Chou Conrad, Kang Misun, Parkinson Dilworth Y, Sulyanto Rosalyn, Ho Sunita P
Division of Pediatric Dentistry, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco (UCSF), San Francisco, CA 94143, USA.
Department of Preventive and Restorative Dental Sciences, School of Dentistry, UCSF, San Francisco, CA 94143, USA.
Dent Mater. 2025 Sep;41(9):1167-1178. doi: 10.1016/j.dental.2025.06.011. Epub 2025 Jul 1.
To investigate the physicochemical effect of silver diamine fluoride (SDF) by correlating permeability with mineral density and elemental composition of hypomineralized enamel and carious dentin.
Enamel and dentin from human carious primary teeth with and without SDF treatment in-vivo, and hypomineralized enamel from permanent molars with and without SDF treatment in-vitro were scanned using micro X-ray computed tomography. Spatial maps of biometals (calcium, zinc), phosphorus, and silver were generated using X-ray fluorescence microprobe. Permeabilities were computed using Porous Microstructure Analysis software.
The intrinsic permeability of SDF-treated carious dentin was 14.3 % lower than untreated sound dentin (6.39e-15 ± 3.01e-15 m² vs 7.46e-15 ± 1.82e-15 m²; P < 0.0001), while untreated carious dentin was 98.4 % higher (1.48e-14 ± 7.11e-15 m²; P < 0.0001). SDF-treated and untreated transparent dentin showed similar reduced permeabilities (75.6 % and 78.4 % lower than untreated sound dentin, respectively; P = 0.93). Severely hypomineralized enamel showed permeability reaching 108.1 % of adjacent sound dentin (5.71e-15 ± 2.04e-15 m² vs 5.28e-15 ± 1.30e-15 m²; P = 0.1409) and was significantly higher than mildly hypomineralized enamel (1.39e-15 ± 1.04e-15 m²; P < 0.0001). SDF treatment did not significantly impact the permeability of severely hypomineralized enamel (12.4 % reduction; P = 0.07). Principal component regression identified Zn level as a significant effector of tissue permeabilities in carious primary teeth (P < 0.0001).
This study introduces a computational method to measure dental tissue permeability, and demonstrates that SDF significantly reduces permeability in carious dentin but not intact hypomineralized enamel. The study reveals biometal Zn localization can alter dentin and enamel permeabilities, providing new insights into pathobiological mechanisms underlying caries and hypomineralization.
通过将渗透性与矿化不足的牙釉质和龋坏牙本质的矿物质密度及元素组成相关联，研究氟化亚锡（SDF）的物理化学作用。
使用微型X射线计算机断层扫描技术，对体内接受和未接受SDF治疗的人类龋坏乳牙的牙釉质和牙本质，以及体外接受和未接受SDF治疗的恒牙磨牙的矿化不足牙釉质进行扫描。使用X射线荧光微探针生成生物金属（钙、锌）、磷和银的空间分布图。使用多孔微结构分析软件计算渗透率。
经SDF处理的龋坏牙本质的固有渗透率比未处理的健康牙本质低14.3%（6.39e-15 ± 3.01e-15 m² 对比 7.46e-15 ± 1.82e-15 m²；P < 0.0001），而未处理的龋坏牙本质则高98.4%（1.48e-14 ± 7.11e-15 m²；P < 0.0001）。经SDF处理和未处理的透明牙本质显示出相似的渗透率降低（分别比未处理的健康牙本质低75.6%和78.4%；P = 0.93）。严重矿化不足的牙釉质的渗透率达到相邻健康牙本质的108.1%（5.71e-15 ± 2.04e-15 m² 对比 5.28e-15 ± 1.30e-15 m²；P = 0.1409），且显著高于轻度矿化不足的牙釉质（1.39e-15 ± 1.04e-15 m²；P < 0.0001）。SDF处理对严重矿化不足的牙釉质的渗透率没有显著影响（降低12.4%；P = 0.07）。主成分回归确定锌水平是龋坏乳牙组织渗透率的显著影响因素（P < 0.0001）。
本研究引入了一种计算方法来测量牙齿组织的渗透率，并证明SDF可显著降低龋坏牙本质的渗透率，但对完整的矿化不足牙釉质无效。该研究揭示生物金属锌的定位可改变牙本质和牙釉质的渗透率，为龋齿和矿化不足的病理生物学机制提供了新的见解。
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