In vitro evaluation of remineralization and staining potential of silver diamine fluoride

This in vitro study aimed to evaluate the effectiveness of remineralization agents commonly used in treating early childhood caries, with a particular focus on the remineralization capacity and staining potential of 38% silver diamine fluoride (SDF). SDF's gel and liquid forms, the SDF combination with potassium iodide (KI), and sodium fluoride were comparatively analyzed on primary teeth. Remineralization efficacy was assessed using DIAGNOdent laser fluorescence, micro- computed tomography (Micro-CT), and scanning electron microscopy with energy- dispersive X-ray spectroscopy (SEM-EDX). The results revealed that the liquid form of SDF provided the highest remineralization effect, especially when used without KI. On the other hand, color analysis demonstrated that the combination of SDF and KI resulted in less discoloration, indicating a more favorable outcome in terms of esthetics. The findings of this study suggest that SDF is a clinically effective caries-arresting agent; however, its esthetic limitations due to irreversible black staining may restrict its use, particularly in anterior teeth. The addition of KI appears to be a promising strategy to mitigate these esthetic concerns. Notably, the investigation of the gel form of SDF—an area with limited existing research—and the combined use of three analytical methods to assess remineralization represent significant contributions to the literature. In conclusion, it is thought that this study will contribute to making more informed decisions regarding the clinical use of SDF by providing scientific evidence for minimally invasive approaches in terms of both treatment efficacy and aesthetic results.