Child discomfort and parental acceptability of silver diamine fluoride and alternative restorative treatment: A randomized controlled clinical trial.

OBJECTIVES: To compare pain perception of young children treated with SDF and ART, as well as their parents' acceptability of both modalities. METHODS: Eighty, 3 to 8-years old children, having at least one deciduous asymptomatic tooth with active caries, as defined by the ICDAS II scores 4, 5, 6 were randomly assigned into two groups; SDF for caries arresting in the test group, and ART for caries removal in the control group. Pain perception was assessed using Sound, Eye, Motor scale (SEM), whereas parental acceptability was assessed using a self-administered questionnaire. RESULTS: Patients treated with SDF reported significantly less discomfort and pain compared to the ART group, with a mean SEM of 3.70 ± 1.47 and 6.18 ± 3.06, respectively (p < 0.001). A significantly higher mean parental acceptability score was detected for SDF treatment (31.85 ± 2.30) than ART treatment (26.75 ± 3.60), p < 0.001, with regard to the treatment duration, child comfortability and quality of treatment (p < 0.001). The only dimension showing more satisfaction for the ART treatment was esthetics of anterior teeth (p= 0.01). CONCLUSIONS: Parental acceptability was higher for the SDF caries treatment of primary teeth compared to ART treatment, especially in relation to the shorter intervention time, child comfortability and acceptance as well as quality of treatment. CLINICAL SIGNIFICANCE: The shorter average time needed and the ease of application of SDF on cavitated primary lesions, in addition to parental acceptability, place SDF in an advantageous position over the ART on clinical level.

Etching Patterns of Sodium Hypochlorite Pretreated Hypocalcified Amelogenesis Imperfecta Primary Molars: SEM Study.

Aim: To investigate the etching patterns of hypocalcified amelogenesis imperfecta (AI) in primary molars pretreated with 5.25% NaOCl prior to phosphoric acid application using scanning electron microscopy (SEM). Study design: Ten hypocalcified AI primary molars were collected, sectioned longitudinally into 2 parts and allocated into two groups of ten specimens each. The enamel surface in the first group (control group) was etched using 37% phosphoric acid gel for 15 seconds; while in the second group (study group), it was pretreated using 5.25 sodium hypochlorite(NaOCl) for 60 seconds prior to acid etching. Each specimen was examined at 16 different sites, and evaluated for the etching pattern (types I, II, and III) distribution using SEM. A total of 320 microphotographs at 1,500 magnification were obtained using Auto-Cad 2007 software. Results: The etching pattern with phosphoric acid was not uniform with predominance of type III etching (65.63%), while the pretreated enamel surfaces showed a significant increase in type I and II(82.5%) etching patterns (P<0.001). Conclusion: Treatment of primary teeth affected by hypocalcified AI using 5.25% NaOCl prior to phosphoric acid etching significantly improves the etching pattern which is required for good resin bonding.

Efficacy of 10 percent Carbamide Peroxide as an Intracoronal Bleaching Agent in Nonvital Discolored Primary Teeth: An In Vitro Study.

PURPOSE: The purpose of this study was to evaluate, in vitro, the efficacy of 10 percent carbamide peroxide used as an intracoronal bleaching agent in blood-stained primary teeth. METHODS: Thirty extracted primary canines were stained using rabbit blood and randomly divided into two groups of 15 teeth each. Stained teeth in the test group were bleached intracoronally using 10 percent carbamide peroxide for 21 days. The bleaching agent was replaced at days seven and 14. The control group was not subjected to bleaching, and a cotton pellet damped with distilled water was placed in the pulp chamber. Shade alteration from the prestaining value was evaluated using a VITA Easyshade spectrophotometer at days zero, seven, 14, and 21. RESULTS: All specimens in the test group returned to the initial baseline shade, with no significant differences from the prestaining values (P=0.097). Teeth in the control group did not undergo any shade alteration after staining, with no significant differences noted from the prestaining values (P<0.001). CONCLUSIONS: Intracoronal bleaching using 10 percent carbamide peroxide is an effective approach for whitening discolored extracted primary teeth.