Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Authors

  • Gabriella Fernandes Rodrigues
  • Amanda Souza Nunes Monteiro
  • Ana Lúcia Vollú
  • Paula Maciel Pires
  • Aline Saddock de Sá Silva
  • Ricardo Tadeu Lopes
  • Branca Heloisa Oliveira
  • Aline de Almeida Neves
  • Fernanda Barja-Fidalgo
  • Andréa Fonseca-Gonçalves

Keywords:

Dental Caries, Cariostatic Agents, Dentin, Tooth Remineralization, X-Ray Microtomography

Abstract

Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.

References

Kassebaum NJ, Smith AGC, Bernabe E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 2017; 96(4):380-7. https://doi.org/10.1177/0022034517693566

Oliveira BH, Cunha-Cruz J, Rajendra A, Niederman R. Controlling caries in exposed root surfaces with silver diamine fluoride: a systematic review with meta-analysis. J Am Dent Assoc 2018; 149(8):671-679.e1. https://doi.org/10.1016/j.adaj.2018.03.028

Oliveira BH, Rajendra A, Veitz-Keenan A, Niederman R. The effect of silver diamine fluoride in preventing caries in the primary dentition: a systematic review and meta-analysis. Caries Res 2019; 53(1):24-32. https://doi.org/10.1159/000488686

Clemens J, Gold J, Chaffin J. Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth. J Public Health Dent 2018; 78(1):63-8. https://doi.org/10.1111/jphd.12241

Johhnson B, Serban N, Griffin PM, Tomar SL. Projecting the economic impact of silver diamine fluoride on caries treatment expenditures and outcomes in young U.S. children. J Public Health Dent 2019; 79(3):215-21. https://doi.org/10.1111/jphd.12312

Mei ML, Chu CH, Low KH, Che CM, Lo EC. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal 2013; 18(6):e824-31. https://doi.org/10.4317/medoral.18831

Mei ML, Li QL, Chu CH, Yiu CK, Lo EC. The inhibitory effects of silver diamine fluoride at different concentrations on matrix metalloproteinases. Dent Mater 2012; 28(8):903-8. https://doi.org/10.1016/j.dental.2012.04.011

Mei ML, Lo ECM, Chu CH. Arresting dentine caries with silver diamine fluoride: what's behind it? J Dent Res 2018; 97(7):751-8. https://doi.org/10.1177/0022034518774783

Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized clinical trial of 12% and 38% silver diamine fluoride treatment. J Dent Res 2018; 97(2):171-8. https://doi.org/10.1177/0022034517728496

Mei ML, Chu CH, Lo EC, Samaranayake LP. Fluoride and silver concentrations of silver diammine fluoride solutions for dental use. Int J Paediatr Dent 2013; 23(4):279-85. https://doi.org/10.1111/ipd.12005

Contreras V, Toro MJ, Elías-Boneta AR, Encarnación-Burgos A. Effectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review. Gen Dent 2017; 65(3):22-9.

Duangthip D, Chu CH, Lo EC. A randomized clinical trial on arresting dentine caries in preschool children by topical fluorides - 18-month results. J Dent 2016; 44:57-63. https://doi.org/10.1016/j.jdent.2015.05.006

Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005; 84(8):721-4. https://doi.org/10.1177/154405910508400807

Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc 2016; 44(1):16-28.

Zhao IS, Mei ML, Li QL, Lo ECM, Chu CH. Arresting simulated dentine caries with adjunctive application of silver nitrate solution and sodium fluoride varnish: an in vitro study. Int Dent J 2017; 67(4):206-14. https://doi.org/10.1111/idj.12291

Pires PM, Santos TPD, Fonseca-Goncalves A, Pithon MM, Lopes RT, Neves AA. A dual energy micro-CT methodology for visualization and quantification of biofilm formation and dentin demineralization. Arch Oral Biol 2018; 85:10-15. https://doi.org/10.1016/j.archoralbio.2017.09.034

McFarland J. The nephelometer: An instrument for estimating the number of bacteria in suspensions used for calculating the opsonic index and for vaccines. J Am Medl Assoc 1907; 14:1176-8. https://doi.org/10.1001/jama.1907.25320140022001f

Antonio AG, Iorio NL, Pierro VS, Candreva MS, Farah A, dos Santos KR, et al. Inhibitory properties of Coffea canephora extract against oral bacteria and its effect on demineralisation of deciduous teeth. Arch Oral Biol 2011; 56(6):556-64. https://doi.org/10.1016/j.archoralbio.2010.12.001

Soares DN, Antonio AG, Iorio NL, Pierro VS, dos Santos KR, Maia LC. Does the presence of sucrose in pediatric antibiotics influence the enamel mineral loss and the Streptococcus mutans counts in dental biofilm? Braz Dent J 2015; 26(3):249-57. https://doi.org/10.1590/0103-6440201302353

Milgrom P, Horst JA, Ludwig S, Rothen M, Chaffee BW, Lyalina S, et al. Topical silver diamine fluoride for dental caries arrest in preschool children: a randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. J Dent 2018; 68:72-8. https://doi.org/10.1016/j.jdent.2017.08.015

Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S, et al. 3D Slicer as an image computing platform for the quantitative imaging network. Magn Reson Imagin 2012; 30(9):1323-41. https://doi.org/10.1016/j.mri.2012.05.001

Thylstrup A, Bruun C, Holmen L. In vivo caries models - mechanisms for caries initiation and arrestment. Adv Dent Res 1994; 8(2):144-57. https://doi.org/10.1177/08959374940080020401

Ishiguro T, Mayanagi G, Azumi M, Otani H, Fukushima A, Sasaki K, et al. Sodium fluoride and silver diamine fluoride-coated tooth surfaces inhibit bacterial acid production at the bacteria/tooth interface. J Dent 2019; 84:30-5. https://doi.org/10.1016/j.jdent.2018.12.017

Sayed M, Tsuda Y, Matin K, Abdou A, Martin K, Burrow MF, et al. Effects of mechanical abrasion challenge on sound and demineralized dentin surfaces treated with SDF. Sci Rep 2020; 10(1):19884. https://doi.org/10.1038/s41598-020-77035-9

Punhagui MF, Jussiani EI, Andrello AC, Favaro JC, Guiraldo RD, Lopes MB, et al. Effect of application time and concentration of silver diamine fluoride on the enamel remineralization. J Clin Exp Dent 2021; 13(7):e653-e658. https://doi.org/10.4317/jced.58318

Srisomboon S, Kettratad M, Pakawanit P, Rojviriya C, Phantumvanit P, Panpisut P. Effects of different application times of silver diamine fluoride on mineral precipitation in demineralized dentin. Dent J 2021; 9(6):70. https://doi.org/10.3390/dj9060070

Mei ML, Ito L, Cao Y, Lo EC, Li Q, Chu CH. An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy. J Dent 2014; 42(4):395-402. https://doi.org/10.1016/j.jdent.2013.12.007

Li Y, Liu Y, Psoter WJ, Nguyen OM, Bromage TG, Walters MA, et al. Assessment of the silver penetration and distribution in carious lesions of deciduous teeth treated with silver diamine fluoride. Caries Res 2019; 53(4):431-40. https://doi.org/10.1159/000496210

Sayed M, Matsui N, Uo M, Nikaido T, Oikawa M, Burrow MF, et al. Morphological and elemental analysis of silver penetration into sound/demineralized dentin after SDF application. Dent Mater 2019; 35(12):1718-27. https://doi.org/10.1016/j.dental.2019.08.111

Neves AA, Coutinho E, Vivan-Cardoso M, Jaecques S, Van Meerbeek B. Micro-CT based quantitative evaluation of caries-excavation. Dent Mater 2010; 26(6):579-88. https://doi.org/10.1016/j.dental.2010.01.012

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Published

2022-03-16

How to Cite

Rodrigues, G. F. ., Monteiro, A. S. N. ., Vollú, A. L. ., Pires, P. M. ., Sá Silva, A. S. de ., Lopes, R. T. ., Oliveira, B. H. ., Neves, A. de A. ., Barja-Fidalgo, F. ., & Fonseca-Gonçalves, A. . (2022). Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e210112. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/1046

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