Silver fluoride/potassium iodide application in hypersensitive MIHaffected molars in schoolchildren: prospective clinical evaluation of immediate and midterm effects in desensitization.

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

Methods: 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 one month before recruitment. Hypersensitivity was assessed using a one-second air blast stimulus at three intervals: baseline, 15 minutes, and three months post-treatment (blinded). The response to the air-stimulus was quantified using the SCASS test, and teeth with grades 2 and 3 were only included. Statistical analysis involved Wilcoxon signed-rank test, Mann-Whitney U test, and Friedman test.

Results: The reported mean SCASS scores declined significantly from 2.51 at baseline to 1.15 after 15-min and 0.98 after three 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 post-treatment evaluation. However, the percentage reduction from baseline was not significant. Additionally, the reduction in hypersensitivity after AgF/KI application was almost identical for treated (desensitising 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.