Comparative Evaluation of Cariostatic and Remineralizing Potential of Two Commercial Silver Diamine Fluoride Preparations Using Confocal Laser Microscopy and EDX-SEM Spectroscopy: An In Vitro Study

AIM: To investigate the cariostatic and remineralizing effect of two commercial silver diamine fluoride (SDF) preparations on enamel and dentinal caries using a plaque bacterial model. MATERIALS AND METHODS: Thirty-two extracted primary molars were divided into two groups (n = 16) as group I (Advantage Arrest) and group II (e-SDF). Plaque bacterial model was used to induce caries on enamel and dentin. Preoperative evaluation of samples was done using confocal laser scanning microscopy (CLSM) and energy-dispersive X-ray spectroscopy-scanning electron microscope (EDX-SEM). All samples were treated with test materials and evaluated for postoperative remineralization quantification. RESULTS: EDX revealed that mean preoperative levels (in weight%) of silver (Ag) and fluoride (F) in enamel carious lesions were 0.0 and 0.0, which increased postoperatively to 11.40 and 31.05 for Advantage Arrest and 13.61 and 31.87 for e-SDF, respectively. For dentinal caries, EDX revealed mean preoperative levels (in weight%) of Ag and F were 0.0 and 0.0, which increased to 11.47 and 48.71 for Advantage Arrest and 10.16 and 47.82 for e-SDF, respectively postoperatively. Both groups showed evident demineralization with exposed collagen under SEM. The mean values of enamel lesion depth for the group I and II were 38.64 and 39.30 µm, that reduced to 28.02 and 28.70 µm, while for dentinal caries, the mean depth from 38.05 to 38.29 µm that reduced significantly to 28.96 and 30.10 µm, respectively (p < 0.001). Caries depth declined significantly after the application of both Advantage Arrest and e-SDF (p < 0.001). CONCLUSION: Advantage arrest and e-SDF show similar cariostatic and remineralization potential for dental caries. The plaque bacterial model used in this study is an efficient method to induce artificial carious lesions in teeth. HOW TO CITE THIS ARTICLE: Kale YJ, Misal S, Dadpe M, et al. Comparative Evaluation of Cariostatic and Remineralizing Potential of Two Commercial Silver Diamine Fluoride Preparations Using Confocal Laser Microscopy and EDX-SEM Spectroscopy: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(4):442-449.