Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study
Abstract
Background When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective The purpose of this study is to determine the effect of selected caries removal on silver penetration when 38% SDF is applied to deep carious lesions in permanent teeth. Methods Extracted permanent teeth with caries extending to the inner third of the dentin were used (N = 18). The periphery of the carious lesion was completely removed to the dentinoenamel junction (DEJ). In group A (n = 9), no further removal of carious tissue was performed, leaving necrotic dentin inner to the DEJ, whereas in group B (n = 9) superficial necrotic dentin was completely removed until leathery, slightly moist, reasonably soft dentin remained. SDF was applied for 3 minutes in both groups. Microcomputer tomography (micro-CT) and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (FESEM-EDS) were used to measure mineral density and silver distribution. The silver penetration depth/lesion depth (PD/LD) ratio was calculated for each sample. The Mann–Whitney U test was used to compare differences between the two groups. Results The micro-CT analysis showed that the PD/LD ratios of group B (1.07–2.29) were marginally greater than those of group A (1.00–1.31). However, a statistically significant difference was not observed (pvalue = 0.5078). When…
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