Children with trisomy 21 exhibit oral health abnormalities that confer higher risk for caries development. Fluorinated varnishes have been used as a preventive method for this pathology, and in the treatment of dental lesions with white spots, considered the first stage of these lesions. Silver nanoparticles have demonstrated to exert a bactericidal effect against oral pathogens, without pigmentation of the dental enamel and with no evidence of toxicity. To assess the affectivity of the combination of these strategies, a randomized controlled double-blind trial with a split-plot design was performed in 22 children with white spots on both maxillary dental teeth. One tooth received three applications of a fluoride varnish with silver nanoparticles, and the other one, three applications of the same varnish without nanoparticles. We measured the mineral content of the teeth with a laser cavity detection pen after the first application of the varnishes, and 3 months after the last application to assess the degree of mineralization of the tissue. We found significant differences between teeth treated with and without silver nanoparticles; teeth treated with the varnish with silver nanoparticles appeared to be more mineralised. Treatment with a fluoride varnish with silver nanoparticles is more effective to promote dental remineralisation of teeth affected with white spot lesions in children with trisomy 21. This strategy may be used as a prophylactic measure to avoid development of caries and to improve oral health in this population.
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