Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA; King Faisal University, Restorative Department, School of Dentistry AlAhsa, Saudi Arabia.
Department of Cariology and Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA; Department of Restorative Dental Sciences, King Khalid University College of Dentistry, Abha, Saudi Arabia.
J Dent. 2024 Aug;147:105139. doi: 10.1016/j.jdent.2024.105139. Epub 2024 Jun 18.
to investigate whether baseline mineral distribution modulates the ability of silver diammine fluoride (SDF) to remineralize and stain enamel caries lesions.
This laboratory study followed a 3 [treatment: SDF/fluoride varnish (FV)/deionized water (DIW)] ×3 [lesion protocol: methylcellulose (MeC)/hydroxyethylcellulose (HEC)/Carbopol 907 (C907)] factorial design. Lesions were created in bovine enamel specimens (n = 20). Treatments were applied and lesions remineralized in artificial saliva. Digital transverse microradiography (TMR-D) was used to analyze lesions. Lesion color was monitored spectrophotometrically. The effects of lesion protocol and treatment on changes in lesion depth (ΔLD), mineral loss (ΔΔZ), maximum mineral density at the surface zone (ΔSZ), and color changes related to remineralization (ΔL*) were analyzed using two-way ANOVA.
The treatment×lesion protocol interaction was significant for ΔΔZ (p < 0.01) and ΔL* (p < 0.01), however not for ΔLD (p = 0.23) or ΔSZ (p = 0.91). There were no differences in ΔΔZ between treatments in HEC and C907 lesions. However, DIW resulted in more remineralization than both SDF (p < 0.01) and FV (p = 0.01) in MeC lesions. Considering changes from lesion baseline after remineralization in MeC lesions, SDF treatment resulted in the highest mineral gain in the surface zone. However, DIW revealed the highest mineral gain after remineralization in the lesion body. SDF stained lesions with the intensity increasing after remineralization in C907 lesions, whereas staining decreased in MeC and HEC lesions.
High fluoride treatments can interfere with continuous remineralization of caries lesions due to partial arrest. Baseline lesion mineral distribution affects SDF's ability to enhance remineralization and the staining caused by SDF.
SDF is being used to arrest active caries lesions extending into dentin and to treat dentin hypersensitivity. This study shed light on SDF's effect on an isolated process in dental caries only, remineralization. It achieved this by examining enamel caries lesions with differing mineral distributions and assessing their staining properties.
研究基线矿物质分布是否会影响银胺氟化物 (SDF) 再矿化和染色釉质龋损的能力。
本实验室研究采用 3 [处理：SDF/氟化物漆 (FV)/去离子水 (DIW)] ×3 [病变方案：甲基纤维素 (MeC)/羟乙基纤维素 (HEC)/Carbopol 907 (C907)] 析因设计。在牛牙釉质标本上制备病变（n = 20）。应用处理并在人工唾液中再矿化病变。数字横向显微放射摄影术 (TMR-D) 用于分析病变。使用分光光度法监测病变颜色。使用双向方差分析分析病变方案和处理对病变深度变化（ΔLD）、矿物质损失（ΔΔZ）、表面区最大矿物质密度（ΔSZ）和与再矿化相关的颜色变化（ΔL*）的影响。
处理×病变方案的相互作用在 ΔΔZ（p < 0.01）和 ΔL*（p < 0.01）方面有统计学意义，但在 ΔLD（p = 0.23）或 ΔSZ（p = 0.91）方面没有统计学意义。在 HEC 和 C907 病变中，SDF 和 FV 之间的 ΔΔZ 没有差异。然而，在 MeC 病变中，DIW 导致的再矿化比 SDF（p < 0.01）和 FV（p = 0.01）更多。考虑到 MeC 病变再矿化后的病变基线变化，SDF 治疗导致表面区获得的矿物质最多。然而，DIW 在病变体中显示出再矿化后的最高矿物质增益。SDF 处理在 C907 病变中增加了病变再矿化后的染色强度，而在 MeC 和 HEC 病变中则降低了染色强度。
高氟处理可能会由于部分抑制而干扰龋病的连续再矿化。基线病变矿物质分布会影响 SDF 增强再矿化的能力和 SDF 引起的染色。
SDF 用于阻止延伸至牙本质的活跃龋病病变，并治疗牙本质过敏。本研究通过检查具有不同矿物质分布的釉质龋损并评估其染色特性，阐明了 SDF 在龋病这一孤立过程中的作用，即再矿化。
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