J Dent. 2024 May 24:105098. doi: 10.1016/j.jdent.2024.105098. Online ahead of print.
ABSTRACT
OBJECTIVES: This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride+potassium iodide (SDF+KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF+KI+Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions.
METHODS: 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF+KI and SMART(SDF+KI+GIC) groups (n=56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher’s Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis.
RESULTS: The caries preventive effect was 100%, 67.9% and 65.4% for SDF+KI-treated teeth; and 100%, 97.6% and 94.7% for SMART(SDF+KI+GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF+KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months),(p<0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction in baseline SCASS scores at all evaluation periods(p<0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups, and by the 18-month follow-up, none of the teeth exhibited hypersensitivity.
CONCLUSIONS: During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART(SDF+KI+GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss.
CLINICAL SIGNIFICANCE: Both SMART(SDF+KI+GIC) sealants and SDF+KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART(SDF+KI+GIC) sealants showed greater caries-preventive effect compared to SDF+KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART(SDF+KI+GIC) sealants.
PMID:38797490 | DOI:10.1016/j.jdent.2024.105098
