Silver Modified Atraumatic Restorative Technique (Smart): An Alternative Caries Prevention Tool

Fa, Bernadette Alvear; Jew, Jordan Arron; Wong, Allen; Young, Douglas A.

doi:10.25241/2016.3(2).15

Cited by 22 publications

(23 citation statements)

References 9 publications

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“…Similarly, SDF can be used alongside the atraumatic restorative technique (ART), thus preventing irreversible pulpitis or dental infections of sealed dental lesions in a technique known as silver-modified ART (SMART) [20].…”

Section: Introductionmentioning

confidence: 99%

Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

et al. 2021

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Background The importance of Silver diamine fluoride (SDF) as a minimally invasive and nonaerosolizing management during COVID-19 pandemic has highly increased. SDF is a caries-arresting agent that causes staining of tooth structure. Managing this discoloration will increase its acceptance in treating primary teeth. The main aim of this study was to quantify the color change associated with the application of SDF on extracted carious primary molars, the potential masking of this color change by potassium iodide (KI), composite (CMP) and glass ionomer cement (GI) and the effect of aging on this color masking effect. Methods An in-vitro study in which 52 carious primary molars were collected, prepared, and distributed randomly into four groups equally as follows: Group A: SDF 38%; Group B: SDF 38% + KI; Group C: SDF 38% + CMP; Group D: SDF 38% + GI. Color changes were recorded for each sample at baseline, and after application of the tested materials. Moreover, all samples had undergone Suntest aging followed by a third color reading. CIELAB values L*, a*, b*, ΔL, Δa, and Δb were measured, ΔE was calculated, and data were analyzed using multivariate analysis of variance (MANOVA) and post-Hoc Scheffé test (p < 0.05). Results MANOVA revealed the significant influence of the factor ‘material’. SDF caused an obvious color change compared to the color of carious dentin. Regarding ΔL, the color change of groups C and D was not significant directly after application of the tested materials. After aging, it was significant among all groups, including groups C and D. In Δa there was a difference between SDF and groups B and C after application of the tested materials, and aging produced the same results. The color shifts of Δb of all tested groups varied significantly from one another. After aging, there was no difference between group D and either group A or B. Conclusions Treatment with SDF caused obvious discoloration of carious dentin. Directly after SDF application, all tested materials could effectively mask the color change associated with the application of SDF. CMP was the only material whose color masking effect was not completely reversed by aging.

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Section: Introductionmentioning

confidence: 99%

Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

et al. 2021

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“…High-viscosity auto-cure GIC has been advocated in ART because it would chemically bond to the moist surface being hydrophilic providing seal, and acid resistance and enhancing remineralization at the tooth-restorative interphase. In the SMART restorations, auto-cure GIC is preferred over the light-cure as the light could cause darkening of the SDF [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The basis for the SMART comes from the fact that by biologically sealing the tooth with caries, the viable bacteria present in the remaining carious dentin lose their viability by being deprived of their sucrose substrate. Thus, if the organisms were made nonviable using SDF and the staining was eliminated by the use of KI, prior to placement of a restorative material like GIC as placed in ART, it would significantly improve the prognosis of the tooth [ 15 ]. Placement of a restoration following SDF would eliminate imminent fracture of the remaining tooth structure, prevent space loss [ 16 ], provide easy access for biofilm removal [ 17 ], and eliminate the need for advanced behavior guidance [ 12 ] while satisfying the parents’ demands or needs [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the GIC in SMART restorations probably controls the caries lesions by preventing biofilm retention and cavity sealing but not predominantly by fluoride release [ 33 ]. Thus, these SMART restorations kill bacteria and cut off the nutrient source for any remaining bacteria by placing a chemically sealed restoration that will arrest and remineralize the caries lesion, enhancing pulp vitality and preserving the tooth structure [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Silver Modified Atraumatic Restorative Technique: A Way Towards “SMART” Pediatric Dentistry During the COVID-19 Pandemic

Divya¹

2022

fid

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As the coronavirus disease-2019 pandemic outbreak continues to be a global public health concern, dentists should seek means to provide oral health care with minimal risk. To meet the recommendations of the Center for Disease Control, alternative non-aerosol generating techniques have been proposed to minimize the risk of disease transmission to patients and dental healthcare personnel. Among recent materials, silver diammine fluoride (SDF) has been shown to be effective in preventing and arresting caries. This along with an atraumatic restorative treatment with glass ionomer cements (GICs) makes it a potentially attractive adjunctive therapy for caries management in pediatric patients. In this technique, SDF is applied over carious tissue and the lesion is restored with auto-polymerizing GIC. This review article aims to provide a practical background and clinical guide for the application of silver-modified atraumatic restorative technique (SMART) as a safe way to provide dental services to children during the pandemic.

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“…The use of SDF combined with the Atraumatic Restorative Technique (ART), termed Silver Modified Atraumatic Restorative Technique (SMART), has also been recommended (Alvear et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The use of silver diamine fluoride in a children's hospital: Critical analysis and action protocol

Brunet‐Llobet

Auría‐Martín

González‐Chópite

et al. 2022

Clinical & Exp Dental Res

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Objectives The present critical analysis aims to propose an action protocol for the use of silver diamine fluoride (SDF) in pediatric patients in a hospital setting, especially for those who are currently awaiting hospital dental treatment under general anesthesia. Material and Methods A literature search was performed in the PubMed/MEDLINE from 2009 to 2021 using the search terms “silver diamine fluoride”, “pediatrics silver diamine fluoride”, “application silver diamine fluoride”, and “AND” ‐ combined with terms: “potassium iodide”, “properties”, “adverse effects”, “early childhood caries”, “patient with disability”, “management”, “special health care needs patient”. Articles that recorded the type of teeth, application protocol, the concentration of the product, and possible complications of the treatment were selected. Results Four hundred and sixteen related articles were obtained, of which 13 were finally chosen on the basis of the search criteria. The age at which the use of SDF was recommended ranged from the first year of life to 12 years, in most cases in primary teeth. The study populations varied in size from 53 to 799 patients. An analysis of the characteristics of SDF and its use in pediatric patients with dental caries was performed. The recommended concentration was 38% SDF, applied twice yearly. The main complication reported was staining. A decision algorithm was designed including SDF as an agent for caries control in patients attending the specific population of our hospital (divided into two groups: healthy children aged 0−4 years and patients with special health care needs (SHCNs) aged 0−18 years). Conclusions SDF therapy appears to be effective in the control of caries in pediatric patients. We propose an action protocol for patients with early childhood caries to reduce risk, complications, and the progression of lesions. The protocol is aimed especially at pediatric patients who also have some systemic pathology, disability, SHCNs, and/or behavioral difficulties.

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Silver Modified Atraumatic Restorative Technique (Smart): An Alternative Caries Prevention Tool

Cited by 22 publications

References 9 publications

Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

Silver Modified Atraumatic Restorative Technique: A Way Towards “SMART” Pediatric Dentistry During the COVID-19 Pandemic

The use of silver diamine fluoride in a children's hospital: Critical analysis and action protocol

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