Silver Diamine Fluoride Research Articles

Evaluation of the Caries-Arresting Potential of Silver Diamine Fluoride Gel With Potassium Iodide Versus Sodium Fluoride Varnish: An Observational Study.

Introduction Silver diamine fluoride (SDF) with potassium iodide (KI) has emerged as a promising, aesthetic, non-invasive management by limiting the staining caused by SDF. However, no studies are comparing the caries-arresting potential of SDF gel with KI. The study aims to observe and evaluate the caries-arresting potential of SDF gel with KI compared to sodium fluoride (NaF) varnish. Materials and methods The present observational study was conducted with a split-mouth design. A total of 33 participants, in the age group of two to six years, with occlusal caries of the International Caries Detection and Assessment System (ICDAS) I and II involving both right and left upper or lower primary molar teeth, were included. SDF gel with KI and fluoride varnish (FV) was applied to the contralateral teeth on the same arch. Participants were recalled at 3, 6, 9, and 12-month intervals to monitor the progression or arrest of carious lesions. Result At the end of 12 months, 66.7% and 70.5% of the teeth showed arrest of caries with SDF gel with KI and FV, respectively. Intra-group analysis using the Friedman test shows significant differences in both groups across the timeline (p=0.001). Intergroup analysis using the Whitney U test reveals no significant difference in caries-arresting potential between the groups at various timelines (p=0.231). Conclusion There was no significant difference in arresting enamel caries of primary teeth between the use of 5% NaF and 38% SDF with KI. However, there was a significant difference within the group between the 3rd and 12th-month follow-up. Hence, the biannual application is recommended in both FV and SDF with KI.

Assessing the impact of the effect of ozone, casein phosphopeptide–amorphous calcium phosphate, silver diamine fluoride, and hydroxyapatite on remineralization of early carious lesions: An investigation using polarized light microscopic study

Abstract Introduction: A popular trend in dental offices, minimal intervention dentistry emphasizes using the least invasive treatments possible to minimize tissue loss and patient discomfort. The earliest indications of dental caries are white spot lesions that can remineralize. Thus, the effects of four different remineralizing agents on early carious lesions were assessed using polarized light microscopy. Materials and Methods: Teeth specimens were immersed in demineralizing agents to create subsurface demineralization. Subsequently, they were randomly assigned to various remineralization regimens, including ozonated water, casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), silver diamine fluoride (SDF), and hydroxyapatite. Each specimen underwent treatment twice daily for 3 min and was then placed in artificial saliva. Mineral content was evaluated at baseline, after demineralization, and during remineralization (on the 7th and 14th day) using a polarized microscopic examination. Results: Group 1 demonstrated the most effective remineralization, consistently displaying the lowest lesion depths at both the 7th and 14th days. Post hoc comparisons indicate significant differences between group 1 and other groups, emphasizing the potential superiority of the remineralization process in group 1 compared to the other treatment groups. Conclusion: Tooth samples treated with ozonated water, followed by CPP-ACP, SDF, and hydroxyapatite demonstrated a more profound level of remineralization. These agents, namely ozonated water, CPP-ACP, SDF, and hydroxyapatite, prove to be effective in reversing the early stages of enamel caries. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge.

Effect of silver diamine fluoride application on the microtensile bond strength of three commonly used restorative materials in primary teeth: An ultrastructural study.

Caries in primary teeth rapidly advances owing to its thin structure, thereby requiring restoration. However, restorations often fail due to various causes such as secondary caries and reduced microtensile bond strength (μTBS), which calls for the use of antimicrobial agents such as silver diamine fluoride (SDF). This study aims to measure and analyse the effect of SDF application on the μTBS of three regularly used restorative materials to dentin of primary teeth as well as compare the types of bond failure interfaces under SEM. The study comprised 60 samples equally divided into six groups among three restorative materials, namely, glass ionomer cement (GIC, Groups I and II), resin-modified glass ionomer cement (RMGIC, Groups III and IV), and composite resin (Groups V and VI) with subdivisions of A and B, where A represented samples with SDF application and B represented samples without SDF application. It was observed that μTBS of RMGIC to sound and carious dentin irrespective of SDF application was found to be statistically significant (P < 0.05), and when GIC, RMGIC, and composite resins were compared to both sound and carious dentin irrespective of SDF application, it was statistically significant (P < 0.05). SEM analysis revealed predominantly cohesive failures among all the groups. Based on the results, it was concluded that SDF has no adverse effect on the μTBS of GIC, RMGIC, and composite resin to both carious and sound dentin of primary teeth.

Effect of silver diamine fluoride versus sodium fluoride varnish in treatment of carious primary teeth: a randomized clinical trial.

Effect of silver diamine fluoride versus sodium fluoride varnish in treatment of carious primary teeth: a randomized clinical trial.

Efficacy of silver diamine fluoride on immediate and delayed adhesive strength of resin composite to sound dentin of permanent teeth: an in vitro study

Objectives: How silver diamine fluoride affected the immediate and prolonged adhesive resin composite's resistance to sound dentin of permanent premolars. Procedures: Three groups were identified (total number=30). The manufacturer's recommendations were followed while applying adhesive resin to the dentin surfaces in Group A after they had been etched. In Group B and C, dentin surfaces were treated with silver diamine fluoride and 0.05% NaF respectively. Then etched and bonded as for the control group. Then resin composite build-ups were created. Following this, each group was divided into two subgroups (for each group n=5), subgroup 1 underwent a shear bond strength test by universal test machine after 24 hrs, subgroups 2 the test was done after thermocycling process (300 cycles). The mode of failure was also examined. Results: The type of dentin surface treated with SDF solution was significantly affect shear bond strength (p=0.000) for both periods (immediate and prolonged). However, there were no significant difference between NaF group and control group on shear bond strength (p&lt;0.05) in immediate and prolong periods. On other hand there were statistically no significant differences between immediate and prolonged shear bond strength in SDF group (p=0.850), NaF group (p=0.637) and control group(p=0.794) When dentin surfaces were treated with silver diamine fluoride , there were more adhesive failures not as 0.05% NaF and control group which showed more mixed failures. Conclusion: silver diamine fluoride significantly reduced bond strength of etch and rinse adhesive system. Pretreatment with NaF maintained the shear bond strength of the adhesive to dentin after 300 thermal cycles.

School-based caries prevention using silver diamine fluoride: A pragmatic randomized trial in low-income rural children.

Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income families and rural geographic areas. The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing silver diamine fluoride (SDF) to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of mixed-effects logistic regression for caries prevalence and weighted least squares and mixed-effects negative binomial regression for caries incidence. A non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. A total of 3345 children were enrolled across 35 schools; however there was a large proportion of children who were noncompliant and received external dental care over the course of the trial. In adjusted analyses of compliant participants (n=1083; 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries prevalence was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term. NCT03448107.

Silver diamine fluoride for the management of dental caries in children in primary dental care: protocol for a feasibility study

BackgroundDental caries remains a significant problem in England, affecting 11% of 3-year-olds and 23% of 5-year-olds. While current approaches have been extensively investigated, their ability to (1) control pain and infection; (2) prevent hospital admissions, and (3) be implemented within the National Health Service (NHS) contractual arrangements, remains unsatisfactory. Silver diamine fluoride (SDF) is an alternative, non-invasive approach that has proven efficacy in arresting caries progression in primary teeth, principally from studies conducted outside of Europe. Its use in primary dental care in the UK is limited, despite the acknowledged need.The clinical and cost-effectiveness of SDF has not been compared to usual care in the UK. Before a pragmatic randomised controlled trial (RCT) can be conducted to compare SDF to usual care for caries management in young children, there are several uncertainties that require investigation. This study aims to establish whether such an RCT is feasible.MethodsThis mixed-method parallel design study is a feasibility study with an embedded process evaluation, to compare SDF with usual treatment in primary dental care in the UK. It will be individually randomised, with 13 dentists and therapists, in 8 different dental primary care sites with a sample size of 80 child participants aged 1–8 years old. The aim will be to recruit ten participants per site with equal arm allocation. Follow-up will be for 1 year. The study will inform whether an RCT is feasible by resolving several key uncertainties. The acceptability and implementation of SDF and the research processes will be explored. Patient and Public Involvement and Engagement representatives will be involved throughout recruitment and retention strategies, participant documentation, analysis, engagement and dissemination.DiscussionThe ability to conduct an RCT will be evaluated. If feasible, this RCT has the potential to evaluate the effectiveness of a non-invasive approach for the management of untreated caries in young children. A feasibility study also offers the opportunity to consider factors associated with the implementation of SDF at an early stage through a process evaluation that will inform the definitive trial and an implementation strategy for SDF by identifying relevant barriers and facilitators.Trial registrationClinicalTrials.gov identifier: NCT06092151. Date: 19/10/2023.

The effect of Fluoride varnish and Silver Diamine Fluoride in prevention of enamel demineralization around orthodontic bracket through UV illumination: An in vitro study

Brief Background The present in vitro study evaluated the effectiveness of Fluoride Vanish and Silver Diamine Fluoride in preventing enamel demineralization around orthodontic brackets, using a UV light on a group of extracted teeth with bonded brackets. Materials and Methods In this study, 30 samples of extracted human permanent teeth with bonded orthodontic brackets were separated into control group I (no fluoride varnish), experimental group II (fluoride varnish was applied), and experimental group III (fluoride varnish with SDF) to examine the preventive effects of fluoride on enamel demineralization. Teeth were subjected to three demineralization cycles in a standard demineralization solution. Enamel demineralization was measured according to the index of Gorelick et al. in all three groups at baseline, after the first and second demineralization cycles under UV light. Results Statistically significant differences were observed between the control group and the FV group after the first demineralization cycle. (p value&lt; 0.0001) No significant difference was found between baseline readings and after two demineralization cycles in the FV+SDF group. Summary and conclusion Fluoride varnish, along with SDF, is effective in reducing enamel demineralization. During the bonding appointment, the initial application of fluoride varnish around the orthodontic bracket can offer significant protection against white spot lesions (WSL). The development of WSL next to brackets can be avoided with regular professional applications of an FV during treatment with fixed orthodontic appliances. Key Words Enamel Demineralization; Fluoride Varnish; Orthodontic Brackets; Silver Diamine Fluoride.

Synthesis of novel silver-loaded clay AgF@Hec for the prevention of dental caries in vitro

Dental caries, a chronic infectious disease characterized by tooth mineral loss caused by plaque, is one of the major global public health problems. Silver diamine fluoride (SDF) has been proven to be a highly effective anti-caries drug due to its high bacterial inhibition and remineralization ability. However, the SDF solution is unstable, which immensely limits its clinical application. Therefore, new silver-load clay named AgF@Hec was designed by replacing the NH3 with hectorite in this study. Fourier transform infrared spectroscopy and x-ray diffraction spectroscopy were employed to confirm the structure of AgF@Hec. Dynamic light scattering analysis was used to reveal the effect of different hectorite concentrations on the stability of AgF@Hec. Moreover, AgF@Hec exhibits significant remineralization and hardness recovery of the initial carious lesions. Bacteriostatic experiments also proved that it has a significant inhibitory effect on A. Viscosus, S. mutans, S. sanguinis, S. salivarius, Lactobacillus sp. and both gram-positive and gram-negative bacteria. We therefore believed that AgF@Hec should be a promising biomaterial that can be applied in the prevention of dental caries.

Effectiveness of nanosilver fluoride and silver diamine fluoride in arresting early childhood caries: a randomized controlled clinical trial

BackgroundOne of the most prevalent health problems affecting children worldwide is untreated caries in primary teeth. Agents to arrest caries are used to manage untreated decay in children in disadvantaged communities. Nano Silver Fluoride (NSF) overcomes the staining problems of Silver Diamine Fluoride (SDF). This study compared the clinical cariostatic effect of NSF to 38% SDF for arresting caries lesions.MethodsThe study included 360 children younger than 4 years, with at least one active lesion, ICDAS score ≥ 3, recruited from nurseries in a rural area in Alexandria, Egypt, in 2022. They were randomly assigned to receive a single application of NSF at baseline, or two applications of SDF at baseline and after 6 months. The arrest of active carious lesions was assessed after 6 and 12 months using ICDAS criteria, and parents’ satisfaction with child appearance was also assessed. Chi-Square test was used to compare the groups and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest at lesion level and binary logistic regression was used to assess the effect at patient level.Results1853 active lesions were included in children whose mean (SD) age was 42.3 (8.2) months. The arrest rate was significantly higher in the NSF than the SDF group at lesion level (78.4% and 65.0% at 6 months and 71.3% and 56.3% at 12 months, p < 0.001). In regression analysis, NSF had significantly higher odds of caries arrest than SDF at lesion level (at 6 months, AOR = 2.57, 95% CI: 1.55, 4.26 and at 12 month, AOR = 3.27, 95% CI: 1.89, 5.67). Parents of children receiving NSF had significantly greater satisfaction with their children’s dental appearance than those receiving SDF: (97.2% and 76.1%, respectively, p < 0.001).ConclusionNSF demonstrated greater effectiveness in arresting caries in preschool children without inducing black staining of teeth and with greater parental satisfaction than SDF. NSF can be an alternative to SDF in arresting caries especially in underprivileged communities.Trial registrationThe trial was registered in the clinicaltrials.gov registry (#NCT05255913)-16/02/2022.

The effect of silver diammine fluoride on In Vitro Enamel caries lesion remineralization and staining as a function of lesion baseline mineral distribution

Objectivesto investigate whether baseline mineral distribution modulates the ability of silver diammine fluoride (SDF) to remineralize and stain enamel caries lesions. MethodsThis laboratory study followed a 3 [treatment: SDF/fluoride varnish (FV)/deionized water (DIW)] ×3 [lesion protocol: methylcellulose (MeC)/hydroxyethylcellulose (HEC)/Carbopol 907 (C907)] factorial design. Lesions were created in bovine enamel specimens (n = 20). Treatments were applied and lesions remineralized in artificial saliva. Digital transverse microradiography (TMR-D) was used to analyze lesions. Lesion color was monitored spectrophotometrically. The effects of lesion protocol and treatment on changes in lesion depth (ΔLD), mineral loss (ΔΔZ), maximum mineral density at the surface zone (ΔSZmax), and color changes related to remineralization (ΔL*remin) were analyzed using two-way ANOVA. ResultsThe treatment×lesion protocol interaction was significant for ΔΔZ (p < 0.01) and ΔL*remin (p < 0.01), however not for ΔLD (p = 0.23) or ΔSZmax (p = 0.91). There were no differences in ΔΔZ between treatments in HEC and C907 lesions. However, DIW resulted in more remineralization than both SDF (p < 0.01) and FV (p = 0.01) in MeC lesions. Considering changes from lesion baseline after remineralization in MeC lesions, SDF treatment resulted in the highest mineral gain in the surface zone. However, DIW revealed the highest mineral gain after remineralization in the lesion body. SDF stained lesions with the intensity increasing after remineralization in C907 lesions, whereas staining decreased in MeC and HEC lesions. ConclusionHigh fluoride treatments can interfere with continuous remineralization of caries lesions due to partial arrest. Baseline lesion mineral distribution affects SDF's ability to enhance remineralization and the staining caused by SDF. Clinical SignificanceSDF is being used to arrest active caries lesions extending into dentin and to treat dentin hypersensitivity. This study shed light on SDF's effect on an isolated process in dental caries only, remineralization. It achieved this by examining enamel caries lesions with differing mineral distributions and assessing their staining properties.

Evaluation of staining potential of Silver Diamine Fluoride, Potassium Iodide, Nanosilver Fluoride: an in vitro study

BackgroundThe black staining effect of silver-containing solutions for use to arrest caries can have a negative aesthetic impact on children and parents. This study aims to assess the staining effects of Silver Diamine Fluoride/Potassium Iodide (SDF/KI), SDF and Nanosilver Fluoride (NSF).Materials and methodsForty-four extracted carious primary molars were collected and randomly divided into four groups (n = 11). The carious tissue in all teeth was removed using a chemo-mechanical caries removal agent with an excavator. After caries removal in all groups, SDF, SDF/KI, and NSF were applied to the different groups, while no solution was applied to the control group. Subsequently, the teeth in all groups were restored with compomer. Color values L*, a* and b* were measured using a spectrophotometer at three time points: immediately after compomer restoration (T0), one week later (T1), and four week later (T2). Changes in brightness (ΔL) and color (ΔE) over time were calculated and comparisons among groups were made.ResultsThe SDF solution induced statistically significant black staining (p = 0.013) and a decrease in L* value (p < 0.001) on the compomer material compared to the other groups over time.ConclusionsIt was observed that SDF/KI has the potential to reduce the black staining effect of SDF, though not entirely. Novel experimental solutions like NSF may offer an alternative to counteract the staining effect of SDF.

Parental acceptance of Silver Diamine Fluoride in two lower-middle-income countries: Iran and Tajikistan

BackgroundUsing Silver Diamine Fluoride (SDF) may be an effective public health approach for managing dental caries in children. Parental acceptance of SDF has rarely been investigated in low-income and middle-income countries (LMICs). The aim of this study was to evaluate parental acceptance of SDF to manage dental caries in children aged 2–12 in Iran and Tajikistan.MethodsThis cross-sectional study was conducted in the Kurdistan province of Iran and Khatlon region of Tajikistan, 2022–2023. Parents watched a video about SDF and its weaknesses and strengths as compared to conventional approaches before completing the questionnaire. We also reported Prevalence Ratios with 95% confidence intervals for the relationship between parental acceptance and associated demographic factors as well as dental attitude and experience.ResultsParticipants were 245 and 160 parents in Iran and Tajikistan, respectively. In both countries, a majority (Iran: 61.6%, Tajikistan: 77.9%) accepted SDF over conventional treatments for all primary teeth. The majority also accepted SDF only for posterior permanent teeth (Iran: 73.5%, Tajikistan: 78.7%). Black discoloration was the main reason for rejecting SDF. Overall, demographic factors and dental experience and attitude were not significantly associated with SDF acceptance.ConclusionsSDF was widely accepted by Iranian and Tajik parents. Establishing parental acceptance of SDF is an important step toward its application in LMICs where inexpensive solutions are needed.

In-Vitro Evaluation of Shear Bond Strength of Glass Ionomer Cement to Primary Teeth Dentin Pretreated with Silver Diamine Fluoride and Sodium Fluoride Varnish

Aim: To evaluate and compare the shear bond strength (SBS) of glass ionomer cement (GIC) to primary teeth dentin pretreated with silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish. Materials and Methods: A total of 50 non carious human primary molars were used in this study. The teeth were prepared to expose a flat dentin surface, ensuring comparability across samples. The samples were then randomly divided into two groups. Group I: The dentin surface of the primary teeth was pretreated with 38% SDF. Group II: The dentin surface of the primary teeth was pretreated with 5% NaF varnish. Following pretreatment, all samples were restored using GIC. The SBS was evaluated using a universal testing machine, which measures the force required to detach the GIC from the dentin surface. Results: The study found that the mean SBS of Group I (SDF 38%) was significantly higher at 10.11 ± 2.34 MPa compared to Group II (NaF 5%), which had a mean SBS of 6.34 ± 2.56 MPa. This represented a mean difference of 3.77 MPa in favor of the SDF pretreatment group. Conclusion: The primary teeth dentin pretreated with 38% SDF demonstrated a significant increase in SBS to GIC compared to the teeth pretreated with 5% NaF varnish. This suggests that SDF not only acts as a caries-preventive agent but also enhances the bond strength of restorative materials adhered to dentin surfaces. Clinical Significance: The findings hold considerable clinical significance, especially for pediatric dentistry. The use of SDF as a dentin pretreatment can improve the adhesion of GIC to the dentin of primary teeth. This is particularly beneficial given the minimally invasive nature of the procedure, making it an optimal choice for young patients who may find conventional dental procedures distressing. In summary, this study supports the use of SDF over NaF varnish for pretreating primary teeth dentin before GIC restoration, due to the superior bond strength observed. Implementing this can improve the longevity and effectiveness of restorative treatments in primary teeth, offering a viable, simple method that aligns well with pediatric dental care standards.

Parental perceptions and acceptance of silver diamine fluoride staining in Italy

AbstractBackgroundParental perceptions of staining due to silver diamine fluoride (SDF) could affect its utilization in paediatric dentistry. This study represents the second part of a wider project focused on SDF esthetic acceptability among Italian parents.AimTo evaluate parental acceptance of SDF staining in Italy and to assess whether the parent's level of acceptance depends on location, child's behavior, or demographic background.DesignA cross‐sectional study was conducted among Italian parents of children attending two university dental clinics. We used a validated Italian version of the questionnaire “Parental Perceptions of Silver Diamine Fluoride Dental Color Changes.”ResultsTwo hundred and thirty‐four parents took part in the survey. Of parents, 65.4% considered the staining on posterior teeth esthetically “acceptable” or “somewhat acceptable,” and 19.3% on anterior teeth (p = .001). In a scenario of positive cooperation, 48.5% of parents were “somewhat likely” or “very likely” to choose SDF to treat posterior teeth, and 17.6% on anterior teeth (p = .001). Level of acceptance increased as the difficulty the child would experience to receive conventional treatment increased.ConclusionStaining on posterior teeth is more acceptable to parents than staining on anterior teeth. Level of acceptance on anterior teeth increases when sedation or general anesthesia is the alternative for the child.

Knowledge, Attitudes, and Practices towards Silver Diamine Fluoride among Dentists in Vietnam.

Silver diamine fluoride (SDF) is a topical solution used for managing dental caries. The mixed-methods study consists of a quantitative study (questionnaire survey) and a qualitative study (in-depth interview) to explore the knowledge, attitudes, and practices towards SDF among dentists in Vietnam. A descriptive approach and a thematic approach were performed to analyze data, respectively. The questionnaire survey invited 436 licensed dentists registered for the national annual dental meeting and 226 dentists participated (response rate: 52%). Among them, 174 (77%, 174/226) dentists knew SDF, and 69 (40%, 69/174) dentists used SDF for caries management. Most of them considered SDF therapy as non-invasive (84%, 146/174) and simple (80%, 140/174). However, most of them expressed concern that SDF could discolor the tooth (74%, 128/174). Their most preferred teeth for SDF therapy were primary posterior teeth (92%, 160/174). The in-depth interview consulted 16 dentists to reach data saturation. They learned about SDF from outside curriculum resources as an effective anti-caries agent. They understood the advantages (simple, non-invasive, timesaving) and disadvantages (tooth discoloring, ammonia odor) of SDF. They used SDF to arrest caries in uncooperative children in the clinic and people living in rural areas in outreach services. Most dentists in Vietnam are supportive of SDF therapy, and they know its advantages and disadvantages for caries management. The results addressed the aim of the study to investigate Vietnamese dentists' perspectives towards SDF.

Silver diamine fluoride: A stem cell cytotoxicity and dentin growth factor release in-vitro study.

To investigate the effect of 38% SDF and its serial dilutions on the Stem cells from Human Exfoliated Deciduous teeth (SHED) and its ability to release growth factors from deciduous dentine. The viability of SHED post-exposure to 38%, 3.8%, 0.38%, 0.038%, and 0.0038% SDF were assessed at 2, 5, and 7 days using the CyQuant assay, and results were validated using the MTT assay. The osteogenic differentiation of the cells was also investigated post-exposure to 0.0038% SDF. The release of the growth factors; TGF-β1, FGF-b, BMP-2, and VEGF from deciduous dentin discs exposed to 38% SDF, 0.0038% SDF, Ca(OH)2, MTA, and 17% EDTA were examined using ELISA. Statistical analysis was performed using means and standard deviations (p < 0.05). Two-way ANOVA compared the means of more than two groups with Tukey's multiple comparison test. The unpaired t-test was also used to compare the differences between the two data sets. 38% SDF released dentinogenic growth factors from dentin discs, potentially explaining its role in reactionary dentinogenesis. Moreover, 0.0038% SDF resulted in a non-cytotoxic concentration that enhanced cellular proliferation and released bioactive molecules from dentin comparable to the 38% concentration. After further investigations, the 0.0038% dilution of SDF could present itself as a clinical concentration.

Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study.

It is difficult to completely eradicate microorganisms from the infected root canal system. Intracanal irrigants seem necessary for eradication of infected tissues and microorganisms in addition to mechanical debridement. Continuous use of chemical antimicrobial agents leads to serious side effects. Therefore, the need arises for alternative agents to overcome the disadvantages of their chemical counterparts. To evaluate and compare the antimicrobial efficacy of three endodontic irrigants against clinically isolated bacteria found in root canals containing necrotic pulp. Preirrigation sample were collected using sterile paper points and sent for microbial count. Chemomechanical preparation was performed, and the root canals were irrigated with 5 mL of test samples. After 3 days, the patient was recalled, and a postirrigation sample was collected and sent for microbial count. Both 3.8% silver diamine fluoride (SDF) and 3% sodium hypochlorite (NaOCl) showed a superior capacity to sterilize the root canals compared to the neem group. The use of SDF as an endodontic irrigant is feasible as it effectively removes the microbes present in the canal. Silver diamine fluoride has not been shown to be cytotoxic or carcinogenic, unlike NaOCl, suggesting it could be used as a potential endodontic irrigant. However, few studies have evaluated the antimicrobial efficacy of SDF as an endodontic irrigant. Raj S, Sharma A, Dhinsa K, et al. Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(6):625-629.

Silver modified atraumatic restorative treatment: a paradigm shift in dental caries management.

Silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) are treatment modalities that are minimally invasive and used for the prevention and control of dental caries. The amalgamation of these two techniques has led to the development of silver modified atraumatic restorative treatment (SMART). In this approach the carious lesion is restored with glass-ionomer cement (GIC) after SDF application. SMART effectively arrests caries without removing additional tooth structure, making it a promising option for caries management in children who lack cooperative ability.This article reviews the literature on SMART, the evidence regarding its applications in dental practice, its advantages, drawbacks, the scope for research, and clinical use.

Silver Diamine Fluoride vs Sealants for Preventing Dental Caries

Silver Diamine Fluoride vs Sealants for Preventing Dental Caries