Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride

Abstract

This study evaluated the effect of Glutathione (GSH) bio-molecule on the reduction of enamel and dentin discoloration after application of 38% silver diammine fluoride solution (SDF). One hundred and twenty bovine teeth specimens were used. The enamel and dentin specimens were divided into three groups: (1) SDF only (control); (2) SDF followed by application of a potassium iodide solution (KI); and (3) SDF mixed with 20% GSH. Half the specimens were exposed to light and the remainder kept in dark conditions (n = 10) Color changes were measured using a spectrophotometer at the following time intervals: before solution application (baseline) and immediately after application, then 3, 6, 24, 48, 72 h, and 7, 10 and 14 days. SEM/EDS analysis was performed on treated enamel and dentin. Statistical analysis was done using a repeated measures ANOVA test. The spectrophotometer results showed that the SDF group exhibited the greatest color changes under both light exposed and dark conditions, while SDF + GSH group was effective in decreasing the color changes in both light and dark conditions. The SDF + KI group showed an insignificant color changes over time. SEM/EDS analysis showed different patterns for the silver crystal formation in each group (SDF, SDF + GSH, and SDF + KI group). It was concluded GSH can effectively minimize color changes after application of SDF, especially on enamel and to a lesser extent on dentin.

Effect of two bleaching regimens on enamel bonding performance

“…Bovine teeth resemble human teeth in many characteristics 20) and have been used to compare the bond strength of bleached enamel with that of unbleached enamel 21) . In order to simulate the clinical situation, an intact enamel surface should be used.…”

Effects of mechanical abrasion challenge on sound and demineralized dentin surfaces treated with SDF

“…Each color record was acquired using the 3-dimensional color space system CIELAB (L*a*b* system), where L* represents brightness ranging from bright (100) to dark (0), a* describes green (− a*) to red (+ a*), and the b* represents blue (− b*) to yellow (+ b*). The color measurements were replicated three times for each specimen at each time period by single operator “who was blinded to the active ingredient of the experimental groups” and the mean values were recorded 18 . The difference in color (ΔE) for each specimen between baseline and each time-interval point was calculated using this equation; …”

“…Application of a saturated KI solution immediately after SDF was suggested www.nature.com/scientificreports/ as a way to resolve the discoloration problem produced by SDF application. In that case, iodide ions react with the excess free silver ions to form a yellowish precipitate of insoluble silver iodide crystals on the surface 18,33 . Although the formation of the insoluble silver iodide crystals contributed to the high surface roughness of the dentin surface even after brushing, it also resulted in protection of the dentin surface against the wearing effect from brushing resulting in lower surface loss.…”

SDF: Enhanced preventive, operative care: Call based on caries risk

“… Knight et al, 2006 [16] reported the addition of potassium iodide (KI) before application to the SDF could reduce the discolouration.  Sayed et al, 2018 [17] reported that glutathione biomolecule reduces tooth discoloration after application of SDF, particularly on enamel and to a minor degree on dentin.  In majority of the cases, the affected gingival or mucosal tissue turns white and the change is transient.…”