Samani Mahsa, Majzoub Hamid, Zakavi Faramarz, Mojaddami Ayyub
Department of Restorative Dentistry, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN.
Department of Medical Chemistry, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN.
Cureus. 2024 Sep 3;16(9):e68498. doi: 10.7759/cureus.68498. eCollection 2024 Sep.
This study aimed to investigate and contrast the degree of dentin discoloration resulting from the application of silver diamine fluoride (SDF) alone, SDF in combination with potassium iodide (KI), and SDF in combination with glutathione. The aim was to assess the effectiveness of these combinations in reducing the aesthetic issues associated with SDF treatment in minimally invasive dentistry and preventive procedures.
We conducted this in-vitro study on 136 permanent molar teeth. The teeth were randomly assigned to two main groups of total-etch and self-etch and four subgroups of control, SDF, SDF plus KI, and SDF with glutathione. The teeth underwent colorimetry before and 1 week after applying materials to compare the color change. We mounted the teeth in acrylic resin 1 mm below their cementoenamel junction. A low-speed diamond saw and 600-grit silicon carbide abrasive paper eliminated the occlusal enamel for 10 seconds under water coolant, exposing the dentin. The teeth were then immersed in a demineralizing solution (pH of 4.4, 50 mmol acetate, 2.2 mmol potassium dihydrogen phosphate, and 2.2 mmol calcium chloride) for 7 days at 37°C to induce dentin demineralization and simulate demineralized dentin artificially. The teeth were then gently polished with 600-grit silicon carbide abrasive paper to create a standard smear layer and eliminate the demineralized dentin layer.
136 teeth were evaluated in the total-etch (n = 68) and self-etch (n = 68) groups. Glutathione and KI significantly decreased the discoloration caused by SDF (P<0.05). No significant difference was noted in color change between SDF/glutathione and SDF plus KI groups (P > 0.05). In self-etch groups, glutathione yielded an ∆E=4.12, while KI yielded an ∆E=4.44, with no significant difference.
The application of glutathione and KI can significantly decrease dentin discoloration caused by SDF.
本研究旨在调查和对比单独应用氟化亚银（SDF）、SDF与碘化钾（KI）联合应用以及SDF与谷胱甘肽联合应用所导致的牙本质变色程度。目的是评估这些联合应用在微创牙科和预防程序中减少与SDF治疗相关美学问题的有效性。
我们对136颗恒牙进行了这项体外研究。这些牙齿被随机分为全酸蚀和自酸蚀两个主要组以及对照组、SDF组、SDF加KI组和SDF加谷胱甘肽组四个亚组。在应用材料之前和之后1周对牙齿进行比色，以比较颜色变化。我们将牙齿在其牙骨质釉质界下方1毫米处安装在丙烯酸树脂中。使用低速金刚石锯和600目碳化硅砂纸在水冷条件下对咬合面釉质进行10秒的切割，暴露出牙本质。然后将牙齿浸泡在脱矿溶液（pH值为4.4，50毫摩尔醋酸盐，2.2毫摩尔磷酸二氢钾和2.2毫摩尔氯化钙）中，在37°C下浸泡7天，以诱导牙本质脱矿并人工模拟脱矿牙本质。然后用600目碳化硅砂纸轻轻打磨牙齿，以形成标准的玷污层并去除脱矿牙本质层。
在全酸蚀组（n = 68）和自酸蚀组（n = 68）中对136颗牙齿进行了评估。谷胱甘肽和KI显著降低了SDF引起的变色（P<0.05）。SDF/谷胱甘肽组和SDF加KI组之间的颜色变化没有显著差异（P>0.05）。在自酸蚀组中，谷胱甘肽产生的∆E = 4.12，而KI产生的∆E = 4.44，没有显著差异。
谷胱甘肽和KI的应用可以显著降低SDF引起的牙本质变色。
