الفهرس 
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Abstract
Untreated caries of primary dentition is a common and global phenomenon. Poverty, difficulty to access dental care, uncooperative behavior, lack of treatment facilities, all are barriers to managing early childhood caries (ECC). A simple preventive program, even though crucial, is not able to deal alone with established carious lesions. Through preventing and arresting caries, silver diamine fluoride (SDF) and also atraumatic restorative treatment (ART) provide temporary care paths for patients to whom traditional restorative measures are not instantly available.
The primary aim of study was to evaluate effectiveness of biannual applying 38% silver diamine fluoride in arrest of early childhood caries compared with atraumatic restorative treatment. While, the secondary aims were to measure duration of intervention visit, evaluate parental satisfaction and evaluate oral health related quality of life (OHRQoL).
It was a randomized controlled clinical trial with two parallel arms that was carried out in the Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University. Participants were one hundred healthy children aging 2-5 years. Caries severity and activity was determined using ICDAS II Caries Detection System and Activity Criteria for Coronal Primary Caries. Teeth having scores 5 or 6, that were active, were included. Children were equally and randomly divided up into two groups. Test group received 38% SDF biannually, while the control group received ART.
Baseline screening and oral examination were done for all patients under the same conditions, caries experience represented by dmft scores was recorded. Parents received age appropriate oral hygiene instructions and dietary advice. Baseline OHRQoL was recorded by allowing parents to fill Parental-Caregiver Perceptions Questionnaire (P-CPQ) and also Family
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Impact Scale (FIS). Children received intervention according to their assigned group and duration of intervention visit was recorded in both groups.
Caries arrest was assessed at the 3, 6, 9 and 12 intervals. In the SDF group, caries arrest was recorded when a lesion was dark and hard, while in the ART group, it was recorded when an intact restoration with less than 0.5 mm marginal defect was present. Duration of intervention visit was measured at baseline, parental satisfaction was assessed after 2 weeks using a 4-item, 5-level, Likert-scale questionnaire and OHRQoL was recorded at the baseline and then after 12 months using P-CPQ and FIS questionnaires.
The results of study revealed that:
After 12 months, SDF and ART groups showed 94.4% and 34.3% overall success, respectively (P<0.0001). Success of anterior teeth was 95.7% for SDF and 28.2% for ART (P<0.0001). Success of posterior teeth was 92.9% for SDF and 42.3% for ART (P<0.0001).
Mean duration of intervention visit was 3.751.23 minutes amongst SDF group and 7.723.93 minutes amongst ART group (P<0.0001).
Eighty percent of the parents accepted their children’s esthetics after SDF versus 98% after ART (p0.05). In the SDF group all parents reported that it was an easy procedure versus 30% among the ART group (P<0.0001). In the SDF group, 96% of parents viewed the procedure to be pain free versus 74% in the ART group (p<0.05). 88% of SDF parents and 82% of ART parents reported that the taste of the received treatment was acceptable to their children (p>0.05).
The total mean difference in scores of P-CPQ domains was 3.162.71 amongst SDF group and 2.982.85 in the ART group (P>0.05). The total mean difference in scores of FIS domains was 1.842.19 in the SDF group and 1.101.91 in the ART group (P>0.05).