Comparison of Nano-silver Fluoride and Silver Diamine Fluoride as Pretreatment Agents for Pit-and-fissure Sealants in Primary Teeth

Traditional enamel preparation methods, such as acid etching, enhance surface roughness to improve mechanical bonding but do not address the potential for bacterial infiltration at the sealant-tooth interface.7 In this context, silver-based fluoride agents, such as silver diamine fluoride (SDF) and nano-silver fluoride (NSF), have garnered interest for their potential dual benefits: microbial inhibition and enamel remineralization.SDF is an established agent in dentistry, renowned for its ability to arrest dental caries and significantly reduce bacterial load.8 However, its application is limited by a critical drawback, enamel discoloration resulting from the formation of silver compounds, a significant concern in pediatric dental esthetics.9 Nano-ilver fluoride, a nanotechnology-based formulation, offers a potential solution to this limitation.NSF combines silver nanoparticles with fluoride and chitosan, a biocompatible polymer that enhances the stability and efficacy of the formulation.The smaller particle size of silver nanoparticles allows deeper IntroductIonDental caries is one of the most common chronic conditions affecting young children, with primary teeth being particularly susceptible due to their distinctive anatomical and compositional characteristics.The pits and fissures of primary molars are especially vulnerable to carious lesions, primarily due to their morphology, that facilitates the accumulation of biofilm and retention of food particles.1,2 This susceptibility, coupled with the thinner and less mineralized enamel of primary teeth, poses unique challenges in caries prevention and management.Additionally, weak bond strength and microleakage in sealants can lead to secondary caries and sealant failure, further complicating long-term preventive strategies.Thus, effective management and prevention of caries in primary teeth are critical for ensuring optimal oral health outcomes in children. 3 Pit-and-fissure sealants have long been established as an effective preventive measure against dental caries, providing a physical barrier that protects these vulnerable areas from bacterial colonization and food impaction.However, the success of sealants in primary teeth is highly dependent on their ability to adhere securely to the enamel surface and resist microleakage.4 The enamel in primary teeth differs from permanent teeth in composition and thickness, often being more porous and less mineralized.These properties can affect how well sealants adhere and perform over time.5 There is a need to reduce the acid-tolerant bacterial strains, which often affect the proper adhesion of the resin.6 To address these limitations, researchers have explored the use of pretreatment agents that not only enhance the physical properties of sealants but also provide additional therapeutic benefits, such as antimicrobial activity and enamel remineralization.