Comparative cariostatic efficacy of a novel Nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial.

S Tirupathi,S Rajasekhar,S Nuvvula,N Svsg

doi:10.4317/jced.54995

Abstract

BackgroundTo evaluate the clinical cariostatic efficacy of a concocted 5% Nano-silver incorporated Sodium fluoride (NSSF) dental varnish with 38% Silver diamine fluoride (SDF) in preventing the progression of dentinal caries of primary molars.Material and MethodsA total of 159 active dentinal carious lesions in primary molars (from 50 children) were selected and randomly divided into two groups; NSSF and SDF. Varnish application was performed at the baseline visit and follow-up is carried out at 1, 3, 6 and 12 months. Parameters such as caries activity, depth, size, colour, and presence or absence of pain were noted at baseline and follow-up visits.Results The intergroup comparison of caries activity status did not reveal significant difference between the number of active and arrested caries lesions in NSSF and SDF groups at any visit (p >0.05) during the 12-month follow-up. There was no difference between overall failure and success rates between the two groups at any follow-up period (p-0.48).ConclusionsAnnual application of 5% NSSF is better than or equal to 38% SDF in preventing the progression of dentinal caries of primary molars. NSSF does not cause dark staining of dentinal tissue compared to the SDF and the use of NSSF can be recommended in children. Key words:Children, Nano-silver fluoride, Primary teeth, Silver diamine fluoride.

Highlights

Despite the advances in dental care, dental caries remains one of the most common oral disease affecting children
In an in-vitro comparison of antimicrobial efficacy and cytotoxicity between Silver diamine fluoride (SDF) and nano silver based fluoride varnish preparation carried out by Targino and co-workers, the antimicrobial efficacy of Nano silver based fluoride varnish preparation was better than SDF, the cytotoxity of Nano silver based fluoride varnish preparation was less when compared to silver diamine fluoride [9]
Trail was registered under Clinical trial registry India (CTRI/2017/03/008135). -Inclusion criteria: Children aged 6 to 10 years with active dentinal caries in primary molars; absence of pulp involvement, pain, mobility, abscess, sinus, fistula; participants should be free of any systemic diseases; written informed consent from the parents/guardians. -Exclusion criteria: Children whose parents refused to give consent: primary teeth with irreversible pulpitis; tooth close to exfoliation

Summary

Introduction

Despite the advances in dental care, dental caries remains one of the most common oral disease affecting children. A metal ion based topical fluoride preparation named Silver diamine fluoride (SDF) has been drawing increased attention contemporarily, due to its efficacy in arresting the progression of dental caries. Asian countries such as Japan and China pioneered its use, due to the promising results and availability of clinical trials it has been popularised throughout the world. Nano-silver containing fluoride varnish preparation showed better efficacy than the control to arrest caries progression in primary teeth [8]. To the best of our knowledge no studies related have been reported till date, comparing the clinical efficacy of SDF and Nano-silver based fluoride varnish preparation in arresting carious lesion progression in-vivo. This study was undertaken to evaluate and compare the clinical cariostatic efficacy of 5% NSSF to that of 38% SDF

Methods

Results

Discussion

Conclusion