Comparative Evaluation of Chitosan Nanoparticles, Silver Diamine Fluoride and Acidulated Phosphate Fluoride Gel on Microhardness of Artificial Carious Lesions Created on Extracted Teeth

Abstract

Introduction: Dental caries is a multifactorial microbial infectious disease characterised by demineralisation of the inorganic and destruction of the organic substance of the tooth. To combat dental caries the application of nanotechnology includes the inhibition of formation of biofilm and regulating the balance of demineralisation-remineralisation processes, ensuring a possible mechanism that can aid in prevention and treatment of tooth decay. Initial caries progression may be prevented by suitable surface treatment, by applying surface remineralising agents. Aim: To evaluate and compare the efficacy of remineralising potential of Acidulated Phosphate Fluoride (APF) gel, Chitosan nanoparticles and Silver Diamine Fluoride (SDF) on microhardness of artificial carious lesions created on extracted teeth. Materials and Methods: This was an in-vitro experimental study associated with Krishna Institute of Medical Sciences, Karad conducted during a period of two months (October and November 2019) at Mechanical Department of Rajarambapu Institute of Technology, Islampur, Maharashtra. The total sample size was 30 premolar teeth. In this in-vitro study, test materials Chitosan nanoparticles, Silver Diamine Fluoride (SDF) and Acidulated Phosphate Fluoride gel (APF) varnishes were manipulated and applied (10 in each group) in accordance with manufacturer’s instructions. Artificial carious lesions were created in the enamel. This was achieved by suspending the teeth in an artificial caries system. Baseline microhardness was then recorded using Vickers Hardness Test and varnish application was carried out. Samples were then placed separately in a demineralisation solution for three hours. Thereafter, samples were placed in a remineralisation solution. Any change in microhardness was determined by evaluating the Vickers Hardness Test at the end of 28 days. The data was then recorded, tabulated and statistically analysed using Kruskal-Wallis Test and Wilcoxon Signed Test for inter and intra groups comparisons to find out if there was a significant difference. Results: All the three varnishes i.e., Chitosan nanoparticle, silver diamine fluoride and APF gel in intragroup comparison after intervention showed significant differences with Chitosan nanoparticle showing the highest increase in microhardness with p-value of 0.001 followed by SDF with p-value of 0.005 and APF gel with p-value of 0.005. Conclusion: All the three varnishes increased enamel microhardness significantly. Chitosan nanoparticle showed highest increase in remineralisation followed by SDF and APF gel. Hence, varnish application is a good method in remineralising the tooth.