Abstract
Background: Fixed orthodontic treatment has been associated with certain side effects such as white spot lesions (WSLs). Many studies showed the positive effect of sodium fluoride (NaF) varnish in remineralizing WSLs. Studies revealed that silver diamine fluoride (SDF) is effective in arresting dentin caries, but its potential for enamel remineralization has not been investigated clearly. The present study aimed to compare the effect of SDF and NaF on the microhardness of demineralized enamel. Methods: A total of 60 intact premolar teeth were collected and divided into 4 equal groups. Group 1 remained intact (control). Groups 2 to 4 were exposed to artificial cariogenic solution to create enamel lesion. Then, groups 3 and 4 were treated with NaF 5% and SDF 38%, respectively. After one month of storage in artificial saliva, NaF and SDF were reapplied. One month later, the surface microhardness values (SMHs) of teeth were assessed. Results: The results of ANOVA showed a significant difference among the 4 groups (P<0.001). There was significantly higher enamel microhardness in the control group compared with groups 2 and 3 (P<0.001); however, it was not significant for the SDF group (P=0.160). There was significantly higher enamel surface microhardness in groups 3 and 4 compared with group 2 (P≤0.001) and significantly higher mean SMH values in the SDF group compared with the NaF group (P=0.004). Conclusions: NaF varnish and SDF can both remineralize early enamel lesion but SDF has greater remineralizing potential.
Highlights
Fixed orthodontic treatment has been associated with certain side effects such as white spot lesions (WSLs)
Fixed orthodontic treatment has become an integral part of modern orthodontics, but it has been associated with certain side effects such as white spot lesions (WSLs) [1]
There was a significant higher enamel microhardness in the control group compared with the demineralized enamel and NaF groups (P < 0.001) according to Tukey post hoc test, but it was not significant for the silver diamine fluoride (SDF) group (P = 0.160)
Summary
Fixed orthodontic treatment has become an integral part of modern orthodontics, but it has been associated with certain side effects such as white spot lesions (WSLs) [1]. Farhadian et al extracted teeth receiving semiannual applications of SDF have demonstrated its effectiveness in arresting lesions as well as higher fluoride uptake compared to fluoride varnish [7,8,13,16,17]. A recent in vitro study conducted by Akyildiz and Sönmez revealed that SDF and sodium fluoride (NaF) varnish could both remineralize artificial enamel lesions, NaF varnish had a higher remineralizing potential [18]. The present in vitro study aimed to compare the effects of SDF and NaF varnish on the microhardness of artificial enamel lesions. Groups 3 and 4 were treated with NaF varnish 5% (Duraphat®, Colgate, Sao Paulo) and SDF solution 38%, respectively They were wiped out with a cotton roll after 3 minutes and were kept in artificial saliva in separate containers.
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