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Chandy TS, Driscoll C, Masri R. Effect of silver diamine fluoride on the surface roughness of dental ceramics. J Prosthet Dent 2024; 132:614-622. [PMID: 36372584 DOI: 10.1016/j.prosdent.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
STATEMENT OF PROBLEM Application of silver diamine fluoride (SDF) can be a straightforward and efficient way to manage recurrent caries around the margins of crowns. However, its effect on ceramic surfaces is unknown. PURPOSE The purpose of this in vitro study was to evaluate and compare the effect of SDF, acidulated phosphate fluoride (APF), and distilled water on the surface roughness of dental ceramics. MATERIAL AND METHODS Forty-five rectangles (10×10×2 mm) each of 5% yttria-stabilized tetragonal zirconia polycrystal (5Y-TZP) zirconia (Zir), lithium disilicate (LDS), overglazed feldspathic porcelain (FO), and polished feldspathic porcelain (FP) were fabricated. The specimens were treated with 38% SDF, 1.23% APF, and distilled water to simulate 3 years of topical applications. The surface roughness (Ra) of each rectangle was measured with a profilometer before and after treatment with the solutions, and the change in Ra (△Ra) was calculated. Scanning electron microscope images were obtained of each treatment group. Multiple comparison of the means among the ceramics and testing solutions was done using 2-way ANOVA followed by the Tukey Honestly Significant test (α=.05). RESULTS ANOVA revealed significant differences in the 2 main factors, as well as their interaction (P<.001). The surface roughness of the treated rectangles was significantly dependent on the type of ceramic and the testing solution. The greatest surface roughness increase was seen in the interaction of LDS:APF (△Ramean=0.51 ±0.13 μm), closely followed by FO:APF (△Ramean=0.49 ±0.20 μm) and FP:APF (△Ramean=0.41 ±0.17 μm) (P<.001). SDF increased the surface roughness of LDS, FO, and FP; however, the increase was not significant (△Ramean LDS=0.25 ±0.11 μm; △Ramean FO=0.17 ±0.16 μm; △Ramean FP=.1 ±0.14 μm; P >.118). None of the solutions had any effect on zirconia (P>.977). CONCLUSIONS SDF is safe to use around zirconia restorations. Long-term and repeated application of SDF on lithium disilicate and feldspathic porcelain must be considered with caution.
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Affiliation(s)
- Tintu Sara Chandy
- Fellow, Maxillofacial Prosthetics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Carl Driscoll
- Clinical Professor, Postgraduate Prosthodontics, School of Dentistry, University of Maryland, Baltimore, Md
| | - Radi Masri
- Professor and Director, Postgraduate Prosthodontics, School of Dentistry, University of Maryland, Baltimore, Md.
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Wang YS, Shi YX, Liu QQ, Hu LQ, Ma FB, Zhang JR, Tang KM, Tang B, Dai J. Synthesis of novel silver-loaded clay AgF@Hec for the prevention of dental caries in vitro. Biomed Mater 2024; 19:045037. [PMID: 38810617 DOI: 10.1088/1748-605x/ad51c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/29/2024] [Indexed: 05/31/2024]
Abstract
Dental caries, a chronic infectious disease characterized by tooth mineral loss caused by plaque, is one of the major global public health problems. Silver diamine fluoride (SDF) has been proven to be a highly effective anti-caries drug due to its high bacterial inhibition and remineralization ability. However, the SDF solution is unstable, which immensely limits its clinical application. Therefore, new silver-load clay named AgF@Hec was designed by replacing the NH3with hectorite in this study. Fourier transform infrared spectroscopy and x-ray diffraction spectroscopy were employed to confirm the structure of AgF@Hec. Dynamic light scattering analysis was used to reveal the effect of different hectorite concentrations on the stability of AgF@Hec. Moreover, AgF@Hec exhibits significant remineralization and hardness recovery of the initial carious lesions. Bacteriostatic experiments also proved that it has a significant inhibitory effect onA. Viscosus, S. mutans, S. sanguinis, S. salivarius, Lactobacillus sp.and both gram-positive and gram-negative bacteria. We therefore believed that AgF@Hec should be a promising biomaterial that can be applied in the prevention of dental caries.
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Affiliation(s)
- Y S Wang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - Y X Shi
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - Q Q Liu
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - L Q Hu
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - F B Ma
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - J R Zhang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
| | - K M Tang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
- ShenZhen College of International Education, shenzhen, People's Republic of China
| | - B Tang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, People's Republic of China
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, shenzhen, People's Republic of China
| | - J Dai
- Department of Stomatology, General Hospital of Shenzhen University, Institute of Stomatology, Shenzhen University, shenzhen, People's Republic of China
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Hunwin K, Page G, Edgar M, Botana A, Armitage R, Bhogadia M, Desai U, Duffin S, Duffin M, Chan W, Grootveld M. Explorations of the chemical constitution and aqueous solution status of caries-arresting silver(I)-diammine fluoride and silver(I)-fluoride products using high-resolution 19F NMR analysis. Spectroscopic and SEM investigations of their interactions with human saliva: evidence for the in vivo salivary-catalysed autoconstruction of Ag/AgCl-based nanoparticles (IV-SCAN)-part I. FRONTIERS IN ORAL HEALTH 2024; 5:1373885. [PMID: 38933119 PMCID: PMC11199528 DOI: 10.3389/froh.2024.1373885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/06/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Silver(I)-diammine fluoride (SDF) and silver(I)-fluoride (SF) complexes have been successfully employed for the arrest of dental caries for many years. However, to date there are very few studies available reporting on the molecular structural compositional and solution status of these agents [typically applied as highly-concentrated 38% (w/v) solutions]. Here, we explored the solution status and chemical constitution of commercially-available SDF and SF products, and secondly investigated the multicomponent interplay of these products with biomolecules present in intact human whole-mouth salivary supernatants (WMSSs) in vitro. Methods High-resolution 19F NMR analysis was employed to explore SDF and SF product solutions, and to determine WMSS fluoride (F-) concentrations, whereas ammonia (NH3) release form SDF was tracked by 1H NMR spectroscopy. SEM and thin-film FTIR-ATR analyses were employed to explore the atomic and molecular compositions of sequentially-generated AgCl deposits and chromophoric Ag/AgCl nanoparticles (CSNPs); the time-dependent generation of the latter was followed spectrophotometrically. Results 19F NMR spectra of aqueous SF solutions contained a very broad F- signal (Δv1/2 70 Hz), demonstrating that much of its solvated F- content was rapidly exchanging with Ag(I) on the NMR timescale, but those of SDF had a much sharper resonance, similar to that of "free" F- (4 Hz). Moreover, further NMR results revealed that a popular SDF product contained high molar excesses of both F- and NH3. Treatment of WMSSs with SDF and SF generated an off-white precipitate, which slowly developed into CSNPs at 23°C; SEM demonstrated high contents of both silver and chloride in this material (ca.1:1 atomic content ratio). FTIR-ATR analysis found that the CSNPs formed contained a range of salivary biomolecules, which appear to encapsulate the Ag/AgCl core (significant thiocyanate contents were also found). In conclusion, NMR results acquired demonstrated that SF, but not SDF, product solutions feature rapidly-exchanging F - between its "free" and Ag(I)-bound forms, and that SDF contains large excesses of both F- and its NH3 ligands. Characterised AgCl deposits and CSNPs were sequentially produced from the interactions of these complexes with WMSS biomolecules. Discussion In view of their well-known microbicidal and cariostatic properties, the observed autobioconstruction of CSNPs involving salivary catalysis is of much therapeutic significance.
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Affiliation(s)
- Kayleigh Hunwin
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Georgina Page
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Mark Edgar
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Adolfo Botana
- JEOL (U.K.) Ltd., JEOL House, 1-2 Silver Court, Watchmead, Welwyn Garden City, United Kingdom
| | - Rachel Armitage
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Mohammed Bhogadia
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Unmesh Desai
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
| | - Steven Duffin
- Shoreview Dental LLC, Keizer, OR, United States
- NoDK LLC, Wilsonville, OR, United States
- Oral Health Outreach LLC, Wilsonville, OR, United States
| | - Marcus Duffin
- Shoreview Dental LLC, Keizer, OR, United States
- NoDK LLC, Wilsonville, OR, United States
- Oral Health Outreach LLC, Wilsonville, OR, United States
| | - Wyman Chan
- SmileStudio (UK) Ltd., London, United Kingdom
| | - Martin Grootveld
- Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, United Kingdom
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Gotas L, Canceill T, Joniot S. The Use of Potassium Iodide in Pediatric Dentistry Does Not Change the Retention of Glass Ionomer Cement on a Dentin Treated with Silver Fluoride: In Vitro Results. Dent J (Basel) 2024; 12:177. [PMID: 38920878 PMCID: PMC11202438 DOI: 10.3390/dj12060177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/27/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
In pediatric and operative dentistry, caries treatment benefits from a therapeutic option based on the use of silver fluoride (AgF) associated with potassium iodide (KI) to avoid dark colorations on dental tissues. The objective of this in vitro study is to evaluate the retention of glass ionomer cement (GIC) on a dentin when treated with AgF and KI. Twenty-two healthy human permanent molars and eight human primary teeth, all free of any decay, were cut to obtain occlusal flat dentinal surfaces and were then treated with AgF for a duration of 60 s. For half of the teeth, a drop of KI was applied for a duration of 30 s. All samples were covered with a plot of GIC and their resistance to shear bond strength was measured. The fracture resistance in both permanent and primary teeth does not show any statistically significant differences whether KI was applied or not. For permanent teeth, the resistance is slightly higher in the group treated with KI than in the group treated with AgF alone. To our knowledge, these data are the first to describe the possible application of KI both on primary and permanent teeth. In any case, further studies are needed to investigate the bond strength between dentin and GIC on a wider range of samples.
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Affiliation(s)
- Louise Gotas
- Dental and Oral Medicine Department, Toulouse Universitary Hospital, 2 Rue de Viguerie, 31000 Toulouse, France
- Dental Department, Health Faculty of Toulouse, Toulouse III Paul Sabatier University, 3 Chemin des Maraichers, 31400 Toulouse, France
| | - Thibault Canceill
- Dental and Oral Medicine Department, Toulouse Universitary Hospital, 2 Rue de Viguerie, 31000 Toulouse, France
- Dental Department, Health Faculty of Toulouse, Toulouse III Paul Sabatier University, 3 Chemin des Maraichers, 31400 Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires (i2MC), Inserm/UPS UMR 1297, 1 Avenue Jean Poulhès, 31432 Toulouse, France
| | - Sabine Joniot
- Dental and Oral Medicine Department, Toulouse Universitary Hospital, 2 Rue de Viguerie, 31000 Toulouse, France
- Dental Department, Health Faculty of Toulouse, Toulouse III Paul Sabatier University, 3 Chemin des Maraichers, 31400 Toulouse, France
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Anant N, Rai N, Nr S, Amaltas P, Kalambe M, Emmanuel A. Assessing the Effects and Acceptance of Silver Diamine Fluoride Treatment in Early Childhood Caries. Cureus 2024; 16:e55767. [PMID: 38586641 PMCID: PMC10999162 DOI: 10.7759/cureus.55767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC) is a widespread dental problem that impacts children below the age of six years. Traditional restorative treatments like fillings are often challenging and invasive for young children. Silver diamine fluoride (SDF) offers a minimally invasive and cost-effective alternative for managing ECC. However, the effects, acceptance, and understanding of this treatment by parents remain crucial for its successful implementation. AIM To evaluate the impact and level of acceptance of SDF treatment in ECC. MATERIALS AND METHODS Thirty-two children from an Anganwadi center aged between two to five years suffering from ECC were selected. A 38% SDF was applied for 3 minutes on the identified carious lesion, and the arrest percentage was checked after a recall period of three weeks and three months. The Likert scale was used for the questionnaire regarding parental feedback about the ease of application procedure, tooth discoloration, possible pain associated with the procedure, and the taste of SDF. RESULTS In the present study, a total of 75 surfaces were subjected to the application of SDF. After a period of three weeks, it was observed that 64 of these surfaces had successfully undergone the process of caries arrest. This finding was deemed to be statistically significant, with a P value of 0.021. Furthermore, the remaining surfaces that had not achieved caries arrest were subsequently treated at three months. The results of this subsequent treatment were also found to be statistically significant, with a P value of 0.027. These findings highlight the efficacy of both caries treatment and caries arrest in relation to the utilization of SDF. CONCLUSION SDF was found to be minimally invasive, easy to administer, inexpensive, highly efficient, and effective treatment in arresting caries in the primary dentition of young children, particularly in patients lacking cooperation.
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Affiliation(s)
- Nishi Anant
- Department of Pedodontics and Preventive Dentistry, Triveni Institute of Dental Sciences Hospital and Research Centre, Bilaspur, IND
| | - Niharika Rai
- Department of Pedodontics and Preventive Dentistry, Triveni Institute of Dental Sciences Hospital and Research Centre, Bilaspur, IND
| | - Sowmya Nr
- Department of Pedodontics and Preventive Dentistry, Triveni Institute of Dental Sciences Hospital and Research Centre, Bilaspur, IND
| | - Pramila Amaltas
- Department of Pedodontics and Preventive Dentistry, Triveni Institute of Dental Sciences Hospital and Research Centre, Bilaspur, IND
| | - Mrunal Kalambe
- Department of Pedodontics and Preventive Dentistry, Dr. Rajesh Ramdasji Kambe Dental College and Hospital, Akola, IND
| | - Ashwarya Emmanuel
- Department of Pedodontics and Preventive Dentistry, Triveni Institute of Dental Sciences Hospital and Research Centre, Bilaspur, IND
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Fernandes LDO, Mendes Soares IP, Anselmi C, Pires MLBA, Ribeiro RADO, Peruchi V, de Souza Costa CA, Hebling J. Pulp cell response to the application of silver diamine fluoride and potassium iodide on caries-like demineralized dentin. Clin Oral Investig 2023; 27:7295-7306. [PMID: 37853265 DOI: 10.1007/s00784-023-05320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES To investigate the response of pulp cells to the application of silver diamine fluoride (SDF) and potassium iodide (KI) on demineralized dentin. MATERIALS AND METHODS The occlusal surfaces of human dentin discs (0.4 mm thick) with similar permeability were subjected to an artificial caries protocol, and then the discs were adapted into artificial pulp chambers. MDPC-23 cells were seeded on the healthy pulp dentin surface, while the demineralized surface was treated with SDF, KI, SDF + KI, or hydrogen peroxide (positive control-PC) (n = 8). The negative control (NC) received ultrapure water. After 24 h, cell viability (alamarBlue) and morphology (SEM) were evaluated. The extracts were then applied to new MDPC-23 cells seeded in culture plates to assess their viability and the formation of mineralized nodules (MN; Alizarin Red) after seven days. The data were analyzed using one-way analysis of variance/Tukey or Games-Howell tests (α = 5%). RESULTS SDF and PC significantly reduced the viability of cells seeded on discs (45.6% and 71.0%, respectively). Only cells treated with SDF or PC detached from the dentin substrate, while the remaining cells showed altered morphology. Cells in contact with extracts showed less reduction in viability, but it was still more toxic compared to NC. Only PC reduced MN deposition. SDF + KI or KI alone did not affect the cell response. CONCLUSIONS SDF applied alone showed a mild to moderate transdentinal cytotoxic effect on pulp cells. However, the combination of SDF + KI reduced the cytotoxic effects. Both materials used alone or in combination did not affect the mineralization ability of pulp cells. CLINICAL RELEVANCE Besides improving esthetic results, associating potassium iodide with silver diamine fluoride may reduce the transdentinal cytotoxic effects of this cariostatic agent on pulp cells.
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Affiliation(s)
- Lídia de Oliveira Fernandes
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Caroline Anselmi
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, 14801-903, Brazil
| | - Maria Luiza Barucci Araujo Pires
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, 14801-903, Brazil
| | | | - Victória Peruchi
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Josimeri Hebling
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, 14801-903, Brazil.
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Yan IG, Zheng FM, Yin IX, Sun IG, Lo ECM, Chu CH. Stability of Silver and Fluoride Contents in Silver Diamine Fluoride Solutions. Int Dent J 2023; 73:840-846. [PMID: 37236855 PMCID: PMC10658427 DOI: 10.1016/j.identj.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE This study aims to determine the stability, alkalinity, and fluoride and silver ion concentrations of 5 commercially available 38% silver diamine fluoride (SDF) solutions-namely Advantage Arrest, e-SDF, Riva Star, Saforide, and Topamine-in 180 days. METHODS Alkalinity was determined using a pH electrode. The fluoride and silver ion concentrations were obtained using a calibrated ion-selective electrode and optical emission spectrometer, respectively. Six bottles of each product were examined on days 0 (freshly opened), 30, 60, 90, and 180. The time taken for each freshly opened product to form a black silver precipitate under room light (500 lx) and 25 °C was also recorded. RESULTS For 180 days, Advantage Arrest, e-SDF, Riva Star, Saforide, and Topamine had the pH range of 9.8-9.8, 10.5-10.6, 13.0-13.1, 9.8-9.8, and 9.3-9.4; fluoride ion concentration range (nearest 1000 ppm) of 40.9%-42.4%, 46.7%-50.9%, 37.0%-39.0%, 37.0%-45.7%, and 47.7%-53.4%; silver ion concentration range (nearest 1000 ppm) of 283.4-307.0, 307.3-315.4, 418.6-435.7, 266.3-281.0, and 416.2-456.1 ppm; and precipitation time (nearest hour) of 17, 12, 6, 7, and 7 hours, respectively. The percentage change of fluoride and silver could be more than 5% after 60 days. CONCLUSIONS The alkalinity of the 5 SDF solutions remained stable after 180 days. In addition, their fluoride and silver concentrations decreased substantially after 60 days. The freshly opened SDF solutions did not precipitate within 5 hours under ambient room conditions. The alkalinity and fluoride and silver concentrations of the 38% SDF solutions could be less stable after 60 days; thereafter, the fluoride and silver concentrations decreased. Thus, the SDF solution should be used within 60 days after opening.
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Affiliation(s)
| | | | | | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Zheng FM, Yan IG, Duangthip D, Lo ECM, Gao SS, Chu CH. Caries Prevention Using Silver Diamine Fluoride: A 12-Month Clinical Trial. Int Dent J 2023; 73:667-673. [PMID: 36682908 PMCID: PMC10509425 DOI: 10.1016/j.identj.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This clinical trial aimed to compare the caries-preventive effect of annual application of 38% silver diamine fluoride solution (SDF) with 5% sodium fluoride varnish (FV) to the anterior primary teeth of children. The hypothesis was that SDF was superior to FV at 1 year. Secondary objectives were to determine the child's cooperation and the parent's satisfaction and assess adverse effects. METHOD We recruited 688 3- to 4-year-old children and randomly allocated them to receive SDF or FV (positive control) on their 6 upper anterior teeth. Tooth-surface status was recorded using the decayed, missing, and filled surfaces index. A trained observer rated the child's cooperation as "totally cooperative" or "not totally cooperative." We used a questionnaire to determine the parent's satisfaction as "satisfied," "neutral," or "dissatisfied." Adverse effects (yes/no) were evaluated 1 day and about 1 year after treatment. RESULTS Of the children, 434 (SDF, n = 209; FV, n = 225) completed the trial. The mean new decayed tooth surfaces developed for SDF and FV groups were 0.4 ± 1.5 and 0.4 ± 1.3, respectively (P = .65). Child's cooperation for SDF and FV therapy was 71% (244/344) and 70% (241/344), respectively (P = .89). Parent's satisfaction for SDF and FV therapy was 71% (148/209) and 69% (155/225), respectively (P = .29). Adverse effects were found neither at 1 day nor at about 1 year after treatment for either treatment arm. CONCLUSIONS SDF is not superior to FV for caries prevention in primary upper anterior teeth at 1-year follow-up. Child's cooperation and parent's satisfaction were similarly high with SDF and FV therapy at 1-year follow-up. Neither short-term nor long-term adverse effects were observed. This study is registered at ClinicalTrials.gov (NCT04399369).
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Affiliation(s)
| | - Iliana Gehui Yan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | | | - Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China; Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China.
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Zaeneldin A, Chu CH, Yu OY. Dental Pulp Response to Silver-Containing Solutions: A Scoping Review. Dent J (Basel) 2023; 11:dj11050114. [PMID: 37232765 DOI: 10.3390/dj11050114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Dentists used silver-containing solutions for deep cavity disinfection before restoration. This review aims to identify the silver-containing solutions reported in the literature for deep cavity disinfection and summarize their effects on dental pulp. An extensive search was performed using the search words "(silver) AND (dental pulp OR pulp)" in ProQuest, PubMed, SCOPUS, and Web of Science to identify English publications on silver-containing solutions for cavity conditioning. The pulpal response to the included silver-containing solutions was summarized. The initial search identified 4112 publications and 14 publications met the inclusion criteria. Silver fluoride, silver nitrate, silver diamine nitrate, silver diamine fluoride, and nano-silver fluoride were used in deep cavities for antimicrobial purposes. Indirect silver fluoride application induced pulp inflammation and reparative dentine in most cases, and pulp necrosis in some cases. Direct silver nitrate application caused blood clots and a wide inflammatory band in the pulp, whilst indirect silver nitrate application caused hypoplasia in shallow cavities and partial pulp necrosis in deep cavities. Direct silver diamine fluoride application induced pulp necrosis, while indirect silver diamine fluoride application induced a mild inflammatory response and reparative dentine formation. No evidence of the dental pulpal response to silver diamine nitrate or nano-silver fluoride was available in the literature.
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Affiliation(s)
- Ahmed Zaeneldin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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10
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Zhang OL, Niu JY, Yin IX, Yu OY, Mei ML, Chu CH. Bioactive Materials for Caries Management: A Literature Review. Dent J (Basel) 2023; 11:dj11030059. [PMID: 36975556 PMCID: PMC10047026 DOI: 10.3390/dj11030059] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Researchers have developed novel bioactive materials for caries management. Many clinicians also favour these materials, which fit their contemporary practice philosophy of using the medical model of caries management and minimally invasive dentistry. Although there is no consensus on the definition of bioactive materials, bioactive materials in cariology are generally considered to be those that can form hydroxyapatite crystals on the tooth surface. Common bioactive materials include fluoride-based materials, calcium- and phosphate-based materials, graphene-based materials, metal and metal-oxide nanomaterials and peptide-based materials. Silver diamine fluoride (SDF) is a fluoride-based material containing silver; silver is antibacterial and fluoride promotes remineralisation. Casein phosphopeptide-amorphous calcium phosphate is a calcium- and phosphate-based material that can be added to toothpaste and chewing gum for caries prevention. Researchers use graphene-based materials and metal or metal-oxide nanomaterials as anticaries agents. Graphene-based materials, such as graphene oxide-silver, have antibacterial and mineralising properties. Metal and metal-oxide nanomaterials, such as silver and copper oxide, are antimicrobial. Incorporating mineralising materials could introduce remineralising properties to metallic nanoparticles. Researchers have also developed antimicrobial peptides with mineralising properties for caries prevention. The purpose of this literature review is to provide an overview of current bioactive materials for caries management.
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Affiliation(s)
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Iris Xiaoxue Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Faculty of Dentistry, The University of Otago, Dunedin 9054, New Zealand
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Correspondence:
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Iovan A, Benchea M, Stoleriu S, Tărăboanță I, Cimpoeșu N, Nica I, Andrian S. Effects of Acidic Challenge on Demineralized Root Surface Treated with Silver Diamine Fluoride and Potassium Iodide. Diagnostics (Basel) 2023; 13:diagnostics13030530. [PMID: 36766635 PMCID: PMC9914569 DOI: 10.3390/diagnostics13030530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of the study was to assess the protective effect of applying potassium iodide (KI) over silver diamine fluoride (SDF) on demineralized root dentin in the case of a sustained acidogenic attack. METHODS Forty caries-free third molars were used in the study. A diamond disc was used to separate the roots and the tooth crowns from the roots. Each root fragment was randomly distributed in one of the four study groups: C-samples were not demineralized; DD-demineralized samples; RS1-demineralized samples covered with SDF+KI (RS-Riva Star product, SDI limited, Bayswater, Australia); RS2-demineralized samples covered with SDF+KI and submersed to another acidic challenge for 3 days. SEM and EDX were used for the morphological and elemental analysis. Vickers hardness assessment was performed using a tribometer CETR UMT-2 (Bruker Corporation, Berlin, Germany). One-way ANOVA and post hoc Bonferroni tests were used for the statistical analysis with a significance level of p < 0.05. RESULTS Morphological and elemental changes were observed on the surface of the study samples. Significant differences were observed between the recorded hardness values of groups C and DD (p = 0.005), C and RS2 (p = 0.002), DD and RS1 (p = 0.011); RS1 and RS2 (p = 0.004). CONCLUSIONS The application of SDF and KI (Riva Star product) on root dentin caries resulted in the formation of a heterogeneous outer layer that sealed the dentin and increased the microhardness of the treated surface. In the conditions of the present study, this layer did not provide enough protection for root dentin exposed to continuous attacks.
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Affiliation(s)
- Alexandru Iovan
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, Romania
| | - Marcelin Benchea
- Faculty of Mechanical Engineering, “Gh. Asachi” Technical University, 67 Dimitrie Mangeron Str., 700050 Iași, Romania
- Correspondence: (M.B.); (S.S.)
| | - Simona Stoleriu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, Romania
- Correspondence: (M.B.); (S.S.)
| | - Ionuț Tărăboanță
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, Romania
| | - Nicanor Cimpoeșu
- Faculty of Materials Science and Engineering, “Gh. Asachi” Technical University, 67 Dimitrie Mangeron Str., 700050 Iași, Romania
| | - Irina Nica
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, Romania
| | - Sorin Andrian
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iași, Romania
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Shabbir J, Khurshid Z, Zafar MS, Farooqui WA, Imran E, Najeeb S, Bencharit S. Antimicrobial Efficacy of Silver Diamine Fluoride against Enterococcus faecalis: A Systematic Review of In Vitro Studies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6544292. [PMID: 36567909 PMCID: PMC9788898 DOI: 10.1155/2022/6544292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/20/2022] [Accepted: 10/11/2022] [Indexed: 12/23/2022]
Abstract
Introduction/Objectives. Enterococcus faecalis has been implicated in infections of treated root canals. Current irrigants and intracanal medicaments cannot eliminate E. faecalis completely from the root canal. Silver diamine fluoride (SDF) prevents caries by promoting remineralization and exerting an antibacterial effect. Studies suggest that SDF may possess antibacterial properties against E. faecalis. The purpose of this review is to systematically and critically analyze the literature, focusing on the use of SDF as an intracanal medicament or irrigant, when compared to other antibacterial agents. Data/Sources. The focused question was "Is the antibacterial effect of SDF against E. faecalis better than other intracanal medicaments and irrigants?" Using the keywords ((silver diamine fluoride) AND (Enterococcus faecalis)) AND ((sodium hypochlorite) OR (NaOCl) OR (chlorhexidine) OR (calcium hydroxide) OR (Ca(OH)2)), an electronic search was conducted on the following databases: PubMed/MEDLINE, ISI Web of Science, Scopus, EMBASE, and Google Scholar. The clinical trial registers ClinicalTrials.gov and CONTROL were also searched using the same keywords. General characteristics and outcomes were extracted, and quality of the studies was assessed using the Preferred Reporting Items for Laboratory studies in Endodontology (PRILE) guidelines. Study Selection. Six articles (five in vitro studies and one ex vivo study) were included in this systematic review. In the majority of the studies, SDF had equal or better antibacterial efficacy against E. faecalis compared to calcium hydroxide, sodium hypochlorite, and chlorhexidine. However, the majority of the studies did not fulfill several items in the PRILE criteria and had numerous sources of bias. Conclusions. Within the limitations of the systematic review and the studies reviewed, SDF may be effective against E. faecalis and therefore could be used as an intracanal medicament and/or irrigant to prevent reinfections of the root canals and improve the outcomes of endodontic treatment. However, animal and clinical studies should be carried out to determine the efficacy of SDF in endodontics. Trial Registration. The protocol for this review was registered on PROSPERO. Registration number: CRD42021224741.
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Affiliation(s)
- Juzer Shabbir
- Department of Operative Dentistry and Endodontics, Baqai Medical University, Karachi, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
- Center of Excellence for Regenerative Dentistry, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | | | - Eisha Imran
- Department of Dental Materials, Islamabad Medical and Dental College (IMDC), Islamabad, Pakistan
| | - Shariq Najeeb
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Evidentia Dental Reseach, Calgary, Alberta, Canada
| | - Sompop Bencharit
- Department of Oral and Molecular Craniofacial Biology, Philips Institute for Oral Health Research, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, VA 23220, USA
- Department of Oral Rehabilitation, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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13
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Zheng FM, Yan IG, Duangthip D, Gao SS, Lo ECM, Chu CH. Silver diamine fluoride therapy for dental care. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:249-257. [PMID: 36097560 PMCID: PMC9463534 DOI: 10.1016/j.jdsr.2022.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 08/05/2022] [Accepted: 08/21/2022] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
| | - Iliana Gehui Yan
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
| | | | - Sherry Shiqian Gao
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen 361000, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 999077, Hong Kong, China
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14
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Effectiveness of Silver Diamine Fluoride compared with Sodium Fluoride Varnish on Oral Saliva pH in the Children with Sever-Early Childhood Caries (S-ECC). JOURNAL OF RESEARCH IN APPLIED AND BASIC MEDICAL SCIENCES 2022. [DOI: 10.52547/rabms.8.4.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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15
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Effectiveness of 38% Silver Diamine Fluoride Application along with Atraumatic Restorative Treatment for Arresting Caries in Permanent Teeth When Compared to Atraumatic Restorative Treatment in Adults-Study Protocol for a Randomized Controlled Trial. Methods Protoc 2022; 5:mps5060087. [PMID: 36412809 PMCID: PMC9680478 DOI: 10.3390/mps5060087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Dental caries in the adult population that require preventive and therapeutic treatment are generally neglected in rural communities. The determination of the effectiveness of the application of 38% silver diamine fluoride (SDF) in arresting caries lesions when combined with atraumatic restorative treatment (ART) is very important, as it serves as a preventive and restorative procedure to regain the function of the permanent dentition. The assessment of optimal SDF application with ART, in comparison with ART alone, in managing cavitated carious lesions in a pragmatic setting, is the need of the hour to recommend optimal dental care, especially in rural settings which have minimal access to comprehensive dental care. METHODS AND ANALYSIS The clinical trial will enrol 220 adults (18-65 years) with cavitated carious lesions attending the Amrita School of Dentistry in the Ernakulam district, India. This study is a randomized, controlled trial with a 1:1 allocation ratio in two parallel groups. Study arm 1 will receive 38% SDF application and ART, and study arm 2 will receive ART only. A digital radiograph will be taken immediately after restoration (baseline) as well as at the end of the 6th month for evaluation of caries arrest. The assessment of the survival of the restoration will be done on the 7th day, 30th day, and at the end of the 6th month. The final analysis would include both the tooth and person levels. ETHICS AND DISSEMINATION This trial adheres to the principles of the Declaration of Helsinki and the guidelines of the Indian Council of Medical Research (ICMR). This study protocol has been approved by the Institutional Review Board. This trial has been registered prospectively with the Clinical Trial Registry of India (Registration No: CTRI/2021/12/038816).
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Rossi G, Valadas LA, Squassi A. Fluoride and silver ion concentrations and pH in silver diamine fluoride solutions from Argentina. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2022; 35:120-124. [PMID: 36260943 DOI: 10.54589/aol.35/2/120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to measure the fluoride (F) and silver (Ag) ion concentration and the pH, over time, of 2 solutions of 38% silver diamine fluoride (SDF) produced in Argentina. The brand Fluorsilver® was established as Group 1 (G1) (Densell), and the brand FAgamin® (Tedequim) as Group 2 (G2), each with two different lots. The following were determined at time 0 (t0) and 30 days after opening (t30): a) fluoride concentration (w/v) by visible spectrophotometry b) Ag content (w/v) by atomic absorption spectrophotometry c) pH. Results: The data in the freshly opened bottles were for G1 lot1/lot2: a) 0.96/1, b) 8.3/7.8, c).11.5/11.3; G2 lot1/lot2: a) 11.5/9.9, b) 39/39, c) 7/6,9; and after 30 days, G1 lot1/lot2: a) 0.85/0.81, b) 7.2/8.2, c) 11.3/11.6; G2 lot1/lot2: a) 9.35/8.43, b) 38/38, c) 7.6/7.6. Conclusion In relation to the expected values (5.0-5.9% fluoride and 24.4-28.8% silver), the average concentration of fluoride and silver ions was lower for G1, but higher for G2. The pH was alkaline for G1 and neutral for G2. Over the 30 days, the content of fluoride and silver tended to decrease.
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Affiliation(s)
- Glenda Rossi
- Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires, Argentina
- Universidad de Buenos Aires. Facultad de Odontología. Instituto de Investigaciones en Salud Pública de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Lidia Ar Valadas
- Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires,
| | - Aldo Squassi
- Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires, Argentina
- Universidad de Buenos Aires. Facultad de Odontología. Instituto de Investigaciones en Salud Pública de la Universidad de Buenos Aires, Buenos Aires, Argentina
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17
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Xue VW, Yin IX, Niu JY, Lo ECM, Chu CH, Zhao IS. Effects of a 445 nm diode laser and silver diamine fluoride in preventing enamel demineralisation and inhibiting cariogenic bacteria. J Dent 2022; 126:104309. [PMID: 36162639 DOI: 10.1016/j.jdent.2022.104309] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To study the effects of a 445 nm diode laser (L) and silver diamine fluoride (F) on preventing enamel demineralisation and inhibiting cariogenic bacteria. METHODS Thirty-three enamel slices were sectioned each into four blocks for four groups to receive L with F (LF), F, L and Water (W, control). Ten blocks from each group were used to evaluate demineralization. Surface morphology, lesion depth and nanohardness of the blocks after pH-cycling were studied by scanning electron microscopy (SEM), nanohardness test, and micro-computed tomography, respectively. Twenty-three blocks per group were used for biofilm assessment. Morphology, viability, and growth kinetics of the Streptococcus mutans biofilm were assessed by SEM, confocal laser scanning microscopy, and the counting of colony-forming units (CFUs), respectively. RESULTS SEM images of LF-treated enamel showed an intact surface compared with other groups. Nanohardness (GPa) for LF, F, L and W were 1.43±0.17, 1.01±0.11, 1.04±0.13 and 0.73±0.14, respectively (p<0.001; LF>F, L>W). Their lesion depths (µm) were 46±8, 52±6, 88±13 and 111±9, respectively (p<0.001; LF, F<L<W). SEM showed few bacteria for LF and F compared with other groups. Their dead-live ratio were 1.67±0.13, 1.60±0.15, 0.39±0.05 and 0.32±0.05, respectively (p<0.001; LF, F>L>W). Log CFUs for LF, F, L and W were 4.2±0.3, 4.5±0.2, 7.9±0.3 and 9.4±0.2, respectively (p<0.05; LF<F<L<W). Two-way ANOVA analysis revealed an interaction effect on nanohardness and Log CFUs between the laser irradiation and SDF treatment (p<0.001). CONCLUSION This study showed a superior caries preventive effect of a combined treatment of the diode laser and SDF. Because diode laser and SDF are affordable and readily available, clinicians can provide this treatment to their patients for caries prevention. CLINICAL SIGNIFICANCE STATEMENT Diode lasers are handy, afforable and readily avaliable to clinicians. This study provides information of use of 445 nm diode laser for caries prevetion. The laser irradiation hopefully can be added before conventional topical SDF application.
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Affiliation(s)
- Vicky Wenqing Xue
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, 518000, China; Faculty of Dentistry, The University of Hong Kong, Hong Kong, 999077, China
| | - Iris Xiaoxue Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, 999077, China
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, 999077, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, 999077, China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, 999077, China.
| | - Irene Shuping Zhao
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, 518000, China.
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Pushpalatha C, Bharkhavy KV, Shakir A, Augustine D, Sowmya SV, Bahammam HA, Bahammam SA, Mohammad Albar NH, Zidane B, Patil S. The Anticariogenic Efficacy of Nano Silver Fluoride. Front Bioeng Biotechnol 2022; 10:931327. [PMID: 35845391 PMCID: PMC9283724 DOI: 10.3389/fbioe.2022.931327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Dental caries is a common chronic disease, and anyone can be at threat of it throughout their lifespan. In school-aged children, dental caries is the most frequent disease related with oral health. Contemporary dental caries management focuses on non-restorative, non-invasive, and micro-invasive therapeutic techniques that effectively eliminate the caries progression at the lesion level and decrease the loss of healthy tooth structure. One of these strategies is to use caries apprehending agents with antibacterial and remineralizing characteristics. Due to recent regulatory approval in the United States, the use of silver diamine fluoride (SDF) for the therapy of dental caries has received substantial interest. SDF has successfully prevented and reversed both primary tooth caries and permanent teeth root caries. Even though SDF is an effective anti-caries agent, but it is associated with certain drawbacks like gum irritation, metallic taste, and irreversible dark stains on applying on cavities. As an alternative agent Nano Silver Fluoride (NSF) is preferable because it performs like SDF without tooth staining. It has comparable preventive and antibacterial activities as SDF. Further, it is ergonomic, economic and safe in children and adults. The current article aims to highlight the superior properties of NSF as a better anti-caries agent outstripping the limitations of discoloration of SDF.
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Affiliation(s)
- C. Pushpalatha
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - K. V. Bharkhavy
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Arshiya Shakir
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Dominic Augustine
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - S. V. Sowmya
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Hammam Ahmed Bahammam
- Department of Pediatric Dentistry, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | | | - Bassam Zidane
- Restorative Dentistry Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Yan IG, Zheng FM, Gao SS, Duangthip D, Lo ECM, Chu CH. Fluoride Delivered via a Topical Application of 38% SDF and 5% NaF. Int Dent J 2022; 72:773-778. [PMID: 35570014 DOI: 10.1016/j.identj.2022.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The objectives of this study were to compare the amount of fluoride delivered via a topical application of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish as well as to determine the amount of 38% SDF solution delivered using various micro-applicators. METHODS The weights of 38% SDF (Saforide) and 5% NaF (Duraphat) applied to the occlusal surface of an extracted human upper first premolar with a regular-size (2.50-mm tip diameter) micro-applicator were measured using an electronic-analytical balance. Afterwards, the weight of 38% SDF applied to a premolar using the micro-applicators of 5 common brands (Premium Plus, 3M, Dentsply, Elevate Oral Care, and SDI) were studied. The tip diameter of each micro-applicator was measured under a microscope. The weights of the delivered fluoride and silver were also calculated. RESULTS The mean weights of the fluoride delivered via the SDF solution and NaF varnish were 0.25 ± 0.07 mg and 0.49 ± 0.08 mg, respectively (P < .001). In addition, the tip diameters of the micro-applicators ranged from 1.89 ± 0.03 mm to 2.76 ± 0.02 mm. The mean weights of the fluoride delivered per application of 38% SDF using different applicators ranged from 0.13 ± 0.06 mg to 0.30 ± 0.09 mg, whereas the mean weights of the silver ranged from 0.76 ± 0.32 mg to 1.68 ± 0.50 mg. The weights of the delivered 38% SDF solution varied with the brand and with the tip diameters of the dental micro-applicators (P < .001). CONCLUSIONS The fluoride of the 38% SDF solution delivered topically was significantly less than that of 5% NaF varnish. Moreover, the amount of SDF solution delivered depends on the brand and size of the micro-applicators.
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Affiliation(s)
- Iliana Gehui Yan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sherry Shiqian Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Jabin Z, Jain G, Jaiswal M, Vishnu Priya V. Top 100 cited articles on Silver diamine fluoride-A bibliometric analysis. J Oral Biol Craniofac Res 2022; 12:413-420. [DOI: 10.1016/j.jobcr.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
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21
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Ion Concentration of Silver Diamine Fluoride Solutions. Int Dent J 2022; 72:779-784. [DOI: 10.1016/j.identj.2022.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/26/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
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22
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Rodrigues GF, Monteiro ASN, Vollú AL, Pires PM, Silva ASDS, Lopes RT, Oliveira BH, Neves ADA, Barja-Fidalgo F, Fonseca-Gonçalves A. Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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Sa’ada MMA, Khattab NMA, Amer MI. Effect of Silver Diamine Fluoride Pretreatment on Shear Bond Strength of Resin Modified Glass Ionomer Cement to Primary Dentin. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study was to evaluate effect of silver diamine fluoride (SDF) on the shear bond strength (SBS) of glass ionomer restoration to primary dentine.
MATERIALS AND METHODS: Twenty extracted primary molars with no restorations or developmental anomalies were only chosen for the study. Twenty dentine slices with 2 mm thickness were prepared and then randomly allocated into two groups (n = 10 per group). For Group 1 (experimental): Dentine surfaces were treated with 38% *SDF solution (Elevate oral care, USA) for 3 min using micro-brush, followed by a 30 s rinse with water and Group 2 (Control): Dentine surfaces were treated with distilled water for 3 min then rinsed for 30 s. The cavity conditioner was applied to flat dentin of both groups for 10 s then washed and dried gently with compressed air. All the specimens were restored with *RMGIC (Riva Light Cure, SDI, Australia). SBS was determined using a Universal Testing machine and Failure mode was evaluated using stereomicroscope. Data were collected and statistically analyzed. Independent t test was used to assess differences in SBS between study groups and mode of failure was analyzed using Fisher’s exact test. Level of significance was set at p ≤ 0.05. IBM SPSS statistical software (version 26) was used to analyze the data.
RESULTS: The experimental group had significantly higher mean of shear bond (11.92 ± 3.35) strength than the control group (6.99 ± 2.98) (p = 0.003).
CONCLUSIONS: Primary dentin pre-treatment with 38% SDF increases the shear bond strength between RMGIC and primary dentin according to the results of this in vitro study.
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Amaechi BT, Phillips TS, Evans V, Ugwokaegbe CP, Luong MN, Okoye LO, Meyer F, Enax J. The Potential of Hydroxyapatite Toothpaste to Prevent Root Caries: A pH-Cycling Study. Clin Cosmet Investig Dent 2021; 13:315-324. [PMID: 34321930 PMCID: PMC8312331 DOI: 10.2147/ccide.s319631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/08/2021] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The effectiveness of a hydroxyapatite (HAP) toothpaste and a fluoride toothpaste in preventing root tissue demineralization (root caries) was compared using an established pH-cycling caries model. MATERIALS AND METHODS Sixty dentin blocks were produced from the root tissue of extracted human teeth and were assigned to 3 test groups (n=20/group): 10% hydroxyapatite toothpaste (HAP), 1450 ppm fluoride toothpaste (fluoride), and artificial saliva (artsaliva). Early root caries lesions were developed in each sample by 7-day demineralization using a pH-cycling caries model. The daily cyclic treatment regimen consists of two 2-minute toothpaste-slurry treatment periods, one 6-hour acid challenge using acidified gel (pH 4.5), and then storage in remineralizing solution (artsaliva) for the rest of the time. Demineralization was assessed as the amount of mineral loss (∆z) using transverse microradiography (TMR). Pairwise comparisons (between treatments) were performed using analysis of variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if p<0.05. RESULTS Both ANOVA and Tukey's HSD indicated no significant (ANOVA; n=20) difference in mean ∆z among the groups, with least ∆z (±Sd) in the HAP (1117±366) compared to fluoride (1392±334) and artsaliva (1406±223). Relative to control, HAP and fluoride inhibited root demineralization by 21% and 6%, respectively. CONCLUSION Within the limit of the present study, the tested toothpaste containing 10% HAP is an effective root caries control toothpaste. Toothpaste containing 10% HAP was slightly more effective in preventing tooth demineralization than 1450 ppm fluoride provided as sodium fluoride. Thus, this study shows that HAP toothpastes can serve as an effective alternative to fluoride toothpastes for root caries management.
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Affiliation(s)
- Bennett Tochukwu Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Thais Santiago Phillips
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Veronica Evans
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | | | - Minh Nguyet Luong
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Linda Oge Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
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26
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Milgrom P. Omissions make silver diamine fluoride paper impossible to interpret. Aust Dent J 2021; 66:212-213. [PMID: 34029387 DOI: 10.1111/adj.12832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- P Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA.,Advantage Silver Dental Arrest, Salem, OR, USA
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Alhothali M, Exterkate R, Lagerweij M, Buijs M, van Loveren C, van Strijp G. The effect of equal fluoride concentrations in silver diamine fluoride and potassium fluoride on demineralized dentin during pH-cycling: chemical data. Eur J Oral Sci 2021; 129:e12789. [PMID: 33955578 PMCID: PMC8453573 DOI: 10.1111/eos.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/01/2022]
Abstract
The actual contribution of silver in silver diamine fluoride (SDF) towards the anti‐demineralizing effect is unclear. This study compared the effects of single applications of three concentrations of fluoride (4.1%, 1.025%, 0.26% F−) in the form of SDF and potassium fluoride (KF) on demineralized dentin in a 15‐day non‐microbial pH‐cycling model. Calcium loss and uptake in de‐ and remineralization buffers were analyzed daily. Fluoride release in both buffers was analyzed on days 1, 2, 3, and 8. The net calcium results of de‐ and remineralization cycles revealed dose‐response protection without significant differences between equal fluoride concentrations of SDF and KF. In the demineralization cycles, all fluoride treatments, except KF 0.26% F−, significantly inhibited demineralization, with KF 4.1% F− being the most effective. In the remineralization cycles, remineralization was enhanced in all fluoride concentration groups in a dose‐response manner with no difference between similar fluoride concentrations of SDF and KF. Daily fluoride effects were constant throughout the experiment. Fluoride analysis revealed statistically significant differences in fluoride release between the treatments on day 1 that diminished on days 2 and 3. The non‐microbial model showed no differences between SDF and KF in inhibiting demineralization and enhancing remineralization of dentin lesions.
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Affiliation(s)
- Marwa Alhothali
- Department of Cariology, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Dentistry, Comprehensive Specialized Clinics and Hospital of Security Forces, Mecca City, Saudi Arabia
| | - Rob Exterkate
- Department of Preventive Dentistry, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maxim Lagerweij
- Department of Cariology, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mark Buijs
- Department of Preventive Dentistry, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Cariology, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Preventive Dentistry, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Guus van Strijp
- Department of Cariology, The Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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28
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Kim S, Nassar M, Tamura Y, Hiraishi N, Jamleh A, Nikaido T, Tagami J. The effect of reduced glutathione on the toxicity of silver diamine fluoride in rat pulpal cells. J Appl Oral Sci 2021; 29:e20200859. [PMID: 33886942 PMCID: PMC8075293 DOI: 10.1590/1678-7757-2020-0859] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 01/15/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction Due to its ability to arrest untreated dental caries, silver diamine fluoride (SDF) has been advocated for indirect pulp capping procedures. However, the high concentrations of silver and fluoride in SDF raise concerns about its biocompatibility to pulpal tissues. Objectives This study aimed to investigate the effect of SDF on the viability, alkaline phosphatase (ALP) activity, and morphology of pulpal-like cells (RPC-C2A) and to evaluate the influence of reduced glutathione (GSH) on SDF-induced cytotoxicity and deposit formation on dentin. Methodology The cytotoxicity of diluted 38% SDF solutions (10-4 and 10-5), with or without the addition of 5 mM or 50 mM GSH, was evaluated at 6 and 24 hours. Cell viability was detected using WST-8 and the effect on ALP activity was performed using an ALP assay kit. Cell morphology was observed using a phase-contrast microscope. Scanning electron microscopy analysis was conducted to evaluate the effect of GSH incorporation or conditioning on SDF-induced deposit formation on dentin discs. Cytotoxicity data were analyzed by two-way analysis of variance (ANOVA) and Tukey post hoc tests (p<0.05). Results There were significant differences between the groups. The results demonstrated that all tested SDF dilutions caused a remarkable cytotoxic effect, while the addition of GSH prevented SDF-induced damage at 6-hour exposure time in the higher dilution of SDF. Dentin treated with plain SDF or GSH-incorporated SDF solution showed deposit formation with occluded dentinal tubules, unlike the other groups. Conclusion SDF severely disturbed the viability, mineralization-ability, and morphology of pulpal-like cells, while controlled concentrations of GSH had a short-term protective effect against SDF-induced damage. GSH showed an inhibitory effect on SDF-induced dentinal deposit formation. Further research is warranted to evaluate the effect of GSH on caries-arresting, anti-hypersensitivity, and antibacterial functions of SDF.
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Affiliation(s)
- Seunggun Kim
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Department of Cariology and Operative Dentistry, Tokyo, Japan
| | - Mohannad Nassar
- University of Sharjah, College of Dental Medicine, Department of Preventive and Restorative Dentistry, Sharjah, United Arab Emirates (UAE)
| | - Yukihiko Tamura
- Tokyo Medical and Dental University, Bio-Matrix (Dental Pharmacology), Tokyo, Japan
| | - Noriko Hiraishi
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Department of Cariology and Operative Dentistry, Tokyo, Japan
| | - Ahmed Jamleh
- National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, College of Dentistry, Restorative and Prosthetic Dental Sciences, Riyadh, Saudi Arabia.,National Guard Health Affairs, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Toru Nikaido
- Asahi University, School of Dentistry, Division of Oral Functional Science and Rehabilitation, Department of Operative Dentistry, Gifu, Japan
| | - Junji Tagami
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Department of Cariology and Operative Dentistry, Tokyo, Japan
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Patel J, Foster D, Smirk M, Turton BJ, Anthonappa RP. Response to 'Letter to the Editor: Fluoride concentration in SDF commercial products'. Aust Dent J 2021; 66:217. [PMID: 33772788 DOI: 10.1111/adj.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Affiliation(s)
- J Patel
- UWA Dental School, The University of Western, Australia
| | - D Foster
- School of Molecular Sciences, The University of Western, Australia
| | - M Smirk
- School of Earth and Environment, The University of Western, Australia
| | - B J Turton
- University of Puthisastra, Phnom Penh, Cambodia
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30
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Patel J, Foster D, Smirk M, Turton B, Anthonappa R. Acidity, fluoride and silver ion concentrations in silver diamine fluoride solutions: a pilot study. Aust Dent J 2021; 66:188-193. [PMID: 33450061 DOI: 10.1111/adj.12822] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There has been renewed interest in the use of silver diamine fluoride (SDF) for the management of carious lesions in high-risk groups. Previous studies have found a difference in clinical efficacy among different concentrations of SDF and discrepancies between ionic concentrations of fluoride (F) and silver (Ag) in SDF preparations. The aim of this study was to measure the free F, Ag ion concentrations and pH of a variety of commercially available SDF preparations. METHODS Seven SDF products used globally were evaluated for F and Ag ion concentrations using a calibrated ion-selective electrode and optical emission spectrometry respectively. Acidity was determined with a pH electrode. RESULTS The 30% SDF solution contained almost half the F concentration and a much higher Ag concentration than expected (16 343 ppmF and 246 000 ppmAg). Comparatively, the mean F concentration of the remaining six 38% solutions was 74 802 ppm (expected mean 44 800 ppm) ranging from 36 457 ppm to 120 760 ppm. The mean Ag concentration was 326 000 ppm (expected mean 253 870 ppm) and ranged from 246 000 ppm to 425 451 ppm. All solutions were found to be neutral or mildly alkaline in nature (pH 7-10.3). CONCLUSIONS Wide variations between claimed and measured F and Ag ion concentrations exist among the different brands of commercially available SDF products.
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Affiliation(s)
- J Patel
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - D Foster
- School of Molecular Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - M Smirk
- UWA School of Agriculture and Environment, The University of Western Australia, Nedlands, WA, Australia
| | - B Turton
- Phnom Penh Cambodia, University of Puthisastra, Phnom Penh, Cambodia
| | - R Anthonappa
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
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31
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Ahn JH, Kim JW, Yoon YM, Lee NY, Lee SH, Jih MK. Time-Dependent Anti-Demineralization Effect of Silver Diamine Fluoride. CHILDREN-BASEL 2020; 7:children7120251. [PMID: 33255281 PMCID: PMC7760551 DOI: 10.3390/children7120251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022]
Abstract
This study compared the demineralization resistance of teeth treated with silver diamine fluoride (SDF) to that treated with fluoride varnish. A total of 105 healthy bovine incisors were divided into control, fluoride varnish, and SDF groups. The enamel surface density change was then measured by micro-computed tomography (micro-CT) at three depths. The demineralized zone volume was measured on 3D micro-CT images to evaluate the total demineralization rate. The enamel surface morphology was assessed by scanning electron microscope. The enamel density had continuously decreased while demineralization increased in the control and fluoride varnish groups. The enamel density had increased in the SDF group till the 7th day of demineralization treatment and decreased thereafter. However, the decrease in the SDF group was less severe than that in the other groups (p < 0.05). The demineralized enamel volume had increased through treatment and was the highest in the control group, followed by the fluoride varnish and SDF group. The enamel surface morphology was the roughest and most irregular in the control group, followed by the fluoride varnish group and SDF groups.
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Affiliation(s)
- Ji-Hye Ahn
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju 61452, Korea; (J.-H.A.); (J.-W.K.); (N.-Y.L.); (S.-H.L.)
| | - Ji-Woong Kim
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju 61452, Korea; (J.-H.A.); (J.-W.K.); (N.-Y.L.); (S.-H.L.)
| | | | - Nan-Young Lee
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju 61452, Korea; (J.-H.A.); (J.-W.K.); (N.-Y.L.); (S.-H.L.)
| | - Sang-Ho Lee
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju 61452, Korea; (J.-H.A.); (J.-W.K.); (N.-Y.L.); (S.-H.L.)
| | - Myeong-Kwan Jih
- Department of Pediatric Dentistry, School of Dentistry, Chosun University, Gwangju 61452, Korea; (J.-H.A.); (J.-W.K.); (N.-Y.L.); (S.-H.L.)
- Correspondence: ; Tel.: +82-62-220-3868; Fax: +82-62-225-8240
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Gao SS, Chen KJ, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting early childhood caries using silver and fluoride products - A randomised trial. J Dent 2020; 103:103522. [PMID: 33166594 DOI: 10.1016/j.jdent.2020.103522] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/31/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this randomised non-inferiority clinical trial was to compare the effectiveness of semi-annual (every six months) applications of 25 % silver nitrate (AgNO3) solution followed by 5 % sodium fluoride (NaF) varnish to semi-annual applications of 38 % silver diamine fluoride (SDF) solution in arresting early childhood caries (ECC). METHODS Three-year-old children with active cavitated carious lesions were recruited and randomly assigned to two intervention groups. Children in Group A received semi-annual applications of 25 % AgNO3 solution followed by 5 % NaF varnish on carious lesions. Children in Group B received semi-annual applications of 38 % SDF solution followed by a placebo varnish. One trained dentist assessed ECC status at baseline and in all follow-up examinations. An independent operator performed the interventions. The dentist, the children, and their caretakers were blinded to the intervention allocation. Data were analysed using a non-inferiority test. Group A's non-inferiority would be accepted if the lower limit of the 95 % confidence interval (CI) for the difference in the mean number of arrested decayed surfaces (ds) was greater than -0.5. RESULTS At baseline, 1,070 children were recruited, and 535 children were assigned to each group. After 30 months, the mean arrested ds in Groups A (n = 447) and B (n = 433) were 3.7 ± 3.6 and 3.6 ± 3.7, respectively (p = 0.694). The difference in the mean arrested ds between the two groups was 0.088 (95 % CI: -0.351 to 0.526). CONCLUSION Semi-annual application of 25 % AgNO3 followed by 5 % NaF is at least as effective as the semi-annual application of 38 % SDF in arresting ECC. CLINICAL SIGNIFICANCE Silver and fluoride products are effective in arresting caries. As a simple, non-invasive, and inexpensive strategy, it can be used in young children, elderly adults, and people with special needs.
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Affiliation(s)
| | - Kitty Jieyi Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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C C BO, A R VO, R Y SB, M A AT. Study of Demineralized Dental Enamel Treated with Different Fluorinated Compounds by Raman Spectroscopy. J Biomed Phys Eng 2020; 10:635-644. [PMID: 33134223 PMCID: PMC7557462 DOI: 10.31661/jbpe.v0i0.2003-1089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Current diagnostic methods for enamel caries detection are unable to detect caries lesions (incipient caries lesion) at a very early stage. OBJECTIVE This study aims to determine the remineralizing effect of three fluorinated compounds on demineralized subsurface tooth enamel using Raman spectroscopy characterization. MATERIAL AND METHODS In this experimental study, sixty impacted 3rd molars, with intact anatomical crowns recently extracted and without structural defects, were sectioned longitudinally in a mesio-distal direction using a diamond disc, obtaining two working surfaces (buccal and lingual). The 120 working surfaces obtained were immersed for 96 h in a demineralization solution at 37°C in order to demineralize the enamel surface. All samples were randomly divided into three groups (n=30 each) and their surfaces were treated with silver diamine fluoride (SDF), Difluoride silane (DSF), and acidulated phosphate fluoride (APF), and with no treatment undertaken in the control group (CG). The samples were immersed in alternating solutions for demineralization and remineralization at pH 4.4 and pH 7.0, respectively. The results were analyzed with Principal Component Analysis (PCA) in order to determine the variance. RESULTS The most important difference (91.7%) is observed in APF group between PCA1 respect to PCA2, followed by DSF (91.5%) and SDF (76.3%) respectively. Therefore, a greater remineralization in the dental enamel can be observed by the three experimental groups. CONCLUSION The APF and DSF have the effect of recovering the mineralization of dental enamel, except for the SDF. Functional groups OH- and PO43- were identified in all subsurface.
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Affiliation(s)
- Barrera-Ortega C C
- PhD, Coordinator Paediatric Stomatology Specialties. Iztacala Faculty of Higher Studies (FESI), National Autonomous University of Mexico (UNAM), State of Mexico, Mexico. Avenida de los Barrios No. 1 Col. Los Reyes Ixtacala Tlalnepantla de Baz, Estado de México CP. 54090.Mexico
| | - Vázquez-Olmos A R
- PhD, Institute of Applied and Technological Sciences, National Autonomous University of Mexico (UNAM), Circuito Exterior S/N C.P. 04510 Cd. Universitaria, Ciudad de México
| | - Sato-Berrú R Y
- PhD, Institute of Applied and Technological Sciences, National Autonomous University of Mexico (UNAM), Circuito Exterior S/N C.P. 04510 Cd. Universitaria, Ciudad de México
| | - Araiza-Téllez M A
- PhD, Dental Materials Laboratory, Division of Postgraduate Studies and Research of the Faculty of Dentistry, National Autonomous University of Mexico (UNAM), Circuito Institutos S/N Ciudad Universitaria, Colonia Copilco Universidad, Delegación Coyoacán, México Distrito Federal, C.P
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YILMAZ N, OCAK M, ÖKTE Z. REMINERALIZATION OF PRIMARY MOLAR DENTINE WITH SILVER DIAMINE FLUORIDE AND SODIUM FLUORIDE : AN IN VITRO STUDY. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.796823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mei ML, Yan Z, Duangthip D, Niu JY, Yu OY, You M, Lo ECM, Chu CH. Effect of silver diamine fluoride on plaque microbiome in children. J Dent 2020; 102:103479. [PMID: 32950631 DOI: 10.1016/j.jdent.2020.103479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the microbiome profile and relative abundance changes of the plaque on silver diamine fluoride (SDF)-treated caries in children with early childhood caries. METHODS A single trained examiner assessed the caries as being arrested or active and then collected plaque samples from the caries lesions from fourteen 5-year-old children immediately before, 2 weeks after, and 12 weeks after a one-off application of 38 % SDF. We assigned 16S rRNA gene sequences to operational taxonomic units (OTUs) using a 98.5 % identity cut-off. We also used a variety of taxonomy- and phylogeny-based statistical approaches to compare the biodiversity and relative abundance among different groups. RESULTS The caries arrest rate were 90 % and 83 % after 2 and 12 weeks, respectively. We studied 46 plaque samples and identified 388 OTUs (254 identified at the species level, 129 identified at the genus level, and 76 identified at the family level). There was no significant change in the diversity in the arrested caries before and 12 weeks after SDF treatment (p = 0.71). The diversity in active caries reduced significantly 12 weeks after SDF treatment (p = 0.006). The relative abundance of certain caries-related species (e.g., Streptococcus mutans and Lactobacillus sp.) was reduced in arrested caries but was increased in active caries after SDF treatment. CONCLUSION There was no overall microbiome changes in the caries arrested by SDF. The relative abundance of some caries-related species is reduced in arrested caries, while increased in active caries. CLINICAL SIGNIFICANCE This study provides information on microbiome changes on SDF-treated caries of children.
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Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Zejun Yan
- Department of Research & Development, Aviagen Ltd, Edinburgh, United Kingdom
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Meng You
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
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Soares-Yoshikawa AL, Cury JA, Tabchoury CPM. Fluoride Concentration in SDF Commercial Products and Their Bioavailability with Demineralized Dentine. Braz Dent J 2020; 31:257-263. [DOI: 10.1590/0103-6440202003669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/04/2020] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this in vitro study was to determine the fluoride concentration in silver diamine fluoride (SDF) products and their bioavailability with demineralized dentine. The products evaluated (expected fluoride concentrations) were: I: Saforide 38% (45,283 ppm F); II: Advantage Arrest 38.3 to 43.2% (45,283 to 51,013 ppm F); III: Ancárie 12% (14,100 ppm F); IV: Ancárie 30% (35,400 ppm F), V: Cariestop 12% (14,100 ppm F) and VI: Cariestop 30% (35,400 ppm F). The fluoride concentration was evaluated using an ion-specific electrode (ISE) by direct technique, which was confirmed after microdiffusion. The pH of the products was determined with a pH test strip. For the bioavailability test, demineralized dentine slabs were treated with one of the products for 1 min. Loosely (CaF2-like) and firmly-bound fluoride (FAp) were determined. The fluoride concentration found in the products (mean±SD; ppm F) by the ISE direct technique was: I:53,491±554; II:57,249±1,851; III:4,814±268; IV:5,726±43; V:10,145±468; VI:11,858±575; these values were confirmed after microdiffusion (t-test; p>0.05) and disagree with the declared by the manufacturers. The pH of Ancárie 12 and 30% was 6.0 and 4.5, respectively, in disagreement with the alkaline pH expected for SDF solution and found in the other products evaluated. There was no correlation between either CaF2-like (r=0.221; p=0.337) or FAp (r=-0.144; p=0.830) formed in demineralized dentine and fluoride concentration found in the products. The problems of pH and fluoride concentration found in available professional commercial SDF products suggest that they are not under sanitary surveillance.
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Liu BY, Liu J, Zhang D, Yang ZL, Feng YP, Wang M. Effect of silver diammine fluoride on micro-ecology of plaque from extensive caries of deciduous teeth - in vitro study. BMC Oral Health 2020; 20:151. [PMID: 32448221 PMCID: PMC7247265 DOI: 10.1186/s12903-020-01141-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/17/2020] [Indexed: 11/19/2022] Open
Abstract
Background The mechanism of action of silver diammine fluoride (SDF) on plaque micro-ecology is seldom studied. This study investigated micro-ecological changes in dental plaque on extensive caries of deciduous teeth after topical SDF treatment. Methods Deciduous teeth with extensive caries freshly removed from school children were collected in clinic. Unstimulated saliva collection and initial plaque sampling were done before tooth extraction, then each caries was topically treated with 38% SDF in vitro. After intervention, each tooth was stored respectively in artificial saliva at 37 °C. Repeated plaque collections were done at 24 h and 1 week post-intervention. Post-intervention micro-ecological changes including microbial diversity, microbial metabolism function as well as species correlations were analyzed and compared after pyrosequencing of the DNA from the plaque sample using Illumina MiSeq platform. Results After SDF application, microbial diversity decreased (P > 0.05), although not statistically significant. Microbial community composition post-intervention was noticeably different from that of supragingival and pre-intervention plaque as well as saliva. At 1 week post-intervention, the relative content of Pseudomonas, Fusobacterium and Pseudoramibacter were higher than before, while most of the other bacteria were reduced, although the changes were not statistically significant (P > 0.05). The inter-microbial associations became more complex, much more positive associations among survived bacteria were observed than negative ones. COG function classification diagram showed carbohydrate transportation and metabolic functions in the plaque were significantly reduced at 24 h and 1 week post-intervention. Conclusions SDF has extensive antimicrobial effect on dental plaque, which may reduce carbohydrate metabolism in dental plaque and help promote new balance of the plaque flora.
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Affiliation(s)
- Bao Ying Liu
- The First Affiliated Hospital of Zhengzhou University (School and Hospital of Stomatology), No 1 Jianshe Road, Pingdingshan, 450001, Henan Province, China.
| | - Jin Liu
- The First Affiliated Hospital of Zhengzhou University (School and Hospital of Stomatology), No 1 Jianshe Road, Pingdingshan, 450001, Henan Province, China
| | - Di Zhang
- The First Affiliated Hospital of Zhengzhou University (School and Hospital of Stomatology), No 1 Jianshe Road, Pingdingshan, 450001, Henan Province, China.,Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zhi Lei Yang
- The First Affiliated Hospital of Zhengzhou University (School and Hospital of Stomatology), No 1 Jianshe Road, Pingdingshan, 450001, Henan Province, China
| | - Ya Ping Feng
- The Second Affiliated Hospital of Pingdingshan College, Pingdingshan, Henan Province, China
| | - Meng Wang
- The Second Affiliated Hospital of Pingdingshan College, Pingdingshan, Henan Province, China
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Mei ML, Yan Z, Duangthip D, Niu JY, Yu OY, You M, Lo ECM, Chu CH. WITHDRAWN: Effect of silver diamine fluoride on plaque microbiome in children. J Dent 2020; 103S:100016. [PMID: 34059301 DOI: 10.1016/j.jjodo.2020.100016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 02/05/2023] Open
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Journal of Dentistry, 102 (2020) article number 103479, https://doi.org/10.1016/j.jdent.2020.103479. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
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Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand; Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Zejun Yan
- Department of Research & Development, Aviagen Ltd, Edinburgh, United Kingdom
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Meng You
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
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Tolba ZO, Hamza HS, Moheb DM, Hassanein HE, El Sayed HM. Effectiveness of two concentrations 12% versus 38% of silver diamine fluoride in arresting cavitated dentin caries among children: a systematic review. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2019. [DOI: 10.1186/s43054-019-0001-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Crystal YO, Rabieh S, Janal MN, Rasamimari S, Bromage TG. Silver and fluoride content and short-term stability of 38% silver diamine fluoride. J Am Dent Assoc 2019; 150:140-146. [PMID: 30691572 PMCID: PMC6500427 DOI: 10.1016/j.adaj.2018.10.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND As silver diamine fluoride (SDF) gains popularity for caries arrest, the authors aimed to investigate the content of fluoride and silver in 38% SDF produced for the US market and its short-term stability. METHODS Five samples of 38% SDF were evaluated when the bottle was first opened, and at 7 and 28 days. Fluoride concentrations were determined with a fluoride ion-selective electrode, and silver concentrations were determined with a simultaneous inductively coupled plasma mass spectrometer. pH was measured with a pH probe. Weight and volume of individual drops were measured. RESULTS At day 0, 40% of individual measured values were above the expected fluoride concentration, and at day 28, 93% were above the expected fluoride concentration (P = .005). At day 0, 19% of individual measured values were below the lowest expected silver concentration, and at day 28, 93% were below (P < .001). Acidity (pH 10) was consistent over the 3 periods. Mean (standard deviation) weight of a drop was 40 (4.0) milligrams, and mean (standard deviation) volume was 32.55 (1.89) microliters, 30% more than the reported value of 25 μL. CONCLUSION Over 28 days, the product pH is stable, whereas the fluoride content tends to increase and the silver content tends to decrease. Drops were larger than expected when dispensed from the bottle. PRACTICAL IMPLICATIONS Drops are larger than expected, so each delivers higher than expected quantities of silver and fluoride. Clinicians should exercise caution when using this product on young children, replace the cap immediately, and use as soon as dispensed.
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Tirupathi S, Svsg N, Rajasekhar S, Nuvvula S. Comparative cariostatic efficacy of a novel Nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial. J Clin Exp Dent 2019; 11:e105-e112. [PMID: 30805113 PMCID: PMC6383905 DOI: 10.4317/jced.54995] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 01/07/2019] [Indexed: 11/05/2022] Open
Abstract
Background To evaluate the clinical cariostatic efficacy of a concocted 5% Nano-silver incorporated Sodium fluoride (NSSF) dental varnish with 38% Silver diamine fluoride (SDF) in preventing the progression of dentinal caries of primary molars. Material and Methods A total of 159 active dentinal carious lesions in primary molars (from 50 children) were selected and randomly divided into two groups; NSSF and SDF. Varnish application was performed at the baseline visit and follow-up is carried out at 1, 3, 6 and 12 months. Parameters such as caries activity, depth, size, colour, and presence or absence of pain were noted at baseline and follow-up visits. Results The intergroup comparison of caries activity status did not reveal significant difference between the number of active and arrested caries lesions in NSSF and SDF groups at any visit (p >0.05) during the 12-month follow-up. There was no difference between overall failure and success rates between the two groups at any follow-up period (p-0.48). Conclusions Annual application of 5% NSSF is better than or equal to 38% SDF in preventing the progression of dentinal caries of primary molars. NSSF does not cause dark staining of dentinal tissue compared to the SDF and the use of NSSF can be recommended in children. Key words:Children, Nano-silver fluoride, Primary teeth, Silver diamine fluoride.
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Affiliation(s)
- Sunnypriyatham Tirupathi
- MDS, Assistant Professor, Department of Pediatric Dentistry, Mallareddy Institute of Dental Sciences, Hyderabad, India
| | - Nirmala Svsg
- MDS, Professor, Department of Pediatric Dentistry, Narayana dental college and hospital, Nellore, India
| | | | - Sivakumar Nuvvula
- MDS, Head of department, Department of Pediatric Dentistry, Narayana Dental College and Hospital, Nellore, India
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Abstract
Medical management of caries is a distinct treatment philosophy that employs topical minimally invasive therapies that treat the disease and is not merely prevention. This strategy is justified as an alternative or supplement to traditional care by significant disease recurrence rates following comprehensive operative treatment under general anesthesia. Silver diamine fluoride (SDF) is one agent to enable effective noninvasive treatment. The announcement of breakthrough therapy designation by the Food and Drug Administration (FDA) suggests that SDF may become the first FDA-approved drug for treating caries. Since our systematic review performed in April 2015, 4 clinical trials have been completed, which inform an update to the application protocol and frequency regimen. Suggestions from these studies are to skip the rinsing step due to demonstration of safety in young children, start patients with high disease severity on an intensive regimen of multiple applications over the first few weeks, and continue with semiannual maintenance doses as previously suggested. Breakthroughs in elucidating the impact of SDF on the dental plaque microbiome inform potential opportunities for understanding caries arrest. SDF can be added to the set of evidence-based noninvasive methods to treat caries lesions in primary teeth, such as the Hall crown technique and sealing lesions with accessible margins.
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Affiliation(s)
- J A Horst
- 1 Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
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Pérez-Hernández J, Aguilar-Díaz FC, Venegas-Lancón RD, Gayosso CAÁ, Villanueva-Vilchis MC, de la Fuente-Hernández J. Effect of silver diamine fluoride on adhesion and microleakage of a pit and fissure sealant to tooth enamel: in vitro trial. Eur Arch Paediatr Dent 2018; 19:411-416. [PMID: 30324562 DOI: 10.1007/s40368-018-0374-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 08/12/2018] [Indexed: 11/28/2022]
Abstract
AIM To identify the effect of silver diamine fluoride in adhesion and microleakage of a pit and fissure sealant to tooth enamel. METHODS An in vitro study including 120 human molars without caries, and caries grade 1 was performed. Molars were randomly divided into four groups. Occlusal surfaces of groups 2 and 4 were sealed. In groups 1 and 3 silver diamine fluoride (SDF) was placed in the occlusal surface and then molars were sealed according to manufacturer's instructions. Afterwards, all groups were submitted to the adhesion test. Groups 1 and 2 were placed in a forming cylinder and their roots were submerged in polymethyl methacrylate after that they were stored in deionised water (37 °C ± 1). Subsequently, they were tested by applying a tractional load (Instron machine, speed cross of 1 mm/min). Sealant adhesion was evaluated through: Resistance to the detachment (MPa), residues of sealant area (mm2) and adhesive remaining index (ARI) (0-3 interval). Microleakage test: Groups 3 and 4 were placed in a plastic container and subjected to 2000 cycles at different temperatures one at 6 °C ± 1 and the other at 60 °C ± 1. Later the occlusal surface was immersed for 24 h in 1% toluidine blue. Microleakage was observed by optical microscopy (10×) and was interpreted in micrometres. RESULTS Of the samples without SDF 18.1 and 23.0% of the sealant remaining and of the samples with SDF present 100% of sealant remaining on enamel. Samples with SDF obtained an average in the test of detachment of 6.89 ± 3.09 MPa, whereas in the group without SDF the average obtained was 6.42 ± 3.35 MPa. Differences were not statistically significant (p = 0.579). Most of the samples not treated with SDF (81.6%) showed microleakage than those treated with SDF in which 47% presented microleakage. CONCLUSIONS There is an improvement in the retention properties of a fissure sealant applied after treatment with silver diamine fluoride. The application of fissure sealant to improve the aesthetics of teeth treated with SDF is recommended.
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Affiliation(s)
- J Pérez-Hernández
- ENES Unidad León, Universidad Nacional Autónoma de México, Boulevard UNAM No 2011, Predio el Saucillo y el Potrero, 37684, León, Gto, Mexico
| | - F C Aguilar-Díaz
- ENES Unidad León, Universidad Nacional Autónoma de México, Boulevard UNAM No 2011, Predio el Saucillo y el Potrero, 37684, León, Gto, Mexico.
| | - R D Venegas-Lancón
- ENES Unidad León, Universidad Nacional Autónoma de México, Boulevard UNAM No 2011, Predio el Saucillo y el Potrero, 37684, León, Gto, Mexico
| | - C A Á Gayosso
- Facultad de Odontología, Universidad Nacional Autónoma de México, Av Universidad 3000, Cd. Universitaria, Coyoacán, 04510, Mexico City, Mexico
| | - M C Villanueva-Vilchis
- ENES Unidad León, Universidad Nacional Autónoma de México, Boulevard UNAM No 2011, Predio el Saucillo y el Potrero, 37684, León, Gto, Mexico
| | - J de la Fuente-Hernández
- ENES Unidad León, Universidad Nacional Autónoma de México, Boulevard UNAM No 2011, Predio el Saucillo y el Potrero, 37684, León, Gto, Mexico
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Yu OY, Zhao IS, Mei ML, Lo ECM, Chu CH. Caries-arresting effects of silver diamine fluoride and sodium fluoride on dentine caries lesions. J Dent 2018; 78:65-71. [PMID: 30114443 DOI: 10.1016/j.jdent.2018.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/06/2018] [Accepted: 08/10/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate the remineralising effect and bacterial growth inhibition of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish on artificial dentine caries lesions. METHODS Demineralised dentine blocks were treated with SDF + NaF (Group 1), SDF (Group 2), NaF (Group 3) and water (Group 4) and subjected to a Streptococcus mutans biofilm challenge. Lesion depth, precipitates' characteristics and matrix (collagen)-to-mineral ratio were evaluated by micro-computer tomography (micro-CT), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR), respectively. The biofilm kinetics, viability and topography were assessed by counts of colony forming units (CFUs), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. Data were analysed by two-way ANOVA test. RESULTS The lesion depths of Groups 1-4 were 170 ± 28 μm, 160 ± 32 μm, 353 ± 38 μm and 449 ± 24 μm, respectively. The addition of NaF to SDF did not show better remineralisation than SDF (p = 0.491). Metallic silver and silver chloride were found in Groups 1 and 2. The amide I-to-hydrogen phosphate ratios of the four groups were 0.14 ± 0.02, 0.14 ± 0.01, 0.29 ± 0.05 and 0.49 ± 0.16, respectively, and the addition of NaF to SDF did not offer better protection against collagen exposure than SDF (p = 0.986). The Log10 CFUs of Groups 1-4 were 5.75 ± 0.56, 4.49 ± 0.57, 6.55 ± 0.39 and 6.40 ± 0.38, respectively. The presence of NaF reduced the antibacterial effect of SDF (p < 0.001). The SEM and CLSM images supported the findings. CONCLUSION Application of SDF with or without NaF reduced the demineralisation of dentine caries, but SDF exerted stronger inhibition of biofilm growth than SDF with NaF. CLINICAL SIGNIFICANCE NaF varnish affects the antibacterialeffects of SDF, the adjunctive application of SDF solution and NaF varnish is not recommended to arrest dentine caries in clinic.
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Affiliation(s)
- Ollie Y Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Irene S Zhao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - May L Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Edward C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - C H Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Amaechi BT. Remineralisation - the buzzword for early MI caries management. Br Dent J 2018; 223:173-182. [PMID: 28798421 DOI: 10.1038/sj.bdj.2017.663] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/09/2022]
Abstract
Minimal intervention (MI) dentistry aims to preserve dental tissues first and restore only when indicated, thus remineralisation of initial (non-cavitated) caries lesions, an integral part of caries management, is an essential treatment strategy in MI. With this understanding, dental practitioners are increasingly embracing the principle of non-operative treatment of initial caries lesions. The purpose of this review was to summarise the most recent literature published in non-operative management of dental caries. Three electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL) were searched, and clinical studies, systematic reviews and meta-analysis were included. This report outlines the strategies and numerous therapeutic materials available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces. However, the level of evidence of effect is variable, as well as the availability in different parts of the world. Options available to practitioners will vary when placing emphasis on the level of evidence supporting them. Strong clinical evidence support the effectiveness of pits/fissure sealants for therapeutic management of active initial caries on occlusal surfaces, and fluoride varnishes for remineralisation of caries lesions on root and coronal smooth surfaces, including proximal surfaces. Other materials formulated to enhance the effectiveness of any chosen remineralisation strategy were discussed. However, it is absolutely necessary that all caries remineralisation treatment be complemented with general behavioural modification in oral health through motivational interviewing directed towards change in oral hygiene to control plaque, dietary attitude modification to reduce the frequency of intake of fermentable sugars, and establishment of risk-based recall visits.
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Affiliation(s)
- B T Amaechi
- Professor and Director of Cariology Department of Comprehensive Dentistry University of Texas Health Science Centre at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas
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Oliveira BH, Rajendra A, Veitz-Keenan A, Niederman R. The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition: A Systematic Review and Meta-Analysis. Caries Res 2018; 53:24-32. [PMID: 29874642 PMCID: PMC6292783 DOI: 10.1159/000488686] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/08/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. METHODS Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth - dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). RESULTS Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = -1.15, PF = 77.5%; FV: WMD = -0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: -6.09%). CONCLUSION When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.
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Affiliation(s)
- Branca Heloisa Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, University of the State of Rio de Janeiro, Brazil.
| | - Anjana Rajendra
- Department of Epidemiology & Health Promotion College of Dentistry, New York University,
| | - Analia Veitz-Keenan
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, College of Dentistry, New York University,
| | - Richard Niederman
- Department of Epidemiology & Health Promotion College of Dentistry, New York University,
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Mei M, Lo E, Chu C. Arresting Dentine Caries with Silver Diamine Fluoride: What’s Behind It? J Dent Res 2018; 97:751-758. [DOI: 10.1177/0022034518774783] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Unlike other fluoride-based caries preventive agents, silver diamine fluoride (SDF) can simultaneously prevent and arrest coronal and root dentine caries. The profound clinical success of SDF has drawn many clinicians and researchers to study the mechanism of SDF in arresting dentine caries. This critical review discusses how silver and fluoride contribute to caries arrest, in terms of their effects on bacteria as well as on the mineral and organic content of dentine. Silver interacts with bacterial cell membrane and bacterial enzymes, which can inhibit bacterial growth. Silver can also dope into hydroxyapatite and have an antibacterial effect on silver-doped hydroxyapatite. Furthermore, silver is also a strong inhibitor of cathepsins and inhibits dentine collagen degradation. Early studies proposed that silver hardened caries lesions by forming silver phosphate. However, recent studies found that little silver phosphate remained on the arrested dentine lesion. The principal silver precipitate was silver chloride, which could not contribute to the significant hardening of the arrested lesions. On the other hand, fluoride enhances mineral formation by forming fluorohydroxyapatite with reduced solubility. A significant increase in microhardness occurs with an elevated level of calcium and phosphorus but not silver on the surface layer of the arrested dentine caries lesion following SDF treatment. Fluoride also inhibits matrix metalloproteinases activities and therefore inhibits dentine collagen degradation. The combination of silver and fluoride in an alkaline solution has a synergistic effect in arresting dentine caries. The alkaline property of SDF provides an unfavorable environment for collagen enzyme activation. Understanding the mechanisms of SDF in arresting dentine caries helps clinicians to develop appropriate protocols for the use of SDF in clinical care.
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Affiliation(s)
- M.L. Mei
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - E.C.M. Lo
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - C.H. Chu
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Abstract
We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity.
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Affiliation(s)
- Jeremy A Horst
- Department of Biochemistry and Biophysics, University of California San Francisco, 1700 4th Street, QB3 Room 404, San Francisco, CA 94158, USA
| | - Jason M Tanzer
- Section on Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut Health, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Peter M Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, USA.
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Zhao IS, Mei ML, Li QL, Lo ECM, Chu CH. Arresting simulated dentine caries with adjunctive application of silver nitrate solution and sodium fluoride varnish: an in vitro study. Int Dent J 2017; 67:206-214. [PMID: 28332192 DOI: 10.1111/idj.12291] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this in vitro study was to assess the ability of silver nitrate solution, followed by sodium fluoride varnish, to arrest caries. METHODS Dentine slices were prepared and demineralised. Each slice was cut into three specimens for three groups (SF, SDF and W). Specimens of the SF group received topical application of 25% silver nitrate solution followed by 5% sodium fluoride varnish. The SDF group received topical application of 38% silver diamine fluoride solution (positive control). Specimens of the W group received deionised water (negative control). All specimens were subjected to pH cycling for 8 days. Dentine surface morphology, crystal characteristics, carious lesion depth and collagen matrix degradation were evaluated by scanning electron microscopy, X-ray diffraction, X-ray microtomography and spectrophotometry with a hydroxyproline assay. RESULTS Scanning electron microscopy showed that dentine collagen was exposed in group W, but not in groups SF and SDF, while clusters of granular spherical grains were formed in groups SF and SDF. The mean lesion depths (±standard deviation) of groups SF, SDF and W were 128 ± 19, 135 ± 24 and 258 ± 53 μm, respectively (SF, SDF < W; P < 0.001). The X-ray diffraction analysis indicated that silver chloride was formed in groups SF and SDF. The concentration of hydroxyproline released from the dentine matrix was significantly lower in groups SF and SDF than in group W (P < 0.05). CLINICAL SIGNIFICANCE The results of this in vitro study indicate that the use of silver nitrate solution and sodium fluoride varnish is effective in inhibiting dentine demineralisation and dentine collagen degradation.
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Affiliation(s)
| | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Quan-Li Li
- College of Stomatology, Anhui Medical University, Hefei, China
| | | | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Gao SS, Zhao IS, Hiraishi N, Duangthip D, Mei ML, Lo ECM, Chu CH. Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review. JDR Clin Trans Res 2016; 1:201-210. [PMID: 30931743 DOI: 10.1177/2380084416661474] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This review aims to investigate the clinical effectiveness of silver diamine fluoride (SDF) in arresting dental caries among children. A systematic search of publications was conducted with the key words "silver diamine fluoride," "silver diammine fluoride," "silver fluoride," "diamine silver fluoride," or "diammine silver fluoride" as well as their translation in Chinese, Japanese, Portuguese, and Spanish in 7 databases: PubMed (English), Embase (English), Scopus (English), China National Knowledge Infrastructure (Chinese), Ichushi-web (Japanese), Biblioteca Virtual em Saude (Portuguese), and Biblioteca Virtual en Salud Espana (Spanish). Duplicated publications were deleted. The title and abstract were screened and irrelevant publications were excluded. The full text of the remaining publications was retrieved. Prospective clinical studies of SDF that reported a caries-arresting effect among children were included. Meta-analysis was performed for quantitative analysis. A total of 1,123 publications were found, including 19 publications of clinical trials. Sixteen clinical trials studied the caries-arresting effect on primary teeth, and 3 clinical trials were on permanent teeth. Fourteen studies used 38% SDF, 3 used 30% SDF, and 2 used 10% SDF. Meta-analysis was performed on extracted data from 8 studies using 38% SDF to arrest caries in primary teeth. The overall percentage of active caries that became arrested was 81% (95% confidence interval, 68% to 89%; P < 0.001). Apart from staining the arrested lesion black, no significant complication of SDF use among children was reported. SDF was commonly used at 38%. It was effective in arresting dentine caries in primary teeth among children. Knowledge Transfer Statement: This systematic review found that 38% silver diamine fluoride (SDF) can effectively arrest caries among children. SDF treatment is noninvasive and easily operated. It can be a promising strategy to manage dental caries in young children or those who have special needs.
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Affiliation(s)
- S S Gao
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - I S Zhao
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - N Hiraishi
- 2 Cariology and Operative Dentistry, Department of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - D Duangthip
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - M L Mei
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - E C M Lo
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C H Chu
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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