SDF Application Research Articles

Is SDF better than the SMART (silver modified atraumatic restorative technique) in the management of molar incisor hypomineralisation molars with initial caries?

A prospective, randomized, split-mouth clinical study by thetwo previously trained and calibrated pediatric dentists without blinding operators and patients due to different protocols in both treatment groups. An SDF + potassium iodide (KI) and SDF + KI + glass ionmer cement(GIC) on International Caries Detection and Assessment System (ICDAS) 1/2 molar was received by each patient on either sideof mouth. The local Ethics Committee approved this study. Sample size calculation was not performed due to the lack of published studies on the longevity of SMART sealant on MIH-affected molarsand the absence of research on the apparent difference between the effectiveness of SMART and SDF treatments in preventing further caries and sensitivity. These were children between the ages of 6 years to 13 years, who visited the Pediatric Dentistry Clinic at XX University School of Dentistry for routine exams and treatment between July 2019 to May 2020. They were in good health and had at least two fully erupted permanent first molars with MIH as per the European Academy of Pediatric Dentistry, ICDAS code 1/2. This study recorded 12 months of treatment outcomes on hypomineralised molars of 48 children with a follow-up of three years. Children were excluded with specific syndromes associated with enamel malformation, lack of cooperation, ongoing orthodontic treatment, and teeth with ICDAS 3/4/5/6 lesions, existing restorations, fluorosis, or pulpal symptoms. Mann-Whitney U Test was used to assess differences between independent groups (SDF and SMART) and the Friedman Test between dependent groups at different time points. Kaplan-Meier analysis to evaluate the cumulative survival of SMART sealants and survival of caries-free hypomineralised molars in both groups. Chi-Square test was used to compare the success percentages of the SDF and SMART groups. To assess the changes in success percentages at three different time intervals for the caries preventive effect of SDF and SMART, and to evaluate the retention percentages for the SMART group. McNemar's test with a Bonferroni correction was used for significant differences. Cohen's kappa test indicated that the inter-examiner reliability determining the presence of MIH was 0.87. The intra-examiner reliability for US Public Health Service (USPHS)-Modified criteria was 0.90. The statistical significance level was set at p < 0.05 for all statistical analyses. At 12, 24 and 36 months the caries preventive effect was 100%, 67.9%, and 65.4% for SDF + KI-treated teeth; and 100%, 97.6%, and 94.7% for SMART (SDF + KI + GIC) respectively. During the recall period, there was no substantial difference in hypersensitivity scores between the groups. There was no hypersensitivity in teeth at 18 months and beyond. Compared to the baseline Schiff Cold Air Sensitivity Scale (SCASS) score 26 molar with initial hypersensitivity to hypomineralisation had a massive reduction at evaluation periods. The mean survival probabilities for the caries-preventive effect were considerably lower in SDF + KI-treated teeth (31.01 months) than in SMART-treated teeth (35.61 months) (p < 0.001). Considering the limitation of the study, both SMART (SDF + KI + GIC) sealants and 6-monthly application of SDF + KI, provided similar and substantial levels of desensitisation on the permanent MIHmolars. When used as a sealing material on non-cavitated permanent MIHmolars, the clinical retention rate for SMART was 88.7%, 73.1%, and 66.6% at 1, 2, and 3 years respectively. The caries preventive effect of SMART (SDF + KI + GIC) sealants was superior to SDF + KI application in hypomineralised teeth, however, a long-term monitoring and review is essential due to the gradual decrease in retention of SMART sealants.

Survival of different caries managements in children with autism and unaffected peers: a retrospective cohort study.

Dental caries is a common oral disease in children with special needs such as those with autism spectrum disorders (ASDs). The aim is to assess whether the type and survival of three caries management, conventional resin restorations (CR), ART technique (ART) and SDF application without caries removal (SDF), in primary teeth carried out at the Pediatric Dentistry Department of San Paolo Hospital (University of Milan) differed between children with ASDs and unaffected peers. Data from a convenience sample of children with and without ASDs, who have received dental care for caries in primary teeth from January 2019 to June 2022, were analysed. Medical history, age, sex, teeth treated, and type of treatment were collected from dental charts. Data on success and minor and major failures of each treatment were also collected. Two survival analysis were performed, one considering both major and minor failures, a second considering only major failures. Cox Proportional Hazards multivariate logistic models were run to assess factors associated with failures. The statistical significance was set at 5% (p< 0.05). In children with autism, the different techniques for approaching caries lesions seem to have the same probability of success. Therefore, the choice of treatment should be patient-oriented rather than lesion-oriented. In unaffected children, the gold standard always seems to be traditional restorative treatment.

Effects of silver diammine fluoride with/without potassium iodide on enamel and dentin carious lesions in primary teeth.

To assess the effects of SDF and SDF+KI treatment on enamel and dentin carious lesions in primary teeth using x-ray Microtomography (XMT) and back scattered scanning electron microscopy (BSE-SEM). Artificial enamel caries of 3 caries free primary teeth were created by immersion of the samples in 50 ml demineralization solution for 72 h. Three other teeth with natural dentin caries were selected. Both groups were divided into 3 subgroups: EC-Enamel Control; ES-Enamel with SDF application; ESK-Enamel with SDF followed by KI application; DC-Dentin Control; DS-Dentin with SDF application; DSK-Dentin with SDF followed by KI application. Each tooth was imaged using XMT at 3 time points: (1) Pretreatment; (2) after immersion in remineralization solution for 120 h, with or without SDF or SDF+KI; (3) after subsequent immersion in demineralization solution for 72 h. The change of radiopacities of the lesions in these time points were assessed from the XMT images. After the XMT scans, all teeth were investigated microscopically using BSE-SEM. In EC, no change in linear attenuation coefficient (LAC) was observed after remineralization, but LAC reduction was observed after subsequent demineralization. For ES, thin layer of high LAC material was deposited on the enamel surface after remineralization, and further reduction of LAC was observed after demineralization. In ESK, the surface layer was lost after SDF+KI, and small reduction of LAC was observed after demineralization. In DC, no LAC change was observed after remineralization, but reduction of LAC was detected after demineralization. In DS, high LAC material was formed on the carious dentin surface and randomly inside the lesion. No further LAC change was found after demineralization. In DSK, thick layer of high LAC material was deposited on the carious surface and inside the dentinal tubules. No further LAC reduction was found after subsequent demineralization. SDF and SDF+KI did not protect artificial enamel under acid attack even though Ag products were deposited in the porous enamel. However, SDF and SDF+KI shows protective properties against acid challenges and Ag products are deposited in carious dentin lesion without tubular structure randomly; and within dentinal tubules when these structures are retained.

Effects of light curing on silver diamine fluoride-treated carious lesions: A systematic review.

This systematic review aims to evaluate the potential benefits and underlying mechanisms of combining SDF with light curing, based on available studies. A systematic search of publications was conducted with the keywords "silver diamine fluoride" or "silver fluoride" and "dental light curing," "LED curing," "dental laser," and "dental polymerization" in 4 databases: PubMed, EBSCO, Scopus, and Google Scholar to identify English-language articles published up to March 2023. Duplicate publications were deleted. Two reviewers screened the titles and abstracts and excluded irrelevant publications. The full text of the remaining publications was retrieved. Studies investigating the effect of light-curing on SDF-treated carious lesions were included. The 175 publications initially found included 5 laboratory studies investigating the effects of light curing on 38% SDF-treated dentine carious lesions, but no clinical study was found. Four of these studies were conducted on extracted primary teeth, and one was on extracted permanent teeth. SDF with light curing increased microhardness (n = 3, p < .05) showed a higher mineral density (n = 1, p < .041) and had more silver ion precipitation in infected dentine (n = 1, p < .016) compared to SDF without light curing. Moreover, no significant differences in the antibacterial activity were observed between SDF with light curing and SDF alone (n = 1, p > .05). Drawing from the limited number of laboratory studies, incorporating light curing subsequent to the SDF application yields potential favorable outcomes that include augmented microhardness, elevated mineral density, and heightened silver ion precipitation within infected dentine. Future clinical research is required to confirm or refute the benefit of light curing on SDF-treated carious lesions.

A randomised clinical trial to arrest caries using silver diamine fluoride therapy with two postoperative instructions

ObjectiveThe objective of this study is to investigate the beneficial effect of not rinsing for 30 min in arresting early childhood caries after SDF therapy. MethodsThis randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38 % SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 min. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups. ResultsThis study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92 %) children with 1,069 (92 %) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p > 0.05). The caries-arrest rate for group A and group B were 65 % (337/519) and 61 % (338/550), respectively (p = 0.28). ConclusionThis randomised clinical trial found not rinsing for 30 min after SDF therapy is not better than immediate rinsing in arresting early childhood caries. Clinical significanceTopical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.

EVALUATING THE EFFICACY OF 38% SDF VS 5% NAF VS APF GEL IN ARRESTING DENTAL CARIES AND REDUCING BACTERIAL ACTIVITY: AN IN-VIVO STUDY

Background: The study was formulated to compare the efficacy of 38% SDF as a caries arresting agent as well as antibacterial and antiplaque agent in vivo with 5% sodium fluoride varnish (NaF) and 1.23% acidulated phosphate fluoride (APF) gel. Study Design: Total of 74 children aged 6-9 years (boys = 34, girls = 40) who had active caries with dmfs/DMFS score equal to or more than 1 were included in the study for a period of 12 months. Children were divided into three different groups-Group 1: 38%SDF Group 2: 5% fluoride varnish and Group 3: 1.23% APF gel. Fluoride application was done at baseline, 6th month and 12th month. Saliva collection was done at baseline, after 72 hrs, 6th month and12thmonth.Tryptone-yeastcysteine-sucrose-bacitracin agar (TYCSB) was used inoculate salivary Streptococcus mutans and incubated at 37°C for 72 hrs.The colony characteristics were studied and number of colony forming units of Streptococcus mutans (CFU/ml) of saliva were counted using digital colony counter.All subjects were evaluated for caries arrest status and plaque score (Silness&amp;Loe index)at 6th and 12thmonthas well as Streptococcus mutans counts in saliva at 72 h, 6th and 12thmonth. Results: Significant reduction was found in caries arrest status plaque score as well as S. mutans counts in Group 1 as compared with Groups 2 and 3. Conclusion: In vivo application of SDF is effective in controlling progression of caries, decreases plaque score and S. mutans counts in saliva as compared to fluoride varnish and APF gel.

Effect of SDF Application versus Diode Laser Irradiation on Incipient Carious Lesion’s Progression in Primary Molars: A Randomize Clinical Trial

Effect of SDF Application versus Diode Laser Irradiation on Incipient Carious Lesion’s Progression in Primary Molars: A Randomize Clinical Trial

Effects of Kiwifruit Dietary Fibers on Pasting Properties and In Vitro Starch Digestibility of Wheat Starch.

In this study, the roles of kiwifruit soluble/insoluble dietary fiber (SDF/IDF, respectively) in the pasting characteristics and in vitro digestibility of wheat starch were explored. According to RVA and rheological tests, the IDF enhanced the wheat starch viscosity, decreased the gelatinization degree of the starch granules, and exacerbated starch retrogradation. The addition of SDF in high quantities could reduce the starch gelatinization level, lower the system viscosity, and exacerbate starch retrogradation. Through determining the leached amylose content and conducing scanning electron microscopy, the IDF and SDF added in high quantities was combined with the leached amylose wrapped around the starch granules, which reduced the leached amylose content and decreased the gelatinization degree of the starch granules. The Fourier transform infrared results showed that the addition of both the IDF and SDF resulted in an enhancement in hydrogen bonding formed by the hydroxyl groups of the system. The in vitro digestion results strongly suggested that both the IDF and SDF reduced the wheat starch digestibility. The above findings are instructive for the application of both IDF and SDF in starchy functional foods.

Determining the fundamental dynamics of global sustainability in the Anthropocene from a vulnerability perspective

This paper conducts a detailed quantitative study of the indicated long-term levels, nature and dynamics of sustainability at the global spatial scale over time, within the context of the vulnerability of the environment-human relationship and system. In this study, the Sustainability Dynamics Framework is applied to the results of the Notre Dame Global Adaptation Initiative index for the period 1995–2018. The study indicates that the obtained S-values at the global spatial scale throughout the specified period were consistent with very weak unsustainability occurring. Through statistical analysis, the study indicates that the triumvirate of influencing factors (Population, GDP, Greenhouse Gases) have a significant influence and impact individually and cumulatively upon obtained S-values. The study then determines the net change in obtained E, HNI and S-values, and consequently evaluates the dynamics of the rate of change of the Earth System ( dE/dt), as defined in the Anthropocene Equation theory. To support this, Fourier analysis of net change of S-values is applied for the first time within the SDF application methodology, using eight time periods of 16 years’ duration over the period 1996–2018. The analysis indicates continuous overlapping cycles of 7 years’ duration, consisting of a lag time of 3 years leading to an impact period of 4 years. The Fourier analysis potentially indicates clearly for the first-time humanity’s footprint signal upon the environment-human relationship and system in the Anthropocene. The study concludes that humanity’s actions and inactions have resulted in the indicated unsustainability and vulnerability of the environment-human relationship and system. As a consequence, there is a potential realistic risk of systemic collapse unless fundamental changes occur in respect to the global environment-human relationship.

Quantitative and dynamic scenario analysis of SDGs outcomes upon global sustainability 1990–2050

The UN Sustainable Development Goals (SDGs) are the keystone policy framework for countries to achieve sustainable development. However, in fulfilling the SDGs, there is no definitive evaluation of the potential long-term outcomes upon the level, nature, and dynamics of global sustainability. This is crucial to understand, as otherwise, governments and societies may implement policies which achieve the SDGs, but are detrimental to the long-term global co-evolutionary environment-human relationship and system. Therefore, this paper determines and evaluates the potential global sustainability outcomes of the implementation of the SDGs for the specified period of 1990–2050. This is achieved by the application of the Sustainability Dynamics Framework to the results of the Earth3 model. The Earth3 model evaluated the degree of success of implementing the SDGs in respect to four development scenarios: (1) Same (business-as-usual); (2) Faster; (3) Harder and (4) Smarter. The results from the SDF application indicate that Scenario 4 (Smarter) had the best potential outcomes of the scenarios evaluated, approaching a borderline weak-strong sustainability state by the end of the specified period. The other scenarios had relatively stagnant levels of very weak sustainability. Based upon the results obtained, the broader context and implications are discussed, primarily in respect to the role and impact of the SDGs. The paper concludes by stating that humanity as a species needs to fundamentally transform its relationship with the environment, or risk being lost not only as a species, but also to the planet as well.

A Comparative Evaluation of Shear Bond Strength of Type IX GIC to Demineralized Dentin in Primary Teeth with and without Application of SDF: An In Vitro Study

A Comparative Evaluation of Shear Bond Strength of Type IX GIC to Demineralized Dentin in Primary Teeth with and without Application of SDF: An In Vitro Study

Effects of a 445 nm diode laser and silver diamine fluoride in preventing enamel demineralisation and inhibiting cariogenic bacteria

ObjectiveTo study the effects of a 445 nm diode laser (L) and silver diamine fluoride (F) on preventing enamel demineralisation and inhibiting cariogenic bacteria. MethodsThirty-three enamel slices were sectioned each into four blocks for four groups to receive L with F (LF), F, L and Water (W, control). Ten blocks from each group were used to evaluate demineralisation. Surface morphology, lesion depth and nanohardness of the blocks after pH-cycling were studied by scanning electron microscopy (SEM), nanohardness test, and micro-computed tomography, respectively. Twenty-three blocks per group were used for biofilm assessment. Morphology, viability, and growth kinetics of the Streptococcus mutans biofilm were assessed by SEM, confocal laser scanning microscopy, and the counting of colony-forming units (CFUs), respectively. ResultsSEM images of LF-treated enamel showed an intact surface compared with other groups. Nanohardness (GPa) for LF, F, L and W were 1.43±0.17, 1.01±0.11, 1.04±0.13 and 0.73±0.14, respectively (p < 0.001; LF>F, L>W). Their lesion depths (µm) were 46±8, 52±6, 88±13 and 111±9, respectively (p < 0.001; LF, F<L<W). SEM showed few bacteria for LF and F compared with other groups. Their dead-live ratio were 1.67±0.13, 1.60±0.15, 0.39±0.05 and 0.32±0.05, respectively (p < 0.001; LF, F>L>W). Log CFUs for LF, F, L and W were 4.2±0.3, 4.5±0.2, 7.9±0.3 and 9.4±0.2, respectively (p < 0.05; LF<F<L<W). Two-way ANOVA analysis revealed an interaction effect on nanohardness and Log CFUs between the laser irradiation and SDF treatment (p < 0.001). ConclusionThis study showed a superior caries preventive effect of a combined treatment of the diode laser and SDF. Because diode laser and SDF are affordable and readily available, clinicians can provide this treatment to their patients for caries prevention. Clinical significance statementDiode lasers are handy, afforable and readily avaliable to clinicians. This study provides information of use of 445 nm diode laser for caries prevetion. The laser irradiation hopefully can be added before conventional topical SDF application.

Growth Increment of Tissue Cultured Abaca Seedlings Applied with Conventional Fertilizer and Biostimulant

This study was conducted purposely to investigate the growth increment of tissue cultured Abaca seedlings applied with conventional fertilizer and biostimulant. And successfully reject the hypothesis that there is no significant difference on the plant height, pseudostem girth, leaf count per plant, leaf area per plant, shoots length, number of primary roots, and roots length of Abaca to the different combination of conventional and biostimulant fertilizers. And there is no correlation between treatments and parameters.&#x0D; The application of SDF significantly promoted plant growth and root architecture of Abaca compared with the control, even with a limited amount of mineral nutrient input. Among the four with SDF treatments applied in the study, 100%, 75%, and 2.5g CF combined with SDF proved to be effective in both root development and aboveground growth promotion. There is a positive correlation between treatments and parameters.

Effect of silver diamine fluoride, potassium iodide, and glutathione on micro-shear bond strength of glass ionomer cement to caries affected dentine.

Silver diamine fluoride (SDF, 38%) is an efficient topical fluoride used to arrest dental caries though it causes black staining of both teeth and restoration. The application of potassium iodide (KI) after SDF reduces the stain, but the color change is only temporary. An alternative method suggested is by mixing glutathione (GSH) with SDF, which preserves the silver ions of SDF within the solution. Hence, the purpose of this in vitro study was to evaluate the microshear bond strength (μSBS) of glass ionomer cement (GIC) to caries affected dentin (CAD) pretreated with SDF/KI/GSH. Thirty dentine slices of 2 mm thickness from human permanent upper premolars were demineralized using pH cycling method to mimic CAD. They were allocated to three groups of 10 each and treated with SDF, SDF-KI (SDF followed by KI), SDF + GSH (SDF mixed with GSH), respectively. Specimens were bonded with GICs. The μSBS was assessed using a universal testing machine and the data obtained were analyzed using one-way ANOVA and Tukey's post hoc test. The μSBS (mean ± standard deviation) values for groups SDF, SDF-KI, and SDF + GSH were 4.81 ± 2.026, 5.78 ± 1.809, 8.18 ± 2.828 megapascal respectively. Group 3 showed significantly better bond strength compared to groups 1 and 2. In group 2, the addition of KI showed better bond strength when compared to group 1, but the difference was not statistically significant. Pretreatment of teeth with GSH along with SDF application showed significantly better bond strength of GIC to CAD compared to SDF and SDF-KI.

The Effect of Various Fluoride Products on Dentine Lesions during pH-Cycling

This study compared the effect of topically applied fluoride products on dentine lesions in an in vitro experiment. Demineralized bovine dentine specimens were treated once with either SDF solution (35,400 ppm F), NaF varnish (22,600 ppm F), TiF₄ solution (9,200 ppm F), SnF₂ gel (1,000 ppm F), no treatment (control), or preserved as baseline lesions. After the application and subsequent removal of the fluoride products, the specimens were subjected to pH-cycling. Calcium loss and uptake in the de- and remineralization buffers were assessed daily. Fluoride release into the buffers was analyzed on days 1, 2, 3, 5, 8, and 13. After the pH-cycling period, mineral distribution throughout the lesion depth was analyzed using transversal microradiography (TMR). X-ray energy-dispersive spectroscopy (EDS) examined the deposition of silver, titanium, and tin after application of SDF, TiF₄, and SnF₂, respectively. Overall, calcium loss and uptake analysis in the de- and remineralization buffers revealed that the SDF product was the most effective in inhibiting lesion progression, followed by the TiF₄, NaF, and SnF₂ products. Fluoride analysis disclosed a steep reduction of the amount of fluoride released into de- and remineralization buffers with time. The fluoride effects on de- and remineralization continued beyond the days that fluoride was released into the buffers. TMR analysis showed significant remineralization in the outer zone of the dentine lesions for all fluoride products, with SDF giving hypermineralization in this zone. In the inner zone, lesions developed in all fluoride groups, with the smallest in the SDF group. EDS showed silver and titanium deposition in depth up to 85 μm and 8 μm, respectively, while no tin deposition was observed. The silver in the dentine lesions did not contribute significantly to the density of the TMR profiles in the SDF group. In conclusion, all topical fluoride products protected the dentine lesions against lesion progression, but at different degrees. SDF showed a superior effect in protection against further demineralization and enhancement of remineralization. This was probably attributed to its fluoride concentration that was the highest among the fluoride products.

Assessment of flow within developing chicken vasculature and biofabricated vascularized tissues using multimodal imaging techniques

Fluid flow shear stresses are strong regulators for directing the organization of vascular networks. Knowledge of structural and flow dynamics information within complex vasculature is essential for tuning the vascular organization within engineered tissues, by manipulating flows. However, reported investigations of vascular organization and their associated flow dynamics within complex vasculature over time are limited, due to limitations in the available physiological pre-clinical models, and the optical inaccessibility and aseptic nature of these models. Here, we developed laser speckle contrast imaging (LSCI) and side-stream dark field microscopy (SDF) systems to map the vascular organization, spatio-temporal blood flow fluctuations as well as erythrocytes movements within individual blood vessels of developing chick embryo, cultured within an artificial eggshell system. By combining imaging data and computational simulations, we estimated fluid flow shear stresses within multiscale vasculature of varying complexity. Furthermore, we demonstrated the LSCI compatibility with bioengineered perfusable muscle tissue constructs, fabricated via molding techniques. The presented application of LSCI and SDF on perfusable tissues enables us to study the flow perfusion effects in a non-invasive fashion. The gained knowledge can help to use fluid perfusion in order to tune and control multiscale vascular organization within engineered tissues.

Child discomfort and parental acceptability of silver diamine fluoride and alternative restorative treatment: A randomized controlled clinical trial

ObjectivesTo compare pain perception of young children treated with SDF and ART, as well as their parents' acceptability of both modalities. MethodsEighty, 3 to 8-years old children, having at least one deciduous asymptomatic tooth with active caries, as defined by the ICDAS II scores 4, 5, 6 were randomly assigned into two groups; SDF for caries arresting in the test group, and ART for caries removal in the control group. Pain perception was assessed using Sound, Eye, Motor scale (SEM), whereas parental acceptability was assessed using a self-administered questionnaire. ResultsPatients treated with SDF reported significantly less discomfort and pain compared to the ART group, with a mean SEM of 3.70 ± 1.47 and 6.18 ± 3.06, respectively (p < 0.001). A significantly higher mean parental acceptability score was detected for SDF treatment (31.85 ± 2.30) than ART treatment (26.75 ± 3.60), p < 0.001, with regard to the treatment duration, child comfortability and quality of treatment (p < 0.001). The only dimension showing more satisfaction for the ART treatment was esthetics of anterior teeth (p= 0.01). ConclusionsParental acceptability was higher for the SDF caries treatment of primary teeth compared to ART treatment, especially in relation to the shorter intervention time, child comfortability and acceptance as well as quality of treatment. Clinical SignificanceThe shorter average time needed and the ease of application of SDF on cavitated primary lesions, in addition to parental acceptability, place SDF in an advantageous position over the ART on clinical level.

Pain, New Caries and Failure of Carious Primary Teeth after Application of Silver Diamine Fluoride Versus Sodium Fluoride Varnish: A Randomized Clinical Trial

Background: The aim of this study was assessment of the pain, new caries and failure of carious primary teeth after application of silver diamine fluoride versus sodium fluoride varnish immediately after application and after 3,6,9,12, months. Methods: This study was performed on 62 children with 255 carious primary teeth. After proper selection according to eligibility criteria and proper diagnosis. They were randomly allocated (1:1) into two groups. Group I (SDF): 38% Silver Diamine Fluoride and group II (NAF): 5% Sodium Fluoride Varnish. Assessment of postoperative pain, new caries,and failure at baseline, after 3,6,9,12, months. Results: Independent t-test was performed to compare between both groups and revealed that group II was significantly higher than group I after 9 and 12 months regarding postoperative pain, new caries, and failure.Also, strong positive significant correlation between failure and pain, and between failure and new caries was found using Spearman`s correlation coefficient test. Conclusions: SDF application isa successful alternative conservative treatment which eliminate the need to general anesthesia. Also, it is inexpensive, fast, and pain-free procedure but it causes discoloration. It`s successful results regardingstopping progression of new caries compensate its drawbacks such as discoloration.

Microbial population shift and metabolic characterization of silver diamine fluoride treatment failure on dental caries.

The objective of this pilot study was to describe the microbial profiles present in the plaque and saliva of children who continued to develop new carious lesions following treatment with silver diamine fluoride ("nonresponders") compared to caries active, caries-free, and children immediately receiving SDF treatment for untreated caries in order to identify potential microbial differences that may relate to a re-incidence of caries. Saliva and plaque samples from infected and contralateral sites were obtained from twenty children who were either caries free, had active carious lesions, were caries active and received SDF treatment immediately before sampling, or had previously received SDF treatment and developed new caries. In total, 8,057,899 Illumina-generated sequence reads from 60 samples were obtained. Reads were processed using the Quantitative Insights Into Microbial Ecology pipeline. Group differences were assessed using Analysis of Variance Models and Tukey Honest Significant Differences. To identify significant taxa between treatment groups, Linear discriminant analysis Effect Size (LefSe) and Analysis of Differential Abundance Taking Sample Variation Into Account were used. Differential abundant analysis indicated that members of the Lachnospiraceae family were significantly enriched in non-responders and the genus Tannerella and species Granulicatella adiances were also highly abundant in this group. LefSe analysis between non-responders and SDF-treated groups revealed that genera Leptotrichia and Granulicatella were enriched in non-responders. We observed the highest abundance of phosphotransferase system and lowest abundance of lipopolysaccharide synthesis in non-responders. The microbiome in dental biofilms is responsible for initiation and progression of dental caries. SDF has been shown to be effective in arresting the progression carious lesions, in part due to its antimicrobial properties. Findings suggest that the differential abundance of select microbiota and specific pathway functioning in individuals that present with recurrent decay after SDF treatment may contribute to a potential failure of silver diamine fluoride to arrest dental caries. However, the short duration of sample collection following SDF application and the small sample size emphasize the need for further data and additional analysis.

Monitoring silver diamine fluoride application with optical coherence tomography.

The objective of this study was to investigate the use of optical coherence tomography (OCT) for monitoring changes in the structure of caries lesions overtime after treatment with silver diamine fluoride (SDF). Artificial caries lesions were formed on dentin bovine blocks. Each block was partitioned into 5 windows: one lesion was covered by nail varnish as control (LC), one sound window was covered with nail varnish (SC), one sound window was exposed to SDF (SCT), one lesion received 2 applications of SDF (L2), while the other lesion received one application of SDF (L1). Each window was scanned using OCT before SDF application, and every week subsequently, for 12 weeks after initial SDF treatment. Parameters such as mean intensity and the width of the peak of increased reflectivity located at the sample surface and the intensity at a depth of 180-μm were monitored. High-resolution microscopy was also used to for the analysis of selected samples. Changes in the parameters measured showed significant changes on dentin lesions after SDF application. OCT resolved structural changes after SDF application as well as changes overtime. High resolution microscopy images confirm penetration of SDF into the samples. Such changes can potentially be monitored to determine if and when re-application of SDF is needed.