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Enhanced effectiveness of silver diamine fluoride application with light curing on natural dentin carious lesions: an in vitro study

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Abstract

This study aimed to compare the mean mineral density difference (mMDD) and surface morphology of 10- and 60-s silver diamine fluoride (SDF)-applied dentin carious lesions and to study the effect of an additional 20-s light curing (LC) on SDF-treated teeth. Forty primary molar blocks with natural dentin carious lesions were measured for baseline lesion depth and mineral density using Image-Pro Plus software. The samples were randomly distributed into 4 groups; 38% SDF applied for 1) 10-s (10SDF), 2) 60-s (60SDF), 3) 10-s + LC (10SDF + LC), 4) 60-s + LC (60SDF + LC) and an additional control group to assess the outcome of pH-cycling only. Then all the groups underwent a 7-d bacterial pH-cycling. The dentin carious lesions’ mMDD was determined by digital subtraction radiographic analysis. The surface morphology and elemental profile were assessed by scanning electron microscopy and energy-dispersive X-ray spectroscopy. The mMDD of the dentin lesions was analyzed using two-way ANOVA, generalized linear models analysis. Light curing was the only factor that affected the mMDD (p = 0.007). The mMDD in the 10SDF + LC and 60SDF + LC groups were significantly higher than those without light curing (p = 0.041 and 0.041, respectively). The 60SDF + LC group demonstrated a significantly higher mMDD than the 10SDF group (p = 0.010), while that in the 10SDF + LC group was similar to the 60SDF group (p = 1.00). Scanning electron microscopy revealed denser mineral content layers, which were likely silver and chloride, in the 10SDF + LC and 60SDF + LC groups than in the 10SDF and 60SDF groups, respectively. In conclusion, shortened application time with light curing enhanced SDF remineralization similarly to the conventional method.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank Dr. Kevin Tompkins, the scientists at the Department of Microbiology, Oral Biology Research Center, and Dental Material Research and Development Center, Faculty of Dentistry, Chulalongkorn University and the scientists at Dental Biomaterial Analysis and Research Center, Faculty of Dentistry, Mahidol University for their assistance in our study.

Funding

This research was supported by the 90th Anniversary of Chulalongkorn University Fund under Grant GCUGR1125633027M from Chulalongkorn University, Thailand.

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Authors and Affiliations

  1. Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand

    Juthamas Karnowakul, Oranuch Techatharatip & Chutima Trairatvorakul

  2. Nongjik Hospital, 223 Moo 2, Petchkasem Road, Nong Chik, Tuyong, Pattani, Thailand

    Juthamas Karnowakul

  3. Private Practice, Samutprakarn, Thailand

    Kulnipa Punyanirun

  4. Maximizing Thai Children’s Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Ketsupar Jirakran

  5. Department of Microbiology and Center of Excellence On Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand

    Panida Thanyasrisung

  6. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand

    Suchaya Pornprasertsuk-Damrongsri

Authors
  1. Juthamas Karnowakul
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  2. Kulnipa Punyanirun
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Corresponding authors

Correspondence to Suchaya Pornprasertsuk-Damrongsri or Chutima Trairatvorakul.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All experimental protocols were performed in accordance with the Declaration of Helsinki. The study protocols were approved by the Human Research Ethics Committee (HREC-DCU 2020–008) and Institutional Biosafety Committee (DENT CU-IBC 007/2020) of the Faculty of Dentistry, Chulalongkorn University.

Informed consent

Each child’s legal guardian donated the extracted teeth for the research purpose of this study. Informed consents were obtained for all teeth.

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Karnowakul, J., Punyanirun, K., Jirakran, K. et al. Enhanced effectiveness of silver diamine fluoride application with light curing on natural dentin carious lesions: an in vitro study. Odontology 111, 439–450 (2023). https://doi.org/10.1007/s10266-022-00755-z

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  • DOI: https://doi.org/10.1007/s10266-022-00755-z

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