出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/03 22:57:36」(JST)
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Silver Diamine Fluoride 38%
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| Clinical data | |
|---|---|
| Trade names | Saforide, Advantage Arrest[1] |
| Legal status |
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| Identifiers | |
| CAS Number | 34445-07-3 |
| ChemSpider | 142121 |
| Synonyms | Diamine silver fluoride, Diammine Silver Fluoride |
| Chemical data | |
| Formula | AgF(NH3)2 |
| Molecular mass | 160.927643 g/mol[2] |
Silver diamine fluoride is a topical medicament (drug) used to treat and prevent dental caries (cavities) and relieve dentinal hypersensitivity.[3][4] Silver diamine fluoride has been available in many countries including China, Japan, New Zealand, Australia and other for many decades. The product was cleared for sale in the USA in August 2014 by the FDA as a class II medical device for the treatment of dentinal hypersensitivity.[5]
6 randomized clinical trials document a profound effect in arresting cavities, simply by drying the cavity and then applying this material. [6] [7] [8] [9] [10] [11] [12]
2 randomized clinical trials document a profound effect in preventing cavities, by application to other surfaces that have cavities. [6] [7] [8]
4 randomized clinical trials document a profound effect in preventing cavities, simply by drying the tooth surface and then applying this material. [12] [13] [14] [15]
A recent Systematic Review of Silver Diamine Fluoride literature and protocols for use has been published in the California Dental Journal[16]
Silver diamine fluoride stains cavities black. A completely darkened cavity is a strong indicator of success. [15]
1. Isolate the affected area of the tooth with cotton rolls or protect the gingival tissue of the affected tooth with petroleum jelly. Alternatively, a rubber dam can be used to isolate the area. 2. Clean and dry the affected tooth surface. 3. For up to 5 treated sites per patient, dispense 1-2 drops of solution into a disposable dappen dish. Transfer material directly to the tooth surface with an applicator applying for one minute. 4. Wipe or rinse away any excess material, Air-dry. If needed, one or two reapplications may be administered at intervals of one week.[17]
Silver Diamine Fluoride will stain most surfaces black. Skin and soft tissue will discolor within minutes to hours after contact and fade away within a few days. Dentin and enamel with no demineralization present will receive surface (pellicle) stains that can be removed with pumice, while Demineralized tooth structure will stain more permanently black. Silver Diamine Fluoride is corrosive to metal and glass. Contact to metal produces hydrogen gas and hydrogen fluoride while contact with glass will create silicone tetra-fluoride. It is a light sensitive clear liquid with a strong ammonia scent and should be stored in a cool, dark, dry place in a plastic container (LDPE or HDPE).[18]
In the USA, silver diamine fluoride is applied in the dental office. Currently the procedure is paid for out of pocket and seldom covered by third party insurance providers. Fees can vary significantly based on region, professional specialty and intra-oral area of application however, median fees tend to be around $35–40 per tooth treated.
Code on Dental Procedures and Nomenclature (CDT Code) in 2015 provides three codes that can potentially be used for silver diamine fluoride. These codes are: D1999 - Unspecified preventive procedure, by report[19] D9910 - Application of a desensitizing medicament[20] D1208 - Application of topical fluoride, excluding varnish[21]
In 2016 the Code on Dental Procedures Nomenclature (CDT Code) will list an additional code for the arresting of carious lesions with Silver Diamine Fluoride or Silver Nitrate. D1354 - Interim caries arresting medicament applicaton.[22]
Various providers across the USA have begun to provide plans with coverage of D1354.
• Federal employees are eligible for coverage [23][24]
• DentalCare USA from Delta Dental of California provides coverage [25]
• Oregon has recommended coverage to state programs [26]
• Delta Dental of Washington DC will provide coverage[27]
• Cigna has provided plans that provide coverage [28]
• Pacific Source Health Plans provide coverage [29]
• United Concordia plans provide coverage (with copay)[30]
• Delta Dental of Washington State will not provide coverage of D1354[31]
• Delta Dental of Arizona will provide coverage for patients ages 3-19 and must be done with risk assessment[32]
• Delta Dental of Iowa will Deny coverage of D1354[33]
Differences in nomenclature have led to confusion around this material. Silver diamine fluoride is also known as:
Popular Silver Diamine Fluoride products include:
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| リンク元 | 「フッ化ジアミン銀」 |
| 関連記事 | 「silver」 |