Advantage Arrest

MECHANISM OF ACTION

Upon application to the decayed surface, a layer of silver protein conjugate and silver minerals forms, increasing resistance to acid dissolution and enzymatic digestion. Hydroxyapatite and fluorapatite form. The treated lesion increases in mineral density and hardness. The silver acts as an antimicrobial, the fluoride acts to remineralize and the proteins that break down the dentin are inhibited. The ammonia acts as a stabilizer, keeping silver and fluoride ionic in solution. SDF will always discolor anything with exposed collagen, meaning it will stain decayed or demineralized sites and soft tissues, but not healthy tooth structure.

HOW DEEP DOES IT PENETRATE?

• ~ 25-30 microns into enamel
• ~ 200-300 microns into dentin
• ~ up to 2mm into a deep lesion

INDICATIONS

Arrests the progress of an already formed cavity in permanent or primary teeth.

CLINICAL USES

• For the treatment of dentinal hypersensitivity
• Excellent desensitizer.
• Behavioral or medical management patients
• Carious lesions that cannot be treated in one visit
• Difficult to treat lesions
• Non-Aerosol generating treatment
• Pediatrics
• Root caries
• Tooth sensitivity

CLINICAL SITUATIONS

• Alternative to restorative treatment
• Around margins of lesions to prevent secondary decay
• Avoid general anesthesia or oral sedation
• Behavioral or medical management
• Carious lesions that cannot be treated in 1 visit
• Difficult access to dental care
• Difficult to treat dental carious lesions
• High risk caries
• Liner

• HOW TO USE

  Before application: take care of your patient: Show them the consent form, inform them about the staining and protect their eyes.

  For Silver Diamine Fluoride treatment without restoration placement:

  1. Isolate the affected area with a cotton roll or dri-angle
  2. Dry the lesion or surface
  3. Dispense 1 drop into a disposable dish (1 drop treats up to five tooth surfaces)
  4. Apply Advantage Arrest to the lesion of tooth surface
  5. Allow it to soak in for 60 seconds. This is the most critical step in the process
  6. Remove excess with a cotton pellet or roll, and then cover the treated area with a thin layer of fluoride varnish (FluoriMax). This will create a barrier and keep the silver in contact for as long as possible. It will also give your patient a nice flavour in their mouth rather than the metallic taste of SDF
  7. If no varnish is applied, let it dry completely for 60 seconds
  8. Reapply again in 1-3 week(s) for the highest chance of arresting the lesion hard
  9. To optimize the caries arrest, reapply once every 6 months OR apply a glass ionomer over the top to seal out the nutrient source for any bacteria to survive under the restoration
  10. There are no post-op patient instructions

  For Silver Diamine Fluoride treatment with restoration placement:

  1. Isolate the affected area with a cotton roll or dri-angle
  2. Dry the lesion or surface
  3. Dispense 1 drop of Advantage Arrest into a disposable dish (1 drop treats up to five tooth surfaces)
  4. Apply Advantage Arrest to the lesion
  5. Allow it to soak in for 60 seconds. This is the most critical step in the process
  6. Rinse and dry the treated area
  7. Proceed with your restorative steps for the material type you are using. To reduce staining of the filling: Polish away discoloration along the margins
  8. Do not use a light cure; instead, use a self cure Gl, or “sandwich” of opaque GI at deeper levels and then composite (If you light cure Advantage Arrest, all of the silver will oxidize even on non-decayed surfaces and your filling may appear dark)
  9. There are no post-op patient instructions

• Bottle 5 ml
• Keep out of reach of children.

BENEFITS

• • Antimicrobial
  • Cost-efficient : 1 drop = ± $0.92^*
    • 8ml bottle = 250 drops
    • Each drop = Up to 5 surfaces
  • Dental hygienists and dental assistants can apply it
  • Increases resistance to acid dissolution¹¹
  • Tinted blue for an easier application!
  • Increases mineral density and hardness while the lesion depth decreases⁵
  • No post-treatment limitations
  • Odourless
  • Outperforms other anti-caries treatments in killing cariogenic bacteria¹⁵
  • Quick application (less than 5 minutes)
  • User-friendly, no need for:
    • Air or water
    • Instruments
    • Anesthesia

*Based on an 8ml bottle at 220$