Willershausen Ines, Schulte Daniel, Azaripour Adriano, Weyer Veronica, Briseño Benjamin, Willershausen Brita
Clin Lab. 2015;61(11):1695-701. doi: 10.7754/clin.lab.2015.150401.
Occurrence of open dentinal tubules as a cause of dental hypersensitivity is a very common pnenomenon in patients. The aim of this in vitro study was to assess the effect of a silver diamine fluoride solution (Ag(NH3)2 F) on human dentin samples.
A total of five fully retained wisdom teeth were selected for this study. The crowns of the teeth were separated from the roots and the occlusal enamel surface was removed. All dentin samples were treated for 60 seconds with phosphoric acid (36%) and rinsed thoroughly to remove the smear layer. Then the desensitizing agent (Riva Star, SDI; 38% Ag(NH3)2 F) was placed according to the manufacturer's instruction. Three dentin samples were prepared for element analysis using an electron beam microprobe analyzer (JEOL JXA 8900RL). The Ag concentrations in the dentin samples were measured in depths ranging from 5 to 40 μm. The other two dentin samples were vertically fractured and accordingly prepared for visualization with SEM (Zeiss DSM).
The application of the desensitizing agent on the dentin areas demonstrated an increased Ag concentration (JEOL JXA 8900RL). On the dentin surface an Ag concentration of 1.7 weight % (? 0.7) was measured, but at a depth of 20 μm only 0.3 weight % (± 0.1) were detected. In depths greater than 40 μm the Ag concentration was below the detection limit. The SEM results showed that deposits could be found in a covering on the dentin layer and in the dentinal tubules to a depth of 20 μm.
In this ex vivo study, the effect of silver diamine fluoride on dentin surfaces could be demonstrated. The desensitizing agent formed a film on the dentin surface and in some dentinal tubules deposits were detected. These findings can explain a certain desensitizing effect, but a direct translation to in vivo conditions can only be done with caution.
开放牙本质小管的出现作为牙齿敏感的一个原因,在患者中是一种非常常见的现象。这项体外研究的目的是评估氟化银氨溶液(Ag(NH3)2F)对人牙本质样本的影响。
本研究共选取了五颗完全保留的智齿。将牙冠与牙根分离,并去除咬合面的釉质表面。所有牙本质样本用36%的磷酸处理60秒,然后彻底冲洗以去除玷污层。然后按照制造商的说明放置脱敏剂(丽娃星,SDI;38% Ag(NH3)2F)。使用电子束微探针分析仪(JEOL JXA 8900RL)制备三个牙本质样本用于元素分析。在深度为5至40μm的范围内测量牙本质样本中的银浓度。另外两个牙本质样本垂直断裂,并相应地制备用于扫描电子显微镜(蔡司DSM)观察。
在牙本质区域应用脱敏剂后,银浓度增加(JEOL JXA 8900RL)。在牙本质表面测量到银浓度为1.7重量%(±0.7),但在20μm深度处仅检测到0.3重量%(±0.1)。在大于40μm的深度处,银浓度低于检测限。扫描电子显微镜结果显示,在牙本质层的覆盖物以及牙本质小管中至20μm深度处均可发现沉积物。
在这项离体研究中,可以证明氟化银氨对牙本质表面的影响。脱敏剂在牙本质表面形成了一层膜,并且在一些牙本质小管中检测到了沉积物。这些发现可以解释一定的脱敏效果,但直接转化到体内情况时只能谨慎进行。