Silver Diamine Fluoride helps in arrest of caries and remineralisation of tooth : Study
Silver diamine fluoride (SDF) is a dental biomaterial used to arrest dental caries. Topical application of SDF to carious lesions can be performed in a few minutes without the need for anesthetics or sedatives , and the use of SDF is a key strategy in minimally invasive dentistry, particularly in the pediatric population .
In 2017, the American Academy of Pediatric Dentistry provided evidenced-based recommendations for the use of 38% SDF to arrest cavitated carious lesions on primary teeth, but highlighted the need for further studies to understand the cariostatic efficacy of SDF.
A recently published research paper in the Journal of Dental Research- Research Reports: Biomaterials & Bioengineering, has highlighted that the interaction of SDF with the dentin-pulp complex ultimately alters the physicochemical properties of the tooth, and these alterations contribute to the mechanism of action of SDF in caries arrest and desensitization, including tertiary dentin formation. Despite, an increasing interest among the dental fraternity , the mechanism of SDF action is not fully understood. The traditional understanding is that the silver component of SDF provides antibacterial activity while the fluoride component helps remineralize the carious dentin.
So, to better understand SDF's mechanism of action, the team of researchers examined the localization of silver within the tissues of SDF-treated teeth.
Carious primary teeth fixed within 2 min of SDF application (SDF-minutes, n = 3), at 3 wk after SDF application in vivo (SDF-weeks, n = 4), and at 2 y after multiple SDF applications in vivo (SDF-multiple, n = 1) were investigated in this study. Carious primary teeth without SDF application (no-SDF, n = 3) served as controls.Mineral density and structural analyses were performed via micro–X-ray computed tomography and scanning electron microscopy.Elemental analyses were performed through X-ray fluorescence microprobe and energy-dispersive X-ray spectroscopic techniques.
Results revealed some interesting facts.
- SDF-treated teeth revealed higher X-ray–attenuated surface and subsurface regions within carious lesions, and similar regions were not present in no-SDF teeth.
- Regions of higher mineral density correlated with regions of silver abundance in SDF-treated teeth.
- The SDF penetration depth was approximated to 0.5 ± 0.02 mm and 0.6 ± 0.05 mm (mean ± SD) for SDF-minutes and SDF-weeks specimens,respectively.
- A higher percentage of dentin tubular occlusion by silver or calcium phosphate particles was observed in primary teeth treated with SDF-weeks as compared with SDF-minutes.
- Elemental analysis also revealed zinc abundance in carious lesions and around the pulp chamber.
- SDF-weeks teeth had significantly increased tertiary dentin than SDF-minutes and no-SDF teeth.
"These results suggest that SDF treatment on primary teeth affected by caries promotes pathologic biomineralization by altering their physicochemical properties, occluding dentin tubules, and increasing tertiary dentin volume. These seemingly serendipitous effects collectively contribute to the cariostatic activity of SDF." the team concluded.
For full article follow the link: Sulyanto RM, Kang M, Srirangapatanam S, Berger M, Candamo F, Wang Y, Dickson JR, Ng MW, Ho SP. Biomineralization of Dental Tissues Treated with Silver Diamine Fluoride. J Dent Res. 2021 Sep;100(10):1099-1108. doi: 10.1177/00220345211026838. Epub 2021 Jul 29. PMID: 34323107; PMCID: PMC8381688.
Source: Journal of Dental Research -Research Reports: Biomaterials & Bioengineering
