Evaluation of silver diamine fluoride and biodentine as agents for indirect pulp therapy in primary teeth - A...

Vital pulp therapy is crucial for preserving primary teeth vitality in deep carious lesions. Silver diamine fluoride (SDF) and biodentine are emerging materials with promising biological and therapeutic outcomes.

The aim of the study was to evaluate and compare the clinical, radiographic, and histological outcomes of SDF and biodentine for indirect pulp therapy in primary molars.

This two-phase study included in vivo clinical and radiographic evaluation (Phase 1) and an ex vivo histological assessment (Phase 2). A split-mouth randomized controlled trial was conducted involving 68 children (4-7 years) with deep carious lesions approaching the pulp in primary molars. A total of 136 teeth were included, forming 68 matched pairs.

Phase 1: Participants were randomly assigned to Group 1 (SDF - Test, n = 68) and Group 2 (Biodentine - Control, n = 68). Following caries excavation, 38% SDF or biodentine was applied. All treated teeth were restored with glass ionomer cement and evaluated clinically and radiographically at 3, 6, and 9 months. Phase 2: Teeth extracted for orthodontic reasons were histologically examined for dentin bridge formation, pulpal inflammation, and tissue integrity.

Data were analyzed using SPSS v23.0. Chi-square test and Fisher's exact test were applied. P <0.05 was considered statistically significant.

At 9 months, Group 2 showed higher clinical success (85.3%) than Group 1 (77.9%) (P = 0.035). Radiographic success was greater in Group 2 (83.8%) compared to Group 1 (70.6%) (P = 0.01). Histological findings favored biodentine.

Both materials were effective, but biodentine demonstrated superior clinical and biological outcomes.