Silver diamine fluoride (SDF) is an aqueous solution of silver (Ag+) and fluoride (F-) ions stabilized by ammonia. It is regarded by the World Health Organization (WHO) as a safe, efficacious and cost-effective pharmacological agent for the minimally invasive management of dental caries. The Ag+ ions in SDF mainly exert an antibacterial effect, while the F- ions remineralize dental tissues. Recently, SDF has also been approved by the US Food and Drug Administration (FDA) for desensitization. The main advantages of SDF over other treatment options are its shorter application time, ease of application and no need for anesthesia. Furthermore, it is suitable for individuals with physical or mental disabilities, non-ambulatory patients, and elderly patients, as it can also be applied by dental nurses, hygienists and healthcare workers. Various studies have confirmed the efficacy of SDF in arresting and preventing coronal and root caries, desensitizing teeth, and disinfecting root canals, highlighting its potential to reduce the global healthcare and economic burden associated with untreated dental caries. The aim of this review is to provide an updated overview of SDF properties and its use in the minimally invasive management of dental caries.
This study aimed to modify an EQUIA coat (EC; GC, Japan) by incorporating 1 and 2 wt.% of zinc oxide (ZnO; EC-Z1 and EC-Z2) and titanium dioxide (TiO2; EC-T1 and EC-T2) nanoparticles, whereby structural and phase analyses were assessed using Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD), respectively. Thermogravimetric analysis/differential scanning calorimetry, micro-hardness, and water absorption analyses were conducted, and the microstructure was studied by scanning electron microscopy/energy-dispersive spectroscopy. FTIR spectra showed a reduction in peak heights of amide (1521 cm-1) and carbonyl (1716 cm-1) groups. XRD showed peaks of ZnO (2θ ~ 31.3°, 34.0°, 35.8°, 47.1°, 56.2°, 62.5°, 67.6°, and 68.7°) and TiO2 (2θ ~ 25.3°, 37.8°, 47.9, 54.5°, 62.8°, 69.5°, and 75.1°) corresponding to a hexagonal phase with a wurtzite structure and an anatase phase, respectively. Thermal stability was improved in newly modified materials in comparison to the control group. The sequence of obtained glass transitions was EC-T2 (111 °C), EC-T1 (102 °C), EC-Z2 (98 °C), EC-Z1 (92 °C), and EC-C (90 °C). EC-T2 and EC-T1 showed the highest (43.76 ± 2.78) and lowest (29.58 ± 3.2) micro-hardness values. EC showed the maximum water absorption (1.6%) at day 7 followed by EC-T1 (0.82%) and EC-Z1 (0.61%). These results suggest that EC with ZnO and TiO2 nanoparticles has the potential to be used clinically as a coating material.