Almuqrin Amjad, Kaur Inder Preet, Walsh Laurence J, Seneviratne Chaminda Jayampath, Zafar Sobia
School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia.
Antibiotics (Basel). 2023 Feb 2;12(2):298. doi: 10.3390/antibiotics12020298.
Topical cariostatic agents have become a reasonable alternative for managing dental caries in young children. Silver diamine fluoride (SDF) is a practical topical approach to arrest caries and avoid extensive and risky dental treatment. However, the literature demonstrates a parental hesitation towards accepting SDF because of black unaesthetic tooth discolouration following application. The rapid oxidation of ionic silver darkens demineralised tooth structure permanently. In this regard, nano-metallic antimicrobials could augment or substitute for silver, and thereby enhance SDF aesthetic performance. Recently, biomedical research has drawn attention to selenium nanoparticles (SeNPs) due to their antimicrobial, antioxidant, and antiviral potencies. Various in vitro studies have examined the effect of SeNPs on the virulence of bacteria. This narrative review explores practical issues when using SDF and suggests future directions to develop it, focusing on antimicrobial metals. Several methods are described that could be followed to reduce the discolouration concern, including the use of nanoparticles of silver, of silver fluoride, or of selenium or other metals with antimicrobial actions. There could also be value in using remineralising agents other than fluoride, such as NPs of hydroxyapatite. There could be variations made to formulations in order to lower the levels of silver and fluoride in the SDF or even to replace one or both of the silver and fluoride components completely. Moreover, since oxidation processes appear central to the chemistry of the staining, adding SeNPs which have antioxidant actions could have an anti-staining benefit; SeNPs could be used for their antimicrobial actions as well. Future research should address the topic of selenium chemistry to optimise how SeNPs would be used with or in place of ionic silver. Incorporating other antimicrobial metals as nanoparticles should also be explored, taking into account the optimal physicochemical parameters for each of these.
局部用防龋剂已成为管理幼儿龋齿的一种合理替代方法。氟化亚锡是一种切实可行的局部防龋方法，可阻止龋齿发展并避免进行广泛且有风险的牙科治疗。然而，文献表明，由于使用后牙齿会出现不美观的黑色变色，家长们对接受氟化亚锡有所犹豫。离子银的快速氧化会使脱矿质的牙齿结构永久变黑。在这方面，纳米金属抗菌剂可以增强或替代银，从而提高氟化亚锡的美观性能。最近，生物医学研究因硒纳米颗粒具有抗菌、抗氧化和抗病毒能力而对其予以关注。各种体外研究已经考察了硒纳米颗粒对细菌毒力的影响。本叙述性综述探讨了使用氟化亚锡时的实际问题，并提出了其未来的发展方向，重点关注抗菌金属。文中描述了几种可以采用的减少变色问题的方法，包括使用银、氟化银、硒或其他具有抗菌作用的金属的纳米颗粒。使用除氟化物以外的再矿化剂（如羟基磷灰石纳米颗粒）可能也有价值。可以对配方进行调整，以降低氟化亚锡中银和氟的含量，甚至完全替代银和氟这两种成分中的一种或两种。此外，由于氧化过程似乎是染色化学的核心，添加具有抗氧化作用的硒纳米颗粒可能具有抗染色的益处；硒纳米颗粒也可因其抗菌作用而使用。未来的研究应解决硒化学的相关课题，以优化硒纳米颗粒与离子银一起使用或替代离子银的方式。还应探索将其他抗菌金属作为纳米颗粒纳入其中的可能性，同时考虑到每种金属的最佳物理化学参数。
