Antibacterial Efficacy of Silver Diamine Fluoride Compared to Casein Phosphopeptide-Amorphous Calcium Phosphate Against Streptococcus mutans in a Biofilm Caries Model

ABSTRACT Objective: To compare the antibacterial efficacy of silver diamine fluoride (SDF) with a product containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) against Streptococcus mutans using a biofilm caries model. Material and Methods: Twenty-seven saliva-coated dentine blocks obtained from extracted human teeth were inoculated with Streptococcus mutans monospecies biofilm in this in vitro study. The biofilms were then exposed to 10% sucrose in brain heart infusion broth eight times daily for seven days. After the biofilm growth period, the dentine blocks (n=9 per group) were treated with one of the following substances: 1) sterile saline (control), 2) 38% SDF, and 3) a product containing CPP-ACP. Then, the samples were incubated at 37ºC for 48 hours, and the numbers of viable microorganisms in the biofilms were counted and compared. ANOVA and Tukey's HSD tests were used to analyze the data (p<0.05). Results: The number of viable bacteria, as determined by the number of colony-forming units (CFU mL-1) of Streptococcus mutans, was significantly reduced following treatment with SDF and the CPP-ACP product (p<0.05). However, SDF showed superior antibacterial activity compared to the CPP-ACP product (mean CFU mL-1 =zero compared to 96 x106) (p<0.05). Conclusion: SDF has higher antibacterial activity against cariogenic Streptococcus mutans biofilm than the CPP-ACP product. The CPP-ACP product showed antibacterial activity, but it was limited.

Potencial remineralizante del fluoruro diamino de plata al 38% en dentina de dientes temporales afectada por caries / Remineralizing potential of 38% silver diamine fluoride in dentin affected by dental caries

Introducción: la caries es una enfermedad compleja que afecta a cualquier edad. La prevalencia es mayor en la primera dentición, sobre todo en población con baja percepción económica. El fluoruro diamino de plata (FDP) al 38% ha sido utilizado como una alter- nativa de tratamiento para esta enfermedad. Funciona como una solución remineralizante y cariostática. Objetivo: evaluar el efecto remineralizante del FDP al 38% en dentina afectada por lesiones de caries en molares temporales. Material y métodos: estudio clínico, epidemiológico, descriptivo, longitudinal y experimental. Se llevó a cabo en molares de primera dentición de niños de tres a cinco años de edad. Los niños seleccionados tenían molares con lesiones cariosas dentinarias, Pitts las denomina D3. No se incluyeron niños con dientes que presentaron patologías pulpares irreversibles. La aplicación del FDP al 38% la efectuó un operador entrenado para esta finalidad. Se utilizaron los criterios de Nyvad para determinar el grado de dureza de la dentina y con ello deducir su remineraliza- ción. Se observó la permanencia de la remineralización efectuada por un periodo de cinco meses. Resultado y conclusión: el FDP es un compuesto eficaz en 91% de los casos en un periodo de cinco meses o más (AU)

Introduction: dental caries is a complex disease that affects any age. The prevalence is higher in primary dentition, especially in a population with low economic perception. 38% silver diamine fluoride (FDP) has been used as an alternative treatment for this disease. It works as a remineralizing and cariostatic solution. Objective: to evaluate the remineralizing effect of 38% FDP on dentin affected by dental caries, in temporary molars. Material and methods: clinical, epidemiological, descriptive, longitudinal and experimental study. It was carried out in temporary molars of children between three and five years of age. The selected children presented molars with dental carious lesions, Pitts calls them D3. Children with teeth that presented irreversible pulp pathologies were not included. The application of the FDP to 38% was carried out by an operator trained for this purpose. The Nyvad criteria were used to determine the degree of hardness of the dentin and thereby deduce its remineralization. The permanence of the remineralization carried out was observed for a period of five months. Result and conclusion: the FDP is an effective compound in 91% of the cases, in a period of five months or more (AU)

Efficacy of 30% and 38% Silver Diamine Fluoride in Arresting Caries Lesions After Different Application Times: An in Vitro Study

Abstract Objective: To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dentin caries lesions when applied under different concentrations and times. Material and Methods: Forty-two bovine blocks were selected and fixed in 24-well plates. Each well received a mixed bacterial inoculum added to the culture medium with 5% sucrose. The plates were incubated in microaerophilia (7 days) for caries formation, confirmed by micro-CT (M1). SDF was applied over the carious lesions for different times and concentrations (n=6): SDF 30% - immediate removal, 1 minute and 3 minutes; SDF 38%, - immediate removal, 1 minute and 3 minutes. The group without treatment was the control. Then, the samples were again scanned by micro-CT (M2) and submitted to a second cariogenic challenge for 21 days. Then, a final scan was performed (M3). Results: Mean pH at the culture medium and lesion depth were compared using Kruskal-Wallis and Wilcoxon tests. 38% SDF showed the lowest metabolic activity of the biofilm. All 38% groups and 30% 1 and 3 minutes did not show an increase in mean lesion depth comparing M3 with M1. However, only 30% 3 minutes and 38% 1 and 3 minutes showed a significant reduction of lesion depth. Conclusion: The minimum application time of 30% SDF to arrest dentin caries lesion was 1 minute, while 38% SDF arrested with application and immediate removal.

Silver Diamine Fluoride versus Bioactive Giomer Light-Curing Varnish: An In Vitro Study on Caries Arrest

ABSTRACT Objective To compare the capacity of silver diamine fluoride (30%) and the bioactive giomer light-curing varnish for arresting ICDAS score 5 non-retentive caries lesions. Material and Methods An in vitro analytical study was conducted using 36 healthy primary teeth, in which a cavity was created, divided into 3 groups: control (distilled and deionized water), giomer-based light-curing varnish - Barrier Coat, and Silver Diamine Fluoride 30% - Cariestop (SDF). The samples were analyzed for mineral loss as measured by surface microhardness (SMH).The Knoop microhardness test was performed using the HVS-1000 microhardness tester. The data were compared by two-way analysis of variance - treatment and time (before and after treatment) followed by Tukey's post-test. The significance level adopted in all analyzes was 5%. Results The specimens treated with giomer showed higher SMH compared to the untreated group but were similar to those of the SDF group. The SDF group, on the other hand, showed no statistically significant difference from the control group (p=0.010). Conclusion The giomer varnish had a remineralizing effect on artificial dentinal caries.

Differential expression on mitochondrial tryparedoxin peroxidase (mTcTXNPx) in Trypanosoma cruzi after ferrocenyl diamine hydrochlorides treatments

Abstract Resistance to benznidazole in certain strains of Trypanosoma cruzi may be caused by the increased production of enzymes that act on the oxidative metabolism, such as mitochondrial tryparedoxin peroxidase which catalyses the reduction of peroxides. This work presents cytotoxicity assays performed with ferrocenyl diamine hydrochlorides in six different strains of T. cruzi epimastigote forms (Y, Bolivia, SI1, SI8, QMII, and SIGR3). The last four strains have been recently isolated from triatominae and mammalian host (domestic cat). The expression of mitochondrial tryparedoxin peroxidase was analyzed by the Western blotting technique using polyclonal antibody anti mitochondrial tryparedoxin peroxidase obtained from a rabbit immunized with the mitochondrial tryparedoxin peroxidase recombinant protein. All the tested ferrocenyl diamine hydrochlorides were more cytotoxic than benznidazole. The expression of the 25.5 kDa polypeptide of mitochondrial tryparedoxin peroxidase did not increase in strains that were more resistant to the ferrocenyl compounds (SI8 and SIGR3). In addition, a 58 kDa polypeptide was also recognized in all strains. Ferrocenyl diamine hydrochlorides showed trypanocidal activity and the expression of 25.5 kDa mitochondrial tryparedoxin peroxidase is not necessarily increased in some T. cruzi strains. Most likely, other mechanisms, in addition to the over expression of this antioxidative enzyme, should be involved in the escape of parasites from cytotoxic oxidant agents.

Effect of silver diamine fluoride (SDF) on the dentin-pulp complex: ex vivo histological analysis on human primary teeth and rat molars / Efecto del diamino fluoruro de plata (DFP) sobre complejo dentino-pulpar. Análisis histológico ex vivo en dientes primarios humanosy molares de rata

The aim of this study was to determine the effect of SDF on thedentin­pulp complex using two models: teeth after SDFapplication (ex vivo) and experimental animal molars. Adescriptive study was performed using two models. In the firstmodel, primary teeth (ex vivo) with enamel­dentin caries, withoutpulp involvement and previously treated with 38% SDF, wereevaluated by means of two techniques: (a) Scanning ElectronMicroscopy (SEM) and energy­dispersive X­ray detector (EDS)to determine qualitative and quantitative composition, and (b)brightfield optical microscopy (OM) after decalcification. Thesecond model used laboratory animal molars from 12 maleWistar rats. Standardized enamel­dentin cavities approximately0.5 mm deep were made the distal fossa of the occlusal face ofboth first lower molars, to one of which a 38% SDF solution wasapplied, while the other was used as a control. Histologicalsections were prepared and dental pulp was evaluatedqualitatively in both groups. SEM on ex vivo teeth showed areasof hypermineralization in the intertubular dentin and few blockedtubules, while EDS detected Ag in the center of the lesion(7.34%), its concentration declining at the edges (1.71%), withnone in the areas farthest from the lesion...

El objetivo del trabajo fue determinar del efecto del DFP encomplejo dentino­pulpar aplicando dos modelos: piezasdentarias luego de su aplicación (ex vivo) y en molares deanimales experimentales. Se realizó un estudio descriptivoaplicando dos modelos: en piezas dentarias primarias (ex vivo)con caries amelodentinarias sin compromiso pulpar que hayansido sometidas previamente con DFP 38%, mediante dosevaluaciones: Microscopía electrónica de Barrido (MEB) ydetector de energía dispersiva de rayos X (EDS) a fin dedeterminar su composición cuali y cuantitativa y Microscopíaóptica de campo claro (MCC) mediante la técnica descalcifi ­cación y en molares de animales de laboratorio donde seutilizaron 12 ratas Wistar macho. La técnica fue estandarizadaen la fosa distal de la cara oclusal del primer molar inferior, serealizó una cavidad amelodentinaria aprox. 0.5 mm de profun ­didad, en ambos molares. En un molar se aplicó la soluciónDFP al 38 % y el opuesto como control. Se realizaron corteshistológicos y se evaluó en forma cualitativa la pulpa dentalen ambos grupos. En las piezas ex vivas mediante MEBse observaron áreas de hipermineralización en la dentinaintertubular y escasos conductillos obliterados y por EDS sedetectó Ag en el centro de la lesión (7.34%), disminuyendo suconcentración en los límites (1,71%) y no se detectó en las zonasmás alejadas de la misma. En MCC se observó DFP sellando losconductillos sólo en sitio de colocación y con una penetraciónlimitada, por debajo, los conductillos se observaron de aspectonormal y el tejido pulpar asociado con la caries tratadaha mostrado un infiltrado inflamatorio crónico y formaciónde dentina terciaria, sin observarse precipitado de Ag...

The in vitro activity of fatty diamines and amino alcohols against mixed amastigote and trypomastigote Trypanosoma cruzi forms

Four diamines and three amino alcohols derived from 1-decanol, 1-dodecanol and 1,2-dodecanediol were evaluated in an in vitro assay against a mixture of trypomastigote and intracellular amastigote forms of Trypanosoma cruzi. Two of these compounds (6 and 7) showed better activity against both proliferative stages of T. cruzi than the positive control benznidazole, three were of similar potency (1, 2 and 5) and two were less active (3 and 4).

Preparation and antitubercular activity of lipophilic diamines and amino alcohols

A series of diamines and amino alcohols derived from 1-dodecanol, 1-tetradecanol, 1,2-dodecanediol and 1,2-tetradecanediol were synthesized and tested for their antitubercular activity. Compounds 3, 8 and 9 were found to be the most active (MIC of 6.25 µg/mL). Nine other compounds displayed activity against Mycobacterium tuberculosis, with a MIC of 12.5 µg/mL.

Organized Filaments in the adhesive system of Macrostomum tuba Graff, 1882 ( Platyhelminthes, Macrostomida)

The adhesive organs or “duo-gland adhesive organs” of platyhelminths are formed by a specialized epithelialcell and extensions of two gland cells. These organs are used for temporary fixation of the organism tosurfaces in aquatic habitats. The mechanisms involved in adhesion to and release from a given surfacedepend on secretions produced by the glands; less is known about the involvement of cytoplasmic filamentsin the anchoring cell itself. In this study, we examined the structure of the adhesive organs present in thetail plate of Macrostomum tuba Graff, 1882 (Platyhelminthes, Macrostomida), a freshwater, free-livingflatworm. Scanning and transmission electron microscopy allowed elucidation of the three-dimensionalorganization of the adhesive system, especially of the microvilli that formed the outer collar (or papilla),which was endowed with a fibrous core. Electrical stimulation caused the flatworms to extend their papillaeabove the ciliated surface. The use of tannin- and diamine-containing fixatives showed that the filamentousarray contained tonofilaments and actin filaments. Tonofilaments concentrate in the axis of each microvillus;actin filaments, about 7-8 nm thick, spread out towards the periphery. Scanning images demonstrated thefinger-like shape of the papillae, about 7-8 ìm high, with a terminal opening. Microvilli followed a straightcourse along the surface.

Eficiencia de tres fluoruros concentrados para la estabilización de caries de esmalte / Efficiency of three concentrated fluorides for the stabilization of enamel caries

El principal objetivo social de la OMS y de los gobiernos ha sido que las poblaciones estén suficientemente sanas para llevar una vida social y económicamente útil. El objetivo de esta investigación fue comparar la eficiencia para estabilizar el proceso de caries determinado por tres tipos de fluoruros tópicos concentrados: el barniz de bifluoruro de amonio (Topic Bi(R) 2,26 por ciento F- y pH 3,5), el fluoruro diamínico de plata (Fluorplat(R) 25,4 por ciento de Ag- 4,48 por ciento de F- y pH 8,6) y fluoruro de sodio (Duraphat(R) 2,26 por ciento de F- y pH 7), a fin de controlar el avance de las lesiones. Fueron incluidos en el estudio treinta y seis niñas entre 6 y 9 años de edad con alto riesgo social y caries de esmalte en dos o más cuadrantes, previa autorización parental. La eficacia del programa fue evaluada clínica y radiográficamente sesenta días y un año después de realizados los tratamientos y se determinó la significación estadística de los resultados (intervalos de confianza). Los estudios de costo-eficiencia incluyeron los costos directos e indirectos. Los resultados revelaron: (a) no existió diferencias significativas en la eficacia alcanzada por los tres tipos de tratamientos; (b) sesenta días postratamiento el fluoruro diamínico de plata alcanzó el mayor porcentaje de superficies estabilizadas (97,1 por ciento), seguido del fluoruro de sodio (88,5 por ciento) y del bifluoruro de amonio (83,3 por ciento); (c) un año después del tratamiento los resultados revelaron que el fluoruro diamínico de plata mantuvo el más alto porcentaje de estabilización de las lesiones (57,14 por ciento), seguido por el bifluoruro de amonio (55,5 por cento) y por el fluoruro de sodio (47,06 por ciento); (d) 60 días después del tratamiento la relación costo-eficacia alcanzada fue de U$S 1,08/ por lesión estabilizada para el fluoruro diamínico de plata; seguido por el bifluoruro de amonio con una relación de U$S 1,34/SE y por el fluoruro de sodio son U$S 1,74 /SE; (e) un año después del tratamiento las relaciones costo-eficacia fueron de U$S 1,77/ por lesión estabilizada para el fluoruro diamínico de plata, seguido por el bifluoruro de amonio con una relación de U$S 1,92 /SE y por el fluoruro de sodio con U$S 2,74 /SE. La relación costo-eficacia de la aplicación de fluoruros concentrados reveló que esta modalidad de tratamiento no invasivo podría ser incluida en programas de salud bucal para determinar la estabilización de caries tempranas en niños

M.E.B. Efecto del grabado ácido aplicado sobre dentina remineralizada con cariostático / S.E.M. Effect of acid etching applied on cariostatic-remineralized dentin

Uno de los agentes cariostáticos más usados en la actualidad en dentición temporaria, es el fluoruro dimaínico de plata. En este estudio realizamos su aplicación sobre caries dentinaria en dientes posteriores de pacientes adultos. Tanto clínica como radiográficamente, pudo observarse la remineralización de la dentina en las 50 piezas dentarias tratadas. Una de las comprobaciones más efectivas de esta remineralización fue llevar 25 de las piezas dentarias que fueron extraídas por otras patologías, al microscopio electrónico de barrido para su estudio. El objetivo de esta observación fue comprobar la obliteración de los conductillos dentinarios y la presencia de retenciones micromecánicas, luego del grabado ácido, en la dentina tratada con el cariostático. Según los resultados obtenidos en la totalidad de las piezas dentarias, la remineralización lograda con el cariostático se conservó en el 100 por ciento de los casos luego de aplicado el ácido grabador y produjo las microrretenciones necesarias para la adhesión de la resina compuesta de fotocurado

Cariostáticos y grabado ácido en pacientes con capacidades diferentes / Cariostatics and acid etching in handicapped patients

Dada la incidencia de caries y la dificultad para su tratamiento en pacientes con capacidades diferentes se utilizó fluoruro diamínico de plata al 38 por ciento, por su acción remineralizante y antibacteriana, su bajo costo y sencialla aplicación. No necesita el uso de anestesia ni elementos rotatorios para eliminar caries. Se restauró con resina compuesta de fotocurado. El objeto de este estudio fue comprobar que las microrretenciones producidas por el grabado ácido necesario para la ahesión de la resina no afecta la remineralización lograda

Procedimientos preventivo-restauradores / Preventive and restorative procedures

Los avances de las investigaciones en cariología y materiales de restauración adhesivos, han estado influenciando ampliamente el tratamiento de las lesiones cariosas. Afortunadamente también, la operatoria dental como parte de un plan preventivo, ya no se limita solamente a reparar el daño sucedido, sino que esta atenta a la enfermedad infecciosa de caries dental, promoviendo su prevención y la remineralización de los tejidos duros dentarios, aún antes de que la enfermedad se manifieste notoria clínicamente. Con esta filosofía, se pretende resumir la considerción de los procedimientos preventivo-restauradores, que van a involucrar la utilización de cariostáticos y/o remineralizantes y el empleo de técnicas que antes se las vinculaba más al área de la prevención que a la restauradora, como ameloplastías, sellantes invasivos y restauraciones adhesivas preventivas, en todos los casos absolutamente conservadoras y respetuosas de los tejidos dentarios sanos

Reaçöes da dentina cariada humana após aplicaçäo do diamino fluoreto de prata a 10 por cento: estudo através de microscópio eletrônico de varredura / Reactions of human caries dentin after using diammine silver fluoride 10 percent: microscopicy electron scanning study

Foram utilizados sete dentes permanentes de crianças, com cáries profundas e agudas. O tratamento foi realizado em duas sessöes. Na primeira, removeu-se amostras de dentina para a análise. A seguir, aplicou-se a soluçäo de diamino fluoreto de prata a 10 por cento, durante 3 minutos. O dente foi fechado com óxido de zinco eugenol do tipo II. Na segunda sessäo, após 43 a 64 dias foram recolhidas novas amostras de dentina. Os resultados evidenciaram que as amostras obtidas após a aplicaçäo do diamino fluoreto de prata a 10 por cento a cárie estava estacionária revelando maior estruturaçäo dentinária e diminuiçäo acentuada do número de microorganismos. Com estes resultados pudemos concluir que, o uso do diamino de prata a 10 por cento, provoca resposta pulpar positiva havendo alteraçöes no processo carioso, que retrocedeu da fase ativa para a estacionária

Avaliação clínica da aplicação de diamino-fluoreto de prata a 12 / (Bioride) na dentição decídua e seu efeito na incidência de cárie em primeiros molares permanentes / Clinical evaluation of the application of 12silver diamino-fluoride on deciduous teeth and its effect on the caries incidence in first permanent molars

Pesquisou-se o efeito cariostático da solução de diamino-fluoreto de prata a 12//na dentição decídua e sua influência na incidência de cárie em primeiros molares permanentes. Os resultados demonstraram uma expressiva ação cariostática, principalmente no esquema de reaplicações trimestrais, onde a redução de cárie nos primeiros molares permanentes foi da ordem de 63//

Efeitos do diamino fluoreto de prata sobre o soalho da câmara pulpar: estudo ao microscópio eletrônico de varredura / Effects of diamine silver fluoride on the pulpar surface: study through scanning electron microscopy

Foi estudada a ação do diamino fluoreto de prata sobre as superfícies do soalho da câmara pulpar e dos canais radiculares de dentes molares permanentes inferiores através da microscopia eletrônica de varredura. Os resultados mostraram que a superfície dentinária não tratada evindenciou extensas áreas contendo pequenos grupamentos de magma dentinário e numerosos forames dentinários. As aberturas dos canaliculos dentinários variavam de 0,5 a 0,3 micrômetros de diâmetro e as particulas de 0,2 a 5,0 micrômetros. No grupo tratado pela técnica ultra-sônica o diamino fluoreto de prata evidenciou superfícies amplas e planas, em que apenas pequenas elevações são vistas em função da disposição dentinária. Houve uma cobertura pelos produtos de reação do diamino fluoreto de prata, contendo pequenas particulas e aglomerados. Raramente notou-se a presença de pequenos forames com diâmetros que variavam de 0,6 a 1,1 micrômetros de diâmetro

Diaminofluoreto de prata / Diammine silver fluoride

O propósito do presente trabalho foi estudar o comportamento da polpa dental quando cavidades rasas, preparadas em dentes humanos, eram submetidas à ação de uma solução de diaminofluoreto de prata a 10//. O estudo realizado em um período de 30 dias, demonstrou ser o produto testado bem tolerado pelo tecido pulpar

Efeitos da aplicaçäo da soluçäo de diaminofluoreto de prata a 38 em dentina de dentes decíduos de cäes / Effects of the application of diamine silver fluoride 38

Dentes decíduos hígidos de cäes foram submetidos a preparos cavitários e nestes foi aplicado o diaminofluoreto de prata a 38%. A análise histológica foi feita após 48 horas, 7 ou 30 dias. Grânulos de prata foram encontrados nos canalículos e, nos espécimes com cavidade profunda; nos períodos mais longos de observaçäo, os grânulos alcançavam a cavidade pulpar, onde apareciam associados à reaçäo inflamatória com distúrbios na camada odontoblástica e, após um mês, com eventual formaçäo de abcessos intrapulpares