Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study

Background. When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective. The purpose of this study is to determine the effect of selected caries removal on sil...

Full description

Saved in:
Bibliographic Details
Main Authors: Jutharat Manuschai, Supitcha Talungchit, Supawadee Naorungroj
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2021/3059129
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832562985267101696
author Jutharat Manuschai
Supitcha Talungchit
Supawadee Naorungroj
author_facet Jutharat Manuschai
Supitcha Talungchit
Supawadee Naorungroj
author_sort Jutharat Manuschai
collection DOAJ
description Background. When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective. The purpose of this study is to determine the effect of selected caries removal on silver penetration when 38% SDF is applied to deep carious lesions in permanent teeth. Methods. Extracted permanent teeth with caries extending to the inner third of the dentin were used (N = 18). The periphery of the carious lesion was completely removed to the dentinoenamel junction (DEJ). In group A (n = 9), no further removal of carious tissue was performed, leaving necrotic dentin inner to the DEJ, whereas in group B (n = 9) superficial necrotic dentin was completely removed until leathery, slightly moist, reasonably soft dentin remained. SDF was applied for 3 minutes in both groups. Microcomputer tomography (micro-CT) and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (FESEM-EDS) were used to measure mineral density and silver distribution. The silver penetration depth/lesion depth (PD/LD) ratio was calculated for each sample. The Mann–Whitney U test was used to compare differences between the two groups. Results. The micro-CT analysis showed that the PD/LD ratios of group B (1.07–2.29) were marginally greater than those of group A (1.00–1.31). However, a statistically significant difference was not observed (pvalue = 0.5078). When stratified by remaining dentin thickness (RDT), the PD/LD ratios of group B were still greater than those of group A only when RDT was >500 µm. The FESEM-EDS analysis indicated that silver particles precipitated throughout the entire thickness of the carious lesions. Conclusion. Applying SDF on a deep carious lesion and leaving the necrotic dentin pulpally did not affect silver penetration. However, the extent to which silver penetrates the remaining dentin beneath the lesions is dependent on the amount and characteristics of that dentin.
format Article
id doaj-art-eb6503ed12d845128c5cb773a955c877
institution Kabale University
issn 1687-8736
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series International Journal of Dentistry
spelling doaj-art-eb6503ed12d845128c5cb773a955c8772025-02-03T01:21:19ZengWileyInternational Journal of Dentistry1687-87362021-01-01202110.1155/2021/3059129Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro StudyJutharat Manuschai0Supitcha Talungchit1Supawadee Naorungroj2Department of Conservative DentistryDepartment of Conservative DentistryDepartment of Conservative DentistryBackground. When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective. The purpose of this study is to determine the effect of selected caries removal on silver penetration when 38% SDF is applied to deep carious lesions in permanent teeth. Methods. Extracted permanent teeth with caries extending to the inner third of the dentin were used (N = 18). The periphery of the carious lesion was completely removed to the dentinoenamel junction (DEJ). In group A (n = 9), no further removal of carious tissue was performed, leaving necrotic dentin inner to the DEJ, whereas in group B (n = 9) superficial necrotic dentin was completely removed until leathery, slightly moist, reasonably soft dentin remained. SDF was applied for 3 minutes in both groups. Microcomputer tomography (micro-CT) and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (FESEM-EDS) were used to measure mineral density and silver distribution. The silver penetration depth/lesion depth (PD/LD) ratio was calculated for each sample. The Mann–Whitney U test was used to compare differences between the two groups. Results. The micro-CT analysis showed that the PD/LD ratios of group B (1.07–2.29) were marginally greater than those of group A (1.00–1.31). However, a statistically significant difference was not observed (pvalue = 0.5078). When stratified by remaining dentin thickness (RDT), the PD/LD ratios of group B were still greater than those of group A only when RDT was >500 µm. The FESEM-EDS analysis indicated that silver particles precipitated throughout the entire thickness of the carious lesions. Conclusion. Applying SDF on a deep carious lesion and leaving the necrotic dentin pulpally did not affect silver penetration. However, the extent to which silver penetrates the remaining dentin beneath the lesions is dependent on the amount and characteristics of that dentin.http://dx.doi.org/10.1155/2021/3059129
spellingShingle Jutharat Manuschai
Supitcha Talungchit
Supawadee Naorungroj
Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
International Journal of Dentistry
title Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
title_full Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
title_fullStr Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
title_full_unstemmed Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
title_short Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
title_sort penetration of silver diamine fluoride in deep carious lesions of human permanent teeth an in vitro study
url http://dx.doi.org/10.1155/2021/3059129
work_keys_str_mv AT jutharatmanuschai penetrationofsilverdiaminefluorideindeepcariouslesionsofhumanpermanentteethaninvitrostudy
AT supitchatalungchit penetrationofsilverdiaminefluorideindeepcariouslesionsofhumanpermanentteethaninvitrostudy
AT supawadeenaorungroj penetrationofsilverdiaminefluorideindeepcariouslesionsofhumanpermanentteethaninvitrostudy