Dentin tubule occlusion by a 38% silver diamine fluoride gel: an in vitro investigation

Andreas Kiesow,Frank Lippert,Peter Milgrom,Matthias Menzel,Jason M Tanzer

doi:10.1038/s41405-022-00095-8

Abstract

Objective Silver diamine fluoride (SDF) is effective in treatment of dentin hypersensitivity and caries lesions. However, the non-viscous solution does not easily allow clinicians to control the application area. A 38% SDF experiment gel was compared in vitro to commercial SDF for its ability to penetrate and occlude dentinal tubules.Materials and methodsHuman root surface dentin specimens were treated with gelled or standard 38% SDF or negative control. Penetration behavior was established by Drop Shape Analysis. Precipitates at the surface and within tubules were analyzed by SEM and EDX after treatment; Results: penetration depths up to 500 µm were observed for both SDF formulations. Both formulations occluded dentinal tubules similarly. Precipitates on the dentin surface and within dentinal tubules were found for both SDF formulations, with a slight tendency for the experimental gel SDF product to be more abundant than the commercially available one. Discussion: behavior of the experimental 38% SDF gel formulation appeared indistinguishable from the commercial 38% SDF product with respect to dentinal tubule penetration and occlusion.ConclusionsThe experimental 38% SDF gel may be a suitable intervention for the prevention of dentin hypersensitivity.

Highlights

OBJECTIVESilver diamine fluoride (SDF) is effective in treatment of dentin hypersensitivity and caries lesions
1234567890();,: INTRODUCTION An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry has recommended the use of 38% silver diamine fluoride (SDF) as a nonrestorative treatment for carious lesions in the primary and permanent dentitions and in enamel and dentin [1]
The depth of penetration of silver particles was measured as up to 500 μm RESULTS Figure 1 describes the penetration of the two SDF formulations over time

Summary

OBJECTIVE

Silver diamine fluoride (SDF) is effective in treatment of dentin hypersensitivity and caries lesions. Precipitates at the surface and within tubules were analyzed by SEM and EDX after treatment; Results: penetration depths up to 500 μm were observed for both SDF formulations. Precipitates on the dentin surface and within dentinal tubules were found for both SDF formulations, with a slight tendency for the experimental gel SDF product to be more abundant than the commercially available one. In vitro studies show morphological evidence of tubule occlusion [6]; open questions remain regarding the mode of action of penetration, precipitation, and the occluding behavior of 38% SDF. We undertook an in vitro study to seek further evidence of the mode of action of 38% SDF in preventing dentin hypersensitivity and compare an experimental gelled 38% SDF formulation to a commercially available 38% SDF product with regard to interactions with dentin

MATERIALS AND METHODS

RESULTS

DISCUSSION

CONCLUSIONS