International Journal of Clinical Pediatric Dentistry

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VOLUME 16 , ISSUE 6 ( November-December, 2023 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study

Sahanai Sunny, Sharan S Sargod, Sham S Bhat, HT Ajay Rao

Keywords : Glass ionomer cement, Incipient enamel lesions, Microhardness, Remineralization, Silver diamine fluoride

Citation Information : Sunny S, Sargod SS, Bhat SS, Rao HA. Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023; 16 (6):858-863.

DOI: 10.5005/jp-journals-10005-2695

License: CC BY-NC 4.0

Published Online: 01-02-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: To evaluate the remineralizing potential of glass ionomer cement (GIC) and silver diamine fluoride (SDF) on artificially induced enamel caries lesions in primary teeth. Materials and methods: The initial baseline surface microhardness (SMH) of 40 primary teeth was tested using Vickers hardness tester, followed by the creation of artificial caries lesions by immersion in the demineralizing solution. Microhardness assessments of demineralized samples were done, and samples were randomly divided into two groups of 20 specimens: in group I, GIC was applied on demineralized enamel, and in group II, SDF was applied on demineralized enamel. Samples were subjected to pH cycling. For group I, GIC from the enamel samples was carefully removed using a surgical blade, and changes in the SMH from both groups were analyzed using Vickers microhardness test. Result: Surface microhardness (SMH) value after pH cycling of GIC (45 ± 10.23) and SDF (47.76 ± 6.69) is statistically highly significant (<0.001) compared to the baseline SMH of both test groups. Comparison of SMH between the two groups showed statistically nonsignificant results. Conclusion: The remineralization potential of SDF is comparable to GIC. So, SDF can be used as a remineralizing agent for incipient enamel caries. Clinical significance: Owing to the remineralizing ability of GIC underneath the restorations, it can be used as a therapeutic sealant for incipient enamel caries lesions, where SDF staining is not always acceptable. A 38% SDF also can be used as a remineralizing agent for incipient enamel caries lesions in situations like noncompliant patients, inaccessibility to dental care, or conditions in which esthetics is not of concern.


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  1. Mohd Said SN, Ekambaram M, Yiu CK. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediatr Dent 2017;27(3):163–173. DOI: 10.1111/ipd.12243
  2. Featherstone JDB, Chaffee BW. The evidence for caries management by risk assessment (CAMBRA®). Adv Dent Res 2018;29(1):9–14. DOI: 10.1177/0022034517736500
  3. Philip N. State of the art enamel remineralization systems: the next frontier in caries management. Caries Res 2019;53(3):284–295. DOI: 10.1159/000493031
  4. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002;81(11):767–770. DOI: 10.1177/0810767
  5. Rao A, Malhotra N. The role of remineralizing agents in dentistry: a review. Compend Contin Educ Dent 2011;32(6):27–34.
  6. Trairatvorakul C, Techalertpaisarn P, Siwawut S, et al. Effect of glass ionomer cement and fluoride varnish on the remineralization of artificial proximal caries in situ. J Clin Pediatr Dent 2009;34(2):131–134. DOI: 10.17796/jcpd.34.2.gr51r535q0607u23
  7. Horst JA, Ellenikiotis H, Milgrom PL. UCSF Protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc 2016;44(1):16–28.
  8. England G. Vickers Hardness Test. Dostupné na World Wide Web: http://www.Gordon England.co.UK/hardness/vickers.html říčný. 2014.
  9. Mei ML, Nudelman F, Marzec B, et al. Formation of fluorohydroxyapatite with silver diamine fluoride. J Dent Res 2017;96(10):1122–1128. DOI: 10.1177/0022034517709738
  10. Rosenblatt A, Stamford TC, Niederman R. Silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res 2009;88(2):116–125. DOI: 10.1177/0022034508329406
  11. Peng JJ, Botelho MG, Matinlinna JP. Silver compounds used in dentistry for caries management: a review. J Dent 2012;40(7):531–541. DOI: 10.1016/j.jdent.2012.03.009
  12. Hatibovic-Kofman S, Suljak JP, Koch G. Remineralization of natural carious lesions with a glass ionomer cement. Swed Dent J 1996;21(1-2):11–17.
  13. Damen JJ, Ten Cate JM. Silica-induced precipitation of calcium phosphate in the presence of inhibitors of hydroxyapatite formation. J Dent Res 1992;71(3):453–457. DOI: 10.1177/00220345920710030601
  14. Forsten L. Fluoride release and uptake by glass-ionomers and related materials and its clinical effect. Biomaterials 1998;19(6):503–508. DOI: 10.1016/s0142-9612(97)00130-0
  15. Paiva LF, Fidalgo TK, Maia LC. Mineral content of ionomer cements and preventive effect of these cements against white spot lesions around restorations. Braz Oral Res 2014;28: DOI: 10.1590/1807-3107bor-2014.vol28.0034
  16. Hassan U, Farooq I, Mahdi S, et al. Newer glass ionomer cements having strontium ions and the effect of their release on acidic medium. Int J Prosthodont Restor Dent 2012;2(2):57–60. DOI: 10.5005/jp-journals-10019-1049
  17. Momoi Y, McCabe JF. Fluoride release from light-activated glass ionomer restorative cements. Dent Mater 1993;9(3):151–154. DOI: 10.1016/0109-5641(93)90112-4
  18. Nantanee R, Santiwong B, Trairatvorakul C, et al. Silver diamine fluoride and glass ionomer differentially remineralize early caries lesions, in situ. Clin Oral Investig 2016;20(6):1151–1157. DOI: 10.1007/s00784-015-1603-4
  19. Allam G, Abd El-Geleel O. Evaluating the mechanical properties, and calcium and fluoride release of glass-ionomer cement modified with chicken eggshell powder. Dent J (Basel) 2018;6(3): DOI: 10.3390/dj6030040
  20. Ionta FQ, Mendonça FL, de Oliveira GC, et al. In vitro assessment of artificial saliva formulations on initial enamel erosion remineralization. J Dent 2014;42(2):175–179. DOI: 10.1016/j.jdent.2013.11.009
  21. Prabhakar AR, Paul M J, Basappa N. Comparative evaluation of the remineralizing effects and surface micro hardness of glass ionomer cements containing bioactive glass (s53p4):an in vitro study. Int J Clin Pediatr Dent 2010;3(2):69–77. DOI: 10.5005/jp-journals-10005-1057
  22. Crystal YO, Janal MN, Hamilton DS, et al. Parental perceptions and acceptance of silver diamine fluoride staining. J Am Dent Assoc 2017;148(7):510–518.e4. DOI: 10.1016/j.adaj.2017.03.013
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