| dc.description.abstract | Clinical trials have proven the cariostatic efficacy of silver diammine fluoride in primary teeth. Many clinicians are promoting its use worldwide since it has earned a place in "Minimally Invasive Dentistry." However, some clinicians avoid using this therapeutic intervention due to the black discolouration imparted to the carious lesions. Broadly, the mechanism of action of silver diammine fluoride is known to be bactericidal due to the presence of silver ions and having remineralising capacity due to the presence of fluoride ions. However, the precise mechanisms or chemical interactions of SDF with tooth structure are still unclear. The overall aim of this study was to investigate the mechanism of action of topically applied SDF on the remineralisation of dental hard tissue and model systems for dental caries. Methods such as ion-selective electrodes, X-ray diffraction, nuclear magnetic resonance, X-ray microtomography, and scanning electron microscopy were employed to understand these mechanisms. These methods provided insight into the kinetics and characterisation of chemical interactions of SDF with the tooth structure under remineralising conditions. This in vitro study showed that SDF has an increased rate of remineralisation. The chemical interaction of SDF and hydroxyapatite during remineralisation results in the formation of fluoride-substituted hydroxyapatite within 24 hours after application. Subsequent application of potassium iodide (KI) results in an enhanced rate of remineralisation, and NMR results showed the formation of fluoride-substituted hydroxyapatite within 30 minutes. XMT results showed better penetration of silver ions within dentine tubules when SDF application was followed by KI application. However, no radiopaque barrier is formed with SDF/KI for caries limited to enamel. Moreover, the remineralisation potential of SDF after potassium iodide application in a biological environment is considerably reduced. In conclusion, SDF has an increased rate of remineralisation. Clinically, applying KI for caries into dentine rather than caries into enamel would be advantageous. | en_US |
