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

Rodrigues, Gabriella Fernandes; Monteiro, Amanda Souza Nunes; Vollú, Ana Lúcia; Pires, Paula Maciel; Silva, Aline Saddock de Sá; Lopes, Ricardo Tadeu; Oliveira, Branca Heloisa; Neves, Aline de Almeida; Barja-Fidalgo, Fernanda; Fonseca-Gonçalves, Andréa

doi:10.1590/pboci.2022.019

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 22 • 2022 • https://doi.org/10.1590/pboci.2022.019 copy

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

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

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.

Keywords:
Dental Caries; Cariostatic Agents; Dentin; Tooth Remineralization; X-Ray Microtomography

Group	After Baseline Caries Formation (M1)		After SDF and Second Cariogenic Challenge (M3)
Control	4.80 + 0.10^a,^b	4.80 + 0.10^a,^A	5.05 + 0.06^a	5.05 + 0.14^a,^B
30 immediate	4.89 + 0.05^a,^b		4.98 + 0.07^a
30 - 1 min	4.93 + 0.22^a,^b	4.85 + 0.14^a,^b,^A	5.08 + 0.06^a	5.06 + 0.08^a,^B
30-3 min	4.74 + 0.01^a		5.12 + 0.05^a
38 immediate	5.00 + 0.01^b		5.32 + 0.21^a
38 - 1 min	4.96 + 0.01^a,^b	4.94 + 0.06^b,^A	5.49 + 0.10^a	5.33 + 0.23^a,^B
38-3 min	4.86 + 0.01^a,^b		5.17 + 0.28^a
All groups	4.88 + 0.12^A		5.17 + 0.20^B

Group	Lesion Depth at Baseline Caries (M1)	Lesion Depth Immediately After SDF (M2)	Lesion Depth After Second Cariogenic Challenge (M3)
Control	311.62 + 51.20^a,^A	254.81 + 59.04^a	576.75 + 85.53^a,^B
30 Immediate	292.68 + 116.62^a,^A	196.28 + 102.88^a	530.27 + 168.43^a,^b,^B
30 - 1 min	426.98 + 203.34^a,^A	201.44 + 107.10^a	323.67 + 140.52^a,^b,^c,^A
30-3 min	315.06 + 94.39^a,^A	144.62 + 142.68^a	197.99 + 142.75^b,^c,^B
38 Immediate	275.46 + 34.97^a,^A	191.11 + 73.55^a	218.65 + 111.72^a,^b,^c,^A
38 - 1 min	287.52 + 73.16^a,^A	170.45 + 59.78^a	203.15 + 96.38^a,^b,^c,^B
38 - 3 min	273.74 + 39.60^a,^A	141.18 + 47.41^a	123.96 + 35.18^c,^B

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[1] Andréa Fonseca-Gonçalves, Departamento de Odontopediatria e Ortodontia , Faculdade de Odontologia, UFRJ, Rua Rodolpho Paulo Rocco, 325, Rio de Janeiro, RJ, Brazil. 21941-913. E-mail: andrea.goncalves@odonto.ufrj.br