The Desensitizing Effect of Nanosilver Fluoride Compared to Photobiomodulation Therapy in Molar-Incisor Hypomineralization: A Randomized Clinical Trial

Abstract

Objectives: Molar-incisor hypomineralization (MIH) can cause hypersensitivity. This study compared nanosilver fluoride (NSF) and photobiomodulation therapy (PBMT) regarding desensitization in MIH-affected first permanent molars (FPMs) and plaque reduction.

Methods: Children aged 7-10 years, with 120 hypersensitive MIH-affected FPMs, were randomly assigned to receive NSF or PBMT. Hypersensitivity was assessed using the Schiff Cold Air Sensitivity Scale (SCASS) at baseline, after 15 minutes and 1 month. Plaque accumulation was assessed using the modified plaque index (PlI) of Silness and Löe at baseline and after 1 month. T-test and Mann-Whitney U test were used to compare groups. Intragroup comparisons were done using paired t-test and Friedman test. Multilevel ordinal logistic regression analysis was used to assess the effect of treatment on the outcomes, controlling for confounders.

Results: The study included 40 children, mean ± SD age = 8.03 ± 1.13 years. There was significantly less sensitivity and greater plaque reduction in the NSF than the PBMT group after 1 month (P < .05). NSF and PBMT significantly reduced sensitivity over time (P < .001), with the lowest scores after 1 month. In multilevel regression, NSF was associated with significantly less sensitivity than PBMT after 1 month (AOR = 0.18, 95% CI: 0.07, 0.51, P = .001). While both groups had reduced plaque accumulation, the decrease was significant only in the NSF group (P < .001).

Conclusion: NSF and PBMT reduced sensitivity associated with MIH and provided immediate pain relief. However, NSF was superior due to its longer-lasting effects on sensitivity and additional benefit in plaque reduction.

Clinical significance: NSF offers a promising alternative to PBMT in desensitizing MIH-related hypersensitivity, particularly for patients with limited access to laser therapy.

Trial registration: The trial was registered in the clinicaltrials.gov registry (# NCT06348849).

Keywords: Nanosilver fluoride; clinical trial; desensitizing; first permanent molars; molar-incisor hypomineralization; pediatric; photobiomodulation therapy.