Nano-Silver Versus Bioactive Glass for Primary Teeth Exposed to Therapeutic Radiation

The study consists of in vitro and in vivo components designed to evaluate the effects of therapeutic radiation on primary teeth and to compare the effects of nano silver fluoride and bioactive glass gel.

For the in vitro component, 12 sound extracted primary molars will be sectioned mesiodistally to obtain 24 enamel specimens. The specimens will be exposed to therapeutic radiation and randomly assigned to two groups. One group will receive nano silver fluoride solution, while the other will receive bioactive glass gel. Enamel specimens will be evaluated at baseline, after radiation exposure, and after application of the assigned material. Assessments will include scanning electron microscopy for surface morphology, energy-dispersive X-ray spectroscopy for mineral analysis, and Vickers microhardness testing.

For the in vivo component, 30 pediatric patients undergoing therapeutic head and neck radiotherapy will be randomly allocated into two groups of 15 participants. The first group will receive a single application of nano silver fluoride solution for one minute. The second group will use bioactive glass gel once daily for one minute for seven days. Clinical assessment will include measurement of salivary pH and bacterial counts before and after application of the assigned intervention.

• Nano Silver Fluoride (Other), also known as nano silver flouride: Nano silver fluoride solution will be topically applied once for 1 minute
• Bioactive Glass Gel (Other): Bioactive glass gel will be topically applied once daily for 1 minute for 7 consecutive days

Primary outcomes

• Change in Salivary Bacterial Count [Baseline and 1 week after intervention]: Salivary bacterial count will be measured to evaluate the antimicrobial effect of nano silver fluoride compared with bioactive glass gel.
• Change in Salivary pH [Baseline and 1 week after intervention]: Salivary pH will be measured before and after the intervention to evaluate changes following treatment with nano silver fluoride or bioactive glass gel

Sex: All, ages: 6 Years to 10 Years

Inclusion Criteria:

* Pediatric patients undergoing therapeutic head and neck radiotherapy.
* Age 6 to 10 years.
* Presence of at least one sound primary tooth.
* The oral cavity lies within the radiotherapy field during treatment.
* Written informed consent obtained from a parent or legal guardian.

Exclusion Criteria:

* Systemic diseases affecting tooth mineralization.
* Use of medications known to influence salivary flow or enamel integrity, other than radiotherapy.
* Edentulous upper and lower jaws.
* Extensive dental caries or severe enamel defects.
* Habitual mouth breathing.
* Uncooperative patients or lack of parental consent.