Silver Diamine Fluoride-Modified Atraumatic Restorative Technique: An Effective Treatment Option for Caries Control in Primary Molars

A new study published in the Journal of Dentistry suggests that the silver diamine fluoride-modified atraumatic restorative technique (SMART) is an effective treatment option for caries control in primary molars.

Study Overview

A study was conducted to compare the success of SMART with the conventional drill and fill method in restoring carious lesions in primary molars.

Methodology

Children aged 4–8 years reporting to a tertiary care hospital with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups: SMART and Conventional. They were subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by a blinded independent evaluator at 6-month intervals to assess the status of restorations. The primary outcome was the success of restorations at 24 months, and the secondary outcome was the child's behavior and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis, and Chi-square test were used to compare the outcomes in the two groups.

Results

A total of 226 children (SMART group: 112, Conventional group: 114) were included, with 280 and 282 GIC restorations placed by the SMART and conventional methods, respectively. At 24 months, 459 (81.6%) primary molars were available for evaluation. Success rates of restorations were 38.4% and 45.8% in the SMART and conventional groups, respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional groups was 79% and 56% (p < 0.001), respectively.

There was no significant difference in the success rates of GIC restorations by SMART and conventional techniques in carious primary molars at 24 months. SMART was better accepted by children compared to the conventional restorative technique. SMART can be an alternative option to treat asymptomatic carious lesions in primary molars and is better accepted by children than the conventional drill and fill technique, thus implying that it has a useful role in uncooperative children.

Keywords

• Silver diamine fluoride
• Primary molars
• Atraumatic restorative technique
• Children
• Glass ionomer cement

Reference

Kalpana Bansal, Azeema Shamoo, Kalaivani Mani, Pavithra Devi K, Ankita Verma, Vijay P Mathur, Nitesh Tewari. Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars–A randomized controlled trial, Journal of Dentistry, Volume 138, 2023, 104698, ISSN 0300-5712, https://doi.org/10.1016/j.jdent.2023.104698.

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