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Table 1 A summary of included studies on non-surgical approaches in treating dentin caries in preschool children

From: Non-surgical treatment of dentin caries in preschool children – systematic review

Author/year Study type/duration Subjects Intervention Outcome assessment Results/conclusion Comment/quality assessment
Zhi et al., 2012 [15] RCT 212 children Gp 1: 38% SDF once a year Clinical examination criteria: At 1 year, the caries arrest rates of Gps 1, 2 and 3 were 37%, 53% and 29%, respectively. Well-planned study design (random allocation, adequate sample size) Dropout rate was not high (15%). Confounding factors were taken into consideration.
2 years aged 3–4 years with active caries in primary teeth Gp 2: 38% SDF twice a year Active: lesion easily penetrated by probe
Gp 3: Flowable GI filling once a year Arrested: smooth, hard surfaces when probing At 2 years, the caries arrest rates of three groups were 79%, 91% and 82%, respectively.
But for Gp 3 also lesions that were totally covered with GI Effect of annual SDF and GI application on arresting caries did not differ significantly. However, blinding of outcome assessment (between Gp 3 and Gp 1, 2) is impossible.
SDF application twice a year increased caries arrest rates. Low risk of bias
Study quality (ADA): good
dos Santos et al., 2012 [14] RCT 91 children aged 5–6 years with caries in primary teeth Gp 1: interim restorative treatment with GI filling without caries removal Clinical examination criteria: At 12 months, the success rate of SDF was higher than interim restoration with GI filling (67% vs. 39%). No details about the random allocation and attrition rate. Non-blinded study and duration of study was short.
1 year
Active: lesion easily penetrated by probe
Gp 2: 30% SDF Arrested: smooth, hard surfaces when probing SDF was more effective than interim restoration with GI for arresting caries in primary teeth. High risk of bias
Study quality (ADA): poor
Chu et al., 2002 [13] RCT 375 children Gp 1: excavation plus 38% SDF once a year Clinical examination criteria: SDF groups (Gp 1, 2) had higher caries arrest rates than those of NaF groups (Gp 3, 4) and control. The respective mean numbers of arrested caries tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5 and 1.3, respectively. Ethical concern regarding the negative control group (no treatment)
30 months (aged 3–5 years)
   Upper anterior primary teeth Gp 2: 38% SDF once a year Arrested caries: cavity with hard floor and walls
Only anterior primary teeth were involved. The generalizability of the results to posterior teeth was limited.
  Gp 3: excavation plus 5% NaF 4 times a year
Gp 4: 5% NaF 4 times a year
Gp 5: Control (no treatment) SDF was effective in arresting dentin caries. Low risk of bias
Study quality (ADA): good
Lo et al., 1998 [9] Longitudinal study 289 children aged 3–6 years Gp 1: Regular oral health education session and daily tooth brushing with 1000 ppm fluoridated toothpaste Clinical examination criteria: Significant difference between the mean no. of arrested caries in Gp 1 and 2 which was 1.8 and 1.1, respectively. Low attrition rate over 3 years. Potential confounders were evaluated. Although no random allocation was performed, comparable groups were assembled initially and maintained throughout the study.
  3 years (168 children in intervention group, 121 children in the control group) Arrested caries: dark brown to black in color with hard surface
At 3 years, 28% of the active dentin caries in Gp 1 children had become arrested while 12% of the caries were arrested in the control.
Gp 2: Control (no intervention)
Moderate risk of bias
Study quality (ADA): good