Cömert H, Olmez A
Department of Paediatric Dentistry, Faculty of Dentistry, Gazi University, 06490, Ankara, Turkey.
Eur Arch Paediatr Dent. 2025 Feb;26(1):169-181. doi: 10.1007/s40368-024-00951-1. Epub 2024 Oct 29.
The aim of this study is to compare the effect of GSH (reduced glutathione) and KI (potassium iodide) on SDF (silver diamine fluoride) discolouration and dentine remineralisation.
Sixteen primary molars were utilised, yielding 4 dentine specimens each. Three specimens per tooth were allocated: one as a control and the others to experimental groups. Initial microhardness measurements were taken from one remaining dentine specimen per tooth. Subsequently, all groups underwent exposure to a demineralisation solution. Colorimetry assessed specimen colour, and post-second microhardness measurements on demineralised specimens, treatments were administered as follows: group 1 (control, n = 16): 38% SDF, group 2 (n = 16): 38% SDF followed by KI, group 3 (n = 16): 38% SDF with 5% GSH added by weight. Following pH cycling across all groups, colorimetry reassessed 48 dentine specimens. Final microhardness measurements ensued, followed by statistical analysis. Normality was checked via Shapiro-Wilk, and homogeneity via Levene's test. Independent samples t test compared normally distributed groups; Mann-Whitney U compared non-normally distributed groups. ANOVA compared means of normally distributed groups, and Kruskal-Wallis for non-normally distributed ones. Repeated measures ANOVA compared dependent groups with normal distribution, and Friedman test for non-normal. Post hoc Bonferroni analyses identified significant differences. IBM SPSS 25 was used to conduct analyses.
The mean ΔE* values for SDF and SDF + GSH groups were significantly higher than those of the SDF + KI group (p < 0.05). Significant differences in L* values during final colour measurement were noted between the SDF + KI group and both SDF and SDF + GSH groups (p < 0.05). Although mean remineralisation microhardness measurements were higher than mean demineralisation microhardness measurements in all groups, statistical significance was observed only in the SDF and SDF + KI groups (p < 0.05).
The study found that the addition of 5% GSH by weight to SDF does not significantly affect discolouration. Moreover, the addition of 5% GSH to the SDF solution may have a minor impact on the remineralisation potential of SDF. The application of KI after SDF reduces discolouration and does not affect the expected remineralisation process.
本研究旨在比较谷胱甘肽（还原型谷胱甘肽）和碘化钾对氟化亚锡银变色及牙本质再矿化的影响。
使用16颗乳牙，每颗牙获取4个牙本质样本。每颗牙的3个样本被分配：1个作为对照组，其他作为实验组。对每颗牙剩余的1个牙本质样本进行初始显微硬度测量。随后，所有组均暴露于脱矿溶液中。用比色法评估样本颜色，并对脱矿样本进行第二次显微硬度测量，处理方式如下：第1组（对照组，n = 16）：38%氟化亚锡银；第2组（n = 16）：38%氟化亚锡银后加碘化钾；第3组（n = 16）：38%氟化亚锡银中按重量添加5%谷胱甘肽。所有组进行pH循环后，比色法重新评估48个牙本质样本。接着进行最终显微硬度测量，随后进行统计分析。通过夏皮罗-威尔克检验检查正态性，通过莱文检验检查同质性。独立样本t检验比较正态分布组；曼-惠特尼U检验比较非正态分布组。方差分析比较正态分布组的均值，非正态分布组用克鲁斯卡尔-沃利斯检验。重复测量方差分析比较正态分布的相关组，非正态分布组用弗里德曼检验。事后邦费罗尼分析确定显著差异。使用IBM SPSS 25进行分析。
氟化亚锡银组和氟化亚锡银+谷胱甘肽组的平均ΔE值显著高于氟化亚锡银+碘化钾组（p < 0.05）。在最终颜色测量时，氟化亚锡银+碘化钾组与氟化亚锡银组和氟化亚锡银+谷胱甘肽组之间的L值存在显著差异（p < 0.05）。尽管所有组的平均再矿化显微硬度测量值均高于平均脱矿显微硬度测量值，但仅在氟化亚锡银组和氟化亚锡银+碘化钾组观察到统计学意义（p < 0.05）。
该研究发现，在氟化亚锡银中按重量添加5%谷胱甘肽对变色无显著影响。此外，在氟化亚锡银溶液中添加5%谷胱甘肽可能对氟化亚锡银的再矿化潜力有轻微影响。氟化亚锡银后应用碘化钾可减少变色且不影响预期的再矿化过程。
