Volume 10, Issue 3 (9-2025)
J Res Dent Maxillofac Sci 2025, 10(3): 238-247 |
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Ethics code: IR.IAU.DENTAL.REC.1401.139
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Seraj F, Tavassoli-Hojjati S. In Vitro Effects of Various Agents on Discoloration of Demineralized Enamel Caused by Silver Diamine Fluoride. J Res Dent Maxillofac Sci 2025; 10 (3) :238-247
URL: http://jrdms.dentaliau.ac.ir/article-1-750-en.html
URL: http://jrdms.dentaliau.ac.ir/article-1-750-en.html
1- Dentist, Private Practice, Tehran, Iran.
2- Department of Pediatric Dentistry, TeMS.C., Islamic Azad University, Tehran, Iran. ,saratavasolihojati@gmail.com
2- Department of Pediatric Dentistry, TeMS.C., Islamic Azad University, Tehran, Iran. ,
Abstract: (17 Views)
Background and Aim: Silver diamine fluoride (SDF) is effective for arresting dental caries. However, its application results in dark tooth discoloration, raising concerns among pediatric patients and their parents. This study assessed the effects of potassium iodide (KI) plus hydrogen peroxide (H2O2), H2O2, and Tooth Stain Remover (TSR) on SDF-induced discoloration of artificially demineralized permanent enamel.
Materials and Methods: In this in vitro study, the buccal surface enamel of 33 sound premolars was artificially demineralized and exposed to 38% SDF. The specimens were then randomly assigned to 3 groups of (I) KI + H2O2 (application of water-soluble KI followed by 35% H2O2 on the discolored surface for 3 minutes), (II) H2O2 (application of 35% H2O2 for three 20-minute cycles), and (III) TSR (application of TSR for 3 minutes on the discolored surface). The color parameters were measured at baseline, 1 week after the application of SDF, and 1 week after the application of the abovementioned bleaching agents by a spectrophotometer. Data were analyzed by ANOVA and Tukey test (alpha=0.05).
Results: SDF caused significant color change (ΔE) of demineralized enamel in all groups (ΔE=36-40), with no significant difference among the study groups (P=0.361). Application of all bleaching agents significantly resolved the dark discoloration in all groups, but KI + H2O2 was significantly more effective than H2O2 and TSR (P<0.001). TSR was the least effective (P<0.001).
Conclusion: Within the study limitations, the results showed optimal efficacy of KI + H2O2 for correction of 38% SDF-induced discoloration in artificially demineralized permanent enamel.
Materials and Methods: In this in vitro study, the buccal surface enamel of 33 sound premolars was artificially demineralized and exposed to 38% SDF. The specimens were then randomly assigned to 3 groups of (I) KI + H2O2 (application of water-soluble KI followed by 35% H2O2 on the discolored surface for 3 minutes), (II) H2O2 (application of 35% H2O2 for three 20-minute cycles), and (III) TSR (application of TSR for 3 minutes on the discolored surface). The color parameters were measured at baseline, 1 week after the application of SDF, and 1 week after the application of the abovementioned bleaching agents by a spectrophotometer. Data were analyzed by ANOVA and Tukey test (alpha=0.05).
Results: SDF caused significant color change (ΔE) of demineralized enamel in all groups (ΔE=36-40), with no significant difference among the study groups (P=0.361). Application of all bleaching agents significantly resolved the dark discoloration in all groups, but KI + H2O2 was significantly more effective than H2O2 and TSR (P<0.001). TSR was the least effective (P<0.001).
Conclusion: Within the study limitations, the results showed optimal efficacy of KI + H2O2 for correction of 38% SDF-induced discoloration in artificially demineralized permanent enamel.
Keywords: Dental Caries, Hydrogen Peroxide, Potassium Iodide, Silver Diamine Fluoride, Spectrophotometry
Type of Study: Original article |
Subject:
pediatric
References
1. Varughese A, Janakiram C, Varma B, Mathew A, Venugopalan SR, Ramanarayanan V, et al. Effectiveness of 38% Silver Diamine Fluoride Application along with Atraumatic Restorative Treatment for Arresting Caries in Permanent Teeth When Compared to Atraumatic Restorative Treatment in Adults-Study Protocol for a Randomized Controlled Trial. Methods Protoc. 2022 Oct 26;5(6):87. [DOI:10.3390/mps5060087] [PMID] []
2. Chu CH, Mei L, Seneviratne CJ, Lo EC. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent. 2012 Jan;22(1):2-10. [DOI:10.1111/j.1365-263X.2011.01149.x] [PMID]
3. Kim S, Nassar M, Tamura Y, Hiraishi N, Jamleh A, Nikaido T, Tagami J. The effect of reduced glutathione on the toxicity of silver diamine fluoride in rat pulpal cells. J Appl Oral Sci. 2021 Apr 19;29:e20200859. [DOI:10.1590/1678-7757-2020-0859] [PMID] []
4. Vennela E, Sharada J, Hasanuddin S, Suhasini K, Hemachandrika I, Singh PT. Comparison of staining potential of silver diamine fluoride versus silver diamine fluoride and potassium iodide under tooth-colored restorations: An in vitro study. J Indian Soc Pedod Prev Dent. 2021 Jan-Mar;39(1):47-52. [DOI:10.4103/jisppd.jisppd_533_20] [PMID]
5. Detsomboonrat P, Thongmak P, Lertpayab P, Aiemsri W, Sooampon S. Optimal concentration of potassium iodide to reduce the black staining of silver diamine fluoride. J Dent Sci. 2022 Jan;17(1):300-7. [DOI:10.1016/j.jds.2021.03.014] [PMID] []
6. Sayed M, Matsui N, Hiraishi N, Nikaido T, Burrow MF, Tagami J. Effect of Glutathione Bio-Molecule on Tooth Discoloration Associated with Silver Diammine Fluoride. Int J Mol Sci. 2018 Apr 29;19(5):1322. [DOI:10.3390/ijms19051322] [PMID] []
7. Al-Angari SS, Lippert F, Platt JA, Eckert GJ, González-Cabezas C, Li Y, Hara AT. Dental bleaching efficacy and impact on demineralization susceptibility of simulated stained-remineralized caries lesions. J Dent. 2019 Feb;81:59-63. [DOI:10.1016/j.jdent.2018.12.008] [PMID]
8. Irusa K, Abd Alrahaem I, Ngoc CN, Donovan T. Tooth whitening procedures: A narrative review. Dentistry Review. 2022 Sep 1;2(3):100055. [DOI:10.1016/j.dentre.2022.100055]
9. Dalmázio I, Moura FC, Araújo MH, Alves T, Lago RM, Lima GF, et al. The iodide-catalyzed decomposition of hydrogen peroxide: Mechanistic details of an old reaction as revealed by electrospray ionization mass spectrometry monitoring. Journal of the Brazilian Chemical Society. 2008;19:1105-10. [DOI:10.1590/S0103-50532008000600008]
10. Silva PL, Maciel PP, Martins LB, Carvalho FG, Santos RL, Medeiros ES, et al. Weight-loss and surface roughness of enamel after microabrasion procedure with different agents. Revista de Odontologia da UNESP. 2021 Oct 25;50:e20210020. [DOI:10.1590/1807-2577.02021]
11. Zhao IS, Yin IX, Mei ML, Lo ECM, Tang J, Li Q, So LY, et al. Remineralising Dentine Caries Using Sodium Fluoride with Silver Nanoparticles: An In Vitro Study. Int J Nanomedicine. 2020 Apr 23;15:2829-39. [DOI:10.2147/IJN.S247550] [PMID] []
12. Turton B, Horn R, Durward C. Caries arrest and lesion appearance using two different silver fluoride therapies on primary teeth with and without potassium iodide: 12-month results. Clin Exp Dent Res. 2021 Aug;7(4):609-19. [DOI:10.1002/cre2.367] [PMID] []
13. Ghadirian H, Geramy A, Shallal W, Heidari S, Noshiri N, Keshvad MA. The Effect of Remineralizing Agents With/Without CO2 Laser Irradiation on Structural and Mechanical Properties of Enamel and its Shear Bond Strength to Orthodontic Brackets. J Lasers Med Sci. 2020 Spring;11(2):144-52.. [DOI:10.34172/jlms.2020.25] [PMID] []
14. Firouzmandi M, Mohaghegh M, Jafarpisheh M. Effect of silver diamine fluoride on the bond durability of normal and carious dentin. J Clin Exp Dent. 2020 May 1;12(5):e468-e473. [DOI:10.4317/jced.56303] [PMID] []
15. Burns J, Hollands K. Nano Silver Fluoride for preventing caries. Evid Based Dent. 2015 Mar;16(1):8-9. [DOI:10.1038/sj.ebd.6401073] [PMID]
16. Duangthip D, Chu CH, Lo EC. A randomized clinical trial on arresting dentine caries in preschool children by topical fluorides--18 month results. J Dent. 2016 Jan;44:57-63. [DOI:10.1016/j.jdent.2015.05.006] [PMID]
17. Rafiee A, Memarpour M, Benam H. Evaluation of bleaching agent effects on color and microhardness change of silver diamine fluoride-treated demineralized primary tooth enamel: An in vitro study. BMC Oral Health. 2022 Aug 12;22(1):347. [DOI:10.1186/s12903-022-02371-3] [PMID] []
18. Pani SC, Alenazi FM, Alotain AM, Alanazi HD, Alasmari AS. Extrinsic tooth staining potential of high dose and sustained release iron syrups on primary teeth. BMC oral health. 2015 Dec;15:1-6. [DOI:10.1186/s12903-015-0072-0] [PMID] []
19. Mehran MA, Bassir MM, Jafari SE. Effect of two kinds of iron drops on the discoloration, atomic absorption and structural changes of primary teeth enamel. Journal of Dental Medicine. 2009 Mar 1;21(4).
20. Patel J, Anthonappa RP, King NM. Evaluation of the staining potential of silver diamine fluoride: in vitro. Int J Paediatr Dent. 2018 Jul 4. [DOI:10.1111/ipd.12401] [PMID]
21. Xavier SR, Pilownic KJ, Gastmann AH, Echeverria MS, Romano AR, Geraldo Pappen F. Bovine Tooth Discoloration Induced by Endodontic Filling Materials for Primary Teeth. Int J Dent. 2017;2017:7401962. [DOI:10.1155/2017/7401962] [PMID] []
22. Lertsukprasert N, Locharoenrat K. Efficiency of tooth bleaching agent on staining and discoloration characteristics of nicotine stained dental enamel model. BMC Oral Health. 2020 Aug 10;20(1):221. [DOI:10.1186/s12903-020-01207-2] [PMID] []
23. Madani Z, Alvandifar S, Bizhani A. Evaluation of tooth discoloration after treatment with mineral trioxide aggregate, calcium-enriched mixture, and Biodentine® in the presence and absence of blood. Dent Res J (Isfahan). 2019 Nov 12;16(6):377-83. [DOI:10.4103/1735-3327.270787] [PMID] []
24. Mutlu ŞN, Akbulut MB. Tooth Discoloration Effect of BIOfactor Mineral Trioxide Aggregate: A 6-Month In Vitro Study. Applied Sciences. 2023 Aug 2;13(15):8914.. [DOI:10.3390/app13158914]
25. Ellakany P, Madi M, Aly NM, Al-Aql ZS, AlGhamdi M, AlJeraisy A, Alagl AS. Effect of CAD/CAM Ceramic Thickness on Shade Masking Ability of Discolored Teeth: In Vitro Study. Int J Environ Res Public Health. 2021 Dec 18;18(24):13359. [DOI:10.3390/ijerph182413359] [PMID] []
26. Możyńska J, Metlerski M, Lipski M, Nowicka A. Tooth Discoloration Induced by Different Calcium Silicate-based Cements: A Systematic Review of In Vitro Studies. J Endod. 2017 Oct;43(10):1593-601. [DOI:10.1016/j.joen.2017.04.002] [PMID]
27. Zaffarano L, Salerno C, Campus G, Cirio S, Balian A, Karanxha L, Cagetti MG. Silver Diamine Fluoride (SDF) Efficacy in Arresting Cavitated Caries Lesions in Primary Molars: A Systematic Review and Metanalysis. Int J Environ Res Public Health. 2022 Oct 9;19(19):12917. [DOI:10.3390/ijerph191912917] [PMID] []
28. Muntean A, Mzoughi SM, Pacurar M, Candrea S, Inchingolo AD, Inchingolo AM, et al. Silver Diamine Fluoride in Pediatric Dentistry: Effectiveness in Preventing and Arresting Dental Caries-A Systematic Review. Children (Basel). 2024 Apr 22;11(4):499. [DOI:10.3390/children11040499] [PMID] []
29. Punyanirun K, Yospiboonwong T, Kunapinun T, Thanyasrisung P, Trairatvorakul C. Silver diamine fluoride remineralized artificial incipient caries in permanent teeth after bacterial pH-cycling in-vitro. J Dent. 2018 Feb;69:55-9. [DOI:10.1016/j.jdent.2017.09.005] [PMID]
30. Gao SS, Zhang S, Mei ML, Lo EC, Chu CH. Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a systematic review. BMC Oral Health. 2016 Feb 1;16:12. [DOI:10.1186/s12903-016-0171-6] [PMID] []
31. Lee KE, Erdenebulgan M, Kang CM, Jung HI, Song JS. Effect of Silver Diamine Fluoride and Potassium Iodide Solution on Enamel Remineralization and Discoloration in Artificial Caries. Materials (Basel). 2022 Jun 27;15(13):4523. [DOI:10.3390/ma15134523] [PMID] []
32. Mouafy NM, Ezz El Din S, Shash RY, Wassef N. Microhardness and Bacterial Inhibitory Effect of Riva Star versus Silver Diamine Fluoride on Carious Dentin of Primary Teeth (In-vitro study). Advanced Dental Journal. 2023 Apr 1;5(2):442-8. [DOI:10.21608/adjc.2023.196751.1271]
33. Nguyen V, Neill C, Felsenfeld J, Primus C. Potassium iodide. The solution to silver diamine fluoride discoloration. Health. 2017;5(1):555655. [DOI:10.19080/ADOH.2017.05.555655]
34. Li R, Lo EC, Liu BY, Wong MC, Chu CH. Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders. J Dent. 2016 Aug;51:15-20. [DOI:10.1016/j.jdent.2016.05.005] [PMID]
35. Krausmann E, Drossinos Y. A model of silver-iodine reactions in a light water reactor containment sump under severe accident conditions. Journal of nuclear materials. 1999 Jan 1;264(1-2):113-21. [DOI:10.1016/S0022-3115(98)00471-1]
36. Alqahtani MQ. Tooth-bleaching procedures and their controversial effects: A literature review. Saudi Dent J. 2014 Apr;26(2):33-46. [DOI:10.1016/j.sdentj.2014.02.002] [PMID] []
37. Feiz A, Barekatain B, Khalesi S, Khalighinejad N, Badrian H, Swift EJ. Effect of several bleaching agents on teeth stained with a resin-based sealer. Int Endod J. 2014 Jan;47(1):3-9. [DOI:10.1111/iej.12116] [PMID]
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