International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 14 , ISSUE 2 ( March-April, 2021 ) > List of Articles

RESEARCH ARTICLE

Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial

Manuela Arnaud, Paulo CM Junior, Maria GS Lima, Amitis VC e Silva, Joas T Araujo, Andre Gallembeck, Arnaldo de França Caldas Júnior, Aronita Rosenblatt

Keywords : Dental caries, Primary teeth, Randomized controlled trial, Silver nanoparticles

Citation Information : Arnaud M, Junior PC, Lima MG, e Silva AV, Araujo JT, Gallembeck A, Júnior AD, Rosenblatt A. Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021; 14 (2):207-211.

DOI: 10.5005/jp-journals-10005-1920

License: CC BY-NC 4.0

Published Online: 30-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: To compare the arresting caries effectiveness of two different silver nanoparticle (AgNP) concentrations of nano-silver fluoride (NSF), namely 400 and 600 ppm. The hypothesis is that in posterior primary teeth with occlusal and approximal active dentin carious lesions, NSF 600's effectiveness will be higher than that of the NSF 400 solution over a 6-month follow-up period. Materials and methods: This was a double-blind randomized clinical trial (RCT) conducted in the city of Recife, Brazil. A total of 337 children aged 5–7 years who attended the University of Pernambuco Dental School's clinics were examined. A single-blinded investigator conducted the examinations and treatment of the children. After baseline examination and recording of the dmft index, children were allocated to one of two study groups (NSF 600—intervention and NSF 400—positive control). In both groups, each tooth received two drops of NSF and treatments were performed only once in 6 months. The follow-up examinations were visual and tactile, performed in 30, 90, and 180 days to determine the activity of caries. The carious lesions that were not arrested in 30 days were recorded and referred for restorative treatment. Results: The NSF 600 showed higher rate of success in arresting caries (72.7%, p = 0.025) compared with NSF 400 (56.5%). Conclusion: The higher rate of success of NSF 600 can be explained by the higher concentration of AgNPs. Clinical significance: Nano-silver fluoride has emerged as an excellent alternative to silver diamine fluoride (SDF), as it adds a high antibacterial effect to better esthetic results. Treatment is simple, non-invasive, and incurs low cost. It is ideal for use in community-based programs to increase the access to dental care without staining teeth black like other silver products.


HTML PDF Share
  1. American Academy of Pediatric Dentistry. AAPD Publications. Available at: http://www.aapd.org/media/Policies_Guidelines/P_SilverDiamine.pdf”. Accessed: 2018-10-29. (Archived by WebCite® at http://www.webcitation.org/73XdZ4zec).
  2. Wong MC, Lo ECM, Schwarz E, et al. Oral health status and oral health behaviors in Chinese children. J Dent Res 2001;80(5):1459–1465. DOI: 10.1177/00220345010800051501.
  3. Fung MHT, Wong MCM, Lo ECM, et al. Arresting early childhood caries with silver diamine fluoride- a literature review. Oral Hyg Health 2013. 1–117.
  4. Crystal YO, Niederman R. Silver diamine treatment considerations in children's caries management brief communication and commentary. Pediatr Dent 2016;38(7):466–471.
  5. Nishino M, Yoshida S, Sobue S, et al. Effect of topically applied ammoniacal silver fluoride on dental caries in children. J Osaka Univ Dent Sch 1969;9:149–155.
  6. Peng JJ-Y, Botelho MG, Matinlinna JP. Silver compounds used in dentistry for caries management: a review. J Dent 2012;40(7):531–541. DOI: 10.1016/j.jdent.2012.03.009.
  7. Rosenblatt A, Stamford TC, Niederman R. Silver diamine fluoride: a caries “silver fluoride bullet”. J Dent Res 2009;88(2):116–125. DOI: 10.1177/0022034508329406.
  8. Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dentistry 2012;40(11):962–967. DOI: 10.1016/j.jdent.2012.08.002.
  9. Chu CH, Lo ECM. Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent 2008;6(4):315–321.
  10. Freire PLL, Stamford TCM, Albuquerque AJR, et al. Action of silver nanoparticles towards biological systems: cytotoxicity evaluation using hen's egg test and inhibition of Streptococcus mutans biofilm formation. Internat J Antimicrobial Agents 2015;45(2):183–187. DOI: 10.1016/j.ijantimicag.2014.09.007.
  11. Dos Santos Jr VE, Vasconcelos Filho AA, Targino AGR, et al. A new “Silver- Bullet” to treat caries in children - nano silver fluoride: a randomized clinical trial. J Dent 2014;42(8):945–951. DOI: 10.1016/j.jdent.2014.05.017.
  12. Targino AGR, Flores MAP, dos Santos Junior VE, et al. An innovative approach to treating dental decay in children - A new anti-caries agent. J Mat Sci: Mat Med 2014;25(8):2041–2047. DOI: 10.1007/s10856-014-5221-5.
  13. Oral Health Survey: Basic Methods, 5th edition. Available at:“http://.www.who.int/oral_health/publications/9789241548649/en/”. Accessed:2018-10-29. (ArchivedbyWebCite® at http://www.webcitation.org/73XcXMdPy).
  14. Cherusova S, Epple M. Silver as antibacterial agent: íon, nanoparticle and metal. Angew Chem 2013;52(6):1636–1653. DOI: 10.1002/anie.201205923.
  15. Agnihotri S, Mukherji S. Size-controlled silver nanoparticles synthesized over the range 5-100 nm using the same protocol and their antibacterial efficacy. RSC Adv 2014;4(8):3974–3983. DOI: 10.1039/C3RA44507K.
  16. Buszewski B, Rafinska K, Pomastowski P, et al. Novel aspects of silver nanoparticles functionalization. Colloids and surfaces A: physicochem. Eng Aspects 2016;506:170–178. DOI: 10.1016/j.colsurfa.2016.05.058.
  17. Durán N, Marcato PD, Conti RD, et al. Potencial use of silver nanoparticles on pathogenic bacteria, their toxicity and possible mechanisms of action. J Braz Chem Soc 2010;21(6):949–959. DOI: 10.1590/S0103-50532010000600002.
  18. Espinosa-Cristóbal LF, Martínez-Castañón GA, Téllez-Déctor EJ, et al. Adherence inhibition of Streptococcus mutans on dental enamel surface using silver nanoparticles. Mater Sci Eng C Mater Biol Appl 2013;C33(4):2197–2202. DOI: 10.1016/j.msec.2013.01.039.
  19. Melo MAS, Guedes SFF, Xu HHK, et al. Nanotechnology-based restorative materials for dental caries management. Trends Biotechnol 2013;31(8). DOI: 10.1016/j.tibtech.2013.05.010.
  20. Amid II, Pitts NB, Tellez M. The international caries classification and management system (ICCMS)- an example of caries management pathway. BMC Oral Health 2015;15(Suppl 1):S9.
  21. Burns J, Hollands K. Nano silver fluoride for preventing caries. Evid Based Dent 2015;16(1):8–9. DOI: 10.1038/sj.ebd.6401073.
  22. Simon R. Are placebo-controlled clinical trials ethical? Editorial Ann Intern Med 2000;133(6):474–475. DOI: 10.7326/0003-4819-133-6-200009190-00017.
  23. Fung MHT, Duangthip D, Wong MCM, et al. Arresting dentine caries with different concentrations and periodicity of silver diamine fluoride. JDR Clin Trans Res 2016;1(2):143–152. DOI: 10.1177/2380084416649150.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.