Citation Information :
Devi C, Chandrasekhar R, RojaRamya KS, Ramesh MV. A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children. Int J Clin Pediatr Dent 2023; 16 (5):667-670.
Aim: The study evaluated the effectiveness of nanosilver fluoride (NSF) in arresting dental caries in 4–8-year-old school children.
Materials and methods: The two-arm, parallel-group randomized controlled trial included a total of 148 children aged 4–8 years with active carious lesions. Children were randomly divided into two groups: group I—NSF (n = 74); and group II—water (placebo and n = 74). Baseline data were recorded using the International Caries Detection and Assessment System (ICDAS) II criteria, and the teeth were treated with either of the solutions. Later, the teeth were evaluated by two blinded examiners for the lesion activity using ICDAS II criteria at 1, 3, and 6-month intervals. The obtained data were analyzed using the Chi-squared test for intergroup comparison and Cochran's Q test for intragroup comparison. Cohen's κ test was used to check the interexaminer and intraexaminer variability.
Results: Carious teeth treated with NSF have shown 56.3, 59.2, and 62% arrested carious lesions, whereas the placebo group has shown 0, 2.9, and 4.4% arrested lesions at 1, 3, and 6-month intervals, respectively. NSF showed a high statistically significant difference (p < 0.001) in arresting dental caries compared to the control group at all the time intervals.
Conclusion: Nanosilver fluoride (NSF) is found to be effective in arresting dental caries without staining carious lesions. Therefore, it can be used to reduce the bacterial load for caries stabilization in the initial phase of the comprehensive treatment protocol for the management of children with active caries lesions.
Clinical significance: Most of the decayed teeth in the primary dentition remain untreated either because of inaccessible dental services or the uncooperativeness of children. Hence, there is an absolute need for a cariostatic agent which arrests the progression of caries in a simple and noninvasive manner. The results of this study evidence that NSF effectively arrests dental caries in primary teeth. Hence, this can be a very economical way of arresting caries in the population who don't have access to regular dental treatment.
Peng JJ, 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
Sharma G, Puranik MP, KR S. Approaches to arresting dental caries: an update. J Clin Diagn Res 2015;9(5):ZE08–ZE11. DOI: 10.7860/JCDR/2015/12774.5943
Fung MHT, Wong MCM, Lo ECM, et al. Arresting early childhood caries with silver diamine fluoride- a literature review. J Oral Hyg Health 2013;1(3):1000117. DOI: 10.4172/2332-0702.1000117
Santos VE Jr, Vasconcelos Filho A, Targino AG, et al. A new “silver – bullet” to treat caries in children- nano silver fluoride: a randomised clinical trial. J Dent 2014;42(8):945–951. DOI: 10.1016/j.jdent.2014.05.017
Targino AG, Flores MA, dos Santos Junior VE, et al. An innovative approach to treating dental decay in children. A new anti-caries agent. J Mater Sci Mater Med 2014;25(8):2041–2047. DOI: 10.1007/s10856-014-5221-5
Hernandez-Sierra JF, Ruiz F, Pena DC, et al. The antimicrobial sensitivity of Streptococcus mutans to nanoparticles of silver, zinc oxide, and gold. Nanomedicine 2008;4(3):237–240. DOI: 10.1016/j.nano.2008.04.005
Tirupathi S, Svsg N, Rajasekhar S, et al. Comparative cariostatic efficacy of a novel nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial. J Clin Exp Dent 2019;11(2):e105–e112. DOI: 10.4317/jced.54995
Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002;81(11):767–770. DOI: 10.1177/0810767
Gangadharan D, Harshvardan K, Gnanasekar G, et al. Polymeric microspheres containing silver nanoparticles as a bactericidal agent for water disinfection. Water Res 2010;44(18):5481–5487. DOI: 10.1016/j.watres.2010.06.057
Kurek A, Grudniak AM, Kraczkiewicz-Dowjat A, et al. New antibacterial therapeutics and strategies. Pol J Microbiol 2011;60(1):3–12. DOI: 10.33073/pjm-2011-001
Mirzajani F, Ghassempour A, Aliahmadi A, et al. Antibacterial effect of silver nanoparticles on Staphylococcus aureus. Res Microbiol 2011;162(5):542–549. DOI: 10.1016/j.resmic.2011.04.009
Agnihotri S, Mukherji S, Mukherji S. Size-controlled silver nanoparticles synthesized over the range 5–100 nm using the same protocol and their antibacterial efficacy. RSC Advances 2014;4: 3974–3983. DOI: 10.1039/c3ra44507k
Lu Z, Rong K, Li J, et al. Size-dependent antibacterial activities of silver nanoparticles against oral anaerobic pathogenic bacteria. J Mater Sci Mater Med 2013;24(6):1465–1471. DOI: 10.1007/s10856-013-4894-5
Martinez-Castanon GA, Nino-Martinez N, Martinez-Gutierrez F, et al. Synthesis and antibacterial activity of silver nanoparticles with different sizes. J Nanopart Res 2008;10:1343–1348. DOI: 10.1007/s11051-008-9428-6
Nozari A, Ajami S, Rafiei A, et al. Impact of nano hydroxyapatite, nano silver fluoride and sodium fluoride varnish on primary teeth enamel remineralization: an in vitro study. J Clin Diagn Res 2017;11(9): ZC97–ZC100. DOI: 10.7860/JCDR/2017/30108.10694
e Silva AVC, de Araujo Teixeira J, de Melo Junior PC, et al. Remineralizing potential of nano-silver-fluoride for tooth enamel: an optical coherence tomography analysis. Pesqui Bras Odontopediatria Clín Integr 2019;19:e4002. DOI: 10.4034/PBOCI.2019.191.50
