Remineralisation effect of SDF+KI solution on artificial caries

Abstract

Fluoride varnishes have become effective for preventing caries and remineralising early caries. The most commonly used fluoride agent today (38% SDF) contains 44,800 ppm, the highest of any fluoride compounds used in dentistry. Aim of this study is to see effect of silver diamine fluoride (SDF) + potassium iodide (KI) solution on the remineralisation on artificial caries. Sixty bovine incisors without cracks or white spots were demineralized and subjected to each of the following treatments: no treatment, 38% SDF+KI, 38% SDF, 5% sodium fluoride varnish (NaF) application. Acid-resistant nail varnish was applied to the surface of each specimen to create two exposed windows with a size of 3.5 mm × 3.5 mm. The specimens were immersed in demineralizing solution and stored at 37˚C in an incubator for 120 hours (n=15 each group) for manufacturing early dental caries with varying lesion depths. Microhardness of enamel surfaces was measured with Vickers Hardness Number (VHN). Evaluation of discoloration was measured with digital single-lens reflex (DSLR) camera image and Delta E. Measurement of lesion depth and histological evaluation was done by Polarized Light Microscope. Scanning Electron Microscope (SEM) images were investigated to compare morphological changes on the surfaces. VHN values of the all demineralized enamel specimens in remineralisation groups were significantly increased after remineralisation agents were applied. Based on the VHN results, SDF+KI and SDF were more effective than NaF. DSLR camera image and Delta E measure showed that the SDF groups recorded the largest color change values in the demineralized enamel group compared to SDF+KI, NaF, and control groups. SDF group showed the most darkness among the groups. PLM showed all the demineralized enamel specimens were remineralised after remineralisation procedure. SDF groups showed black staining on PLM and DSLR camera image. Remineralisation of incipient lesion area, measured by enamel surface hardness and PLM calibration increase, of SDF+KI and SDF were greater than NaF application. But it is important to obtain prior consent for the aesthetic results of only SDF treatment. Treatments of teeth with KI solution after SDF treatment significantly reduced the discoloration caused by SDF.

이 연구의 목적은 SDF+KI 용액이 인공우식의 재광화에 미치는 영향을 평가하는 것이다. 60개의 금이나 백점이 없는 우치를 준비하여 다음과 같은 군으로 분류하여 각각 적용하여 처리하였다. 처리 안한 군 (대조군); 38% silver diamine fluoride+potassium iodide; 38% silver diamine fluoride; 5% sodium fluoride varnish. 항산 nail varnish을 각 시편 표면에 적용하여 3.5 mm × 3.5 mm 사이즈의 2개의 창을 만들었다. 모든 시편을 탈회 용액에 넣어 37도에 120시간을 담궈 우식과 다양한 병소를 (lesion) 만들었다. 법랑질의 microhardness을 Vickers Hardness Number (VHN) 측정하였다. DSLR camera image로 변색을 측정하고, lesion 깊이는 white light image and Delta E로 측정되었다. 그리고 Polarized Light Microscope로 조직변화를 측정하였다. Scanning Electron Microscope (SEM) 사진으로 형태변화를 측정하였다. 모든 탈회된 법랑질의 VHN 값은 재광화 이후로 유의하게 증가하였다. VHN 결과에 따르면, SDF+KI 과 SDF 는 NaF 보다 더 효과적이있다. DSLR image와 Delta E 값은 SDF 군의 변색 정도가 SDF+KI, NaF, 그리고 대조군과 비교하였을 때 가장 컸다고 보였다. SDF 군은 다른 군과 비교하였을 때 어두은 색상을 보였다. PLM 값이 탈회된 모든 법랑질 재광화됐다는 것을 입증하였다. SDF 군은 검은 PLM, DSLR image에서 검은 staining을 보였다. SDF+KI, SDF의 재광화 값은 NaF 보다 더 유의하게 컸습니다. 항우식 치료로 SDF만 치료했을 때 심미적은 문제를 잘 알아 두는 것이 중요하다. SDF 치료후에 KI 처리하는 것이 변색을 유의하게 줄어주였다.