Preventive effect of tooth fracture by pulsed Nd:YAG laser irradiation with diamine silver fluoride solution

Silver diamine fluoride therapy for dental care

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent dental erosion, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm fluoride ions. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the demineralisation of teeth. SDF also inactivates proteolytic peptidases and inhibits dentine collagen degradation. It arrests caries without affecting dental pulp or causing dental fluorosis. Indirect pulp capping with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes pulp necrosis. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF treatment. SDF therapy is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection.

Antibacterial efficacy of silver diamine fluoride as a root canal irrigant

Objectives

Conventional disinfectants and medicaments have not been able to achieve and maintain sterilization of root canals. The purpose of the study was to evaluate the antibacterial efficacy of 3.8% silver diamine fluoride (SDF) in comparison with 2% chlorhexidine (CHX) against Enterococcus faecalis biofilm.

Materials and methods

Extracted human teeth were used to make 70 dentin discs that were then inoculated with E. faecalis to generate a 3‐week‐old biofilm model. The discs were subjected to treatment with 3.8% SDF, 2% CHX, sodium hypochlorite (NaOCl), or saline for 10 min. After exposure, the dentin discs were examined with a confocal laser scanning microscope to verify the percentage of live versus dead cells within the biofilm. Univariate one‐way analysis of variance and Tukey‐honestly significant difference post hoc analysis (p < .05) were performed to detect significant differences.

Results and conclusion

The NaOCl group showed the greatest percentage of dead cells (62.26%) among all groups (p < .05). The SDF group showed a significantly higher percentage of dead cells (57.39%) than the 2% CHX and saline groups (p < .05). SDF possessed higher antimicrobial activity than 2% CHX against E. faecalis biofilms.

Anti-microbial efficiency of silver diamine fluoride as an endodontic medicament - An ex vivo study

CONTEXT

Antisepsis achieved through appropriate use of irrigants is essential for endodontic success. Identification of newer anti-bacterial agents gives alternatives to clean the canal as eradication of the infection prior to obturation does affect prognosis.

OBJECTIVE

Comparison of the anti-bacterial action of 3.8% silver diamine fluoride and 2% chlorhexidine gluconate against Enterococcus faecalis in root canals.

MATERIALS AND METHODS

Forty-four single-rooted teeth were decoronated, and the root section was enlarged with peeso-reamer (No: 3) to standardize length and diameter. The samples were then autoclaved and divided into two study groups and two control groups. Enterococcus faecalis ATCC 29212 was inoculated into all test samples for 72 hours. The samples were enlarged with peeso-reamer (No: 5) after placement of respective medicament for 24 hours. Shavings were collected and inoculated on Brain Heart Infusion agar for 24 hrs to measure the colony forming units.

RESULTS

Both 3.8% silver diamine fluoride and 2% chlorhexidine showed a superior capacity to sterilize the root canals than control groups.

CONCLUSION

The use of silver diamine fluoride as an endodontic irrigant is feasible as it can effectively remove the microbes present in the canal and circumpulpal dentin.