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

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          A bstract

          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.

          How to cite this article

          Arnaud M, Junior PCM, Lima MGS, et al. 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.

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          Most cited references22

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          Silver as antibacterial agent: ion, nanoparticle, and metal.

          The antibacterial action of silver is utilized in numerous consumer products and medical devices. Metallic silver, silver salts, and also silver nanoparticles are used for this purpose. The state of research on the effect of silver on bacteria, cells, and higher organisms is summarized. It can be concluded that the therapeutic window for silver is narrower than often assumed. However, the risks for humans and the environment are probably limited. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
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            Size-controlled silver nanoparticles synthesized over the range 5–100 nm using the same protocol and their antibacterial efficacy

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              Silver diamine fluoride: a caries "silver-fluoride bullet".

              The antimicrobial use of silver compounds pivots on the 100-year-old application of silver nitrate, silver foil, and silver sutures for the prevention and treatment of ocular, surgical, and dental infections. Ag(+) kills pathogenic organisms at concentrations of <50 ppm, and current/potential anti-infective applications include: acute burn coverings, catheter linings, water purification systems, hospital gowns, and caries prevention. To distill the current best evidence relative to caries, this systematic review asked: Will silver diamine fluoride (SDF) more effectively prevent caries than fluoride varnish? A five-database search, reference review, and hand search identified 99 human clinical trials in three languages published between 1966 and 2006. Dual review for controlled clinical trials with the patient as the unit of observation, and excluding cross-sectional, animal, in vitro studies, and opinions, identified 2 studies meeting the inclusion criteria. The trials indicated that SDF's lowest prevented fractions for caries arrest and caries prevention were 96.1% and 70.3%, respectively. In contrast, fluoride varnish's highest prevented fractions for caries arrest and caries prevention were 21.3% and 55.7%, respectively. Similarly, SDF's highest numbers needed to treat for caries arrest and caries prevention were 0.8 (95% CI=0.5-1.0) and 0.9 (95% CI=0.4-1.1), respectively. For fluoride varnish, the lowest numbers needed to treat for caries arrest and prevention were 3.7 (95% CI=3.4-3.9) and 1.1 (95% CI=0.7-1.4), respectively. Adverse events were monitored, with no significant differences between control and experimental groups. These promising results suggest that SDF is more effective than fluoride varnish, and may be a valuable caries-preventive intervention. As well, the availability of a safe, effective, efficient, and equitable caries-preventive agent appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine's criteria for 21st century medical care.
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                Author and article information

                Journal
                Int J Clin Pediatr Dent
                Int J Clin Pediatr Dent
                IJCPD
                International Journal of Clinical Pediatric Dentistry
                Jaypee Brothers Medical Publishers
                0974-7052
                0975-1904
                Mar-Apr 2021
                : 14
                : 2
                : 207-211
                Affiliations
                [1–5 ]Department of Pediatric Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil
                [6 ]Department of Chemistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
                [7 ]Department of Clínica Integrada, Faculdade de Odontologia de Pernambuco - Universidade de Pernambuco, Camaragibe, Brazil
                [8 ]Department of Postgraduation/Pediatric Dentistry, University of Pernambuco, Camaragibe, Brazil
                Author notes
                Manuela Arnaud, Department of Pediatric Dentistry, University of Pernambuco, Recife, Pernambuco, Brazil, Phone: +5581981031983, e-mail: manuelaarnaud83@ 123456gmail.com
                Article
                10.5005/jp-journals-10005-1920
                8343678
                34413593
                557ab210-702d-4143-8069-0dafb7cd90c9
                Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.

                © Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Categories
                Research Article

                dental caries,primary teeth,randomized controlled trial,silver nanoparticles

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