Antimicrobial effects of silver diamine fluoride: An in vivo study.

PURPOSE: To compare the antimicrobial effect of treating dentin caries lesions with silver diamine fluoride (SDF) in different concentrations and chlorhexidine (CHX). METHODS: Children aged 7-10 years presenting one occlusal dentin carious lesion in primary molars were selected, totaling 40 teeth. The sample was randomly divided into four groups: (G1) 38%-SDF + potassium iodide (KI); (G2) 30%-SDF; (G3) 2%-CHX; and (G4) control group. After cleaning the cavity up to firm dentin, a sample of dentin from the pulp wall was collected; the cavity was then treated with the antimicrobial agent tested and, immediately after, another dentin sample was collected. Cavities were restored with high viscosity glass ionomer cement. Microorganisms were counted, and species from the Streptococcus genus were analyzed for susceptibility to antimicrobial agents. Shapiro-Wilk and Levene's tests were used to assess normality and homogeneity, respectively. Student's t-test, two-way ANOVA, and Bonferroni post-test were applied for multiple comparisons. RESULTS: For the overall microorganisms count, it was observed that G1 and G2 presented a statistically lower number of microorganisms following treatment in comparison to G3 and G4 (P< 0.05). When analyzing the Streptococcus spp. and Enterococcus sp. separately, a statistical reduction in the microorganism count before and after the treatment was observed for all groups (P< 0.05), excluding the control group. Among the species tested, S. mutans were the least susceptible to SDF treatments compared to the other species. The treatments with SDF were more effective in reducing microorganisms when compared to CHX. Similarly, the susceptibility of Streptococcus to CHX was lower than that observed for SDF. CLINICAL SIGNIFICANCE: In cases where the dental professional decides to apply an antimicrobial agent prior to the placement of a restoration, silver diamine fluoride proved to be more effective than chlorhexidine, slowing the progression of carious lesions, and possibly preventing future restorative interventions thus improving children's quality of life. It is important to note that clinicians should consider the type of restorative material that will be used due to the possibility that the use of SDF may influence adhesion of the subsequent restoration.

Efficacy of Propolis on the Denture Stomatitis Treatment in Older Adults: A Multicentric Randomized Trial.

Our hypothesis tested the efficacy and safety of a mucoadhesive oral gel formulation of Brazilian propolis extract compared to miconazole oral gel for the treatment of denture stomatitis due to Candida spp. infection in older adults. Forty patients were randomly allocated in a noninferiority clinical trial into two groups. The control group (MIC) received 20 mg/g miconazole oral gel and the study group (PROP) received mucoadhesive formulation containing standardized extract of 2% (20 mg/g) propolis (EPP-AF®) during 14 days. Patients were examined on days 1, 7, and 14. The Newton's score was used to classify the severity of denture stomatitis. The colony forming unity count (CFU/mL) was quantified and identified (CHROMagar Candida®) before and after the treatment. Baseline characteristics did not differ between groups. Both treatments reduced Newton's score (P < 0.0001), indicating a clinical improvement of the symptoms of candidiasis with a clinical cure rate of 70%. The microbiological cure with significant reduction in fungal burden on T14 was 70% in the miconazole group and 25% in the EPP-AF group. The EPP-AF appears to be noninferior to miconazole considering the clinical cure rate and could be recommended as an alternative treatment in older patients.