Anti-erosive effect of silver diamine fluoride against enamel erosion: An in situ study
Abstract
OBJECTIVE: To investigate anti-erosive effect of silver diamine fluoride (SDF) against enamel erosion and assessed associated color change.
METHODS: This three-phase crossover in situ study compared anti-erosive effect of SDF and stannous chloride/amine fluoride/sodium fluoride mouthrinse (SNF) against distilled water (DW, control), while evaluating enamel color changes. Fifteen adults (27-35 years) wore palatal appliances with four-enamel blocks per phase, alternating 14-day intervention periods (weekly 38% SDF [255,000 ppm Ag, 44,800 ppm F], daily SNF mouthrinse [800 ppm Sn, 500 ppm F], or weekly DW) separated by 7-day washouts. Appliances were exposed with five 2 min extraoral erosive challenges (citric acid, pH 3.2) daily. Post-intervention analyses included salivary pellicle morphology (atomic force microscopy, AFM), enamel surface integrity (scanning electron microscopy, SEM), elemental composition (energy-dispersive X-ray spectroscopy, EDS), crystal structure (X-ray diffraction, XRD), surface microhardness loss (hardness tester), surface loss (optical profilometry), and color change (spectrophotometry).
RESULTS: AFM revealed altered pellicle morphology in SDF and SNF groups. SEM demonstrated reduced enamel erosion in SDF and SNF versus DW. EDS confirmed Ag+ deposition in SDF and Sn2+ in SNF. XRD identified fluorapatite in SDF and SNF groups. SDF showed the lowest surface microhardness loss (21.7±1.0%) and surface loss (µm) (2.7±0.6), followed by SNF (30.0±1.1%;…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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