Effect of Silver Diamine Fluoride and Sodium Fluoride Varnish on Remineralization in Artificially Induced Enamel Caries: An in vitro Study

Abstract

The purpose of this study was to compare the remineralization effect of 38% silver diamine fluoride (SDF) and 5% sodium fluoride (NaF) varnish on artificially induced enamel caries.The present study standardized the physiochemical characteristics of the tooth structure using bovine teeth, realized the wash-off action of agents using a saliva, reproduced an environment similar to mouth through pH-cycling, and comparatively assessed the remineralization effect of 38% SDF and 5% NaF varnish in a non-destructive method using micro-CT. And the remineralized enamel surface structure was analyzed by scanning electron microscopy (SEM) and energy dispersive X-Ray spectroscopy (EDS).In both SDF and NaF varnish, mineral density (△Hounsfield unit value) and the volume of enamel restored to normal mineral density through remineralization gradually increased with time. And the SDF showed a much higher level of increase in mineral density at all depths and remineralized volume than NaF varnish.According to SEM analysis, the surface roughness decreased in the order of artificial saliva, NaF varnish and SDF. In addition, EDS analysis showed that silver ion was precipitated on the enamel surface in SDF group.In conclusion, SDF had a greater remineralization effect than NaF varnish on demineralized enamel.