Comparing the remineralization potential of silver diamine fluoride versus various fluoride agents on dental enamel

The aim of this study is to compare the remineralization potential of silver diamine fluoride versus various fluoride agents for surface microhardness and surface roughness on artificially created caries lesions on dental enamel, in vitro. Enamel samples from bovine incisors were divided into 3 groups (n=22). In each group, half of the samples were allocated for surface microhardness and the other half for surface roughness analyses. To create artificial initial caries lesions, the specimens were placed in a demineralization solution at 37°C for 72 hours. In accordance with the manufacturer's instructions, NAF varnish (ProShield Varnish) was applied to Group 1, SDF (Rivastar) to Group 2, and CPP-ACFP varnish (MI Varnish™) to Group 3. Then the samples were subjected to a pH cycle for 14 days, with 6 hours in demineralization solution and 18 hours in remineralization solution. At the baseline, post-demineralization (PD) and post-remineralization (PR) stages, Vickers microhardness measurements, surface roughness measurements with a profilometer, and 2D and 3D surface topographies were obtained with an AFM device. The data obtained in the study were analyzed using SPSS (Statistical Package for Social Sciences) for Windows 25.0 software. According to the PR surface microhardness results, the mean VHN value of the SDF group was statistically lower than the NaF and CPP-ACFP groups (p<0.05). There was no statistically significant difference between the mean VHN values of the NaF and CPP-ACFP groups (p>0.05). The mean PR surface roughness values showed a statistically significant difference between the groups (p<0.05). The sequence of surface roughness values was observed as follows: NaF group > SDF group > CPP-ACFP group. Based on the AFM analysis results, the NaF group exhibited the highest roughness values (0.153 μm), followed by the SDF group (0.147 μm), and the CPP-ACFP group showed the lowest values (0.118 μm) after the application of the remineralization agents. In conclusion, it was observed that the remineralization materials applied in all groups positively affected the remineralization on the initial caries lesions, but SDF was not as successful as CPP-ACFP in all parameters examined. However, in vivo studies should complement in vitro research for determine the best agent for remineralizing dental hard tissues.