Protective effect of titanium tetrafluoride and silver diamine fluoride on radiation-induced dentin caries in vitro

Beatriz Martines De Souza,Ana Carolina Magalhães,Marília Afonso Rabelo Buzalaf,Patrícia Sanches Kerges Bueno,Aline Silva Braga,Mayara Souza Silva,Paulo Sergio Da Silva Santos

doi:10.1038/s41598-021-85748-8

Beatriz Martines De Souza, Ana Carolina Magalhães + Show 5 more

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https://doi.org/10.1038/s41598-021-85748-8

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Journal: Scientific Reports	Publication Date: Mar 16, 2021
Citations: 5	License type: open-access

Affiliation: Universidade de São Paulo

Abstract

This in vitro study evaluated the protective effect of titanium tetrafluoride (TiF4) varnish and silver diamine fluoride (SDF) solution on the radiation-induced dentin caries. Bovine root dentin samples were irradiated (70 Gy) and treated as follows: (6 h): 4% TiF4 varnish; 5.42% NaF varnish; 30% SDF solution; placebo varnish; or untreated (negative control). Microcosm biofilm was produced from human dental biofilm (from patients with head-neck cancer) mixed with McBain saliva for the first 8 h. After 16 h and from day 2 to day 5, McBain saliva (0.2% sucrose) was replaced daily (37 °C, 5% CO2) (biological triplicate). Demineralization was quantified by transverse microradiography (TMR), while biofilm was analyzed by using viability, colony-forming units (CFU) counting and lactic acid production assays. The data were statistically analyzed by ANOVA (p < 0.05). TiF4 and SDF were able to reduce mineral loss compared to placebo and the negative control. TiF4 and SDF significantly reduced the biofilm viability compared to negative control. TiF4 significantly reduced the CFU count of total microorganism, while only SDF affected total streptococci and mutans streptococci counts. The varnishes induced a reduction in lactic acid production compared to the negative control. TiF4 and SDF may be good alternatives to control the development of radiation-induced dentin caries.

Highlights

This in vitro study evaluated the protective effect of titanium tetrafluoride (TiF4) varnish and silver diamine fluoride (SDF) solution on the radiation-induced dentin caries
Due to the need for finding alternatives to minimize the development of radiation-induced dentin caries, the aim of this work was to evaluate: (1) the protective effect of TiF4 varnish compared to NaF varnish and SDF solution on irradiated root dentin with respect to demineralization; and (2) the antimicrobial action of TiF4 varnish compared to NaF varnish and SDF solution on microcosm biofilm produced from biofilm collected from patients subjected to head and neck radiation
TiF4 varnish and SDF solution significantly reduced the integrated mineral loss compared to NaF varnish, placebo varnish and negative control (p < 0.0001)

Summary

Introduction

This in vitro study evaluated the protective effect of titanium tetrafluoride (TiF4) varnish and silver diamine fluoride (SDF) solution on the radiation-induced dentin caries. TiF4 and SDF significantly reduced the biofilm viability compared to negative control. Normal cells are affected by head and neck radiotherapy, which can cause salivary gland dysfunction and, hyposalivation that dramatically increases the risk for dental caries. Depending on the radiotherapy site, teeth can be significantly affected by the maximum dosage (around 99% in case of tongue tumors, for example)[10]. Both enamel and dentin are already softened by 10 Gy11–13, a dose much lower than those applied in case of HNC. Wu et al.[18] showed in vitro that dentin (exposed to 68.25 Gy of radiation) treated daily with 5% NaF varnish, effectively showed a restored surface and increased microhardness compared to untreated irradiated dentin

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