Silver fluoride/potassium iodide application in hypersensitive MIH-affected molars in schoolchildren: prospective clinical evaluation of immediate and mid-term effects in desensitization.

Abstract

Objectives: This single-arm prospective interventional study evaluated the effectiveness of silver-fluoride combined with potassium-iodide (AgF+KI; Riva Star Aqua, SDI) in decreasing hypersensitivity after its application on permanent molars affected by molar incisor hypomineralization (MIH Treatment Need Index [TNI] 3 and 4) immediately (15 minutes) and after 3 months.

Method and materials: In total, 22 children with 53 hypersensitive MIH-affected permanent molars (MIH TNI 3 or 4) underwent AgF+KI application after isolation with cotton rolls. Teeth included had no prior in-office desensitizing agents or sealants within 1 month before recruitment. Hypersensitivity was assessed using a 1-second air blast stimulus at three intervals: baseline, 15 minutes, and 3 months posttreatment (blinded). The response to the air-stimulus was quantified using the Schiff Cold Air Sensitivity Scale (SCASS), and teeth with grades 2 and 3 only were included. Statistical analysis involved the Wilcoxon signed-rank test, Mann-Whitney U test, and Friedman test.

Results: The reported mean SCASS scores declined significantly from 2.5 (± 0.5) at baseline to 1.2 (± 0.9) after 15 minutes and 1.0 (± 1.0) after 3 months (n = 20 patients, n = 49 molars). Molars with SCASS 2 had a statistically significantly lower mean hypersensitivity score (from n = 26 to n = 24) compared to SCASS 3 teeth (from n = 27 to n = 19) at the subsequent posttreatment evaluation. However, the percentage reduction from baseline was not significant. Additionally, the reduction in hypersensitivity after AgF+KI application was almost identical for treated (desensitizing agent >1 month prior enrolment) and untreated molars.

Conclusion: AgF+KI is an effective and simple desensitizer providing instant and mid-term relief in schoolchildren with hypersensitive MIH-molars.