Evaluation of the remineralizing capacity of silver diamine fluoride on demineralized dentin under pH-cycling conditions
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AuthorCifuentes Jiménez, Carolina Cecilia; Bolaños Carmona, María Victoria; ENRICH-ESSVEIN, Tattiana; González López, Santiago; Álvarez Lloret, Pedro
Universidad Sao Paulo Facultdad de Odontología Bauru
DentinSodium fluorideBiomineralizationDental cariesSilver compoundsSilver diamineCrystallization
Cifuentes-Jiménez, C.C. et al. Evaluation of the remineralizing capacity of silver diamine fluoride on demineralized dentin under pH-cycling conditions. J Appl Oral Sci. 2023;31:e20220306. [http://dx.doi.org/10.1590/1678-7757-2022-0306]
SponsorshipSpanish Government PID2020-116660GB-I00; European Commission A-RNM-408-UGR20; European Regional Development Fund (ERDF) - Next Generation/EU program
Objective: (1) to determine the effects of the silver diamine fluoride (SDF) and sodium fluoride (NaF) in demineralized dentin exposed to an acid challenge by pH-cycling, (2) to evaluate the remineralizing capacity of SDF/NaF products based on the physicochemical and mechanical properties of the treated dentin surfaces. Methodology: In total, 57 human molars were evaluated in different stages of the experimental period: sound dentin - negative control (Stage 1), demineralized dentin - positive control (Stage 2), and dentin treated with SDF/ NaF products + pH-c (Stage 3). Several commercial products were used for the SDF treatment: Saforide, RivaStar, and Cariestop. The mineral composition and crystalline and morphological characteristics of the dentin samples from each experimental stage were evaluated by infrared spectroscopy (ATR-FTIR), X-ray diffraction, and electron microscopy (SEM-EDX) analytical techniques. Moreover, the mechanical response of the samples was analyzed by means of the three-point bending test. Statistics were estimated for ATR-FTIR variables by Wilcoxon test, while the mechanical data analyses were performed using Kruskal-Wallis and Mann Whitney U tests. Results: Regarding the chemical composition, we observed a higher mineral/organic content in the SDF/NaF treated dentin + pH-c groups (Stage 3) than in the positive control groups (Saforide p=0.03; Cariestop p=0.008; RivaStar p=0.013; NaF p=0.04). The XRD results showed that the crystallite size of hydroxyapatite increased in the SDF/NaF treated dentin + pH-c groups (between +63% in RivaStar to +108% in Saforide), regarding the positive control. SEM images showed that after application of the SDF/NaF products a crystalline precipitate formed on the dentin surface and partially filled the dentin tubules. The flexural strength (MPa) values were higher in the dentin treated with SDF/NaF + pH-c (Stage 3) compared to the positive control groups (Saforide p=0.002; Cariestop p=0.04; RivaStar p=0.04; NaF p=0.02). Conclusions: The application of SDF/ NaF affected the physicochemical and mechanical properties of demineralized dentin. According to the results, the use of SFD/NaF had a remineralizing effect on the dentin surface even under acid challenge.