Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

Abstract

Background: This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and casein phosphopeptide-amorphous calcium phosphate fluoride varnish (CPP-ACPFV) in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children.

Methods: A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or CPP-ACPFV treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed.

Results: The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and CPP-ACPFV ( P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups ( P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period.

Conclusions: In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with CPP-ACPFV. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and CPP-ACPFV as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health.

Trial registration: ISRCTN54243749 (13/01/2022).

Keywords: Caries prevention; Children; Enamel breakdown; MI Varnish; Molar-Incisor Hypomineralization; Sensitivity; Silver Diamine Fluoride.

Figure 1.. The difference between the percentage of active caries in both groups.

(SDF: Silver diamine fluoride, CPP-ACPFV: Casein phosphopeptide-amorphous calcium phosphate fluoride varnish).

Figure 2.. The change in the mean rank of Schiff cold air sensitivity scale SCASS between the groups and between the time points.

(SDF: Silver diamine fluoride, CPP-ACPFV: Casein phosphopeptide-amorphous calcium phosphate fluoride varnish).