Preventing proximal enamel caries in neighboring tooth with glass ionomer cement restoration and silver diamine fluoride pretreatment

• Published in: Journal of dentistry 2024-10, Vol.149, p.105312, Article 105312
• Main Authors: Ge, Kelsey Xingyun, Jakubovics, Nicholas Stephen, Quock, Ryan, Lam, Walter Yu-Hang, Chu, Chun-Hung, Yu, Ollie Yiru
• Format: Article
• Language: English
• Subjects: Biofilms - drug effects; Candida albicans - drug effects; Cariostatic Agents - pharmacology; Cariostatic Agents - therapeutic use; Dental caries; Dental Caries - microbiology; Dental Caries - prevention & control; Dental Enamel - drug effects; Dental Restoration, Permanent - methods; Enamel; Fluorides, Topical - pharmacology; Fluorides, Topical - therapeutic use; Glass ionomer cement; Glass Ionomer Cements - pharmacology; Glass Ionomer Cements - therapeutic use; Humans; Microscopy, Confocal; Microscopy, Electron, Scanning; Prevention; Quaternary Ammonium Compounds - pharmacology; Quaternary Ammonium Compounds - therapeutic use; Remineralisation; Silver Compounds - pharmacology; Silver Compounds - therapeutic use; Silver diamine fluoride; Streptococcus mutans - drug effects; X-Ray Diffraction; X-Ray Microtomography
• ISSN: 0300-5712; 1879-176X; 1879-176X
• DOI: 10.1016/j.jdent.2024.105312

To investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. SDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. PMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead−to-live ratio in Groups 1–4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. SDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. SDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.