Efficacy Of Silver Diamine Fluoride Research Articles

Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

Background This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and casein phosphopeptide-amorphous calcium phosphate fluoride varnish (CPP-ACPFV) in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or CPP-ACPFV treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and CPP-ACPFV (P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups (P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with CPP-ACPFV. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and CPP-ACPFV as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration ISRCTN54243749 (13/01/2022).

The Efficacy of Silver Diamine Fluoride as a Caries Preventive Agent on Permanent Teeth: A Scoping Review

AbstractDental caries is a chronic condition that affects people of all ages and has a high prevalence in Indonesia. Applying silver diamine fluoride (SDF) as a topical fluoridation agent is one of the approaches to prevent bacterial interactions that lead to the development of carious lesions. This study aims to determine the efficacy of SDF as a caries preventive agent on permanent teeth. Article searches were conducted using the keywords “silver diamine fluoride” AND “permanent tooth OR permanent teeth” AND “caries OR dental caries” AND “remineralize” through digital databases including PubMed, Cochrane Library, Science Direct, and Google Scholar. Articles with randomized controlled trial or nonrandomized controlled trial designs, articles written in Indonesian or English, publications published within the last 5 years (2016–2021), and aligned with the PCC (population, concept, and context) framework were included. Articles that were not accessible in full text or in a paid format, those that were of the meta-analysis or systematic review study type, and those that did not evaluate the use of SDF as a caries preventive agent were excluded from consideration. This scoping review refers to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Reviews (PRISMA-ScR) guidelines. A total of 8 articles were reviewed, encompassing various locations, designs, and samples, which demonstrated the use of SDF resulted in a high percentage of fluoride release with a high degree of remineralization efficacy. The deposition of crystals or minerals into fissures and crevices caused by demineralization indicated a reduction in lesion depth and influenced the microhardness of enamel. SDF can stimulate the rehardening of tooth structures rich in calcium and phosphate. The solution of SDF has the potential to serve as an alternative substance for preventing caries in permanent teeth because it enhances mineral precipitation and mineral density, promotes the remineralization of hydroxyapatite in enamel by increasing fluoride, and increases tooth structure resistance to acid attack.

Efficacy of Silver Diamine Fluoride in Arresting Dental Caries in Primary Teeth in Patient Visiting Tertiary Hospital of Kathmandu

IntroductionCarious lesions can both be prevented and arrested using fluoride-based materials. This study was done to evaluate and compare the efficacy of silver diamine fluoride in arresting dental caries at different frequencies of applications. MethodsThis experimental study was conducted among ten preschool children of 3-5 years old with seventy-four active carious lesions taking teeth as a sample unit. Children were randomly allocated into two intervention groups: Group 1— application of 38% silver diamine fluoride solution atthree consecutive weeks and Group 2— three applications of 38% silver diamine fluoride solution at monthly interval. The time taken of caries arrest was recorded. Data were collected and entered in Microsoft Excel sheet and analysis was done in Statistical Package for the Social Sciences (SPSS) version 16. ResultsThe mean time taken for caries arrest for Group II (57.20 days) was found to be statistically longer than Group I (21.54 days) (p-value < 0.001). As the mean time taken for caries arrest for Group I was shorter, the weekly application was found to have higher efficacy than the monthly application. ConclusionsEfficacy of Silver Diamine Fluoride was found to be more in Group I (weekly application) compared to Group II (monthly application).

Efficacy of Different Fluoride Therapies on Hypersensitive Carious Lesions in Primary Teeth.

Background and Objectives: This prospective, comparative, double-cohort study aimed to compare the efficacy of silver diamine fluoride and potassium iodide (38% SDF+KI; Riva Star®) with sodium fluoride varnish (5% NaF; Duraphat®) in hypersensitive carious lesions in primary teeth to evaluate caries arrest and hypersensitivity relief. Materials and Methods: This study included thirty 2-5-year-olds (mean age = 3.67 ± 1.06 years; 16 males and 14 females) who required a desensitizing treatment for hypersensitive carious defects with visible dentin. A total of 15 of the participants were consecutively allocated to treatment with 5% NaF, and they were further compared to an equal number of participants treated with 38% SDF+KI solutions (n = 15). The treatments were performed following clinical evaluation of caries activity using the International Caries Classification and Management System (ICCMSTM) and the Bjørndal criteria (score of 0-9). Parental-reported hypersensitivity was evaluated using a visual analogue scale (0-10 = no to severe pain). Results: Clinical variables were evaluated at baseline and three months after treatment. Thereafter, a significant decline in hypersensitivity/pain led to lower final scores in the Riva Star® group (0.40 ± 1.12, p = 0.002) than in the Duraphat® group (1.40 ± 2.20, p = 0.004). The caries arrest effect was significantly higher in the Riva Star® group (86.7%) compared to the Duraphat® group three months after treatment (13.3%, p < 0.001). In both groups, there were no statistically significant differences in the children's behavior before, during, and after treatment. Conclusions: Ultimately, with both fluoride therapies reducing hypersensitivity/pain significantly, treatment with 38% SDF+KI was clearly more effective in caries arrest than 5% NaF varnish after a 3-month period.

Antibacterial Behavior of Silver Diamine Fluoride, Sodium Hypochlorite and Ozone Gel on Enterococcus faecalis in Root Canal of Deciduous Teeth

Introduction: Enterococcus faecalis (E. faecalis) has been reported as one of the most important causes of failed endodontic treatments. Various antibacterial agents have been suggested to remove E. faecalis from the root canal. We aimed to investigate and compare the antibacterial efficacy of silver diamine fluoride (SDF), Sodium hypochlorite (NaOCl) and ozone gel on E. faecalis in the root canal. Materials and Methods: This study involved 60 extracted roots of molar teeth with a single root canal to generate a 6-week-old biofilm for evaluating antibacterial effects. After teeth decorating and removing the smear layer using sodium hypochlorite (2.5%) and EDTA (17%), roots were sterilized by autoclave. Under sterile conditions, 1 ml of the suspension containing E. faecalis bacteria was transferred to each of the microtubes containing teeth. The samples were divided into four groups: exposed to NaOCl (2.5%) as a positive control, exposed to liquid ozone (25 ppm), exposed to SDF (3.8%), and exposed to normal saline as a negative control group. Then, the colony forming unit (CFU) was counted in the studied groups. Kruskal-Wallis test and Dunn-Bonferroni post-hoc analysis were carried out for comparison of CFU in the studied groups. Results: The mean of CFU were 17846, 920, 234, and 336 for saline, ozone, NaOCl, and SDF, respectively. There were significant differences in CFU in the comparison of (NaOCl-Ozone), (NaOCl-saline), (SDF-saline), and (ozone-saline) (P&lt; 0.05). However, there was no significant difference for CFU in the comparison of NaOCl-SDF (P= 0.570). Conclusion: The study findings showed that NaOCl (2.5%) and SDF (3.8%) were more effective against the 6-week-old E. faecalis biofilms than ozone and saline.

Preventive efficacy of silver diamine fluoride and MI Varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

Background: This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and MI Varnish in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods: A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or MI Varnish treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results: The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and MI Varnish (P-value &lt; 0.05). Similarly, there was a significant difference in caries progression between the two groups (P-value &lt; 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions: In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with MI Varnish. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and MI Varnish as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration: ISRCTN54243749 (13/01/2022).

Is silver diammine fluoride effective in arresting dental caries in cavitated primary molars?

To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dental caries in cavitated caries lesions in primary molars. A systematic search was carried out in PubMed, Scopus, and Embase. Furthermore, cross-referencing was performed using the references lists of full-text articles and grey literature was also retrieved for eligible studies. Two independent reviewers were responsible for study selection and data extraction. Randomized and non-randomized clinical studies that evaluated the caries arrest rate of SDF compared to no treatment or any other type of non-invasive or minimally-invasive treatment were included. Only publications in the English, Italian and French language and with a minimum follow-up of 6 months were considered for study eligibility. The characteristics of the included studies-age, sex, type of study, sample size, caries at baseline, setting, operator, blinding, intervention, outcomes and assessment of any confounders-were extracted from the included papers. The quality assessment was carried out using the Cochrane risk of bias tool. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of nine publications were included for qualitative review and five of them were included in the meta-analysis. Around half of lesions that received annual or biannual application SDF ≥ 38% were arrested. SDF 38% application was found to be effective in arresting dental caries progression in cavitated primary molars.

Silver Diamine Fluoride (SDF) Efficacy in Arresting Cavitated Caries Lesions in Primary Molars: A Systematic Review and Metanalysis.

A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars. A search for randomized and non-randomized trials with follow-up > 6 months was performed using PubMed, Scopus and Embase. The Cochrane risk of bias tools were used for the quality assessment. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of 792 papers were identified and 9 were selected. A high variability regarding SDF application protocol was found; otherwise, caries arrest was always recorded using visual/tactile methods. Two studies were judged at low risk of bias, six at moderate risk and one at high risk. Data from five studies were aggregated for meta-analysis. Heterogeneity was found moderate (I2 = 35.69%, p = 0.18). SDF application was found to be overall effective (fixed effect model) in arresting caries progression (ES = 0.35, p < 0.01). In a total of 622 arrested lesions, out of 1205 considered, the caries arrest rate was 51.62% ± 27.40% (Confidence = 1.55) using SDF ≥ 38% applied annually or biannually. In conclusion, when applied to active cavitated caries lesions in primary molars, SDF appears to be effective in arresting dental caries progression, especially if applied biannually.

Morphological aspects in remineralizing potential of Silver Diamine Fluoride.

Objectives: The purpose of this study was to demonstrate the efficacy of Silver Diamine Fluoride (SDF) antibacterial solution in penetrating the demineralized areas of enamel. Materials and Methods: It was considered a group of four extracted teeth (with no color fading, fissures, decay, or demineralization). Each tooth was sectioned in two equal parts, in mesio-distal direction, using a dental handpiece and a special rounded, flat bur. Each specimen was demineralized, for one minute, with 45% orthophosphoric acid, on occlusal and proximal zones. The specimens were then washed and dried with water-air dental syringe. All the probes were inspected with an optical microscope and enamel thickness was digitally measured. Advantage Arrest (Elevate Oral Care, USA), which contains SDF, was applied on the previous demineralized zones. The penetration of the substance was visually inspected with the optical microscope and electronically measured. Results: It was observed an improvement in remineralizing the white spots on enamel surfaces, the optical microscope being able to detect both demineralization and the penetration of SDF through enamel. Conclusions: Based on our in vitro study, SDF (Advantage Arrest) was capable to induce/increase enamel remineralization, through SDF penetration.

Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.

The effect of silver diamine fluoride on the remineralization of early enamel carious lesions under pH-cycling conditions

BackgroundThis study explored the in vitro anticaries efficacy of silver diamine fluoride (SDF) in remineralizing early enamel carious lesions. MethodsLesions were created in human enamel specimens, which were divided into 5 groups (n = 36): SDF (38%), SDF and potassium iodide (SDF and KI), potassium fluoride (KF), silver nitrate (AgNO3), and deionized water (DIW). Treatments were applied once. Groups were divided into 2 subgroups (n = 18), pH cycled for 5 days with twice-daily treatments with either fluoride or DIW. Vickers hardness number measurements were conducted at each stage. Data were analyzed using a 2-way analysis of variance. ResultsThe 2-way analysis of variance for ΔVickers hardness number was significant (P < .0001). In both pH-cycling models (with or without fluoride), SDF, SDF and KI, and KF promoted more remineralization than AgNO3 and DIW (P < .0001). In the presence of twice-daily fluoride treatments, there was no difference between SDF, SDF and KI, and KF (P = .4577). However, in the absence of fluoride treatments, SDF promoted more remineralization than SDF and KI and KF (P < .0001). There were no differences between SDF and KI and KF (P = .4577 and P = .2156; pH-cycling models with and without fluoride, respectively) and AgNO3 vs DIW (P = .6553 and P = .1194). ConclusionWith the copresence of fluoride, SDF and SDF and KI equally promote remineralization of enamel lesions. KI impairs SDF-related remineralization in the absence of fluoride treatments.

Effect of Sodium Fluoride Varnish and Potassium Iodide on Remineralization Efficacy of Silver Diamine Fluoride

The purpose of this study was to compare the effect of sodium fluoride(NaF) varnish and potassium iodide(KI) on remineralization efficacy of silver diamine fluoride(SDF) by measuring microhardness and evaluating surface morphology by scanning electron microscope(SEM). Artificial caries lesions were induced on extracted primary molars and vickers microhardness was measured. Specimens were randomly separated into 4 groups for treatment. The specimens in group I were treated with SDF, group II with NaF varnish after SDF, group III with KI after SDF and group IV with distilled water. After 8 days of pH cycling, vickers microhardness was measured and difference before and after treatment was calculated. For SEM, 2 samples were evaluated respectively after enamel polishing, lesion formation and after pH cycling. Group III showed highest increase in microhardness. Group I showed higher increase in microhardness than Group II but without statistical difference. Group IV showed lowest increase in microhardness value among 4 groups. On SEM image, group I, II and III showed smoother and less irregular surface compared to group IV. Amorphous crystal pellicles were observed in group III. In conclusion, SDF, SDF and NaF, SDF and KI groups showed smoother surface and increase in microhardness suggesting the possibility that remineralization effect might take place in oral conditions. In addition, in limited conditions of this study, applying NaF varnish after SDF did not increase the remineralization efficacy of SDF while KI significantly increased the remineralization efficacy of SDF. However, additional study considering various conditions that might affect demineralization and remineralization in clinical situations need to be conducted.

Efficacy of Silver Diamine Fluoride on Streptococcus mutans Count Present in Saliva.

ABSTRACTAim and objectiveEvaluate the efficacy and longevity of silver diamine fluoride (SDF) to inhibit the dental caries initiator bacteria; Streptococcus mutans count in saliva.Study designTwenty children having class I and II dental caries with no prior restorations were included in the study. Unstipulated saliva samples were collected before and immediately after application of SDF, 1, 3, and 6 months after application, and intergroup comparison was done.Materials and methodsSilver diamine fluoride was applied on the cavitated surfaces with microbrush tip under isolation, then wait for 4 minutes and washed away all surfaces with water spray. Saliva was collected in a sterile saliva collection tube and sent for microbiological culture assessment. CFU/mL of S. mutans count was done with the Digital colony counter. For statistical analysis, paired T-test was performed.ResultsSilver diamine fluoride showed a significant drop in CFU/mL of S. mutans count at 1 month then 3 and 6 months accordingly.ConclusionSilver diamine fluoride can be used to prevent and arrest dental caries and the best result can be achieved by quarterly application.How to cite this articleChakraborty S, Gupta N, Gambhir N, et al. Efficacy of Silver Diamine Fluoride on Streptococcus mutans Count Present in Saliva. Int J Clin Pediatr Dent 2021;14(5):700–704.

Comparative Evaluation of the Efficacy of Silver Diamine Fluoride, Sodium Fluoride and GC Tooth Mousse Plus and Fluoride Varnish as an Antibacterial Agent in Childhood Caries: As a Literature Review

Background: In preventive dentistry, it is important for the need to prevent rather than to treat early childhood caries and to improve the types of fluoride and application to see if the comparative efficacy is sufficient or insufficient because every type can relieve and give comfort to patients. Aims: To compare the effect of Silver Diamine Fluoride (SDF), fluoride varnish, fluoride gel and GC tooth mousse plus on Streptococcus mutants bacterial load. To evaluate the effect on the types of fluoride on caries. To compare the effect of prevention’s of early childhood caries by using different types of fluoride. Searching the databases using the keywords: sodium diamine fluoride; GC tooth mousse; fluoride varnish; fluoride gel; early childhood caries; caries; varnish; prevention. Materials and methods: 2010-December 2018, databases which were searched: MEDLINE via Ovid, Web of science, Embase, Cochrane Library, LILACS, and Dental specialties: pediatrics, oral preventive. Foreigner languages, editorials, letter to the editor, experimental studies with animals and Short communications were excluded from this review. Results: 2 studies assessed un-clear and need further research of SDF. 5 studies assessed that 12% of SDF has no effect but 38% has an effect with dentin and enamel with black staining as a disadvantage. 1 study showed that SDF is safe and effective compared to fluoride varnish, 2 studies showed that tooth mousse is recommended for early child caries without mentioning SDF and 3 studies found that it decreases the growth of mutants and aids in the remineralization of both enamel and dentin structure. Conclusion: To sum up this study silver diamine fluoride is effective and safe to use for preventing childhood caries than silver fluoride, GC tooth mousse and fluoride varnish, which saves time with increase accuracy and patient satisfaction.

Silver Diamine Fluoride Versus Atraumatic Restorative Treatment in Pediatric Dental Caries Management: A Systematic Review and Meta-analysis.

ABSTRACTIntroduction:The objective was to compare the clinical efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting active caries in primary teeth and first permanent molars in children.Materials and Methods:The study protocol was registered in PROSPERO (CRD42020205675). A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, and gray literature for randomized controlled trials (RCTs) published in English language with a minimum follow-up of 6 months, comparing the caries arrest potential of SDF with ART in primary teeth and first permanent molars in children. The risk of bias and quality assessment of the studies was done using the Cochrane Collaboration Tool and Joanna Briggs Institute Critical Appraisal Tool. Data analysis was performed using RevMan software; the outcomes were summarized in meta-analysis (MA) using the random-effects model, and the odds ratio (OR) at 95% confidence interval (CI) was computed.Results:A total of 1059 studies were identified, out of which 562 remained after removal of duplicates. Eight studies were considered for full-text eligibility, and four studies were included in the qualitative review. Three out of four studies were conducted on primary dentition, whereas one study was done on erupting first permanent molars in children. MA of the two studies compared 30% SDF with ART in primary molars at 12 months and revealed the OR to be 2.02 (95% CI: 0.86–4.71; I2 = 62%; P = 0.10).Conclusion:The current review points to the lack of solid evidence comparing SDF with ART for arresting active caries in primary teeth, especially in the first permanent molars. No statistically significant difference between 30% SDF and ART in primary molars at 12 months was found in the present review. Well-designed RCTs are required to determine a minimum concentration of SDF which is effective and safe for caries arrest in children.

Comparative evaluation of antimicrobial efficacy of silver diamine fluoride, chlorhexidine varnish with conventional fluoride varnish as a caries arresting agent. An in vivo sodium dodecyl sulfate-polyacrylamide gel electrophoresis study.

Silver diamine fluoride (SDF) is employed as an adjunct cariostatic agent in the management of dental caries in high-risk population. Other than fluorides, chlorhexidine (CHX) is the most potent antimicrobial and efficacious agent against Streptococcus mutans. The aim of this study is to evaluate and differentiate the efficacy of 38% silver diamine fluoride, CHX varnish, and fluoride varnish on carious primary teeth. Ninety children having a count of ≥1 carious lesion were recruited. Thirty-eighty percent silver diamine fluoride or fluoride varnish and CHX varnish were topically applied on the lesion. The primary outcome measured was the arrest of carious lesion (lesion rendered inactive as per the Nyvad criteria) after a follow-up of 14-21 days. Dental biofilm sample was obtained from each child and subsequently assessed for microbial composition by colony-forming unit method before and after treatment followed by protein analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis method. Average proportion of arrested caries lesions in the SDF group was higher followed by CHX and fluoride varnish groups. Decreased total protein amount was found in SDF group. This proves that there is decrease in microbial load posttreatment in SDF group. Thirty-eight percent SDF is more effective than CHX varnish and fluoride varnish in arresting dentin carious lesions in young children.

The antibacterial efficacy of silver diamine fluoride (SDF) is not modulated by potassium iodide (KI) supplements: A study on in-situ plaque biofilms using viability real-time PCR with propidium monoazide.

Silver diamine fluoride (SDF) is commonly used to arrest caries lesions, especially in early childhood caries. Recently, it was suggested that SDF can be combined with potassium iodide (KI) to minimize the discoloration of demineralized dentine associated with SDF application. However, the antibacterial efficacy of SDF alone or combined with KI on in-situ biofilm is unknown. Hence, we compared the anti-plaque biofilm efficacy of two different commercially available SDF solutions, with or without KI, using an in-situ biofilm, analysed using viability real-time PCR with propidium monoazide (PMA). Appliance-borne in-situ biofilm samples (n = 90) were grown for a period of 6 h in five healthy subjects who repeated the experiment on three separate occasions, using a validated, novel, intraoral device. The relative anti-biofilm efficacy of two SDF formulations; 38.0% Topamine (SDFT) and 31.3%, Riva Star (SDFR), KI alone, and KI in combination with SDFR (SDFR+KI) was compared. The experiments were performed by applying an optimized volume of the agents onto the biofilm for 1min, mimicking the standard clinical procedure. Afterwards the viability of the residual biofilm bacteria was quantified using viability real-time PCR with PMA, then the percentage of viable from total bacteria was calculated. Both SDF formulations (SDFT and SDFR) exhibited potent antibacterial activities against the in-situ biofilm; however, there was non-significant difference in their efficacy. KI alone did not demonstrate any antibacterial effect, and there was non-significant difference in the antibacterial efficacy of SDF alone compared to SDF with KI, (SDFT v SDFR/KI). Thus, we conclude that the antibacterial efficacy of SDF against plaque biofilms is not modulated by KI supplements. Viability real-time PCR with PMA was successfully used to analyze the viability of naturally grown oral biofilm; thus, the same method can be used to test the antimicrobial effect of other agents on oral biofilms in future research.

Antimicrobial efficacy of silver diamine fluoride in comparison to photodynamic therapy and chlorhexidine on canal disinfection and bond strength to radicular dentin.

To assess the antimicrobial efficacy of Silver diamine fluoride (SDF), Sodium hypochlorite (NaOCl), Chlorhexidine (CHX) and Photodynamic therapy (PDT) in radicular dentin and subsequent bond strength of Fiber reinforced composite post (FRCP) to radicular dentin. Forty extracted premolars were disinfected and decoronated up-to cement-o-enamel junction (CEJ). Canals were instrumented using crown-down technique, dried and filled with gutta percha. Post space was prepared with the help of peso reamers and inoculated with E. faecalis. Samples were randomly allocated into four groups based on chemical irrigation (n = 10). Group 1, canal disinfected with (PDT, MB), group 2 (5.25 % NaOCl +17 % EDTA), group 3 (3.8 % SDF) and group 4 (CHX). Specimens were tested with confocal laser scanning microscopy analysis (CLSM) to confirm the presence of E. faecalis. Fibre post were luted in root canal and sectioned at three levels (apical, middle and coronal). Push-out test was performed and failure analysis of debonded surfaces was evaluated using stereomicroscope. Live and dead cells after exposure were calculated in percentage. One-way analysis of variance (ANOVA) assessed the means and standard deviations of extrusion bond strength (EBS). Tukey multiple comparison tests was used to compare means of bond strength (p = 0.05). The maximum antimicrobial efficacy against E. faecalis was observed in group 2 which included canal disinfected with 5.25 % NaOCl and 17 % EDTA (64.41 ± 1.22). Similarly, CHX showed lowest effectiveness as canal irrigant against E.faecalis (58.29 ± 2.41). Intragroup comparison revealed highest bond strength for group 2 at all three level. Similarly, the lowest EBS was found in CHX group. Inter-group comparison confirmed comparable EBS at all root levels (apical, middle and coronal) for group 2 and group 3 (p > 0.05). Radicular dentin treated with 5.25 % NaOCl and 17 % EDTA displayed highest antimicrobial and bond strength scores. SDF and PDT can potentially be used in canal irrigation.

Efficacy of silver diamine fluoride and sodium fluoride in inhibiting enamel erosion: an ex vivo study with primary teeth.

To assess the efficacy of silver diamine fluoride (SDF) and sodium fluoride (NaF) in inhibiting enamel erosion in primary teeth. 80 primary canine teeth were immersed for 24h in 2% NaF, 10% SDF, or distilled water. Afterward, some of them underwent a 10-min acid challenge using either 1% or 10% citric acid while others did not. Specimens selected for negative controls were immersed in distilled water but not exposed to the acids, whereas those selected for positive controls were not only immersed in distilled water, but also exposed to the acids. Following, 3-mL samples were collected for calcium and phosphorus analysis by an atomic emission spectrometer. 1% acid caused higher phosphorus loss in the positive control group than in the others (no differences between them). Regarding 10% acid, the SDF group showed lower phosphorus loss compared to the positive control and NaF groups. From calcium loss analysis, SDF and NaF groups presented no significant difference when compared to the positive control groups after both acidic challenges. Considering phosphorus loss values, 10% SDF seems to be effective in inhibiting enamel erosion after 1% and 10% citric acid challenges, whereas 2% NaF only after 1% citric acid challenge. Regarding calcium loss values, both fluoride agents seem to have no impact on inhibiting enamel erosion after 1% and 10% citric acid challenges.

Clinical efficacy and the antimicrobial potential of silver formulations in arresting dental caries: a systematic review

BackgroundThe use of silver-formulation as microbicide to arrest dentinal caries is gaining popularity. The primary objective of the present appraisal was to systematically review the clinical (in vivo) applications and antimicrobial potential of silver-containing formulations in arresting dentinal caries. Our secondary aim was to sum up the available in vitro applications of silver-containing formulations against cariogenic microbes isolated from dentine lesions.MethodsOvid MEDLINE, EBSCO host, Web of Science, and Cochrane Library databases was searched between January 2009–May 2019.ResultsIn vivo: We observed conflicting evidence of antimicrobial efficacy of SDF on a diverse array of microbial taxa present in carious dentine of primary and permanent teeth. Moreover, there is insufficient evidence on the application of AgNP-fluoride as an effective microbicidal against cariogens of dentine lesions.In vitro: We found a good evidence of microbicidal efficacy of silver diamine fluoride (SDF) on selective cariogenic microbes in human dentine model. Additionally, a good evidence was noted of in vitro application of silver nanoparticles (AgNPs) as a useful microbicidal against S. mutans adhesion, growth and subsequent biofilm formation in human dentine models.ConclusionsTaken together, in vitro evidence indicates the promising antimicrobial potential of silver-based formulations (SDF and nanosilver) against the predominant cariogenic flora, particularly from dentine lesions. Post-treatment clinical data of either the bactericidal and bacteriostatic effects of SDF or nanosilver are sparse. Furthermore, the current understanding of the specific size, concentration, antimicrobial mechanisms, and toxicological aspects of nano-silver compounds is inadequate to draw firm conclusions on their clinical utility.