Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study
Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diami...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
|
| Series: | Journal of Indian Society of Pedodontics and Preventive Dentistry |
| Subjects: | |
| Online Access: | http://www.jisppd.com/article.asp?issn=0970-4388;year=2022;volume=40;issue=4;spage=383;epage=390;aulast=Patel |
| _version_ | 1797775491610968064 |
|---|---|
| author | Megha C Patel Disha A Makwani Rohan K Bhatt Vijeta Raj Chhaya Patel Foram Patel |
| author_facet | Megha C Patel Disha A Makwani Rohan K Bhatt Vijeta Raj Chhaya Patel Foram Patel |
| author_sort | Megha C Patel |
| collection | DOAJ |
| description | Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection. |
| first_indexed | 2024-03-12T22:37:23Z |
| format | Article |
| id | doaj.art-71d707b92e8d4903aa3a3937162de7f1 |
| institution | Directory Open Access Journal |
| issn | 0970-4388 1998-3905 |
| language | English |
| last_indexed | 2024-03-12T22:37:23Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian Society of Pedodontics and Preventive Dentistry |
| spelling | doaj.art-71d707b92e8d4903aa3a3937162de7f12023-07-21T11:45:25ZengWolters Kluwer Medknow PublicationsJournal of Indian Society of Pedodontics and Preventive Dentistry0970-43881998-39052022-01-0140438339010.4103/jisppd.jisppd_360_22Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical studyMegha C PatelDisha A MakwaniRohan K BhattVijeta RajChhaya PatelForam PatelBackground: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection.http://www.jisppd.com/article.asp?issn=0970-4388;year=2022;volume=40;issue=4;spage=383;epage=390;aulast=Pateldental cariesindirect pulp cappingminimal invasive dentistryprimary molarspulpotomyselective caries removalsilver diamine fluoridesilver-modified atraumatic restorative technique |
| spellingShingle | Megha C Patel Disha A Makwani Rohan K Bhatt Vijeta Raj Chhaya Patel Foram Patel Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study Journal of Indian Society of Pedodontics and Preventive Dentistry dental caries indirect pulp capping minimal invasive dentistry primary molars pulpotomy selective caries removal silver diamine fluoride silver-modified atraumatic restorative technique |
| title | Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study |
| title_full | Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study |
| title_fullStr | Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study |
| title_full_unstemmed | Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study |
| title_short | Evaluation of silver-modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars – A comparative prospective clinical study |
| title_sort | evaluation of silver modified atraumatic restorative technique versus conventional pulp therapy in asymptomatic deep carious lesion of primary molars a comparative prospective clinical study |
| topic | dental caries indirect pulp capping minimal invasive dentistry primary molars pulpotomy selective caries removal silver diamine fluoride silver-modified atraumatic restorative technique |
| url | http://www.jisppd.com/article.asp?issn=0970-4388;year=2022;volume=40;issue=4;spage=383;epage=390;aulast=Patel |
| work_keys_str_mv | AT meghacpatel evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy AT dishaamakwani evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy AT rohankbhatt evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy AT vijetaraj evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy AT chhayapatel evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy AT forampatel evaluationofsilvermodifiedatraumaticrestorativetechniqueversusconventionalpulptherapyinasymptomaticdeepcariouslesionofprimarymolarsacomparativeprospectiveclinicalstudy |