Silver diamine fluoride in preventing enamel erosion: An in vitro study with salivary pellicle.

OBJECTIVES

To compare the prevention of enamel erosion and discolouring effect with a single and two weekly topical applications of silver diamine fluoride (SDF) solution.

METHODS

Human enamel blocks were divided into four groups. Group 1 (SDF2) received two weekly applications of SDF solution (Advantage Arrest: 260,000 ppm Ag, 44,300 ppm F, pH 9.1). Group 2 (SDF1) received a single application of SDF solution. Group 3 (SNF, Positive Control) received daily application of stannous-chloride/amine-fluoride/sodium-fluoride solution (Elmex® Enamel professional: 800 ppm Sn(II), 500 ppm F, pH 4.5). Group 4 (DW, Negative Control) received daily application of deionised water. The treated blocks were subjected to a 14-day erosive challenge. Crystal characteristics, elemental composition, surface morphology, percentage of surface microhardness loss (%SMHL), surface loss, and total colour change (ΔE) of the blocks were investigated using X-ray diffraction (XRD), energy-dispersive spectrometry (EDS) and scanning electron microscopy (SEM), Vickers' hardness testing, non-contact profilometry, and digital spectrophotometry, respectively.

RESULTS

XRD and EDS revealed precipitates of silver for SDF2 and SDF1 and tin for SNF. SEM showed prominent etched enamel pattern on DW than the other three groups. The%SMHL (%) of SDF2, SDF1, SNF, and DW were 26.6 ± 2.9, 33.6 ± 2.8, 38.9 ± 2.9, and 50.5 ± 2.8 (SDF2<SDF1<SNF<DW, p < 0.001). Surface loss (μm) of SDF2, SDF1, SNF, and DW were 3.1 ± 0.6, 3.9 ± 0.6, 3.9 ± 0.7, and 5.5 ± 0.8 (SDF2<SDF1=SNF<DW, p < 0.05). Colour change of SDF2, SDF1, SNF, and DW were 7.9 ± 3.9, 4.0 ± 3.6, 3.6 ± 3.5, and -4.4 ± 3.9 (SDF2>SDF1=SNF>DW, p < 0.05).

CONCLUSION

Two weekly applications was more effective than a single application of SDF in preventing enamel erosion, though it caused more discolouration.

CLINICAL SIGNIFICANCE: Topical application of 38 % SDF with two weekly applications protocol is effective in preventing enamel erosion.