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Ge KX, Quock R, Yan F, Lam WYH, Chu CH, Yu OY. Ion release of the glass ionomer restoration with silver diamine fluoride dentin pretreatment. J Dent 2024; 148:105247. [PMID: 39025427 DOI: 10.1016/j.jdent.2024.105247] [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: 05/29/2024] [Revised: 07/14/2024] [Accepted: 07/16/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE To assess the fluoride and silver ion release of glass ionomer cement (GIC) restorations, including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations, with 38 % silver diamine fluoride (SDF) solution dentin pretreatment. METHODS Eighty dentin blocks were allocated into 4 groups and restored with SDF+CGIC, CGIC, SDF+RMGIC and RMGIC, respectively. Each block was stored in deionized water at 37 °C for 2 years. Fluoride and silver ion concentration in storage solution was measured using ion-selective electrode and inductively coupled plasma-optical emission spectrometry for up to 2 years. The cross-sectional surfaces of restored dentin blocks were assessed by X-Ray diffraction analysis (XRD), scanning electron microscope (SEM) with energy-dispersive X-ray spectroscopy (EDS) after 1 week and 2 years, respectively. RESULTS The mean ± standard deviation (SD) of accumulative fluoride releasing in SDF+CGIC, CGIC, SDF+RMGIC and RMGIC for 2 years were 0.13±0.005 mg, 0.09±0.006 mg, 0.15±0.008 mg and 0.05±0.003 mg, respectively (Groups SDF+RMGIC > SDF+CGIC > CGIC >RMGIC, p < 0.05). The mean ± SD of accumulative silver releasing in SDF+CGIC, CGIC, SDF+RMGIC and RMGIC for 2 years were 0.03±0.009 mg, 0.00±0.00 mg, 0.01±0.003 mg, and 0.00±0.00 mg, respectively (Groups SDF+CGIC > SDF+RMGIC > CGIC&RMGIC, p < 0.05). Groups SDF+CGIC and SDF+RMGIC showed sustainably higher fluoride and silver releasing compared to Groups CGIC and RMGIC (p < 0.05). XRD analysis indicated the fluorapatite and silver chloride were observed only in Groups SDF+CGIC and SDF+RMGIC, but not in Groups CGIC and RMGIC. SEM images of the cross-sectional view of the dentin blocks showed silver crystals within dentinal tubules 1 week and 2-year in Groups with SDF pretreatment. CONCLUSION The 38 % SDF dentin pretreatment sustainably increased the fluoride and silver release of GIC and RMGIC restorations for up to 2 years.
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Affiliation(s)
- Kelsey Xingyun Ge
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China
| | - Ryan Quock
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China; Department of Restorative Dentistry and Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Texas, USA
| | - Feng Yan
- Department of Applied Physics, The Hong Kong Polytechnic University, Research Institute for Intelligent Wearable Systems, Hong Kong, S.A.R., PR China
| | - Walter Yu-Hang Lam
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, S.A.R., PR China.
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Ge KX, Jakubovics NS, Quock R, Lam WYH, Chu CH, Yu OY. Preventing proximal enamel caries in neighboring tooth with glass ionomer cement restoration and silver diamine fluoride pretreatment. J Dent 2024; 149:105312. [PMID: 39154833 DOI: 10.1016/j.jdent.2024.105312] [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: 07/28/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 08/20/2024] Open
Abstract
OBJECTIVE To investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. METHODS HUMAN TOOTH BLOCKS WERE RESTORED WITH: SDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. RESULTS PMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead-to-live ratio in Groups 1-4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. CONCLUSION SDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. CLINICAL SIGNIFICANCE SDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.
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Affiliation(s)
- Kelsey Xingyun Ge
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China
| | - Nicholas Stephen Jakubovics
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China; School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4BW, UK
| | - Ryan Quock
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China; University of Texas School of Dentistry at Houston, Houston, TX, USA
| | - Walter Yu-Hang Lam
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong Special administrative regions of China.
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Chawhuaveang DD, Lam WYH, Chu CH, Yu OY. Silver diamine fluoride in preventing enamel erosion: An in vitro study with salivary pellicle. J Dent 2024; 149:105287. [PMID: 39103075 DOI: 10.1016/j.jdent.2024.105287] [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: 06/06/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/07/2024] Open
Abstract
OBJECTIVES To compare the prevention of enamel erosion and discolouring effect with a single and two weekly topical applications of silver diamine fluoride (SDF) solution. METHODS Human enamel blocks were divided into four groups. Group 1 (SDF2) received two weekly applications of SDF solution (Advantage Arrest: 260,000 ppm Ag, 44,300 ppm F, pH 9.1). Group 2 (SDF1) received a single application of SDF solution. Group 3 (SNF, Positive Control) received daily application of stannous-chloride/amine-fluoride/sodium-fluoride solution (Elmex® Enamel professional: 800 ppm Sn(II), 500 ppm F, pH 4.5). Group 4 (DW, Negative Control) received daily application of deionised water. The treated blocks were subjected to a 14-day erosive challenge. Crystal characteristics, elemental composition, surface morphology, percentage of surface microhardness loss (%SMHL), surface loss, and total colour change (ΔE) of the blocks were investigated using X-ray diffraction (XRD), energy-dispersive spectrometry (EDS) and scanning electron microscopy (SEM), Vickers' hardness testing, non-contact profilometry, and digital spectrophotometry, respectively. RESULTS XRD and EDS revealed precipitates of silver for SDF2 and SDF1 and tin for SNF. SEM showed prominent etched enamel pattern on DW than the other three groups. The%SMHL (%) of SDF2, SDF1, SNF, and DW were 26.6 ± 2.9, 33.6 ± 2.8, 38.9 ± 2.9, and 50.5 ± 2.8 (SDF2SDF1=SNF>DW, p < 0.05). CONCLUSION Two weekly applications was more effective than a single application of SDF in preventing enamel erosion, though it caused more discolouration. CLINICAL SIGNIFICANCE Topical application of 38 % SDF with two weekly applications protocol is effective in preventing enamel erosion.
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Affiliation(s)
| | | | - 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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Ajcharanukul O, Kosakarn P, Sujjapong M, Berkbandee S, Bussabong P. Increased Fluorohydroxyapatite across Dentin after Fluoride Iontophoresis. J Dent Res 2024; 103:830-838. [PMID: 38808538 DOI: 10.1177/00220345241254017] [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] [Indexed: 05/30/2024] Open
Abstract
Due to the multiple factors contributing to dentin demineralization and hypersensitivity among individuals, the effectiveness of the available treatments in the long term remains unclear. A recent study reported a simple strategy to potentially mimic natural remineralization with increased crystallization on the enamel caries using fluoride iontophoresis. Such an effect is also ideal for accomplishing dentin biomineralization and structural strength. This study aimed to investigate structural and compositional characteristics and permeability changes after fluoride iontophoresis with different polarities, cathodal iontophoresis (CIP), anodal iontophoresis (AIP), and the control without iontophoresis for the treatment of etched dentin under simulated pulpal pressure. The 24 premolars were divided into 3 groups: CIP, AIP, and topical application of 5% sodium fluoride (NaF) for 40 s. Relative to before treatment, iontophoresis with both polarities significantly decreased the permeability with a visible increase in occluding tubules containing crystal formation and growth throughout the dentin structure and depth. The CIP not only restored the etched dentin surface into a sound condition but also reinforced the dentin across the structure and depth by the synergistic effects of remineralization, increasing crystal formation and transformation toward the more crystalline structure of fluorohydroxyapatite. Following topical treatment, X-ray diffraction analysis and Raman spectra revealed a significant reduction in the crystal size and crystallinity associated with the raised B-type carbonate substitution into the hydroxyapatite compared with that in the sound dentin. The result was the first to reveal the ideal strategy to rapidly restore the etched dentin surface into a sound condition, including reinforcing the dentin across the structure and depth by the synergistic effects of decreasing permeability, increasing crystal formation, and transformation toward the more crystalline structure of fluorohydroxyapatite using the 5% NaF applied with the DC cathode iontophoresis. The technique is noninvasive and simple and deserves further development for clinical application.
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Affiliation(s)
- O Ajcharanukul
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - P Kosakarn
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - M Sujjapong
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - S Berkbandee
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - P Bussabong
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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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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Chawhuaveang DD, Mei ML, Chu CH, Yu OY. Preventive dental erosion with silver diamine fluoride: An in vitro study. J Dent 2024; 145:105022. [PMID: 38670330 DOI: 10.1016/j.jdent.2024.105022] [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: 03/11/2024] [Revised: 04/14/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVES To evaluate the erosion preventive effect of 38 % silver diamine fluoride (SDF) solution in enamel and dentin of human permanent teeth. METHODS Ninety enamel and ninety dentin blocks were prepared from permanent molars and allocated into three groups. Gp-SDF received a one-off application of 38 % SDF solution. Gp-SNF received a one-off application of a solution containing 800 ppm stannous chloride and 500 ppm fluoride. Gp-DW received a one-off application of deionized water. The blocks were submitted to acid challenge at pH 3.2, 2 min, 5 times/day for 7 days. All blocks were immersed in human saliva between cycles for one hour. The crystal characteristics, percentage of surface microhardness loss (%SMHL), surface loss, and elemental analysis and surface morphology were examined by X-ray diffraction (XRD), microhardness test, non-contact profilometry, and energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM), respectively. Data of%SMHL and surface loss were analyzed by one-way ANOVA. RESULTS XRD spectra revealed that fluorapatite and silver compounds formed in Gp-SDF, while fluorapatite and stannous compounds formed in Gp-SNF. Gp-DW presented only hydroxyapatite. The median (interquartile range) of%SMHL in Gp-SDF, Gp-SNF and Gp-DW were 27.86(3.66), 43.41(2.45), and 46.40(3.54) in enamel (p< 0.001), and 14.21(1.57), 27.99(1.95), and 33.18(1.73) in dentin, respectively (p < 0.001). The mean (standard deviation, μm) of surface loss of Gp-SDF, Gp-SNF, and Gp-DW were 2.81(0.59), 4.28(0.67), and 4.63(0.64) in enamel (p < 0.001) and 4.13(0.69), 6.04(0.61), and 7.72(0.66) in dentin, respectively (p < 0.001). SEM images exhibited less enamel corruption and more dentinal tubular occlusion in Gp-SDF compared to Gp-SNF and Gp-DW. EDS analysis showed silver was detected in Gp-SDF while stannous was detected in the dentin block of Gp-SNF. CONCLUSION 38 % SDF yielded superior results in protecting enamel and dentin blocks from dental erosion compared to SNF and DW. CLINICAL SIGNIFICANCE Topical application of 38 % SDF is effective in preventing dental erosion in human enamel and dentin.
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Affiliation(s)
- Darren Dhananthat Chawhuaveang
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China
| | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China; Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, 3B12 Prince Philip Dental Hospital, 34 Hospital Road 999077, Hong Kong Special Administrative Regions of China.
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Shen DN, Xu YD, He C, Zhou ZH, Zhu HH, Shi Y, Yu MF, Hu J, Fu BP. Citrate Improves Biomimetic Mineralization Induced by Polyelectrolyte-Cation Complexes Using PAsp-Ca&Mg Complexes. Adv Healthc Mater 2024; 13:e2303870. [PMID: 38412305 DOI: 10.1002/adhm.202303870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/14/2024] [Indexed: 02/29/2024]
Abstract
Magnesium ions are highly enriched in early stage of biological mineralization of hard tissues. Paradoxically, hydroxyapatite (HAp) crystallization is inhibited significantly by high concentration of magnesium ions. The mechanism to regulate magnesium-doped biomimetic mineralization of collagen fibrils has never been fully elucidated. Herein, it is revealed that citrate can bioinspire the magnesium-stabilized mineral precursors to generate magnesium-doped biomimetic mineralization as follows: Citrate can enhance the electronegativity of collagen fibrils by its absorption to fibrils via hydrogen bonds. Afterward, electronegative collagen fibrils can attract highly concentrated electropositive polyaspartic acid-Ca&Mg (PAsp-Ca&Mg) complexes followed by phosphate solution via strong electrostatic attraction. Meanwhile, citrate adsorbed in/on fibrils can eliminate mineralization inhibitory effects of magnesium ions by breaking hydration layer surrounding magnesium ions and thus reduce dehydration energy barrier for rapid fulfillment of biomimetic mineralization. The remineralized demineralized dentin with magnesium-doped HAp possesses antibacterial ability, and the mineralization mediums possess excellent biocompatibility via cytotoxicity and oral mucosa irritation tests. This strategy shall shed light on cationic ions-doped biomimetic mineralization with antibacterial ability via modifying collagen fibrils and eliminating mineralization inhibitory effects of some cationic ions, as well as can excite attention to the neglected multiple regulations of small biomolecules, such as citrate, during biomineralization process.
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Affiliation(s)
- Dong-Ni Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Yue-Dan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Cheng He
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Zi-Huai Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Hai-Hua Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Ying Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Meng-Fei Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Bai-Ping Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, 310000, China
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D' Alessandro C, Mancuso E, Mazzitelli C, Maravic T, Josic U, D' Urso D, Forte A, Florenzano F, Generali L, Checchi V, Mazzoni A, Breschi L. Comparisons of ammonia- and water-based silver-containing solutions on dentin bonding and enzymatic activity: 1-yr evaluation. Dent Mater 2024; 40:777-788. [PMID: 38458917 DOI: 10.1016/j.dental.2024.03.003] [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: 11/21/2023] [Revised: 02/28/2024] [Accepted: 03/02/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To evaluate the effects of an ammonia-based and a water-based silver-containing solutions on bonding performance and matrix-metalloproteinases (MMPs) activity of a universal adhesive to dentin after 1 year of artificial aging. METHODS Mid-coronal dentin surfaces of 60 sound human molars were exposed and the following groups were formed according to the surface pre-treatment and etching mode of the universal adhesive (Zipbond Universal, SDI) (n = 10): G1) Zipbond in the self-etch mode (ZSE); G2) Riva Star (SDI) applied before ZSE; G3) Riva Star Aqua (SDI) applied before ZSE; G4) Zipbond in the etch-and-rinse mode (ZER); G5) Riva Star applied before ZER; G6) Riva Star Aqua applied before ZER. The specimens were sectioned and subjected to microtensile bond strength (µTBS) test at baseline (T0) and after 12 months (T12) of artificial storage. Scanning electron microscope (SEM) and energy dispersive spectroscopy analysis (EDS) were also conducted. Three additional molars per group were processed for the in situ zymography analysis at T0 and T12. Data were statistically analyzed (p < 0.05). RESULTS Dentin pre-treatments and aging decreased bonding values, regardless of the etching mode (p < 0.05). No differences in µTBS were observed between the two silver-containing solutions, both at T0 and T12. Riva Star Aqua and etching significantly increased the MMPs activity, independent of the storage period (p < 0.05). SIGNIFICANCE Dentin surface pre-treatment with silver-containing solutions negatively affects the bonding performances of resin composite restorations placed with a universal adhesive. However, the ammonia-based product Riva Star might show better stability in the long term, due to lower activation of MMPs.
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Affiliation(s)
- Carlo D' Alessandro
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Edoardo Mancuso
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Claudia Mazzitelli
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Tatjana Maravic
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Uros Josic
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Diego D' Urso
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Annamaria Forte
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Federica Florenzano
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Italy
| | - Vittorio Checchi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Italy
| | - Annalisa Mazzoni
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
| | - Lorenzo Breschi
- Dental Clinic, Department of Biomedical and Neuromotor Science (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy.
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Saxena K, Ann CM, Azwar MABM, Banavar SR, Matinlinna J, Peters OA, Daood U. Effect of strontium fluoride on mechanical and remineralization properties of enamel: An in-vitro study on a modified orthodontic adhesive. Dent Mater 2024; 40:811-823. [PMID: 38490919 DOI: 10.1016/j.dental.2024.02.010] [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: 10/12/2023] [Revised: 01/05/2024] [Accepted: 02/12/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES Evaluate the ability of strontium fluoride on bond strength and enamel integrity after incorporation within orthodontic adhesive system as a delivery vehicle. METHODS Experimental orthodontic adhesive system Transbond™ XT were modified with 1% Sr2+, 0.5% SrF2, 1% strontium, 0.5% Sr2+, 1% F-, 0.5% F-, and no additions were control. Mixing of formulation was monitored using Fourier transform infrared spectroscopy. Small-molecule drug-discovery suite was used to gain insights into Sr2+, F-, and SrF2 binding. Shear bond testing was performed after 6-months of ageing. Enamel blocks were cut, and STEM pictures were recorded. Specimens were indented to evaluate elastic modulus. Raman microscope was used to collect Raman spectra and inspected using a scanning electron microscope. Crystal structural analysis was performed using X-ray diffraction. Effect of material on cellular proliferation was determined. Confocal was performed to evaluate the effect of formulation on biofilms. RESULTS FTIR of modified adhesives depicted peak changes within range due to various functional groups existing within samples. TEM represented structurally optimized hexagonal unit-cell of hydroxyapatite. Mean shear bond strength is recorded highest for Transbond XT with 1% SrF2. Dead bacterial percentage appeared higher in 0.5% SrF2 and 1% F- specimens. Crystal lengths showed an increase in 0.5% and 1% SrF2 specimens. Phase contrast within TEM images showed a union of 0.5% SrF2 crystal with enamel crystal with higher elastic modulus and highly mineralized crystalline hydroxyapatite. Intensity of ν1 PO43- and ν1 CO32- along with carbonate - / ν1PO43- ratio displayed good association with strontium fluoride. The formulation showed acceptable cell biocompatibility (p < 0.353). All specimens displayed characteristic diffraction maxima of different apatite angles within XRD. SIGNIFICANCE Experimental results suggested good biocompatibility, adequate mechanical strength, and far-ranging crystallization ability. This would provide a new strategy to overcome the two major challenges of fixed orthodontics, biofilm growth, and demineralization of enamel.
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Affiliation(s)
- Kirti Saxena
- Children and Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Chew Ming Ann
- Restorative Dentistry Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur 57000, Malaysia
| | - Masturina Anati Binti Mohd Azwar
- Restorative Dentistry Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur 57000, Malaysia
| | - Spoorthi Ravi Banavar
- Children and Community Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Jukka Matinlinna
- Dental Materials Science, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Special Administrative Regions of China; Biomaterials Science, Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Ove A Peters
- Department of Endodontics, Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA; School of Dentistry, The University of Queensland, Herston, Qld 4006, Australia
| | - Umer Daood
- Restorative Dentistry Division, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur 57000, Malaysia; Dental Materials Science, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Special Administrative Regions of China.
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Kaur M, Anderson P, Shahid S, Wong FSL. Chemical kinetics of silver diammine fluoride in demineralization and remineralization solutions-an in vitro study. FRONTIERS IN ORAL HEALTH 2024; 5:1374333. [PMID: 38708061 PMCID: PMC11069299 DOI: 10.3389/froh.2024.1374333] [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: 01/21/2024] [Accepted: 04/08/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Silver Diammine Fluoride (SDF) is a clinical minimal intervention to manage dentin caries. Its chemistry in demineralization conditions has been investigated widely, but far less in remineralization conditions. The aim was to investigate and compare the chemical reactions when SDF is added to remineralization and demineralization solutions. Methods 0.01 ml SDF (Riva Star) was added to deionized water (DW); demineralization (DS = pH4) and remineralization (RS = pH7.0) solutions. The time sequence of concentrations of NH4+, F-, and Ag+ were measured using ion selective electrodes (ISEs) every 2 min. The pH was also measured. Precipitates were characterized using x-ray Diffraction (XRD) and, 31P and 19F nuclear magnetic resonance spectroscopy (NMR). Results The concentrations of NH4+ and Ag+ showed decreasing trends in DW (-0.12 and -0.08 mM/h respectively), and in DS (-1.06 and -0.5 mM/h respectively); with corresponding increase in F- concentration (0.04 and 0.7 mM/h respectively). However, in RS, NH4+ concentration showed little change (0.001 mM/h), and Ag+ and F- concentrations were negligible. XRD results showed that precipitates (in RS only) contained AgCl, and metallic Ag. NMR showed that fluorapatite/carbonated fluorapatite (FAP/CFAP) were formed. The pH increased after SDF addition in all three solutions. Discussion SDF dissolved to release NH4+, F- and Ag + . In DW and DS, NH4+ combined with Ag+ to form diamminesilver, causing an increase of F- and pH. In RS, F- reacted with Ca2+ and (PO)43- to form FAP/CFAP, and Ag+ reacted with Cl- to form AgCl/Ag. These suggests why SDF is effective in managing dentin caries.
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Affiliation(s)
| | | | | | - F. S. L. Wong
- Dental Physical Sciences Unit, Centre for Oral Bioengineering, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Intajak P, Yuan Y, Sakaguchi N, Saikaew P, Eamsaard P, Matsumoto M, Sano H, Tomokiyo A. Effect of Silver Diamine Fluoride on Bonding Performance and Ultra-morphological Characteristics to Sound Dentin. Dent Mater 2024; 40:e24-e32. [PMID: 38423937 DOI: 10.1016/j.dental.2024.02.020] [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: 10/23/2023] [Revised: 01/21/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES This study aimed to evaluate microtensile bond strength (µTBS) and ultra-morphological characteristic changes in sound dentin resulting from silver diamine fluoride (SDF) when using adhesives. METHODS Ninety-six extracted human third molars were divided into the SDF-contaminated dentin group and the sound dentin group. In the SDF-contaminated dentin group, 38% SDF was agitated for 1 min, left undisturbed for 2 min, and rinsed with distilled water for 30 s. Then, each group was further subdivided into six subgroups (n = 8 / group) according to application modes: self-etch mode (SE) and etch-and-rinse mode (ER) followed by three adhesives: (1) Scothbond Universal Plus Adhesive (SUP); (2) G2-Bond Universal Adhesive (G2B); and (3) Clearfil Mega Bond 2 (MB2). All specimens were restored with resin composite and were stored in distilled water for 24 h before μTBS testing. Data from the μTBS test were analyzed using Three-way ANOVA and Duncan test (p < 0.05). The morphology of fractured surface and adhesive-dentin interfaces were evaluated by SEM, TEM, and STEM. Further elemental analysis was done by EDX. RESULTS All SDF-contaminated dentin groups demonstrated significantly lower μTBS than sound dentin groups. All ER groups had higher μTBS than SE groups, except for G2B in the sound dentin group. STEM/EDX revealed an SDF-dentin-reacted layer in the SDF-contaminated dentin group. SIGNIFICANCE SDF had an adverse effect on adhesives. Additionally, ER mode is preferable when bonded to SDF-contaminated dentin. A calcium and fluoride-contained layer was observed in all SDF-contaminated dentin.
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Affiliation(s)
- Papichaya Intajak
- Department of Restorative Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo, 060-080, Japan.
| | - Yuan Yuan
- Department of Restorative Dentistry, Graduate School of Dental Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo, 060-080, Japan.
| | - Norihito Sakaguchi
- Center of Advanced Research of Energy and Materials, Faculty of Engineering, Hokkaido University, Kita 13, Nishi 8, Kita-ku, Sapporo, 060-8628, Japan
| | - Pipop Saikaew
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Radchathewi, Bangkok 10400, Thailand
| | - Pimpinee Eamsaard
- Department of Operative Dentistry, College of Dental Medicine, Rangsit University, 52/347, Muang-Ake Paholyothin Road, Lakhok 12000, Pathum Thani, Thailand
| | - Mariko Matsumoto
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo 060-080, Japan
| | - Hidehiko Sano
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo 060-080, Japan
| | - Atsushi Tomokiyo
- Department of Restorative Dentistry, Faculty of Dental Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo 060-080, Japan
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Xu GY, Zhao IS, Lung CYK, Yin IX, Lo ECM, Chu CH. Silver Compounds for Caries Management. Int Dent J 2024; 74:179-186. [PMID: 38008704 PMCID: PMC10988255 DOI: 10.1016/j.identj.2023.10.013] [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: 06/21/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/28/2023] Open
Abstract
Silver metal and compounds have antibacterial properties, although their action's mechanisms are not fully understood. Scientists generally consider that silver disrupts the bacterial cell wall. It causes a structural change in the bacterial cell membrane and cytoplasm. It also stops deoxyribonucleic acid replication, resulting in inactivating enzymatic activity and cell death. The antimicrobial effect of silver-containing compounds relies on the release of bioactive silver ions. Hence, silver metal and compounds have been used in medicine to prevent infection for hundreds of years. Silver metal and compounds are also used as antibacterial agents in dentistry. Studies have shown that silver compounds are effective in the management of dental caries. Fluoride-containing silver compounds have been found in experiments to be beneficial at remineralising dental cavities. Silver diamine fluoride (SDF) can assist in preventing and arresting tooth cavities. The World Health Organization included SDF in its Model List of Essential Medicine for both adults and children in 2021. Clinicians also use SDF to manage dentine hypersensitivity as well as to inhibit growth of periodontal pathogens. However, traditional silver compounds cause tooth discolouration because of the silver-staining effect. These side effects of their applications depend on the amount applied and the frequency of application. Researchers are developing nanosilver fluoride and silver nanoparticles to overcome the staining. This review gives an overview of the antibacterial mechanism of silver compounds, namely silver nitrate, silver fluoride, SDF, silver nanoparticles, and nano silver fluoride for caries management. The outlook for the future development of silver compounds will be discussed.
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Affiliation(s)
- Grace Y Xu
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China; Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Irene S Zhao
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen, China; Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Christie Y K Lung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Iris X Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Edward C M Lo
- 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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13
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Kaur M, Shahid S, Karpukhina N, Anderson P, Wong FSL. Characterization of chemical reactions of silver diammine fluoride and hydroxyapatite under remineralization conditions. FRONTIERS IN ORAL HEALTH 2024; 5:1332298. [PMID: 38496333 PMCID: PMC10940413 DOI: 10.3389/froh.2024.1332298] [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: 11/02/2023] [Accepted: 01/24/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Silver Diammine Fluoride (SDF) is a clinically used topical agent to arrest dental caries. However, the kinetics of its chemical interactions with hydroxyapatite (HA), the principal inorganic component of dental enamel, are not known. The aim was to characterize the step-wise chemical interactions between SDF and HA powder during the clinically important process of remineralization. Methods Two grams of HA powder were immersed in 10 ml acetic acid pH = 4.0 for 2 h to mimic carious demineralization. The powder was then washed and dried for 24 h and mixed with 1.5 ml SDF (Riva Star) for 1 min. The treated powder was then air-dried for 3 min, and 0.2 g was removed and stored in individual tubes each containing 10 ml remineralizing solution. Powder was taken from each tube at various times of exposure to remineralization solution (0 min, 10 min, 2 h, 4 h, 8 h, 24 h, and 10 days), and characterized using Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR) spectroscopy. Results and discussion 19F MAS-NMR spectra showed that calcium fluoride (CaF2) started to form almost immediately after HA was in contact with SDF. After 24 h, the peak shifted to -104.5 ppm suggesting that fluoride substituted hydroxyapatite (FSHA) was formed with time at the expense of CaF2. The 31P MAS-NMR spectra showed a single peak at 2.7 ppm at all time points showing that the only phosphate species present was crystalline apatite. The 35Cl MAS-NMR spectra showed formation of silver chloride (AgCl) at 24 h. It was observed that after the scan, the whitish HA powder changed to black color. In conclusion, this time sequence study showed that under remineralization conditions, SDF initially reacted with HA to form CaF2 which is then transformed to FSHA over time. In the presence of chloride, AgCl is formed which is subsequently photo-reduced to black metallic silver.
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Affiliation(s)
| | | | | | | | - F. S. L. Wong
- Dental Physical Sciences Unit, Centre for Oral Bioengineering, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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14
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Samani M, Alimirzaei S, Kaviani A, Zakavi F. Evaluating the Effect of Silver Diamine Fluoride, with or without Glutathione and Potassium Iodide, on Fluoride Release, Dentin Microhardness and Surface Properties of Dentin. MAEDICA 2024; 19:48-56. [PMID: 38736910 PMCID: PMC11079747 DOI: 10.26574/maedica.2024.19.11.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
This study aimed to evaluate the effect of silver diamine fluoride (SDF) in combination with or without glutathione (Glu) and potassium iodide (KI) on the fluoride release and the enhancement of dentin microhardness. In this et al study, 90 intact premolar teeth from human subjects were allocated into nine groups, each consisting of ten samples: A) control; B) SDF; C) SDF combined with 5% Glu; D) SDF combined with 10% Glu; E) SDF combined with 20% Glu; F) KI after SDF; G) 5% Glu after SDF; H) 10% Glu after SDF; and I) 20% Glu after SDF. Data were analyzed using SPSS version 22 software and ANOVA and post-hoc and repeated measure test (P value <0.05). Dentin microhardness exhibited variations across different treatments, with the highest value being observed in the SDF-5% Glu group and the lowest in the control group. However, there was a significant difference between the mean values of SDF-5% Glu group and the SDF group. Significant increases in microhardness were observed when comparing SDF-5% Glu to SDF+5% Glu and SDF-10% Glu to SDF+10% Glu in peer groups (P value <0.05). Over time, there was a significant increase in the amount of fluoride released as compared to the initial day. The utilization of SDF-5% Glu group exhibited the most favorable effect on improving dentin hardness. Additionally, utilizing Glu in concentrations of 5% and 10% after SDF application proved more effective in increasing dentin microhardness than combining it with SDF. Moreover, in all three fluoride measurement periods, adding 5% Glu to SDF and using 20% Glu following SDF administration led to a significant increase in fluoride release compared to the application of SDF alone.
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Affiliation(s)
- Mahsa Samani
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sanaz Alimirzaei
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Azita Kaviani
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Faramarz Zakavi
- Department of Restorative Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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15
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Mohammed NY, Abdel-Ghany DM, Ben Hamadi N, Özdemir S, Selamoglu Z, Plavan G, Boufahja F, Elassar DM. The Impact of Silver Diamine Fluoride Only or Simultaneously With Potassium Iodide Treatment on the Bond Durability of Resin Composite Material on Primary Teeth. Cureus 2024; 16:e57064. [PMID: 38681260 PMCID: PMC11052556 DOI: 10.7759/cureus.57064] [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] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
We aim to evaluate the bond strength between resin composite and primary demineralized dentin, pretreated with silver diamine fluoride (SDF) and simultaneous SDF with potassium iodide (KI) after thermal aging. In this in vitro study, human carious-free primary molars were randomly assigned into three groups and prepared by exposing the superficial dentin. The primary dentin of each molar was demineralized. The first group (the control) received saline treatment before bond application. SDF was pretreated for the second group, whereas SDF and KI were used for the third. After that, the pretreated dentin was immediately built with resin composite bonded with a universal adhesive and kept wet for 24 hours. Then, the pretreated molars were prepared into beam specimens for microtensile bond strength (µTBS), 16 for each group, and subjected to thermal aging. Lastly, they were tested using a universal testing machine, and the resulting data were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post hoc test. It was found that the SDF-KI group had a significant difference with both the control and SDF groups (p < 0.05), while the control and SDF groups showed no significant differences (p = 0.310). The SDF-KI group had the highest mean value of 11.73 ± 4.39 megapascal (MPa). In contrast, the control group had the lowest mean value of 9.31 ± 3.41 MPa. Post hoc pairwise comparison results showed that SDF-KI pretreatment had a significantly higher strength value than the control and SDF groups. Pretreatment of demineralized primary dentin with SDF-KI does not negatively affect the immediate loading of resin composite. However, under the limitation of this study, KI application after SDF pretreatment is recommended to enhance the bond's durability of resin composite to demineralized dentin.
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Affiliation(s)
- Nesreen Y Mohammed
- Dental Biomaterials Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, EGY
| | - Dina M Abdel-Ghany
- Pediatric Dentistry and Oral Public Health Department, October 6 University, Giza, EGY
| | - Naoufel Ben Hamadi
- Chemistry Department, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Sadin Özdemir
- Food Processing Programme, Technical Science Vocational School, Mersin University, Mersin, TUR
| | - Zeliha Selamoglu
- Medical Biology Department, Medicine Faculty, Nigde Omer Halisdemir University, Nigde, TUR
| | - Gabriel Plavan
- Biology Department, Faculty of Biology, Alexandru Ioan Cuza University, Iasi, ROU
| | - Fehmi Boufahja
- Biology Department, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Dalia M Elassar
- Operative Dentistry Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, EGY
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16
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Kongyodsueb P, Poolthong S, Chumprasert S, Sae-Ear P, Tantilertanant Y. The effect of silver nanoparticles in addition to sodium fluoride on remineralization of artificial root dentin caries. Aust Dent J 2024; 69:56-66. [PMID: 37813824 DOI: 10.1111/adj.12985] [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] [Accepted: 09/24/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Silver nanoparticle was developed to overcome the drawback of silver diamine fluoride. However, evidence is limited, especially in root caries. The aim of this study was to evaluate the remineralization effect of silver nanoparticles on root caries. MATERIALS AND METHODS Fifty-five root human dentin slices size 5 × 5 mm2 from patients aged over 60 years old were immersed in demineralized solution to create artificial caries. Specimens were allocated into five groups according to the remineralizing agents: silver diamine fluoride (SDF), silver nanoparticles solution (AgNPs), silver nanoparticle solution followed by sodium fluoride varnish (AgNPs+NaF), sodium fluoride varnish (NaF), and tap water. After 8 days of pH-cycling challenge, the microhardness test, lesion depth evaluation, dentin surface morphology, and elemental analysis were performed. Data was analysed using F-test One-way ANOVA followed by Tukey's post hoc test and paired T-test. RESULTS All test groups demonstrated a significantly higher microhardness value and lower lesion depth compared with the control group. AgNPs+NaF and NaF-treated groups showed lower efficacy than SDF. Crystal precipitation was presented in all groups composed of silver. CONCLUSION Addition of fluoride varnish did not benefit for silver nanoparticles in preventing further demineralization. SDF provides the highest effectiveness in elderly root carious dentin.
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Affiliation(s)
- P Kongyodsueb
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Poolthong
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Chumprasert
- Oral Biology Research Center, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - P Sae-Ear
- Oral Biology Research Center, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Y Tantilertanant
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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17
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Rodrigues Vieira B, Costa Cruz SBS, Maia Silvaa CA, Lippert F, Kelly A, Hara AT, Barbosa de Sousa F. Effect of Three Chemical Agents on Stain Removal from Dentin Caries Lesions Treated with Silver Diamine Fluoride. Caries Res 2023; 58:49-58. [PMID: 38043513 DOI: 10.1159/000535614] [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: 04/29/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF). METHODS Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent. RESULTS SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p < 0.0001), time (p = 0.01), and their interaction (p < 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p < 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30). CONCLUSION This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect.
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Affiliation(s)
- Basílio Rodrigues Vieira
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | - Frank Lippert
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Adam Kelly
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Anderson Takeo Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Elmallah S, Abdou A, Rizk A, Kusumasari C, Ashraf R. Effect of silver diamine fluoride activation on bond strength to root dentin. BMC Oral Health 2023; 23:733. [PMID: 37814251 PMCID: PMC10561427 DOI: 10.1186/s12903-023-03457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND To investigate the effect of silver diamine fluoride (SDF) application and activation on the bond strength of gutta-percha to dentin and resin bonded post to dentin. METHODS Thirty-six human premolar teeth were used. The coronal part tooth was removed, and endodontic mechanical preparation was performed for all the teeth. The teeth were divided according to final rinse protocol (n = 9) as follows: Control group; no SDF application, SDF/NA; 38% SDF as a final rinse with no activation, SDF/MDA; 38% SDF as a final rinse with manual dynamic activation and SDF/US; 38% SDF as a final rinse with ultrasonic activation. Root canal obturation using lateral condensation technique followed by fiber post insertion after 48 h in the root canal after corresponding preparations. The roots were cut with a low-speed precision saw creating 2 mm thickness sections. A total of 4 sections were obtained from each tooth, 2 coronal specimens (with post) and 2 apical specimens (with Gutta percha). Each specimen was subjected to push-out bond strength test with a universal testing machine. Data were analyzed using two-way ANOVA. RESULTS The Push-out bond strength at the apical root section was significantly higher in SDF/MDA and SDF/US groups compared to control group. While for the coronal part, all SDF treated specimen showed reduced Push-out bond strength. CONCLUSION SDF application as final rinse may reduce the bonding performance between fiber post and dentine. Activation with manual and ultrasonic methods improved the bond strength at the apical root section.
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Affiliation(s)
- Sara Elmallah
- Department of Endodontics, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Ahmed Abdou
- Department of Prosthetic Dentistry, Biomaterials Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt.
- Faculty of Dentistry, Al-Ayen University, Thi-Qar, Iraq.
| | - Amr Rizk
- Department of Prosthetic Dentistry, Fixed Prosthodontics Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
| | - Citra Kusumasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Reem Ashraf
- Department of Prosthetic Dentistry, Biomaterials Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
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Mubaraki H, Ingle NA, Baseer MA, AlMugeiren OM, Mubaraki S, Cicciù M, Minervini G. Effect of Silver Diamine Fluoride on Bacterial Biofilms-A Review including In Vitro and In Vivo Studies. Biomedicines 2023; 11:1641. [PMID: 37371736 DOI: 10.3390/biomedicines11061641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Caries/carious lesions are a growing concern among the general population across the world, and different strategies are evolving to combat the bacterial invasion that resultantly leads to caries. In this systematic review, we are looking to analyse the role of silver diamine fluoride (SDF) on the growth of bacterial biofilms. The search strategy for the studies to be selected for the review was initiated by a search across multiple databases, which ultimately yielded 15 studies that were in accordance with our objectives. The reviewed articles indicate a very clear correlation between the usage of SDF and the decrease in bacterial biofilms, which are limited not just to one or two but multiple bacterial species. As shown by the events favoring SDF's odds ratio of 3.59 (with a 95% confidence interval of 2.13 to 6.05), a risk ratio of 1.63 (1.32 to 2.00), and a risk difference of 0.28 (0.16 to 0.40), there was strong evidence that SDF is a successful treatment for reducing bacterial biofilms in dental practice. This study offers substantial proof that SDF works well to reduce bacterial biofilms in dentistry practices. We advise further investigation to examine the potential of SDF as a standard therapy choice for dental caries and related conditions given the obvious relationship between the use of SDF and the reduction in bacterial biofilms.
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Affiliation(s)
- Hind Mubaraki
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Navin Anand Ingle
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Mohammad Abdul Baseer
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Osamah M AlMugeiren
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Sarah Mubaraki
- Preventive Dentistry Department, College of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, 80138 Naples, Italy
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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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21
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Chen X, Inoue G, Ikeda M, Sadr A, Shimada Y. Time-dependent structural changes and hypermineralisation of artificially demineralised dentine following treatment with silver diammine fluoride and glass ionomer cement. J Dent 2023; 131:104452. [PMID: 36804340 DOI: 10.1016/j.jdent.2023.104452] [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: 12/28/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate the change of mineral content in dentine lesions over time and examine the effectiveness of the combined treatment with silver diammine fluoride (SDF) and glass ionomer cement (GIC). METHODS Sixty bovine dentine specimens were divided into 4 groups: cont, Fuji, Safo, and Safo+Fuji. The specimens were imaged and measured using microcomputed tomography (microCT) at 7 time points: pre-demineralisation, after demineralisation for two weeks, immediately after treatment, 1 week, 2 weeks, 1 month, and 3 months after treatment. The 3-month group was evaluated with a light microscope, attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy, and scanning electron microscope (SEM)/energy-dispersive X-ray spectroscopy (EDS). Data were analysed by Dunn's test and Wilcoxon signed rank test with Bonferroni correction for microCT, and Kruskal-Wallis test and two-way analysis of variance for EDS characterisation. RESULTS MicroCT images showed high mineral density beneath dentine lesions in Safo+Fuji. The mineral density at 600 μm in Safo+Fuji increased significantly over time, while Safo showed an opposite trend (adjusted p<0.005). In Safo+Fuji, EDS revealed significantly high energy of fluorine (p<0.05, at 300 μm) and a tendency towards high energy of calcium (p>0.05). However, Safo+Fuji showed lower energy of silver compared to Safo (p<0.001). ATR-FTIR revealed that phosphate groups had the highest peak at a depth between 300 and 400 μm in Safo+Fuji. CONCLUSIONS Safo+Fuji was effective in remineralising the deep lesion in dentine after one and three months, and a hypermineralisation zone generated beneath the lesion demonstrated additional benefit in this study. CLINICAL SIGNIFICANCE This long-term in vitro study showed that SDF+GIC treatment could strengthen the structure of decayed teeth when applied in the treatment of patients with advanced rampant caries.
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Affiliation(s)
- Xuefei Chen
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
| | - Go Inoue
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
| | - Masaomi Ikeda
- Oral Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
| | - Alireza Sadr
- Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA..
| | - Yasushi Shimada
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan..
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Chaiwat A, Chunhacheevachaloke E, Kidkhunthod P, Pakawanit P, Ajcharanukul O. Enamel Remineralization and Crystallization after Fluoride Iontophoresis. J Dent Res 2023; 102:402-411. [PMID: 36546596 DOI: 10.1177/00220345221138513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Early caries lesions consist of noncavitated subsurface demineralization caused by the dissolution of hydroxyapatite from the surface to the subsurface area of the enamel. Such lesions cannot be remineralized effectively by the conventional treatment. Thus, there is a need for a noninvasive technique capable of delivering the remineralizing agent to subsurface sites. For this purpose, fluoride iontophoresis (IP) using weak currents has been investigated with some conflicting results and no information on the crystal structure and composition. Because enamel remineralization involves the role of fluid from dentin, the presence of enamel fluid is necessary to determine the repair associated with the physiological condition. This study aimed to investigate structural and compositional characteristics, including the remineralizing effect of 5% sodium fluoride (NaF) IP with different polarities, cathodal iontophoresis (CIP), and anodal iontophoresis (AIP) for the treatment of natural enamel caries under simulated pulpal pressure. A bulk measurement of the crystal structure inside the lesion was first determined using calcium (Ca) K-edge X-ray absorption spectroscopy. IP with both polarities significantly promoted subsurface remineralization. The CIP generated a significant increase in the Ca/phosphorus ratio, and fluoride at the surface lesion significantly correlated with higher mineral density (MD) and more strengthening crystal structure of the lesion volume, while the lesion's MD and other impurities at the lesion surface, mostly the carbonate ions, affected the significant increase in MD with the unchanged structure of the lesion volume after AIP. The CIP of NaF is an ideal method for rapid enamel remineralization and recrystallization of fluoroapatite/fluorohydroxyapatite.
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Affiliation(s)
- A Chaiwat
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - E Chunhacheevachaloke
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - P Kidkhunthod
- Synchrotron Light Research Institute (Public Organization) Muang District, Nakhon Ratchasima, Thailand
| | - P Pakawanit
- Synchrotron Light Research Institute (Public Organization) Muang District, Nakhon Ratchasima, Thailand
| | - O Ajcharanukul
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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Karnowakul J, Punyanirun K, Jirakran K, Thanyasrisung P, Techatharatip O, Pornprasertsuk-Damrongsri S, Trairatvorakul C. Enhanced effectiveness of silver diamine fluoride application with light curing on natural dentin carious lesions: an in vitro study. Odontology 2023; 111:439-450. [PMID: 36269519 DOI: 10.1007/s10266-022-00755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/09/2022] [Indexed: 10/24/2022]
Abstract
This study aimed to compare the mean mineral density difference (mMDD) and surface morphology of 10- and 60-s silver diamine fluoride (SDF)-applied dentin carious lesions and to study the effect of an additional 20-s light curing (LC) on SDF-treated teeth. Forty primary molar blocks with natural dentin carious lesions were measured for baseline lesion depth and mineral density using Image-Pro Plus software. The samples were randomly distributed into 4 groups; 38% SDF applied for 1) 10-s (10SDF), 2) 60-s (60SDF), 3) 10-s + LC (10SDF + LC), 4) 60-s + LC (60SDF + LC) and an additional control group to assess the outcome of pH-cycling only. Then all the groups underwent a 7-d bacterial pH-cycling. The dentin carious lesions' mMDD was determined by digital subtraction radiographic analysis. The surface morphology and elemental profile were assessed by scanning electron microscopy and energy-dispersive X-ray spectroscopy. The mMDD of the dentin lesions was analyzed using two-way ANOVA, generalized linear models analysis. Light curing was the only factor that affected the mMDD (p = 0.007). The mMDD in the 10SDF + LC and 60SDF + LC groups were significantly higher than those without light curing (p = 0.041 and 0.041, respectively). The 60SDF + LC group demonstrated a significantly higher mMDD than the 10SDF group (p = 0.010), while that in the 10SDF + LC group was similar to the 60SDF group (p = 1.00). Scanning electron microscopy revealed denser mineral content layers, which were likely silver and chloride, in the 10SDF + LC and 60SDF + LC groups than in the 10SDF and 60SDF groups, respectively. In conclusion, shortened application time with light curing enhanced SDF remineralization similarly to the conventional method.
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Affiliation(s)
- Juthamas Karnowakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Nongjik Hospital, 223 Moo 2, Petchkasem Road, Nong Chik, Tuyong, Pattani, Thailand
| | | | - Ketsupar Jirakran
- Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Panida Thanyasrisung
- Department of Microbiology and Center of Excellence On Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Oranuch Techatharatip
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Chutima Trairatvorakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Mohammed SME, Awad SM, Wahba AH. Comparison of Clinical Outcomes of Silver-modified Atraumatic Restorative Technique vs Atraumatic Restorative Technique in Primary Teeth: A Randomized Controlled Trial. J Contemp Dent Pract 2023; 23:1140-1145. [PMID: 37073938 DOI: 10.5005/jp-journals-10024-3437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
AIM To compare the clinical outcomes of silver-modified atraumatic restorative technique (SMART) vs atraumatic restorative technique (ART) in primary teeth. MATERIALS AND METHODS This study was a randomized clinical trial conducted on 30 children. The study was split-mouth design, so each group was consisted of 30 children. Children aged 3-6 years old of both genders. Communication with the children was established. Gross debris from cavitation was removed. Carious dentin on walls was excavated using spoon excavator and low-speed contra with round or fissure bur. The areas to be treated were isolated with cotton rolls. For ART, glass ionomer cement (GIC) was applied according to the manufacturer's instructions. For silver-modified atraumatic restorative technique (SMART), a protective coating was applied to the lips and skin to prevent a temporary tattoo. Silver diamine fluoride (SDF) was applied carefully using bended microsponge brush. It was applied directly to only the affected tooth surface. The lesion was dried for 15 seconds with gentle flow of compressed air. After 1 week, GIC was applied according to the manufacturer's instructions. Clinical evaluation was done for all teeth at 6 and 12 months. The data were collected and then statistically analyzed using the Chi-square test to show the difference between groups. RESULTS The restoration of the first primary molar with ART restoration alone showed a lower success rate when compared with the restoration with a combination of SDF and ART (SMART technique), with percentages of 70% and 76.67% and 53.33% and 60% after 6 months and 12 months of follow-up, respectively. CONCLUSION Silver diamine fluoride is successful in arresting dentin caries and can be used to increase the efficacy of the ART technique in primary teeth. CLINICAL SIGNIFICANCE It is recommended to use SDF as a noninvasive approach to control dentin caries with the ART technique.
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Affiliation(s)
| | | | - Ahmed Hamdy Wahba
- Pediatric Department, Faculty of Dentistry, Mansoura University, Egypt
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25
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Sun IG, Chai HH, Lo ECM, Chu CH, Duangthip D. Dental Fear and Anxiety of Chinese Preschool Children in a School-Based Outreach Service Using Silver Diamine Fluoride for Caries Control: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4467. [PMID: 36901476 PMCID: PMC10001995 DOI: 10.3390/ijerph20054467] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/19/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children's demographic information and their dental treatment experiences. The children's DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children's DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children's DFA after SDF therapy (p > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting.
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Almuqrin A, Kaur IP, Walsh LJ, Seneviratne CJ, Zafar S. Amelioration Strategies for Silver Diamine Fluoride: Moving from Black to White. Antibiotics (Basel) 2023; 12:antibiotics12020298. [PMID: 36830209 PMCID: PMC9951939 DOI: 10.3390/antibiotics12020298] [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: 01/18/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Topical cariostatic agents have become a reasonable alternative for managing dental caries in young children. Silver diamine fluoride (SDF) is a practical topical approach to arrest caries and avoid extensive and risky dental treatment. However, the literature demonstrates a parental hesitation towards accepting SDF because of black unaesthetic tooth discolouration following application. The rapid oxidation of ionic silver darkens demineralised tooth structure permanently. In this regard, nano-metallic antimicrobials could augment or substitute for silver, and thereby enhance SDF aesthetic performance. Recently, biomedical research has drawn attention to selenium nanoparticles (SeNPs) due to their antimicrobial, antioxidant, and antiviral potencies. Various in vitro studies have examined the effect of SeNPs on the virulence of bacteria. This narrative review explores practical issues when using SDF and suggests future directions to develop it, focusing on antimicrobial metals. Several methods are described that could be followed to reduce the discolouration concern, including the use of nanoparticles of silver, of silver fluoride, or of selenium or other metals with antimicrobial actions. There could also be value in using remineralising agents other than fluoride, such as NPs of hydroxyapatite. There could be variations made to formulations in order to lower the levels of silver and fluoride in the SDF or even to replace one or both of the silver and fluoride components completely. Moreover, since oxidation processes appear central to the chemistry of the staining, adding SeNPs which have antioxidant actions could have an anti-staining benefit; SeNPs could be used for their antimicrobial actions as well. Future research should address the topic of selenium chemistry to optimise how SeNPs would be used with or in place of ionic silver. Incorporating other antimicrobial metals as nanoparticles should also be explored, taking into account the optimal physicochemical parameters for each of these.
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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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CIFUENTES-JIMÉNEZ CC, BOLAÑOS-CARMONA MV, ENRICH-ESSVEIN T, GONZÁLEZ-LÓPEZ S, ÁLVAREZ-LLORET P. Evaluation of the remineralizing capacity of silver diamine fluoride on demineralized dentin under pH-cycling conditions. J Appl Oral Sci 2023; 31:e20220306. [PMID: 36995879 PMCID: PMC10065761 DOI: 10.1590/1678-7757-2022-0306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/17/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE (1) to determine the effects of the silver diamine fluoride (SDF) and sodium fluoride (NaF) in demineralized dentin exposed to an acid challenge by pH-cycling, (2) to evaluate the remineralizing capacity of SDF/NaF products based on the physicochemical and mechanical properties of the treated dentin surfaces. METHODOLOGY In total, 57 human molars were evaluated in different stages of the experimental period: sound dentin - negative control (Stage 1), demineralized dentin - positive control (Stage 2), and dentin treated with SDF/NaF products + pH-c (Stage 3). Several commercial products were used for the SDF treatment: Saforide, RivaStar, and Cariestop. The mineral composition and crystalline and morphological characteristics of the dentin samples from each experimental stage were evaluated by infrared spectroscopy (ATR-FTIR), X-ray diffraction, and electron microscopy (SEM-EDX) analytical techniques. Moreover, the mechanical response of the samples was analyzed by means of the three-point bending test. Statistics were estimated for ATR-FTIR variables by Wilcoxon test, while the mechanical data analyses were performed using Kruskal-Wallis and Mann Whitney U tests. RESULTS Regarding the chemical composition, we observed a higher mineral/organic content in the SDF/NaF treated dentin + pH-c groups (Stage 3) than in the positive control groups (Saforide p=0.03; Cariestop p=0.008; RivaStar p=0.013; NaF p=0.04). The XRD results showed that the crystallite size of hydroxyapatite increased in the SDF/NaF treated dentin + pH-c groups (between +63% in RivaStar to +108% in Saforide), regarding the positive control. SEM images showed that after application of the SDF/NaF products a crystalline precipitate formed on the dentin surface and partially filled the dentin tubules. The flexural strength (MPa) values were higher in the dentin treated with SDF/NaF + pH-c (Stage 3) compared to the positive control groups (Saforide p=0.002; Cariestop p=0.04; RivaStar p=0.04; NaF p=0.02). CONCLUSIONS The application of SDF/NaF affected the physicochemical and mechanical properties of demineralized dentin. According to the results, the use of SFD/NaF had a remineralizing effect on the dentin surface even under acid challenge.
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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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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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Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10081413. [PMID: 36011070 PMCID: PMC9408325 DOI: 10.3390/healthcare10081413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022] Open
Abstract
A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.
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Hamdi K, Hamama HH, Motawea A, Fawzy A, Mahmoud SH. Remineralization of early enamel lesions with a novel prepared tricalcium silicate paste. Sci Rep 2022; 12:9926. [PMID: 35705597 PMCID: PMC9200717 DOI: 10.1038/s41598-022-13608-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
To evaluate the remineralization potential of prepared tricalcium silicate (TCS) paste compared to silver diamine fluoride-potassium iodide (SDF-KI) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on artificial enamel lesions. Thirty permanent sound molars were collected for the study. After cleaning, root cutting, and applying acid-resistant nail varnish, leaving a 4 × 4 mm buccal window, the teeth were subjected to demineralization process. The teeth were divided into three treatment groups (n = 10). In each group, the teeth were sectioned buccolingually to obtain two halves (30 self-control and 30 experimental halves). The self-control halves were subjected to cross-sectional microhardness (CSMH), energy-dispersive X-ray spectroscopy at 50, 100, and 150 µm from the external enamel surface, and micromorphological analysis at the superficial enamel surface. The experimental halves were subjected to the same tests after 30 days of remineralization. Three-way analysis of variance (ANOVA) outcomes showed no significant difference in CSMH after treatment among the three different groups at the different levels (p > 0.05). Meanwhile, three-way ANOVA outcomes showed a significant difference in calcium/ phosphate ratio after treatment among the three different groups at the different levels. (p < 0.05). The tricalcium silicate paste used in this study showed potential remineralization in subsurface enamel lesions.
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Affiliation(s)
- Kareem Hamdi
- Operative Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt
| | - Hamdi H Hamama
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt.
| | - Amira Motawea
- Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Amr Fawzy
- UWA Dental School, University of Western Australia, Perth, Australia
| | - Salah Hasab Mahmoud
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Algomhoria St, Mansoura City, 35516, Egypt
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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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An extensive description of the microbiological effects of silver diamine fluoride on dental biofilms using an oral in situ model. Sci Rep 2022; 12:7435. [PMID: 35523839 PMCID: PMC9076617 DOI: 10.1038/s41598-022-11477-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/15/2022] [Indexed: 12/23/2022] Open
Abstract
Silver diamine fluoride (SDF) has been long studied in laboratories, and its clinical effectiveness in the treatment and prevention of root caries has been reported. In the present study, we assessed the microbiological effects of SDF on dental biofilms grown on demineralized dentin in situ. Specifically, demineralized bovine root dentin slabs used as biofilm substrates were treated with 38% SDF, and the biofilms formed after this treatment were analyzed via real-time PCR, DEAD/LIVE cell staining, and SEM. Next, the viable cell count was determined, and microbial profiles were compared using 16S rRNA gene sequencing. Untreated slabs were used as controls. We observed significant decreases in viable cell counts (p < 0.05), number of biofilm-forming cells (p < 0.01), biofilm thickness (p < 0.01), and high proportion of dead cells with SDF treatment (p < 0.01). The microcolonies in the SDF-treated biofilms showed less complexity, and only a limited number of genera were differentially abundant between the groups. Microbial diversity index comparisons showed no significant differences between the groups with respect to treatments days (p = 0.362). Thus, SDF negatively influenced dental biofilm growth on demineralized root dentin in situ; however, its antimicrobial action did not target a specific oral taxon.
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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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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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Alcorn A, Al Dehailan L, Cook NB, Tang Q, Lippert F. Longitudinal In Vitro Effects of Silver Diamine Fluoride on Early Enamel Caries Lesions. Oper Dent 2022; 47:309-319. [PMID: 35776957 DOI: 10.2341/20-237-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
This laboratory study evaluated the longitudinal surface microhardness changes in early, incipient, noncavitated, white-spot, enamel caries lesions treated with silver diamine fluoride (SDF). Five intervention groups (SDF, AgNO3, KF, 5% sodium fluoride varnish (FV), deionized water (DI)) × two-time intervals after intervention (immediate & delayed pH-cycling) resulted in 10 groups (n=18). Silver nitrate (AgNO3) and potassium fluoride (KF) groups served as controls to assist in evaluating if remineralization effects were due to the silver or fluoride component in SDF. Early, incipient, noncavitated, white-spot, enamel caries lesions were created in bovine enamel, the extent of demineralization was determined using Vickers surface microhardness (VHNlesion). Intervention treatments were applied. Half the specimens from each group underwent immediate 5-day pH-cycling, and half were stored in an incubator with artificial saliva for 2 weeks before undergoing 5-day pH-cycling. After pH-cycling, lesion hardness was evaluated using VHNpost. Specimens were then exposed to a second demineralization challenge, and lesion softening was evaluated (VHNsecdem). Hardness variables were calculated: ΔVHN = VHNpost - VHNlesion; ΔVHNsecdem = VHNsecdem - VHNpost. Data were analyzed using two-way ANOVA (α=0.05). Immediately cycled, SDF had significantly (p<0.0001) greater remineralization than DI, AgNO3, and FV. All delayed cycling groups had significantly greater remineralization than FV (p<0.0001). Significantly greater remineralization was noted in delayed AgNO3 (p≤0.0001), DI (p=0.0003), and FV (p=0.0006) compared to immediately cycled. After the second demineralization challenge, FV had significantly less surface softening than AgNO3 (p=0.0002), DI (p=0.0003), KF (p=0.0225), and SDF (p=0.0388) intervention groups. No significant difference was found between the pH-cycle timings (p=0.2710). Based the present findings, FV may be better suited than SDF to treat early, incipient, noncavitated, white-spot, enamel caries lesions.
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Affiliation(s)
- Aat Alcorn
- Alice-Anne Thompson Alcorn, DDS, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - L Al Dehailan
- Laila Al Dehailan, BDS, MSD, PhD, Indiana University School of Dentistry, IN, USA
| | - N B Cook
- Norman Blaine Cook, DDS, MSD, Indiana University School of Dentistry, IN, USA
| | - Q Tang
- Qing Tang, MS, Indiana University School of Medicine, IN, USA
| | - F Lippert
- *Frank Lippert, PhD, Indiana University School of Dentistry, Indianapolis, IN, USA
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Anticaries Agent Based on Silver Nanoparticles and Fluoride: Characterization and Biological and Remineralizing Effects—An In Vitro Study. Int J Dent 2022; 2022:9483589. [PMID: 35497178 PMCID: PMC9042602 DOI: 10.1155/2022/9483589] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/07/2022] [Indexed: 12/21/2022] Open
Abstract
Objective The aim of the study was to characterize and evaluate the stability, antimicrobial activity, cytotoxicity, and remineralizing effects of silver nanoparticles and fluoride anticaries agent (AgF) on staining dental enamel. Materials and Methods An experimental AgF solution was prepared and compared to silver diamine fluoride (SDF). First, the AgF was characterized and the stability was evaluated by transmission electron microscopy (TEM). Streptococcus mutans, Enterococcus faecalis, and Escherichia coli strains were used to evaluate the minimum inhibitory and bactericidal concentration and cytotoxicity performed using L929 fibroblastic cells by MTT test. Caries-like lesions induced by pH-cycling in human enamel were obtained, and then, the superficial microhardness, cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) were performed. Photographic images were taken to analyze the enamel staining. Results The AgF showed stableness in long term with bacteriostatic and bactericidal actions without cytotoxicity. Enamel remineralization, in surface and in depth (CSMH), was observed when the AgF was used, and it was similar to SDF. SEM showed enamel precipitation, and EDS observed the presence of P, Ca, Au, Ag, and Cl elements. Contrary to SDF, AgF did not stain the enamel. Conclusion The nano silver fluoride anticaries agent tested presented long-term stability, superficial and in-depth remineralizing capacity with antimicrobial potential and biocompatibility and did not stain the enamel.
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Solid-state NMR spectroscopy measurement of fluoride reaction by bovine enamel and dentin treated with silver diammine fluoride. Dent Mater 2022; 38:769-777. [PMID: 35450704 DOI: 10.1016/j.dental.2022.04.017] [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: 11/27/2021] [Revised: 03/06/2022] [Accepted: 04/01/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the formation of fluoride compounds in bovine enamel and dentin treated with silver diammine fluoride (SDF) using 19F and 31P solid-state magic angle spinning nuclear magnetic resonance (MAS NMR) spectroscopy. METHODS Enamel and dentin powder, obtained from bovine teeth, were treated with 38% SDF for four minutes and then washed thoroughly with Milli-Q water. The dehydrated SDF-treated samples were then examined. 19F solid-state MAS NMR spectra were acquired and 1H-31P cross-polarization (CP) experiments were performed on SDF-treated enamel and dentin powder. The surfaces of SDF-treated enamel and dentin blocks were observed by Scanning Electron Microscope (SEM). RESULTS 19F MAS NMR detected a more pronounced signal intensity for the dentin sample than the enamel, indicating an increased reactivity of SDF for dentin, compared with enamel. 19F NMR spectra for the SDF-treated samples showed fluorhydroxyapatite (FHAp), and other fluoride compounds such as CaF2 and the fluoride-substituted carbonate. The 1H-31P CP intensities of prominent peaks were lower for the SDF-treated samples than the non-treated sample, indicating that the F- ion replaced the OH- ion in the lattice tunnel. SEM observations on the SDF-treated samples showed pronounced multiple precipitation and particles in dentin compared with enamel. SIGNIFICANCE The solid-state MAS NMR revealed the reaction of fluoride on enamel and dentin and the identification of fluoride compounds. In particular, the formation of FHAp indicates that SDF is effective in reducing the risk of tooth decay.
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Campos MS, Fontana M. Caries Management in Special Care Dentistry. Dent Clin North Am 2022; 66:169-179. [PMID: 35365271 DOI: 10.1016/j.cden.2021.12.003] [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] [Indexed: 06/14/2023]
Abstract
The objective of this article is to provide a summary of the current evidence-based recommendations for caries management in patients with special health care needs (SHCNs). Considerations regarding caries risk assessment and preventive measures are also discussed with the goal of helping clinicians to manage the caries disease process using a person-centered approach and risk-based interventions. Importantly, most of the evidence is still based on the general population, because the evidence for those with SHCNs is still limited.
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Affiliation(s)
- Marcia S Campos
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Room 3169, Ann Arbor, MI 48109, USA.
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Room 2303, Ann Arbor, MI 48109, USA
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Peptide-Enabled Nanocomposites Offer Biomimetic Reconstruction of Silver Diamine Fluoride-Treated Dental Tissues. Polymers (Basel) 2022; 14:polym14071368. [PMID: 35406242 PMCID: PMC9002525 DOI: 10.3390/polym14071368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023] Open
Abstract
Caries is the most ubiquitous infectious disease of mankind, and early childhood caries (ECC) is the most prevalent chronic disease in children worldwide, with the resulting destruction of the teeth recognized as a global health crisis. Recent the United States Food and Drug Administration (FDA) approval for the use of silver diamine fluoride (SDF) in dentistry offers a safe, accessible, and inexpensive approach to arrest caries progression in children with ECC. However, discoloration, i.e., black staining, of demineralized or cavitated surfaces treated with SDF has limited its widespread use. Targeting SDF-treated tooth surfaces, we developed a biohybrid calcium phosphate nanocomposite interface building upon the self-assembly of synthetic biomimetic peptides. Here, an engineered bifunctional peptide composed of a silver binding peptide (AgBP) is covalently joined to an amelogenin derived peptide (ADP). The AgBP provides anchoring to the SDF-treated tooth tissue, while the ADP promotes rapid formation of a calcium phosphate isomorph nanocomposite mimicking the biomineralization function of the amelogenin protein. Our results demonstrate that the bifunctional peptide was effective in remineralizing the biomineral destroyed by caries on the SDF-treated tooth tissues. The proposed engineered peptide approach offers a biomimetic path for remineralization of the SDF-treated tissues producing a calcium phosphate nanocomposite interface competent to be restored using commonly available adhesive dental composites.
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Ferreira AC, de Lima Oliveira RF, Amorim AA, Geng-Vivanco R, de Carvalho Panzeri Pires-de-Souza F. Remineralization of caries-affected dentin and color stability of teeth restored after treatment with silver diamine fluoride and bioactive glass-ceramic. Clin Oral Investig 2022; 26:4805-4816. [PMID: 35301597 DOI: 10.1007/s00784-022-04445-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the microhardness of caries-affected dentin and color stability of teeth restored after treatments with silver diamine fluoride (SDF) associated to potassium iodide (KI) and Biosilicate. MATERIAL AND METHODS Different samples from bovine teeth were obtained. For color readings, 80 cavities (6 mm × 6 mm × 2 mm) were prepared, and for microhardness, teeth were flattened into dentine to obtain 40 samples. All samples were submitted to cariogenic challenge and separated in 4 groups, according to the treatment used: 12% SDF + KI; 38% SDF; Biosilicate and control (no treatment). Cavities were restored with resin-modified glass-ionomer cement (RMGIC, Vitremer, 3 M ESPE) or composite resin (CR, Z350, 3 M ESPE). After restoration, the samples were submitted to thermo-mechanical cycling (TMC) for 1,200,000 cycles. Color readings (EasyShade, Vita) were performed after restorations, after TMC, and 30 days after TMC. Knoop microhardness was evaluated on the planned samples before and after cariogenic challenge, after treatments, and after 30 days. Scanning electron microscopy (SEM) evaluated the dentine surface after treatments. Data were analyzed (ANOVA, Bonferroni, p < .05). RESULTS The results showed a higher color alteration for RMGIC than CR. The time of analysis was significant (p < .05) for the 12% SDF + KI and control group. There was no difference (p < .05) in microhardness between groups. However, there was evidence of dentin remineralization after treatments. CONCLUSIONS It was concluded that the samples treated with Biosilicate resulted in a color alteration similar to control. The treatments presented dentin remineralizing potential for microhardness, below the demineralization level, caused by the cariogenic challenge. CLINICAL RELEVANCE Considering the remineralizing potential presented by Biosilicate, this agent is a promising alternative that overcomes the SDF adverse effects such as tooth staining.
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Affiliation(s)
- Adriana Cavalcanti Ferreira
- Department of Dental Materials and Prosthodontics, Universidade de São Paulo/Faculdade de Odontologia de Ribeirão Preto, Av do Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Rebeca Franco de Lima Oliveira
- Department of Dental Materials and Prosthodontics, Universidade de São Paulo/Faculdade de Odontologia de Ribeirão Preto, Av do Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Ayodele Alves Amorim
- Department of Dental Materials and Prosthodontics, Universidade de São Paulo/Faculdade de Odontologia de Ribeirão Preto, Av do Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Rocio Geng-Vivanco
- Department of Dental Materials and Prosthodontics, Universidade de São Paulo/Faculdade de Odontologia de Ribeirão Preto, Av do Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil
| | - Fernanda de Carvalho Panzeri Pires-de-Souza
- Department of Dental Materials and Prosthodontics, Universidade de São Paulo/Faculdade de Odontologia de Ribeirão Preto, Av do Café s/n, Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil.
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Surendranath P, Krishnappa S, Srinath S. Silver Diamine Fluoride in Preventing Caries: A Review of Current Trends. Int J Clin Pediatr Dent 2022; 15:S247-S251. [PMID: 35645531 PMCID: PMC9108851 DOI: 10.5005/jp-journals-10005-2167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim and objective Background Review results Conclusion Clinical importance How to cite this article
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Affiliation(s)
- Padmapriya Surendranath
- Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India
- Padmapriya Surendranath, Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India, Phone: +91 9497293318,
| | - Srinath Krishnappa
- Department of Pediatric and Preventive Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sahana Srinath
- Department of Oral Pathology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
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Effect of topically applied silver compounds on the demineralisation of hydroxyapatite. Dent Mater 2022; 38:709-714. [DOI: 10.1016/j.dental.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/22/2021] [Accepted: 02/21/2022] [Indexed: 11/21/2022]
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Srisomboon S, Kettratad M, Stray A, Pakawanit P, Rojviriya C, Patntirapong S, Panpisut P. Effects of Silver Diamine Nitrate and Silver Diamine Fluoride on Dentin Remineralization and Cytotoxicity to Dental Pulp Cells: An In Vitro Study. J Funct Biomater 2022; 13:16. [PMID: 35225979 PMCID: PMC8884014 DOI: 10.3390/jfb13010016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 02/01/2023] Open
Abstract
Silver diamine nitrate (SDN) is expected to help control caries similar to silver diamine fluoride (SDF). The aim of this study was to determine the mineral precipitation in demineralized dentin and the cytotoxicity of SDN and SDF to dental pulp cells. Demineralized dentin specimens were prepared, and SDF, SDN, or water (control) was applied. The specimens were then remineralized in simulated body fluid for 2 weeks. The mineral precipitation in the specimens was examined using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). Additionally, the cytotoxicity of SDF and SDN to human dental pulp stem cells was analyzed using an MTT assay. The increase in FTIR spectra attributable to apatite formation in demineralized dentin in the SDF group was significantly higher compared to the SDN and control groups (p < 0.05). Dentinal tubule occlusion by the precipitation of silver salts was detected in both SDF and SDN groups. The mineral density as shown in SRXTM images and cytotoxicity of both SDN and SDF groups were comparable (p > 0.05). In conclusion, SDF demonstrated superior in vitro apatite formation compared to SDN. However, the degree of mineral precipitation and cytotoxic effects of both were similar.
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Affiliation(s)
- Surapong Srisomboon
- Department of Oral Health Care, Lamlukka Hospital, Pathum Thani 12150, Thailand;
| | - Matana Kettratad
- Faculty of Dentistry, Thammasat University, Pathum Thani 12120, Thailand; (M.K.); (S.P.)
| | | | - Phakkhananan Pakawanit
- Synchrotron Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand; (P.P.); (C.R.)
| | - Catleya Rojviriya
- Synchrotron Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand; (P.P.); (C.R.)
| | - Somying Patntirapong
- Faculty of Dentistry, Thammasat University, Pathum Thani 12120, Thailand; (M.K.); (S.P.)
- Thammasat University Research Unit in Dental and Bone Substitute Biomaterials, Thammasat University, Pathum Thani 12120, Thailand
| | - Piyaphong Panpisut
- Faculty of Dentistry, Thammasat University, Pathum Thani 12120, Thailand; (M.K.); (S.P.)
- Thammasat University Research Unit in Dental and Bone Substitute Biomaterials, Thammasat University, Pathum Thani 12120, Thailand
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Ballikaya E, Ünverdi GE, Cehreli ZC. Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig 2022; 26:2197-2205. [PMID: 34743243 PMCID: PMC8572062 DOI: 10.1007/s00784-021-04236-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study evaluated and compared the effect of silver diamine fluoride (SDF) and silver-modified atraumatic restorative treatment (SMART) sealants for the treatment of initial carious lesions of permanent molars affected by molar incisor hypomineralization (MIH). METHODS One hundred and twelve hypomineralized permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF and SMART sealant groups (n = 56 teeth/group) in a split-mouth fashion. Hypersensitivity, formation of caries, and enamel breakdown were evaluated in both groups. Hypersensitivity was assessed by Schiff Cold Air Sensitivity Scale (SCASS), and clinical assessments of SMART sealants were performed according to modified USPHS criteria at 1, 6, and 12 months. The data were analyzed statistically using Fisher's exact test, Kaplan-Meier analysis, Mann-Whitney U test, and Friedman test. RESULTS Twenty-six hypomineralized molars with marked baseline hypersensitivity showed significantly lower SCASS scores at all evaluation periods (p < 0.001). There was no significant difference in hypersensitivity scores between the groups at the repeated applications of SDF at 1, 6, and 12 months. The cumulative survival rates of SMART sealants on occlusal and palatal surfaces were 88.7% and 58.8%, respectively. CONCLUSIONS In hypomineralized molars, both SDF and SMART sealants showed favorable short-term prevention against dental caries while providing effective desensitization. Marginal discoloration was the most common side effect of the SMART sealants as a result of SDF application. CLINICAL SIGNIFICANCE Both SDF and SMART sealants showed similar short-term effectiveness as non-aerosol procedures in arresting enamel caries and reducing hypersensitivity in hypomineralized molars. TRIAL REGISTRATION Clinical Trials Registration Number: NCT03862014.
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Affiliation(s)
- Elif Ballikaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Gizem Erbas Ünverdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
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Effect of silver diamine fluoride on vital dental pulp: A systematic review. J Dent 2022; 119:104066. [DOI: 10.1016/j.jdent.2022.104066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/21/2022] [Accepted: 02/05/2022] [Indexed: 12/14/2022] Open
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Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study. Int J Dent 2022; 2021:3059129. [PMID: 34976061 PMCID: PMC8716243 DOI: 10.1155/2021/3059129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective The purpose of this study is to determine the effect of selected caries removal on silver penetration when 38% SDF is applied to deep carious lesions in permanent teeth. Methods Extracted permanent teeth with caries extending to the inner third of the dentin were used (N = 18). The periphery of the carious lesion was completely removed to the dentinoenamel junction (DEJ). In group A (n = 9), no further removal of carious tissue was performed, leaving necrotic dentin inner to the DEJ, whereas in group B (n = 9) superficial necrotic dentin was completely removed until leathery, slightly moist, reasonably soft dentin remained. SDF was applied for 3 minutes in both groups. Microcomputer tomography (micro-CT) and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (FESEM-EDS) were used to measure mineral density and silver distribution. The silver penetration depth/lesion depth (PD/LD) ratio was calculated for each sample. The Mann–Whitney U test was used to compare differences between the two groups. Results The micro-CT analysis showed that the PD/LD ratios of group B (1.07–2.29) were marginally greater than those of group A (1.00–1.31). However, a statistically significant difference was not observed (pvalue = 0.5078). When stratified by remaining dentin thickness (RDT), the PD/LD ratios of group B were still greater than those of group A only when RDT was >500 µm. The FESEM-EDS analysis indicated that silver particles precipitated throughout the entire thickness of the carious lesions. Conclusion Applying SDF on a deep carious lesion and leaving the necrotic dentin pulpally did not affect silver penetration. However, the extent to which silver penetrates the remaining dentin beneath the lesions is dependent on the amount and characteristics of that dentin.
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KHOR MMY, ROSA V, SIM CJ, HONG CHL, HU S. SMART: Silver diamine fluoride reduces microtensile bond strength of glass ionomer cement to sound and artificial caries-affected dentin. Dent Mater J 2022; 41:698-704. [DOI: 10.4012/dmj.2021-319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Vinicius ROSA
- Faculty of Dentistry, National University of Singapore
| | - Chien Joo SIM
- National University Centre for Oral Health, National University Health System
| | | | - Shijia HU
- Faculty of Dentistry, National University of Singapore
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Dai LL, Mei ML, Chu CH, Zhao IS, Lo ECM. Effect of Strontium-Doped Bioactive Glass on Preventing Formation of Demineralized Lesion. MATERIALS 2021; 14:ma14164645. [PMID: 34443169 PMCID: PMC8399109 DOI: 10.3390/ma14164645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 01/01/2023]
Abstract
This study investigated the effect of strontium-doped bioactive glass (SBAG) on the formation of dental demineralized lesions. Materials and methods: The study materials were 48 sound human tooth specimens with both dentine and enamel, divided equally into four groups: Group 1 (SBAG), Group 2 (SBAG+Fluoride), Group 3 (Fluoride), and Group 4 (Water as control). After 14 days of pH cycling, the surface morphology of the specimens was observed by scanning electron microscopy. Crystal characteristics of the precipitates were assessed by X-ray diffraction (XRD). Micro-CT was used to measure the mineral loss and the depths of the demineralized lesions formed. Results: Exposure of collagen in inter-tubular areas in dentine was seen in the control group (Group 4) but not in Groups 1 to 3. In Group 2, there were obvious granular particles on the surface of the dentine. XRD revealed precipitation of apatites on the surface of the tooth specimens in Groups 1 to 3. The mean lesion depths in dentine were 81.80 μm, 30.68 μm, 39.04 μm, and 146.36 μm in Groups 1 to 4, respectively (p < 0.001). Lesions in enamel were only found in the control group. The mean mineral loss values in the dentine lesions were 1.25 g/cm3, 0.88 g/cm3, 0.87 g/cm3, and 1.65 g/cm3, in Groups 1 to 4, respectively (p < 0.001). Conclusion: Strontium-doped bioactive glass has a preventive effect on the formation of demineralized lesions in enamel and dentine.
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Affiliation(s)
- Lin-Lu Dai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong; (L.-L.D.); (C.-H.C.)
| | - May-Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin 9016, New Zealand;
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong; (L.-L.D.); (C.-H.C.)
| | - Irene Shuping Zhao
- School of Dentistry, Shenzhen University Health Science Center, Shenzhen 518000, China;
| | - Edward Chin-Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong; (L.-L.D.); (C.-H.C.)
- Correspondence: ; Tel.: +852-2859-0292
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