1. Jovan Vojinović, University Business Academy Novi Sad, Faculty of Dental Medicine in Pancevo, Serbia i Medicinski fak,
Republic of Srpska, Bosnia and Herzegovina
2. Milica Gajic, University Business Academy Novi Sad, Faculty of Dental Medicine in Pancevo, Serbia
3. Katarina Kalevski, University Business Academy Novi Sad, Faculty of Dental Medicine in Pancevo, Serbia
4. Đorđe Mirjanić, JZU Dom zdravlja Banja Luka , Republic of Srpska, Bosnia and Herzegovina
Early childhood caries is currently the biggest public health problem in dentistry, affecting 23,8% children under the age of 36 months and 57,3% aged 3-5 years. In our region, it amounts 12% (Serbia) to 35% (Banja Luka) for the younger, and increase of over 50% in the older ones. An even greater problem is non-treatment of existing lesions, which amounts to over 90%, which is a consequence of the very difficult application of classical therapy methods. In developed countries, the only way of treatment before the third year was until recently via general anesthesia, which is impossible to do in the vulnerable ages, where pathology is the most common. In recent years, the widespread use of silver and fluoride preparations in stopping carious lesions has become increasingly common.
Silver has long been known in medicine as an agent with antimicrobial and antirheumatic potentials. In dentistry, silver has been used since the very beginning of the scientific phase, primarily through silver nitrate to stop carious lesions (which was abandoned with the introduction of fluoride) and silver amalgam. In recent years, the idea of combining the effects of fluoride and silver in order to stop progression of carious lesion has been revitalized and widely applied. Today, three systems based on the combination of silver and fluoride are used in treatment of caries: silver diamine fluoride (SDF), silver nitrate, and nanosilver fluoride is still in the experimental phase. Silver ions have bactericidal effect, prevent collagen degradation and close the openings of dentinal tubules, while fluorides in high concentrations help the remineralization of dentin and enamel. The preparations can also be used to detect an active carious lesion (it turns black). The advantages of mass application are: a) it does not require removal of the changed tissue; b) simple and short application c) possibility of simultaneous treatment of large number of teeth in one session; d) possibility of application with other materials; e) economically acceptable; f) the possibility of application in the conditions outside the office. Indications are all types of lesions, especially the filling of caries fissures, ruptured deciduous teeth that cannot be restored without a factory crown, to the initial proximal lesions. It can also be used in adults, especially in gerontostomatology for caries in the neck of a tooth and in people with developmental disabilities. A number of systematic analyzes of numerous studies indicate that the efficiency of silver preparations (primarily SDF) in stopping the progression of carious lesion ranges from 65% - 91%. The best results are achieved on mandibular incisors (91,7%) and the worst on the maxillary molars (54%).
No significant negative effects were registered, except for aesthetic ones due to dark staining of treated carious lesion, which nevertheless limits the wider application. There are possibilities of alleviating staining with subsequent restorations with aesthetic materials. Nano silver fluoride preparations do not cause staining.
SIMPOZIJUM B - Biomaterijali i nanomedicina