Effect of Silver Diamine Fluoride and Proanthocyanidin on Mechanical Properties of Caries-Affected Dentin

Abstract

Objectives Inner carious dentin is specified with decreased minerals and collagen cross-links but without protein denaturation. Current minimally invasive dentistry concepts recommend removal of only the outer layer of carious dentin and biomodification of repairable inner carious dentin. The present study aims to investigate the possibility of functional repair of this layer using silver diamine fluoride (SDF) and grape seed extract (GSE). Materials and Methods Molar teeth with occlusal caries were used to prepare caries-affected dentin specimens for hardness and elastic modulus measurements. The specimens of each test were divided randomly into four equal groups. In the GSE group, the specimens were immersed in 6.5% GSE solution for 10 minutes. In the SDF group, the specimens underwent a topical application of a 30% SDF. In the GSE+SDF group, first the specimens were immersed in GSE and then exposed to SDF. In the SDF+GSE group, first SDF was applied and then the specimens were immersed in GSE. Microhardness measurements were taken at baseline and after treatment. A control group with distilled water treatment was also prepared for elastic modulus measurements. Statistical Analysis One-way analysis of variance and post-hoc tests were used for statistical analysis. Results There were significant differences in H1-H0 (final hardness—baseline hardness) among the groups. Baseline and final hardness of each group was also significantly different (SDF>SDF+GSE>GSE>GSE+SDF). Elastic modulus of SDF and SDF+GSE increased compared to the control group. Conclusions SDF and SDF+GSE treatment can be recommended to increase hardness and elastic modulus of caries-affected dentin.

Effect of silver diamine fluoride and proanthocyanidin on resistance of carious dentin to acid challenges

“…Our previous study showed the improvement of mechanical properties of carious dentin after SDF treatment [ 8 ]. This beneficial effect persisted after acid challenge, which can be attributed to increased mineral content.…”

“…In order to repair carious dentin, biological changes should first be made in the dentin matrix, and subsequently the mineral content should be replaced. Also, the repaired dentin should be able to withstand the acidic challenges of the oral cavity [ 8 ]. Accordingly, teeth will become more resistant to further demineralization.…”

“…Silver compounds penetrate into the dentinal tubules invading cariogenic microorganisms [ 13 ]. In addition, it can harden carious lesion [ 8 , 16 , 18 ], inhibit degradation of collagen in demineralized dentin [ 19 ], and exert an inhibitory effect on MMPs [ 6 ] and cysteine cathepsins [ 20 ]. Arresting coronal and root dentin caries [ 14 , 18 , 21 , 22 ] by modifying both mineral and organic structure of dentin is the endpoint that makes SDF superior to other remineralizing agents.…”

“…Our previous research focused on the effect of PA and SDF on mechanical properties of carious dentin [ 8 ]. Although the immediate effect of SDF and SDF+PA on restoring mechanical properties of carious dentin was recorded, the resistance to further acid challenges was not investigated.…”

Research Advances in the Use of Bioactive Compounds from Vitis vinifera By-Products in Oral Care

“…Firouzmandi et al analyzed the remineralization of dentin after the treatment with GSE and GSE+ silver diamine fluoride. The results showed that both agents increased the hardness values, but not the elastic modulus of caries-affected dentin [ 95 ]. These findings are consistent with the previous studies showing that GSE can improve the mechanical properties of demineralized dentin by stimulating the inter- and intrafibrillar cross-links in the collagen matrix from dentin [ 96 , 97 , 98 , 99 , 100 , 101 , 102 ] and by improving resin-dentin bond strength [ 101 , 103 ].…”