Silver diamine fluoride effectiveness in arresting initial approximal caries lesions in adults: A triple-blinded, randomized controlled clinical trial.

Aim: Despite the advancement in dental care, dental caries remains the most prevalent oral disease, necessitating the need for effective, preventive, and minimally invasive treatment options. The aim of this study was to evaluate the effectiveness of silver diamine fluoride (SDF) in arresting initial approximal carious lesions in adults. Materials and Methods: This study was a randomized, triple-blinded, placebo-controlled clinical trial. Participants were randomly assigned to one of two arms (A or B). One randomly selected lesion received either treatment (SDF solution) or placebo (water). Lesions were followed at 6- and 12-month using bitewing radiographs. Lesion progression was assessed via three evaluation methods: (1) pairwise comparison of bitewing radiographs (visual assessment), (2) assessment of subtraction radiographs (digital subtraction radiography [DSR]), and (3) histogram analysis of subtraction radiographs (HA). All the statistical analyses were performed using R software (the R Foundation, Vienna, Austria) at the 5% significance level. Results: Over 12-month period, more than 90% of the lesions were arrested in both groups. The SDF group performed significantly better according to the DSR method between baseline and 6 months (P = 0.05). There were no significant differences between the groups at the 12-month follow-up. Conclusion: SDF treatment was superior in arresting initial approximal caries lesions during the first 6 months of use. This is significant for disease control in high-risk individuals who present to the clinic with multiple initial approximal caries lesions. Further studies are needed to confirm its effectiveness.