Can silver diamine fluoride or silver nanoparticle-based anticaries agents to affect enamel bond strength?

The use of silver diamine fluoride to prevent/treat enamel carious lesions: a narrative review

This comprehensive literature review examines the use of silver diamine fluoride (SDF) for the prevention and treatment of enamel carious lesions. SDF has been approved by different international drug associations as a caries-preventing agent to be used on deep carious lesions (dentin). However, SDF can cause staining of exposed tooth structures. Furthermore, the effect of SDF on the bond of adhesives to the tooth structure is still being determined. This review explores various studies on the use of SDF to treat enamel carious lesions, highlighting its effectiveness and preventive action. The literature suggests that SDF inhibits bacterial growth, promotes remineralization, and does not negatively affect adhesive retentions. Potassium iodide (KI) or glutathione (GSH) can reduce staining and discoloration. However, the reviewed studies have limitations. Further research, including well-designed clinical trials, is necessary to validate the findings and evaluate the long-term implications of SDF treatment. Conclusion: Despite the above-mentioned limitations, SDF shows potential as a therapy for enamel caries prevention, remineralization, and use as an adjuvant to other dental treatments, warranting further investigation and the refinement of application methods.

Phosphoric Acid Etch Partially Restores the Initial Bond Strength of Composite to Silver Diamine Fluoride-Treated Enamel Using Universal Adhesives

BACKGROUND

Restoring bonding composite to silver diamine fluoride (SDF)-treated enamel is challenging. This study investigates if phosphoric acid etch restores composite bond strength to SDF-treated enamel using universal adhesives.

METHODS

Twenty-four recently extracted permanent teeth were randomly divided into 4 (2 experimental (SDF) and 2 control (CTR)) groups: SDF+Water: SDF (1 min) then water rinse (15 mL); CTR+Water: no treatment and water rinse (15 mL); SDF+Etch+Water: SDF (1 min), 35% phosphoric acid (40 s) then water rinse (15 mL); CTR+Etch+Water no treatment, 35% phosphoric acid (40 s) then water rinse (15 mL). The enamel surface in all the groups was bonded (All-Bond Universal) to 4-5 mm composite blocks (Z-250). Each sample was sectioned, and 6-8 beams (1 mm × 1 mm) were selected. The micro-tensile bond strength was measured by dividing the micro-tensile force peak by the adhesive surface area. Univariate ANOVA and Chi-square were used for between-group comparisons with p < 0.05.

RESULTS

SDF+Water had significantly lower tensile strength compared to all the groups (p < 0.05). Although no difference was found in the tensile strength between the SDF+Etch+Water and the CTR+Etch+Water, the SDF+Etch+Water had significantly more adhesive failures compared to the CTR+Etch+Water (p = 0.047).

CONCLUSIONS

While phosphoric acid etch seems to restore the initial composite bond strength to SDF-treated enamel, the long-term success of composite restorations bonded to SDF-treated enamel may need further investigation.

Efficacy of Nano Silver Fluoride and/or Diode Laser In Enhancing Enamel Anticariogenicity around orthodontic brackets

PURPOSE

This in vitro study aimed to compare the anticariogenic effect of using diode laser irradiation and/or nano silver fluoride varnish around orthodontic brackets.

MATERIALS AND METHODS

60 caries-free and intact premolars were randomly divided into 3 experimental groups as follow: (1) Group I (nano silver fluoride treated group, n = 20), (2) Group II (diode laser treated group, n = 20) and (3) Group III (combined nano silver fluoride and diode laser treated group, n = 20). Anticariogenicity was assessed using polarized light, scanning electron microscope, elemental and shear bond strength analyses.

RESULTS

PLM and SEM showed presence of few demineralized areas in group I. Group II revealed a dramatic increased demineralization. Group III disclosed almost typical homogenous surface enamel. elemental analysis showed a highly significant difference between Group III and II and a significant difference between Group III and I. Shear bond strength analysis revealed a significant difference between group I and II and between group III and II. The difference between group III and I was non-significant.

CONCLUSION

Both diode laser and nano silver fluoride positively affected dental enamel with the most superior enhancement in enamel criteria was achieved by surface pretreatment by combined nano silver fluoride varnish and diode laser irradiation.

Amelioration Strategies for Silver Diamine Fluoride: Moving from Black to White

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.

The Effect of Loading Time on Color Stability of Various Restorative Materials Bonded to Silver Diamine Fluoride-Treated Demineralized Dentin

Aim

To investigate the effect of immediate versus one week later loading time on color stability of resin-based composite (RBC), resin-modified glass ionomer cement (RMGIC) and glass ionomer cement (GIC) restorative materials bonded to silver diamine fluoride (SDF)-treated demineralized dentin.

Materials and Methods

Ninety extracted premolars were randomly assigned to the following groups (n = 30 each): group-I (loaded with RBCs), group-II (loaded with RMGIC), and group-III (loaded with GIC). Each group was divided randomly into the following subgroups (n = 10): subgroup-A (control specimens) consisted of sound dentin and the restorative material was immediately loaded; subgroup-B consisted of demineralized dentin, underwent a SDF treatment and the restorative material was immediately loaded; subgroup-C consisted of demineralized dentin, underwent a SDF treatment and the restorative material was loaded 1 week later. The color difference (ΔE) and visual color changes (L*a*b*) of each specimen were calculated using a spectrophotometer. Data were analyzed using one-way ANOVA and post hoc Tukey's tests to compare the ΔE values and a paired t test to compare the mean of L* a* b* coordinates.

Results

The highest color stability was observed for GIC, followed by RMGIC, and the lowest color stability was observed for the RBC group. Significant differences within groups were noted in RBC and RMGIC (p < 0.001). Regarding the loading time of the restorative material, in RBCs, a significantly lower ΔE value was observed in the delayed loading group than in the immediate loading group (p = 0.035). In the RMGIC and GIC groups, there were no significant differences.

Conclusion

Delaying the loading time of the restorative material for 1 week following the application of SDF resulted in greater color stability than that of immediate loading. The caries arresting potential of SDF was revealed by the dark staining, which could be improved with the subsequent delayed restoration.