132 - Title: Effectiveness of SDF Gel Versus Liquid Applications

Abstract:

Purpose: Silver Diamine Fluoride (SDF) is an established antimicrobial agent used to arrest dentinal caries and promote remineralization. A recently introduced gel formulation offers increased viscosity, potentially improving handling and retention on tooth surfaces. This randomized, controlled clinical trial aimed to evaluate and compare the caries‑arresting effectiveness of SDF gel versus the traditional liquid formulation.

Methods: Forty‑four pediatric patients were enrolled and randomly assigned to receive either the liquid or gel formulation of Advantage Arrest®. Eighteen participants received the liquid formulation and twenty‑six received the gel. SDF was applied to clinically visible carious lesions following standardized protocols. Clinical evaluations were conducted at 3, 6, and 12 months. Caries arrest was defined as lesion hardening and absence of progression.

Results: The liquid formulation demonstrated superior caries‑arresting effectiveness at all follow‑up intervals. At three months, effectiveness was 87% for the liquid and 46% for the gel. At six months, arrest rates were 50% and 40%, respectively. At twelve months, the liquid maintained a 50% arrest rate, compared with 25% for the gel. Variability in follow‑up attendance, oral hygiene practices, and dietary behaviors contributed to a higher prevalence of active lesions among children treated with the gel formulation.

Conclusions: Although the liquid formulation of SDF exhibited higher overall effectiveness in arresting caries, the gel formulation offers clinical advantages, including improved viscosity, ease of placement, and enhanced retention on targeted surfaces. These handling benefits may support its use in specific clinical situations, particularly when moisture control or patient cooperation presents challenges.

Identify Supporting Agency and Grant Number: Drexel University IRB- 2311010220