Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique)

Aust Dent J. 1996 Oct;41(5):328-34. doi: 10.1111/j.1834-7819.1996.tb03142.x.

Abstract

Histological assessment of the dental pulps of 55 carious primary teeth was carried out 3 to 58 months after treatment by the 'atraumatic' technique involving application of 40 per cent silver fluoride to residual caries followed by restoration with glass ionomer cement. Fifty of the 55 teeth examined showed a favourable pulpal response, inducing presence of abundant reparative dentine and a wide odontoblast layer. Histological comparisons were made between these teeth and others not treated with silver fluoride but restored with glass ionomer cement, amalgam or zinc oxide and eugenol. Possible mechanisms of the action of silver fluoride in arresting residual caries are discussed. The question of whether or not treatment of carious dentine with silver fluoride represents a biologically acceptable clinical procedure cannot be answered on the basis of pulpal histology alone. The very high concentration of fluoride in commercial preparations of silver fluoride raises several questions concerning its clinical safety.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Dental Amalgam / pharmacology
  • Dental Caries / therapy*
  • Dental Pulp / blood supply
  • Dental Pulp / drug effects*
  • Dental Pulp / pathology
  • Dental Restoration, Permanent*
  • Dentin / blood supply
  • Dentin / drug effects
  • Dentin / ultrastructure
  • Dentin, Secondary / drug effects
  • Dentin, Secondary / pathology
  • Erythrocytes / pathology
  • Female
  • Fluorides / therapeutic use*
  • Follow-Up Studies
  • Glass Ionomer Cements / pharmacology*
  • Humans
  • Male
  • Neutrophils / pathology
  • Odontoblasts / drug effects
  • Odontoblasts / pathology
  • Silver Compounds / therapeutic use*
  • Tooth, Deciduous / blood supply
  • Tooth, Deciduous / drug effects*
  • Tooth, Deciduous / pathology
  • Zinc Oxide-Eugenol Cement / pharmacology

Substances

  • Glass Ionomer Cements
  • Silver Compounds
  • Zinc Oxide-Eugenol Cement
  • Dental Amalgam
  • Fluorides