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Contribuição do diamino fluoreto de prata no tratamento de lesões cariosas em crianças : uma revisão narrativa
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Abstract(s)
Apesar do estado atual dos conhecimentos e dos avanços técnicos em constante evolução, a cárie dentária continua a ser a doença oral crónica mais comum nas crianças. O tratamento de lesões cariosas em crianças no consultório dentário pode por vezes revelar-se difícil, particularmente quando a criança é muito jovem ou não coopera. O comportamento não cooperante da criança pode impedir um tratamento dentário eficaz (Kohli et al, 2022). Para ultrapassar esta dificuldade, recorre-se frequentemente a formas avançadas de controlo do comportamento, como a sedação e/ou a anestesia geral (Bagher et al, 2019). A gestão das lesões cariosas pode realizar-se por métodos de remineralização baseados em produtos fluoretados. Esta abordagem não restauradora das lesões de cárie é particularmente recomendada para pacientes jovens e pouco cooperantes. Recentemente, foram desenvolvidos vernizes à base de diamino fluoreto de prata. O diamino fluoreto de prata (SDF) combina os efeitos antibacterianos da prata com os efeitos remineralizantes do flúor. Trata-se de um agente terapêutico prometedor para o tratamento de lesões cariosas em crianças. Numerosos estudos in vitro documentam a sua eficácia bactericida e o seu potencial de remineralização do esmalte e da dentina. O seu mecanismo de ação in vitro é objeto de investigações em curso. Assim, o SDF é uma das ferramentas disponíveis para o tratamento da cárie, modificando as acções bacterianas sobre os tecidos e melhorando a remineralização (Crystal & Niederman, 2019). O objetivo desta revisão narrativa é clarificar a gestão da cárie na primeira infância e especificar a contribuição do diamino fluoreto de prata nesta área. Através de uma análise da literatura, iremos detalhar a composição e os efeitos do tratamento. Analisaremos também o protocolo de aplicação e a sua utilização clínica. A revisão narrativa proposta será realizada tendo por base artigos científicos escritos português, francês, inglês e espanhol, recorrendo às plataformas de bases de dados PubMed, B-On, Medline, ScienceDirect, SciELO, Scopus e Google Scholar.
Despite de current state of knowledge and constantly evolving technical advances, dental caries remains the most common chronic oral disease in children. Treating carious lesions in children at the dentist's office can sometimes prove difficult, particularly when the child is very young or uncooperative. The child's uncooperative behaviour can prevent effective dental treatment (Kohli et al, 2022). To overcome this difficulty, advanced forms of behaviour control are often used, such as sedation and/or general anaesthesia (Bagher et al, 2019). Carious lesions can be managed using remineralisation methods based on fluorite products. This non-restorative approach to caries lesions is particularly recommended for young and uncooperative patients. Recently, varnishes based on silver diamine fluoride have been developed. Silver diamine fluoride (SDF) combines the antibacterial effects of silver with the remineralising effects of fluoride. It is a promising therapeutic agent for the treatment of carious lesions in children. Numerous in vitro studies document its bactericidal efficacy and its potential to remineralise enamel and dentin. Its mechanism of action in vivo is the subject of ongoing research. Thus, SDF is one of the tools available for caries treatment, modifying bacterial actions on tissues and improving remineralisation (Crystal & Niederman, 2019). The aim of this narrative review is to clarify the management of early childhood caries and specify the contribution of silver diamine fluoride in this area. Through an analysis of the literature, we will detail the composition and effects of the treatment. We will also analyse the application protocol and its clinical use. The proposed narrative review will be based on scientific articles written in portuguese, french, english and spanish, using the PubMed, B-On, Medline, ScienceDirect, SciELO, Scopus and Google Scholar database platforms.
Despite de current state of knowledge and constantly evolving technical advances, dental caries remains the most common chronic oral disease in children. Treating carious lesions in children at the dentist's office can sometimes prove difficult, particularly when the child is very young or uncooperative. The child's uncooperative behaviour can prevent effective dental treatment (Kohli et al, 2022). To overcome this difficulty, advanced forms of behaviour control are often used, such as sedation and/or general anaesthesia (Bagher et al, 2019). Carious lesions can be managed using remineralisation methods based on fluorite products. This non-restorative approach to caries lesions is particularly recommended for young and uncooperative patients. Recently, varnishes based on silver diamine fluoride have been developed. Silver diamine fluoride (SDF) combines the antibacterial effects of silver with the remineralising effects of fluoride. It is a promising therapeutic agent for the treatment of carious lesions in children. Numerous in vitro studies document its bactericidal efficacy and its potential to remineralise enamel and dentin. Its mechanism of action in vivo is the subject of ongoing research. Thus, SDF is one of the tools available for caries treatment, modifying bacterial actions on tissues and improving remineralisation (Crystal & Niederman, 2019). The aim of this narrative review is to clarify the management of early childhood caries and specify the contribution of silver diamine fluoride in this area. Through an analysis of the literature, we will detail the composition and effects of the treatment. We will also analyse the application protocol and its clinical use. The proposed narrative review will be based on scientific articles written in portuguese, french, english and spanish, using the PubMed, B-On, Medline, ScienceDirect, SciELO, Scopus and Google Scholar database platforms.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Odontopediatria Cárie dentária Diamino fluoreto de prata Tratamento restaurador atraumático