The Synergetic Effect of Silver Diamine Fluoride with Potassium Iodide and Grape Seed Extract on Dentin Remineralization

Abstract

Purpose: This study was conducted to evaluate the synergetic effect of using silver diamine fluoride containing potassium iodide and grape seed extract on dentin microhardness. Materials and Methods: Sixty freshly extracted human deciduous second molars were enrolled in this study. Sixty dentin discs were cut from the crown and were randomly divided into four groups according to the applied treatment after dentin demineralization, (15 samples each). In the first group, samples were received no treatment, only stored in artificial saliva (positive control), in the second group, samples were treated with silver diamine fluoride containing potassium iodide only, in the second group, samples were treated with grape seed extract only (GSE), in the third group, samples were treated with silver diamine fluoride containing potassium iodide (SDF), whereas in the fourth group, samples were treated with combined therapy of grape seed extract followed with silver diamine fluoride containing potassium iodide (GSE+SDF). Microhardness measurements were taken for each dentin disc at baseline, after demineralization, and after treatment. Results: There was a statistically significant increase in dentin microhardness after each treatment as compared to the demineralized dentin microhardness. The mean percent change of dentin microhardness was statistically significant increased in GSE, SDF, and GSE+SDF groups when compared to the control group. Conclusions: Considering the limitations of this study, monotherapy of GSE, SDF solution, and their combination can be recommended to enhance the micro-hardness of demineralized dentin. SDF applications after GSE improved the micro-hardness of demineralized dentin when compared to the monotherapy of each treatment.

Evaluation of Remineralizing Potential of Cranberry and Chitosan on Demineralized Dentin (An in Vitro Study)

“…This stabilized collagen matrix could serve as a mechanical Evaluation of Remineralizing Potential of Cranberry and Chitosan on Demineralized Dentin (91) barrier, which inhibits the adverse effect of acid and further loss of minerals (19) . These findings are in accordance with previous studies (3,12) which evaluated the remineralizing effect of proanthocyanidin on demineralized dentin and recorded significant increase in dentin microhardness after treatment with proanthocyanidin. However, the current findings are in contrary with previous studies (24,25) which revealed that demineralized dentin treated with proanthocyanidin did not show any significant increase in dentin microhardness.…”

“…ANOVA repeated measures was performed to compare the effect of evaluation time on microhardness and percentage of change of microhardness within each treatment group. Percentage of change (MH%) of dentin was calculated according to a previous study (3)…”

“…Cranberry extract treated demineralized dentin group revealed significant increase in percentage of microhardness recovery, this could be explained by establishment of crosslinks by proanthocyanidins. These cross-links could improve the resistance of dentin surface to deformation by the indenter of microhardness tester (3) . The phenolic hydroxyl groups of proanthocyanidins could form hydrogen bond with the amide carbonyl or hydroxyl groups of collagen fibrils, thus enhancing their mechanical properties.…”

“…This might be due to the establishment of collagen crosslinks by proanthocyanidins. This cross-linked collagen matrix could act as a scaffold for minerals precipitation (3) .…”

“…With progression of carious lesion, the exposed organic matrix is degraded by proteolytic enzymes. All these alterations cause reduction in mechanical properties of dentin (3) . Medical model of caries management is highly desirable and is one of the corner stones of minimal invasive dentistry.…”