF in other countries to reduce the global burden of ECC. TRIAL REGISTRATION ClinicalTrials.gov, NCT04075474. Registered on 30 Aug 2019.
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Affiliation(s)
- Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Kitty Jieyi Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - May Chun Mei Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
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Cai J, Burrow MF, Manton DJ, Tsuda Y, Sobh EG, Palamara JEA. Effects of silver diamine fluoride/potassium iodide on artificial root caries lesions with adjunctive application of proanthocyanidin. Acta Biomater 2019; 88:491-502. [PMID: 30776507 DOI: 10.1016/j.actbio.2019.02.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/29/2019] [Accepted: 02/14/2019] [Indexed: 12/26/2022]
Abstract
Treatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the original structure of root dentine. Current treatments targeting the de-/re-mineralisation processes are not entirely satisfactory in terms of the protection of the dentinal organic matrix and the highly organised structure of dentine. In this in vitro study, a cross-linking agent - proanthocyanidin (PA) was used in conjunction with a fluoride-based treatment - silver diamine fluoride/potassium iodide (SDF/KI) to putatively stabilise the organic dentinal framework as well as strengthen the collagen-mineral phase interaction. The effectiveness of this strategy was evaluated 24 h after application in terms of the distribution of ion uptake and microstructure of dentine after treatment as well as analysis of the nano-mechanical properties using a dynamic behaviour model. Results showed that individual use of SDF/KI significantly improved the surface microhardness and integrated mineral density (Z) up to 60 µm depth and the recovery of creep behaviour of demineralised dentine in the surface area compared to that treated with deionised distilled water (DDW). The combined treatment of PA and SDF/KI achieved a more homogenous mineral distribution throughout the lesions than SDF/KI alone; a more significant incremental increase in surface microhardness and Z was observed. Specifically, a superior effect on the subsurface area occurred with PA + SDF/KI, with significant improvements in microhardness, elastic modulus and recovery of creep behaviour of the demineralised dentine. Application of SDF/KI induced small discrete crystal formation distributed over the dentine surface and PA contributed to the formation of slit-shaped orifices of the dentinal tubules that were partially occluded. STATEMENT OF SIGNIFICANCE: Demographic transitions and improved oral health behaviour have resulted in increased tooth retention in elderly people. As a consequence, the risk of root dentine caries is increasing due to the age-associated gingival recession and the related frequent exposure of cervical root dentine. Root caries is difficult to repair because of the complex aetiology and dentine structure. The recovery of dentine quality depends not only on reincorporation of minerals but also an intact dentinal organic matrix and the organic-inorganic interfacial structure, which contribute to the biomechanics of dentine. With the capability of dentine modification, cross-linking agents were applied with a fluoride regimen, which improved its treatment efficacy of root caries regarding the distribution of ion uptake and recovery of dentine biomechanics.
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Affiliation(s)
- Jing Cai
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Michael F Burrow
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia; Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong Special Administrative Region
| | - David J Manton
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Yuka Tsuda
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Eman G Sobh
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia
| | - Joseph E A Palamara
- Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, VIC 3053, Australia.
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Horst JA, Heima M. Prevention of Dental Caries by Silver Diamine Fluoride. Compend Contin Educ Dent 2019; 40:158-164. [PMID: 30829497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The use of silver diamine fluoride (SDF) for management of dental caries has gained considerable attention due to recent regulatory clearance in the United States. The primary focus of policies, presentations, and publications has been the arrest of caries lesions (cavities) because of the material's unique ability to non-invasively achieve this elusive and clinically important goal. However, SDF also has proven efficacy in prevention, ie, decreasing the incidence of new caries lesions. Analysis of nine clinical trials in children shows that SDF prevented 61% of new lesions compared to controls. To prevent one new caries lesion, clinicians need to treat four primary teeth (one patient) or 12.1 permanent molars (three patients) with SDF. The preventive effect appears to be immediate and maintains at the same fraction over time. Direct comparisons of SDF applied once per year with alternative treatments show that SDF is more effective than other topical fluorides placed two to four times per year and more cost-effective than dental sealants. Enamel lesions may be even more responsive than cavitated dentin lesions. Annual application of SDF to high-risk surfaces (eg, mesial surfaces of permanent first molars where the distal surface of the second primary molar is carious) in patients with any risk of new caries lesions appears to be the most cost-effective approach available to prevent dental caries. SDF is an underutilized evidence-based preventive agent for dental caries.
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Affiliation(s)
- Jeremy A Horst
- Postdoctoral Scholar, Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California; Private Practice, San Francisco, California
| | - Masahiro Heima
- Assistant Professor, Pediatric Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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Trieu A, Mohamed A, Lynch E. Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis. Sci Rep 2019; 9:2115. [PMID: 30765785 PMCID: PMC6376061 DOI: 10.1038/s41598-019-38569-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/07/2018] [Indexed: 11/08/2022] Open
Abstract
Dental caries can compromise quality of life and is associated with demineralization of tooth structure by organic acids produced by microorganisms. This study systematically reviewed the dentine caries arrest capabilities of silver diamine fluoride (SDF) and sodium fluoride (NaF). A comprehensive search strategy was developed to identify the relevant publications in electronic databases and hand searched journals and reviews (to March 2018). By applying strict inclusion and exclusion criteria, only six papers (two randomized controlled trials, two follow-up articles and two secondary statistical analysis studies) were considered for full text qualitative and quantitative assessment. The included studies were critically appraised and statistically evaluated. Only four articles were considered for meta-analysis, as the other two were secondary analyses of included studies. When comparing the caries arrest lesions of SDF and NaF, SDF was found to be statistically more effective in dentine caries arrest of primary teeth during the 18 and 30 month clinical examinations. The weighted total effect size of the differences between SDF and NaF regarding arrested caries surfaces was calculated and showed nearly double the effectiveness of SDF to NaF at 30 months. Therefore, SDF is a more effective caries management reagent than NaF. Further clinical research is needed to consolidate the findings of this systematic review.
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Affiliation(s)
- Alice Trieu
- Pediatric Dental Resident, Pediatric Dentistry Department, University of Nevada, Las Vegas (UNLV), 89106, USA
| | - Ahmed Mohamed
- Visiting Faculty, Biomedical and Clinical Research, University of Nevada, Las Vegas (UNLV), 89106, USA
| | - Edward Lynch
- Professor and Principal Director of Biomedical and Clinical Research, University of Nevada, Las Vegas (UNLV), 89106, USA.
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Hansen R, Shirtcliff RM, Ludwig S, Dysert J, Allen G, Milgrom P. Changes in Silver Diamine Fluoride Use and Dental Care Costs: A Longitudinal Study. Pediatr Dent 2019; 41:35-44. [PMID: 30803475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: This study evaluated the impact of silver diamine fluoride (SDF) by investigating coverage and reimbursement policies. Methods: We performed a population-level retrospective cohort analysis (N equals 117,599) using claims. We evaluated two policy events: (1) dental board approval permitting SDF use by expanded practice dental hygienists (EPDHs); (2) approval of SDF by Medicaid. Coincident with coverage, Advantage Dental Services instituted EPDH practice algorithms. To evaluate changes, we: estimated CDT code 1354 utilization and average quarterly costs; stratified the population into patients who initiated preventive care from an EPHD or dentist; estimated outcome differences with either policy in quarterly trends; and counted SDF use with claims by quarter and calculated utilization per 1,000 patients. Results: Average per-patient quarterly dental costs (June 2017) ranged from $384 to $423. SDF use grew associated with Medicaid policy: rates increased from $0.32 per 1,000 to $156 per 1,000 in six quarters. Care initiated by EPDHs had lower costs, with quarterly savings of $201 (P=0.011) per patient, without differences in SDF utilization. Conclusions: Policy makers can use our results to improve access and reduce costs. Clinical experts should address more clearly when SDF substitutes for or is used in conjunction with restorative treatment.
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Affiliation(s)
- Ryan Hansen
- Dr. Hansen is an assistant professor, Comparative Health Outcomes Policy and Economics Institute, School of Pharmacy
| | - R Mike Shirtcliff
- Dr. Shirtcliff is president of RMS Dental Director, Inc., Redmond, Ore., USA
| | - Sharity Ludwig
- Ms. Ludwig is director of Community Programs, Advantage Dental Services, LLC, Redmond, Ore., USA
| | - Jeanne Dysert
- Ms. Dysert is retired, a former vice president for operations advantage Dental Services, LLC, Redmond, Ore., USA
| | - Gary Allen
- Dr. Allen is vice president and dental director, all at Advantage Dental Services, LLC, Redmond, Ore., USA
| | - Peter Milgrom
- Dr. Milgrom is Emeritus professor, Department of Oral Health Sciences, School of Dentistry, both at the University of Washington, Seattle, Wash., USA;,
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Burgette JM, Weintraub JA, Birken SA, Lewis TA, White BA. Development of a Silver Diamine Fluoride Protocol in Safety Net Dental Settings. J Dent Child (Chic) 2019; 86:32-39. [PMID: 30992099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: In the United States, silver diamine fluoride (SDF) is a new method to arrest dental caries. Protocols for using SDF are under development as the research evolves and experience is gained with different populations and settings. The purpose of this study was to develop a comprehensive SDF protocol for young children tailored to safety net dental clinics (SNDCs).<br/> Methods: We developed the SDF protocol for SNDCs through a two-step process: (1) an expert panel of pediatric dentists reviewed, modified, and expanded existing SDF protocols including clinical, pre- and post-clinical components; and (2) the new SDF protocol was implemented in three SNDCs in North Carolina with on-site didactic training, clinical observations and discussion. We obtained feedback from SNDC dentists, staff, and administrators to further refine the SDF protocol.<br/> Results: The SDF protocol was tailored to SNDCs based on recommendations from SNDCs themselves. Suggested improvements were primarily non-clinical in nature, such as the provision of laminated SDF information with color pictures of staining in each operatory, a timer for SDF procedure, and templates for documentation, coding, and billing.<br/> Conclusion: To facilitate SDF use in SNDCs, we developed an expert-consensus protocol that incorporated the clinical experience of SNDCs that implemented the protocol. (J Dent Child 2019;86(1):32-9)<br/> Received September 17, 2018; Last Revision November 7, 2018; Accepted November 7, 2018.
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Affiliation(s)
- Jacqueline M Burgette
- Assistant professor, Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pa., and a research fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA,
| | - Jane A Weintraub
- Alumni distinguished professor, Department of Dental Ecology, School of Dentistry, and an adjunct professor, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
| | - Sarah A Birken
- Assistant professor, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
| | - Teresa A Lewis
- research assistant, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
| | - B Alex White
- Associate professor, Department of Health Policy and Management, Gillings School of Global Public Health, and Associate Professor, Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, N.C., USA
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Abstract
This article reviews current evidence on the effectiveness of silver diamine fluoride (SDF) as a caries arresting and preventive agent. It provides clinical recommendations around SDF's appropriate use as part of a comprehensive caries management program. Systematic reviews confirm that SDF is effective for caries arrest on cavitated lesions in primary teeth and root caries in the elderly. It may also prevent new lesions. Application is easy, noninvasive, affordable, and safe. Although it stains the lesions dark as it arrests them, it provides clinicians with an additional tool for caries management when esthetics are not a primary concern.
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Affiliation(s)
- Yasmi O Crystal
- Pediatric Dentistry, New York University College of Dentistry, 345 East 24th Street. 9W, New York, NY 10010, USA.
| | - Richard Niederman
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, 433 1st Avenue, Room 720, New York, NY 10010, USA
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Zhang J. [National experts consensus on application of silver-containing dressings in wound therapy (2018 version)]. Zhonghua Shao Shang Za Zhi 2018; 34:761-765. [PMID: 30481914 DOI: 10.3760/cma.j.issn.1009-2587.2018.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
New silver-containing dressings developed in recent years have brought new and powerful means for the prevention and treatment of wound infection, which promote development and progress of wound therapy. There are many kinds of silver-containing dressings, however, misunderstanding and even misapplication exist in how to choose and use these dressings. Based on literature evidence, we propose this national expert consensus on clinical application of silver-containing dressings, particularly in terms of kinds and mechanisms, indications, contraindications, rational selections in different wounds, and cautions in the clinical application of silver-containing dressings. This consensus would be helpful for medical and nursing personnel to use silver-containing dressings in wound repair field in clinic correctly and professionally.
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Wang H, Lv B, Tang Z, Zhang M, Ge W, Liu Y, He X, Zhao K, Zheng X, He M, Bu W. Scintillator-Based Nanohybrids with Sacrificial Electron Prodrug for Enhanced X-ray-Induced Photodynamic Therapy. Nano Lett 2018; 18:5768-5774. [PMID: 30052464 DOI: 10.1021/acs.nanolett.8b02409] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
X-ray-induced photodynamic therapy (X-PDT) has high depth of penetration and has considerable potential for applications in cancer therapy. Scintillators and heavy metals have been adopted to absorb X-rays and transmit the energy to photosensitizers. However, the low efficiency of converting X-rays to reactive oxygen species (ROS) presents a challenge for the use of X-PDT to cure cancer. In this study, a new method based on LiLuF4:Ce@SiO2@Ag3PO4@Pt(IV) nanoparticles (LAPNP) is presented that could be used to enhance the curative effects of X-PDT. To make full use of the fluorescence produced by nanoscintillators (LiLuF4:Ce), a cisplatin prodrug Pt(IV) was utilized as a sacrificial electron acceptor to increase the yield of hydroxyl radicals (·OH) by increasing the separation of electrons and holes in photosensitizers (Ag3PO4). Additionally, cisplatin is produced upon the acceptance of electrons by Pt(IV) and further enhances the damage caused by ·OH. Via two-step amplification, the potential of LAPNP to enhance the effects of X-PDT has been demonstrated.
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Affiliation(s)
- Han Wang
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure , Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Bin Lv
- Department of Radiation Oncology, Shanghai Huadong Hospital , Fudan University , Shanghai 200040 , China
| | - Zhongmin Tang
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure , Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Meng Zhang
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure , Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050 , China
- University of Chinese Academy of Sciences , Beijing 100049 , China
| | - Weiqiang Ge
- Department of Radiation Oncology, Shanghai Huadong Hospital , Fudan University , Shanghai 200040 , China
| | - Yanyan Liu
- Shanghai Key Laboratory of Green Chemistry and Chemical Processes, School of Chemistry and Molecular Engineering , East China Normal University , Shanghai 200062 , China
| | - Xinhong He
- Department of Radiology, Shanghai Cancer Hospital , Fudan University , Shanghai 200032 , China
| | - Kuaile Zhao
- Department of Radiology, Shanghai Cancer Hospital , Fudan University , Shanghai 200032 , China
| | - Xiangpeng Zheng
- Department of Radiation Oncology, Shanghai Huadong Hospital , Fudan University , Shanghai 200040 , China
| | - Mingyuan He
- Shanghai Key Laboratory of Green Chemistry and Chemical Processes, School of Chemistry and Molecular Engineering , East China Normal University , Shanghai 200062 , China
| | - Wenbo Bu
- State Key Laboratory of High-Performance Ceramics and Superfine Microstructure , Shanghai Institute of Ceramics, Chinese Academy of Sciences , Shanghai 200050 , China
- Shanghai Key Laboratory of Green Chemistry and Chemical Processes, School of Chemistry and Molecular Engineering , East China Normal University , Shanghai 200062 , China
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Yu OY, Zhao IS, Mei ML, Lo ECM, Chu CH. Caries-arresting effects of silver diamine fluoride and sodium fluoride on dentine caries lesions. J Dent 2018; 78:65-71. [PMID: 30114443 DOI: 10.1016/j.jdent.2018.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/06/2018] [Accepted: 08/10/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate the remineralising effect and bacterial growth inhibition of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish on artificial dentine caries lesions. METHODS Demineralised dentine blocks were treated with SDF + NaF (Group 1), SDF (Group 2), NaF (Group 3) and water (Group 4) and subjected to a Streptococcus mutans biofilm challenge. Lesion depth, precipitates' characteristics and matrix (collagen)-to-mineral ratio were evaluated by micro-computer tomography (micro-CT), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR), respectively. The biofilm kinetics, viability and topography were assessed by counts of colony forming units (CFUs), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. Data were analysed by two-way ANOVA test. RESULTS The lesion depths of Groups 1-4 were 170 ± 28 μm, 160 ± 32 μm, 353 ± 38 μm and 449 ± 24 μm, respectively. The addition of NaF to SDF did not show better remineralisation than SDF (p = 0.491). Metallic silver and silver chloride were found in Groups 1 and 2. The amide I-to-hydrogen phosphate ratios of the four groups were 0.14 ± 0.02, 0.14 ± 0.01, 0.29 ± 0.05 and 0.49 ± 0.16, respectively, and the addition of NaF to SDF did not offer better protection against collagen exposure than SDF (p = 0.986). The Log10 CFUs of Groups 1-4 were 5.75 ± 0.56, 4.49 ± 0.57, 6.55 ± 0.39 and 6.40 ± 0.38, respectively. The presence of NaF reduced the antibacterial effect of SDF (p < 0.001). The SEM and CLSM images supported the findings. CONCLUSION Application of SDF with or without NaF reduced the demineralisation of dentine caries, but SDF exerted stronger inhibition of biofilm growth than SDF with NaF. CLINICAL SIGNIFICANCE NaF varnish affects the antibacterialeffects of SDF, the adjunctive application of SDF solution and NaF varnish is not recommended to arrest dentine caries in clinic.
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Affiliation(s)
- Ollie Y Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Irene S Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - May L Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - C H Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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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 2018; 53:24-32. [PMID: 29874642 PMCID: PMC6292783 DOI: 10.1159/000488686] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/08/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. METHODS Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth - dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). RESULTS Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = -1.15, PF = 77.5%; FV: WMD = -0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: -6.09%). CONCLUSION When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.
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Affiliation(s)
- Branca Heloisa Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, University of the State of Rio de Janeiro, Brazil.
| | - Anjana Rajendra
- Department of Epidemiology & Health Promotion College of Dentistry, New York University,
| | - Analia Veitz-Keenan
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, College of Dentistry, New York University,
| | - Richard Niederman
- Department of Epidemiology & Health Promotion College of Dentistry, New York University,
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McReynolds D, Duane B. Systematic review finds that silver diamine fluoride is effective for both root caries prevention and arrest in older adults. Evid Based Dent 2018; 19:46-47. [PMID: 29930359 DOI: 10.1038/sj.ebd.6401304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Data sourcesPubMed, Pubmed Clinical Queries, EMBASE, the American Dental Associations Evidence-Based Dentistry Website, Cochrane Library, Web of Science, repository of the Journal of the American Dental Association and Google Scholar.Study selectionFour authors independently assessed the abstracts of studies resulting from the above searches which compared treatment of root caries in an older population with SDF versus other preventive agents or placebos.Data extraction and synthesisTitles and abstracts of all reports identified through the electronic searches were assessed independently by four authors based on agreed upon inclusion and exclusion criteria. Of the selected studies for final inclusion in the systematic review, study quality was assessed using the critical appraisal worksheet for randomised controlled trials from the Oxford Centre for Evidence-Based Medicine (CEBM 2005). Prevented fraction (PF), number needed to treat (NNT) and relative risk (RR) were calculated as outcome measures in each study. In addition, the published evidence on SDF was reviewed in order to formulate clinical recommendations on safety and effectiveness when treating root or coronal caries in an adult population with SDF, as well as treatment of dental hypersensitivity.ResultsThree randomised controlled trials were identified that addressed the effectiveness of SDF on root caries in older adults, but none addressed coronal caries. Root caries prevented fraction and arrest rate for SDF were significantly higher than placebo. The prevented fraction for caries prevention for SDF compared to placebo was 71% in a three-year study and 25% in a two-year study. The prevented fraction for caries arrest for SDF was 725% greater in a 24-month study and 100% greater than placebo in a 30-month study. No severe adverse effects were observed.ConclusionsExisting reports of SDF trials support effectiveness in root caries prevention and arrest, remineralisation of deep occlusal lesions and treatment of hypersensitive dentine.
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Steffi W, Zaliana B, Amreen A, Nasirudin N. Management of malodour fungating wound with nanocrystalline silver coated dressing. Med J Malaysia 2017; 72:316-317. [PMID: 29197891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Chronic exudative malodorous fungating wound of four years at the right arm due to diffuse large B cell lymphoma managed with silver dressings. In two months of application with nanocrystalline silver coated dressings, there was significant improvement in wound.
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Affiliation(s)
- W Steffi
- Miri General Hospital, Wound Care Team, Miri, Sarawak, Malaysia.
| | - B Zaliana
- Miri General Hospital, Wound Care Team, Miri, Sarawak, Malaysia
| | - A Amreen
- Miri General Hospital, Wound Care Team, Miri, Sarawak, Malaysia
| | - N Nasirudin
- Miri General Hospital, Wound Care Team, Miri, Sarawak, Malaysia
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40
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Mao C, Xiang Y, Liu X, Cui Z, Yang X, Yeung KWK, Pan H, Wang X, Chu PK, Wu S. Photo-Inspired Antibacterial Activity and Wound Healing Acceleration by Hydrogel Embedded with Ag/Ag@AgCl/ZnO Nanostructures. ACS Nano 2017; 11:9010-9021. [PMID: 28825807 DOI: 10.1021/acsnano.7b03513] [Citation(s) in RCA: 388] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Ag/Ag@AgCl/ZnO hybrid nanostructures are embedded in a hydrogel by a simple two-step technique. The Ag/Ag@AgCl nanostructures are assembled in the hydrogel via ultraviolet light chemical reduction followed by incorporation of ZnO nanostructures by NaOH precipitation. The hydrogel accelerates wound healing and exhibits high antibacterial efficiency against both Escherichia coli and Staphylococcus aureus under visible light irradiation. The Ag/Ag@AgCl nanostructures enhance the photocatalytic and antibacterial activity of ZnO due to the enhancement of reactive oxygen species by visible light. This hydrogel system kills 95.95% of E. coli and 98.49% of S. aureus within 20 min upon exposure to simulated visible light, and rapid sterilization plays a crucial role in wound healing. In addition, this system provides controllable, sustained release of silver and zinc ions over a period of 21 days arising from the reversible swelling-shrinking transition of the hydrogel triggered by the changing pH value in the biological environment. About 90% Zn2+ release is observed in the acidic environment after 3 days, whereas only 10% Zn2+ release occurs in the neutral environment after 21 days. In vivo results show that release of Ag+ and Zn2+ stimulates the immune function to produce a large number of white blood cells and neutrophils (2-4 times more than the control), thereby producing the synergistic antibacterial effects and accelerated wound healing.
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Affiliation(s)
- Congyang Mao
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science and Engineering, Hubei University , Wuhan 430062, China
| | - Yiming Xiang
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science and Engineering, Hubei University , Wuhan 430062, China
| | - Xiangmei Liu
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science and Engineering, Hubei University , Wuhan 430062, China
| | - Zhenduo Cui
- School of Materials Science and Engineering, Tianjin University , Tianjin 300072, China
| | - Xianjin Yang
- School of Materials Science and Engineering, Tianjin University , Tianjin 300072, China
| | - Kelvin Wai Kwok Yeung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong , Pokfulam 999077, Hong Kong, China
| | - Haobo Pan
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences , Shenzhen 518055, China
| | - Xianbao Wang
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science and Engineering, Hubei University , Wuhan 430062, China
| | - Paul K Chu
- Department of Physics and Department of Materials Science and Engineering, City University of Hong Kong , Tat Chee Avenue, Kowloon 999077, Hong Kong, China
| | - Shuilin Wu
- Hubei Collaborative Innovation Center for Advanced Organic Chemical Materials, Ministry-of-Education Key Laboratory for the Green Preparation and Application of Functional Materials, Hubei Key Laboratory of Polymer Materials, School of Materials Science and Engineering, Hubei University , Wuhan 430062, China
- School of Materials Science and Engineering, Tianjin University , Tianjin 300072, China
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Bhattacharyya M, Bradley H. Management of a Difficult-to-Heal Chronic Wound Infected With Methycillin-Resistant Staphylococcus aureus in a Patient With Psoriasis Following a Complex Knee Surgery. INT J LOW EXTR WOUND 2016; 5:105-8. [PMID: 16698914 DOI: 10.1177/1534734606288410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This report presents the difficulties encountered in managing a wound colonized with methycillin-resistant Staphylococcus aureus (MRSA) following a complex knee surgery in an elderly female patient with generalized psoriasis. The patient’s chronic wound was successfully treated with nanocrystalline silver-releasing dressings (Acticoat™). The patient did not develop a deep-seated infection, nor was removal of the implant needed. However, the wound infection persisted for 6 months. At 3 years follow-up, the patient has satisfactory skin over the implant on the knee.
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Zhou Y, Chen R, He T, Xu K, Du D, Zhao N, Cheng X, Yang J, Shi H, Lin Y. Biomedical Potential of Ultrafine Ag/AgCl Nanoparticles Coated on Graphene with Special Reference to Antimicrobial Performances and Burn Wound Healing. ACS Appl Mater Interfaces 2016; 8:15067-15075. [PMID: 27064187 DOI: 10.1021/acsami.6b03021] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In recent years, researchers have proven the release of silver ions (Ag(+)) from silver nanoparticles (Ag NPs) significantly affects their toxicity to bacteria and other organisms. Due to the difficulty in maintaining a steady flux of a high concentration of Ag(+), it is still challenging to develop a highly efficient, stable, and biocompatible Ag NP-based antimicrobial material. To circumvent this issue, we developed a new Ag-based bactericide through the fabrication of sunlight-driven and ultrafine silver/silver chloride anchored on reduced graphene oxide (Ag/AgCl/rGO). This stable Ag/AgCl nanophotocatalyst with negligible release of Ag(+) generated a high amount of oxidative radicals, killing the bacteria, thus achieving both high bactericidal efficiency and stability. Moreover, functionalization of the nanomaterial with poly(diallyldimethylammonium chloride) (PDDA) gives it a highly adsorptive capacity, which allows it to capture the bacteria and possibly enhances the bactericidal activity. In vivo histopathological studies showed that the Ag/AgCl/rGO nanomaterial could obviously promote the regeneration of the epidermis, which indicated the good biomedical potential of Ag/AgCl/rGO nanomaterial in burn wound healing.
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Affiliation(s)
- Yazhou Zhou
- School of Mechanical and Materials Engineering, Washington State University , Pullman, Washington 99164-2920, United States
| | | | | | | | - Dan Du
- School of Mechanical and Materials Engineering, Washington State University , Pullman, Washington 99164-2920, United States
| | | | | | | | | | - Yuehe Lin
- School of Mechanical and Materials Engineering, Washington State University , Pullman, Washington 99164-2920, United States
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Lai NM, Taylor JE, Tan K, Choo YM, Ahmad Kamar A, Muhamad NA. Antimicrobial dressings for the prevention of catheter-related infections in newborn infants with central venous catheters. Cochrane Database Syst Rev 2016; 3:CD011082. [PMID: 27007217 PMCID: PMC6464939 DOI: 10.1002/14651858.cd011082.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Central venous catheters (CVCs) provide secured venous access in neonates. Antimicrobial dressings applied over the CVC sites have been proposed to reduce catheter-related blood stream infection (CRBSI) by decreasing colonisation. However, there may be concerns on the local and systemic adverse effects of these dressings in neonates. OBJECTIVES We assessed the effectiveness and safety of antimicrobial (antiseptic or antibiotic) dressings in reducing CVC-related infections in newborn infants. Had there been relevant data, we would have evaluated the effects of antimicrobial dressings in different subgroups, including infants who received different types of CVCs, infants who required CVC for different durations, infants with CVCs with and without other antimicrobial modifications, and infants who received an antimicrobial dressing with and without a clearly defined co-intervention. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review Group (CNRG). We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2015, Issue 9), MEDLINE (PubMed), EMBASE (EBCHOST), CINAHL and references cited in our short-listed articles using keywords and MeSH headings, up to September 2015. SELECTION CRITERIA We included randomised controlled trials that compared an antimicrobial CVC dressing against no dressing or another dressing in newborn infants. DATA COLLECTION AND ANALYSIS We extracted data using the standard methods of the CNRG. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using risk difference (RD) and risk ratio (RR) with 95% confidence intervals (CIs). MAIN RESULTS Out of 173 articles screened, three studies were included. There were two comparisons: chlorhexidine dressing following alcohol cleansing versus polyurethane dressing following povidone-iodine cleansing (one study); and silver-alginate patch versus control (two studies). A total of 855 infants from level III neonatal intensive care units (NICUs) were evaluated, 705 of whom were from a single study. All studies were at high risk of bias for blinding of care personnel or unclear risk of bias for blinding of outcome assessors. There was moderate-quality evidence for all major outcomes.The single study comparing chlorhexidine dressing/alcohol cleansing against polyurethane dressing/povidone-iodine cleansing showed no significant difference in the risk of CRBSI (RR 1.18, 95% CI 0.53 to 2.65; RD 0.01, 95% CI -0.02 to 0.03; 655 infants, moderate-quality evidence) and sepsis without a source (RR 1.06, 95% CI 0.75 to 1.52; RD 0.01, 95% CI -0.04 to 0.06; 705 infants, moderate-quality evidence). There was a significant reduction in the risk of catheter colonisation favouring chlorhexidine dressing/alcohol cleansing group (RR 0.62, 95% CI 0.45 to 0.86; RD -0.09, 95% CI -0.15 to -0.03; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 7 to 33; 655 infants, moderate-quality evidence). However, infants in the chlorhexidine dressing/alcohol cleansing group were significantly more likely to develop contact dermatitis, with 19 infants in the chlorhexidine dressing/alcohol cleansing group having developed contact dermatitis compared to none in the polyurethane dressing/povidone-iodine cleansing group (RR 43.06, 95% CI 2.61 to 710.44; RD 0.06, 95% CI 0.03 to 0.08; number needed to treat for an additional harmful outcome (NNTH) 17, 95% CI 13 to 33; 705 infants, moderate-quality evidence). The roles of chlorhexidine dressing in the outcomes reported were unclear, as the two assigned groups received different co-interventions in the form of different skin cleansing agents prior to catheter insertion and during each dressing change.In the other comparison, silver-alginate patch versus control, the data for CRBSI were analysed separately in two subgroups as the two included studies reported the outcome using different denominators: one using infants and another using catheters. There were no significant differences between infants who received silver-alginate patch against infants who received standard line dressing in CRBSI, whether expressed as the number of infants (RR 0.50, 95% CI 0.14 to 1.78; RD -0.12, 95% CI -0.33 to 0.09; 1 study, 50 participants, moderate-quality evidence) or as the number of catheters (RR 0.72, 95% CI 0.27 to 1.89; RD -0.05, 95% CI -0.20 to 0.10; 1 study, 118 participants, moderate-quality evidence). There was also no significant difference between the two groups in mortality (RR 0.55, 95% CI 0.15 to 2.05; RD -0.04, 95% CI -0.13 to 0.05; two studies, 150 infants, I² = 0%, moderate-quality evidence). No adverse skin reaction was recorded in either group. AUTHORS' CONCLUSIONS Based on moderate-quality evidence, chlorhexidine dressing/alcohol skin cleansing reduced catheter colonisation, but made no significant difference in major outcomes like sepsis and CRBSI compared to polyurethane dressing/povidone-iodine cleansing. Chlorhexidine dressing/alcohol cleansing posed a substantial risk of contact dermatitis in preterm infants, although it was unclear whether this was contributed mainly by the dressing material or the cleansing agent. While silver-alginate patch appeared safe, evidence is still insufficient for a recommendation in practice. Future research that evaluates antimicrobial dressing should ensure blinding of caregivers and outcome assessors and ensure that all participants receive the same co-interventions, such as the skin cleansing agent. Major outcomes like sepsis, CRBSI and mortality should be assessed in infants of different gestation and birth weight.
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Affiliation(s)
- Nai Ming Lai
- Taylor's UniversitySchool of MedicineSubang JayaMalaysia
| | - Jacqueline E Taylor
- Monash Medical Centre/Monash UniversityMonash Newborn246 Clayton RoadClaytonVictoriaAustralia3168
| | - Kenneth Tan
- Monash UniversityDepartment of Paediatrics246 Clayton RoadClaytonMelbourneVictoriaAustraliaVIC 3168
| | - Yao Mun Choo
- University of MalayaDepartment of PaediatricsKuala LumpurMalaysia
| | | | - Nor Asiah Muhamad
- Ministry of Health MalaysiaDisease Control DivisionPutrajayaMalaysia62590
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Zhou K, Krug K, Stachura J, Niewczyk P, Ross M, Tutuska J, Ford G. Silver-Collagen Dressing and High-voltage, Pulsed-current Therapy for the Treatment of Chronic Full-thickness Wounds: A Case Series. Ostomy Wound Manage 2016; 62:36-44. [PMID: 26978858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Research suggests high-voltage, pulsed-current electric therapy (HVPC) is safe and effective for treating chronic wounds, and some data suggest silver- and collagen-based dressings may facilitate healing. A combination therapy utilizing both HVPC and silver-collagen dressing may present clinical advantages. To explore the effect of the combined therapy for chronic full-thickness wounds, a prospective, consecutive case series study was conducted. All participants were adults with wounds of at least 6 weeks' duration. After obtaining informed consent, patient and wound characteristics were obtained, wounds were assessed and measured, and patients received 2 to 3 HVPC treatments per week followed by application of the silver- and collagen-based dressing for a period of 2 weeks. Data were analyzed descriptively, and changes in wound size and volume from baseline were analyzed using Wilcoxon Signed Rank Test. The dressings were saturated with normal saline, used simultaneously during the 45-minute HVPC treatment, and left on top of the wound after treatment. The HVPC electro pads (stainless steel electrodes with a sponge interface) also were moistened with normal saline and the cathode placed on top of the wound. If the patient had more than 1 wound on the same leg, the anode was placed on the additional wound (otherwise over the intact skin nearby). Secondary dressings (eg, foam and/ or gauze) were used as clinically appropriate, and a 4-layer compression wrap was used, if indicated, for patients with venous ulcers. Ten (10) patients (3 women, 7 men, 57.30 ± 9.70 years old with 14 wounds of 273.10 ± 292.03 days' duration before study) completed the study and were included in the final analyses. Average wound surface area decreased from 13.78 ± 21.35 cm(2) to 9.07 ± 16.81 cm(2) (42.52% ± 34.16% decrease, P = 0.002) and wound volume decreased from 3.39 ± 4.31 cm(3) to 1.28 ± 2.25 cm(3) (66.84% ± 25.07% decrease, P = 0.001). One (1) patient was discharged with complete wound closure. No serious adverse events were noted, but a diagnosis of osteomyelitis in 1 patient and increased pain in a patient with significant Reynaud's syndrome suggest clinicians should be cautious using HVPC in these instances. The combined intervention utilizing both HVPC and silver-collagen dressing was effective in the treatment of chronic fullthickness wounds in this patient population. Controlled clinical studies of longer duration are needed to further explore the safety, effectiveness, and efficacy of this treatment.
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Affiliation(s)
- Kehua Zhou
- Daemen College Physical Therapy Wound Care Clinic and Department of Health Care Studies, Daemen College, Amherst, NY
| | - Kenneth Krug
- Daemen College Physical Therapy Wound Care Clinic, Daemen College, Amherst, NY
| | - John Stachura
- Department of Physical Therapy, Daemen College, Amherst, NY
| | | | - Michael Ross
- Department of Physical Therapy, Daemen College, Amherst, NY
| | - Justine Tutuska
- Department of Health Care Studies, Daemen College, Amherst, NY
| | - Gregory Ford
- Department of Physical Therapy, Daemen College, Amherst, NY
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Pajardi G, Rapisarda V, Somalvico F, Scotti A, Russo GL, Ciancio F, Sgrò A, Nebuloni M, Allevi R, Torre ML, Trabucchi E, Marazzi M. Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study. Int Wound J 2016; 13:44-52. [PMID: 24517418 PMCID: PMC7950180 DOI: 10.1111/iwj.12223] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/20/2013] [Accepted: 01/02/2014] [Indexed: 01/01/2023] Open
Abstract
Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.
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Affiliation(s)
- Giorgio Pajardi
- Unità Operativa Complessa di Chirurgia della Mano, Università degli Studi di Milano, Ospedale San Giuseppe Milan /IRCCS MultiMedica, Milano, Italy
| | - Vicenzo Rapisarda
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | | | - Andrea Scotti
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Giulia Lo Russo
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Francesco Ciancio
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Arturo Sgrò
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Manuela Nebuloni
- Struttura Complessa di Anatomia Patologica, Polo Universitario "A.O. Ospedale Luigi Sacco", Milano, Italy
| | - Raffaele Allevi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Maria L Torre
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
| | - Emilio Trabucchi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Mario Marazzi
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
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Guo ZQ, Qiu L, Gao Y, Li JH, Zhang XH, Yang XL, Peszel A, Chen XL. Use of porcine acellular dermal matrix following early dermabrasion reduces length of stay in extensive deep dermal burns. Burns 2016; 42:598-604. [PMID: 26777449 DOI: 10.1016/j.burns.2015.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/19/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Extensive deep partial-thickness burns still seriously challenge the surgeon's abilities. This study aimed to assess the impact of early dermabrasion combined with porcine acellular dermal matrix (ADM) in extensive deep dermal burns. METHODS From September 2009 to September 2013, a total of 60 adult patients sustained greater than 50% total body surface area (TBSA) burn by hot water or gas explosion were divided into three groups based on dermabrasion: group A (early dermabrasion and porcine ADM), group B (early dermabrasion and nano-silver dressings), and group C (conservative group). The wound healing time and length of hospital stay were analyzed. Scar assessment was performed at 3 and 12 months after the injury with a modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA). RESULTS No significant difference was found in mean burn size, burn depth, age, male-to-female ratio, or incidence of inhalation injury between the patients in the three groups (p>0.05). Compared with groups B and C, the patients that received early dermabrasion combined with porcine ADM had a shorter wound healing time (p<0.01). The burn patients treated with early dermabrasion and porcine ADM coverage had a mean length of hospital stay of 28.3 days (±7.2), which was significantly shorter than that of groups B and C (p<0.05-0.01). The mVSS-TBSA of patients in group A was significantly improved in comparison with groups B and C at 3 and 12 months after the injury. There was no significant difference in the mortality rate between the three groups (p>0.05). CONCLUSION Early dermabrasion combined with porcine ADM coverage facilitates wound healing, reduces the length of hospital stay, and improves esthetic and functional results in extensive deep dermal burns with burn size over 50% TBSA.
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Affiliation(s)
- Zhi-Qian Guo
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, PR China; Department of Burns and Plastic Surgery, No. 174 Hospital of PLA, Xiamen, Fujian 361003, PR China
| | - Le Qiu
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, PR China
| | - You Gao
- Department of Burns and Plastic Surgery, No. 174 Hospital of PLA, Xiamen, Fujian 361003, PR China
| | - Jin-Hu Li
- Department of Burns and Plastic Surgery, No. 174 Hospital of PLA, Xiamen, Fujian 361003, PR China
| | - Xin-He Zhang
- Department of Burns and Plastic Surgery, No. 174 Hospital of PLA, Xiamen, Fujian 361003, PR China
| | - Xin-Lei Yang
- Department of Burns and Plastic Surgery, No. 174 Hospital of PLA, Xiamen, Fujian 361003, PR China
| | - April Peszel
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, PR China
| | - Xu-Lin Chen
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, PR China.
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McLean J. Case closed: An economical treatment protocol for peristomal skin excoriation. Ostomy Wound Manage 2015; 61:12-14. [PMID: 26158998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Gouma E, Batistatou A, Verginadis II, Simos YV, Kyros L, Hadjikakou SK, Karkabounas SC, Evangelou AM, Ragos VN, Peschos D. The healing effect of four different silver complexes on full-thickness skin burns in a rat model. In Vivo 2015; 29:55-63. [PMID: 25600531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM This study was carried-out to investigate the effect of four different silver substances (S1, S2, S3, and S4) on burn wound healing in a rat model. MATERIALS AND METHODS One hundred and eighty Wistar rats were used. Animals were randomized into six groups to receive no treatment (CG, control group), and local application of the solvent of silver substances (SG, solvent group), as well as of the four silver substances (EG1-EG4 groups for substances S1-S4, respectively). On days 0, 3, 6, 12, 21, and 31 following burn wound infliction, the size and healing progress of each wound were recorded and evaluated by means of clinical evaluation, planimetry and histological examination. RESULTS According to our findings lower infection rates, as well as significantly accelerated wound healing and faster re-epithelialization were recorded in EG1, EG2, and EG4 compared to the other groups. DISCUSSION The use of S1, S2, and S4 substances proved to be an effective treatment of burn wounds that ensured better outcomes compared to the control and solvent groups, as well as with the use of S3 substance. Nevertheless, they failed to produce short-term healing of the full-thickness burn. Further research is required to examine the possibility of speeding the treatment of full-thickness burns by these complexes in order to reduce healing time to acceptable limits and prevent the need for surgery.
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Affiliation(s)
- Efthalia Gouma
- Department of Physiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Anna Batistatou
- Department of Pathology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Ioannis I Verginadis
- Department of Physiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Yannis V Simos
- Department of Physiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Loukas Kyros
- Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Ioannina, Ioannina, Greece
| | - Sotiris K Hadjikakou
- Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Ioannina, Ioannina, Greece
| | | | - Angelos M Evangelou
- Department of Physiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Vasilios N Ragos
- Department of Maxillofacial Surgery, Faculty of Medicine, University of Ioannina, Ioannina, Greece
| | - Dimitrios Peschos
- Department of Physiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
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Krychowiak M, Grinholc M, Banasiuk R, Krauze-Baranowska M, Głód D, Kawiak A, Królicka A. Combination of silver nanoparticles and Drosera binata extract as a possible alternative for antibiotic treatment of burn wound infections caused by resistant Staphylococcus aureus. PLoS One 2014; 9:e115727. [PMID: 25551660 PMCID: PMC4281117 DOI: 10.1371/journal.pone.0115727] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/01/2014] [Indexed: 02/02/2023] Open
Abstract
Staphylococcus aureus is the most common infectious agent involved in the development of skin infections that are associated with antibiotic resistance, such as burn wounds. As drug resistance is a growing problem it is essential to establish novel antimicrobials. Currently, antibiotic resistance in bacteria is successfully controlled by multi-drug therapies. Here we demonstrate that secondary metabolites present in the extract obtained from Drosera binata in vitro cultures are effective antibacterial agents against S. aureus grown in planktonic culture and in biofilm. Moreover, this is the first report demonstrating the synergistic interaction between the D. binata extract and silver nanoparticles (AgNPs), which results in the spectacular enhancement of the observed bactericidal activity, while having no cytotoxic effects on human keratinocytes. Simultaneous use of these two agents in significantly reduced quantities produces the same effect, i.e. by killing 99.9% of bacteria in inoculum or eradicating the staphylococcal biofilm, as higher amounts of the agents used individually. Our data indicates that combining AgNPs with either the D. binata extract or with its pure compound (3-chloroplumbagin) may provide a safe and highly effective alternative to commonly used antibiotics, which are ineffective towards the antibiotic-resistant S. aureus.
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Affiliation(s)
- Marta Krychowiak
- Laboratory of Biologically Active Compounds, Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland
| | - Mariusz Grinholc
- Laboratory of Molecular Diagnostics, Department of Biotechnology, IFB UG & MUG, Gdansk, Poland
| | - Rafal Banasiuk
- Laboratory of Biologically Active Compounds, Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland
| | | | - Daniel Głód
- Department of Pharmacognosy with Medicinal Plant Garden, Medical University of Gdansk, Gdansk, Poland
| | - Anna Kawiak
- Laboratory of Plant Protection and Biotechnology, Department of Biotechnology, IFB UG & MUG, Gdansk, Poland
| | - Aleksandra Królicka
- Laboratory of Biologically Active Compounds, Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdansk, Poland
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Linden L, Emmans P, Safranek S. Topical preparations for wound healing. Am Fam Physician 2014; 89:978-979. [PMID: 25162167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Leslie Linden
- Alaska Family Medicine Residency, Anchorage, AK, USA
| | - Paul Emmans
- Central Washington Family Medicine Residency, Yakima, WA, USA
| | - Sarah Safranek
- University of Washington Health Sciences Library, Seattle, WA, USA
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