Nano Silver Fluoride and Photobiomodulation Therapy for Hypersensitivity and Pain in MIH-Affected Molars

Summary

Molar-incisor hypomineralization (MIH) is a developmental condition affecting primarily the first permanent molars and may be associated with post-eruptive enamel breakdown, hypersensitivity, and difficulties in achieving adequate pain control during dental treatment. This randomized controlled trial will evaluate the effectiveness of nano silver fluoride (NSF) and photobiomodulation therapy (PBMT) as desensitizing interventions applied before cavity preparation in children aged 7-12 years with MIH-affected first permanent molars with post-eruptive enamel breakdown. The study will compare the effects of NSF and PBMT with a control group receiving pre-appointment analgesics. Hypersensitivity will be assessed using the Cumulative Hypersensitivity Index (CHI), while pain during cavity preparation and restoration will be evaluated using the Wong-Baker FACES Pain Rating Scale and pulse rate monitoring. All treated molars will receive glass ionomer cement restorations, which will subsequently be evaluated using the Modified United States Public Health Service (USPHS) criteria at 3, 6, and 12 months.

Timeline

Start

2027-05-01

Primary completion

2028-05-01

Completion

2028-12-01

Publications

• Background Osman SA, Elmasry ES, Abd Al Gawad RY. Prevalence of Molar Incisor Hypominerlization among a Group of Egyptian Children: A Cross Sectional Study. Egypt Dent J. 2020;66(4):2021-2028. doi:10.21608/edj.2020.40437.1222.
• Background Olley RC, Wilson R, Moazzez R, Bartlett D. Validation of a Cumulative Hypersensitivity Index (CHI) for dentine hypersensitivity severity. J Clin Periodontol. 2013 Oct;40(10):942-7. doi: 10.1111/jcpe.12144. Epub 2013 Aug 19.
• Background Al-Nerabieah Z, AlKhouli M, Dashash M. Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial. F1000Res. 2024 May 7;12:1052. doi: 10.12688/f1000research.136653.3. eCollection 2023.
• Background Nabil N, Sharaf AA, Essawy MM, Soliman RS. The Desensitizing Effect of Nanosilver Fluoride Compared to Photobiomodulation Therapy in Molar-Incisor Hypomineralization: A Randomized Clinical Trial. J Evid Based Dent Pract. 2025 Sep;25(3):102139. doi: 10.1016/j.jebdp.2025.102139. Epub 2025 Mar 14.
• Background Muniz RSC, Carvalho CN, Aranha ACC, Dias FMCS, Ferreira MC. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: Randomised clinical trial. Int J Paediatr Dent. 2020 May;30(3):323-333. doi: 10.1111/ipd.12602. Epub 2019 Dec 23.
• Background da Silva FG, de Almeida SB, de Campos PH, Abrantes RM, de Oliveira AVA, Guare RO, Diniz MB. Low-Level Laser Therapy for Management of Hypersensitivity in Molar-Incisor Hypomineralization and Oral Health-Related Quality of Life: Case Report. J Clin Pediatr Dent. 2022 Mar 1;46(2):107-111. doi: 10.17796/1053-4625-46.2.3.
• Background Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent. 2022 Feb;23(1):3-21. doi: 10.1007/s40368-021-00668-5. Epub 2021 Oct 20.
• Background Elhennawy K, Manton DJ, Crombie F, Zaslansky P, Radlanski RJ, Jost-Brinkmann PG, Schwendicke F. Structural, mechanical and chemical evaluation of molar-incisor hypomineralization-affected enamel: A systematic review. Arch Oral Biol. 2017 Nov;83:272-281. doi: 10.1016/j.archoralbio.2017.08.008. Epub 2017 Aug 19.
• Background Americano GC, Jacobsen PE, Soviero VM, Haubek D. A systematic review on the association between molar incisor hypomineralization and dental caries. Int J Paediatr Dent. 2017 Jan;27(1):11-21. doi: 10.1111/ipd.12233. Epub 2016 Apr 21.
• Background Fagrell T. Molar incisor hypomineralization. Morphological and chemical aspects, onset and possible etiological factors. Swed Dent J Suppl. 2011;(216):5, 11-83.
• Background Santos PS, Vitali FC, Fonseca-Souza G, Maia LC, Cardoso M, Feltrin-Souza J, Fraiz FC. Dentin hypersensitivity and toothache among patients diagnosed with Molar-Incisor Hypomineralization: A systematic review and meta-analysis. J Dent. 2024 Jun;145:104981. doi: 10.1016/j.jdent.2024.104981. Epub 2024 Apr 4.
• Background Saber F, Waly N, Moheb D. Prevalence of molar incisor hypomineralisation in a group of Egyptian children using the short form: a cross-sectional study. Eur Arch Paediatr Dent. 2018 Oct;19(5):337-345. doi: 10.1007/s40368-018-0364-6. Epub 2018 Sep 3.
• Background Dave M, Taylor G. Global prevalence of molar incisor hypomineralisation. Evid Based Dent. 2018 Oct;19(3):78-79. doi: 10.1038/sj.ebd.6401324.
• Background Garot E, Rouas P, Somani C, Taylor GD, Wong F, Lygidakis NA. An update of the aetiological factors involved in molar incisor hypomineralisation (MIH): a systematic review and meta-analysis. Eur Arch Paediatr Dent. 2022 Feb;23(1):23-38. doi: 10.1007/s40368-021-00646-x. Epub 2021 Jun 24.
• Background Vieira AR. On the genetics contribution to molar incisor hypomineralization. Int J Paediatr Dent. 2019 Jan;29(1):2-3. doi: 10.1111/ipd.12439. Epub 2018 Oct 26. No abstract available.
• Background Rodd HD, Graham A, Tajmehr N, Timms L, Hasmun N. Molar Incisor Hypomineralisation: Current Knowledge and Practice. Int Dent J. 2021 Aug;71(4):285-291. doi: 10.1111/idj.12624. Epub 2021 Jan 27.

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