Effect of radiotherapy on microhardness and surface morphology of pretreated primary teeth with silver diamine fluoride: an in vitro study

Abstract

Abstract Background: Children with head and neck cancer undergo radiation therapy, which has proved to be a successful treatment option. One of the common side effect of radiation therapy has been radiation induced caries. This is not as a result of the decreased salivary flow, but rather as a result of the direct impacts of these harmful rays on the enamel of the teeth. Silver diamine fluoride (SDF) is an effective remineralising agent for initial carious lesions and prevents demineralisation of the already deep carious agent. Various studies have also proved its effectiveness in improving the microhardness of the teeth. Hence, the objective of this study was to evaluate whether radiotherapy causes changes in the microhardness and surface morphology of enamel in primary teeth pretreated with SDF. Method: 22 primary teeth samples were divided into two groups with 11 samples in each group. The study group samples were pretreated with SDF and in the control group no pretreatment was done. Both groups were subjected to radiotherapy of 60 Gy radiation for a duration of 30 days. The samples were tested using the Vickers microhardness test and scanning electron microscope (SEM) analysis for surface morphological changes post radiotherapy. Results: It was found that there was a statistically significant difference (p<0.001) in mean microhardness values between the two groups. The mean microhardness of the SDF group (254.07 ± 35.84) was significantly higher that the control group (88.18 ± 6.79). SEM image of enamel of control teeth displayed loss of smooth homogeneous surface and more amorphous structures were seen which was very evident in comparison to the SDF group. Conclusion: Following radiation therapy, SDF application led to greater microhardness of the enamel surface and less morphological alteration in the surface enamel of primary teeth.