Introduction: This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF). Methods: Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent. Results: SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p < 0.0001), time (p = 0.01), and their interaction (p < 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p < 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30). Conclusion: This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect.

1.
Zheng
FM
,
Yan
IG
,
Duangthip
D
,
Gao
SS
,
Lo
ECM
,
Chu
CH
.
Silver diamine fluoride therapy for dental care
.
Jpn Dent Sci Rev
.
2022
;
58
(
1
):
249
57
. .
2.
Zhao
IS
,
Gao
SS
,
Hiraishi
N
,
Burrow
MF
,
Duangthip
D
,
Mei
ML
, et al
.
Mechanisms of silver diamine fluoride on arresting caries: a literature review
.
Int Dent J
.
2018
;
68
(
2
):
67
76
. .
3.
Mei
ML
,
Nudelman
F
,
Marzec
B
,
Walker
JM
,
Lo
ECM
,
Walls
AW
, et al
.
Formation of fluorohydroxyapatite with silver diamine fluoride
.
J Dent Res
.
2017
;
96
(
10
):
1122
8
. .
4.
Crystal
YO
,
Niederman
R
.
Evidence-based Dentistry update on silver diamine fluoride
.
Dent Clin North Am
.
2019
;
63
(
1
):
45
68
. .
5.
Lo
ECM
,
Duangthip
D
.
Non-restorative approaches for managing cavitated dentin carious lesions
. In:
Leal
SC
,
Takeshita
EM
, editors.
Pediatric restorative dentistry
.
Springer
:
Springer International Publishing
;
2019
. p.
141
60
.
6.
Llodra
JC
,
Rodriguez
A
,
Ferrer
B
,
Menardia
V
,
Ramos
T
,
Morato
M
.
Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36- month clinical trial
.
J Dent Res
.
2005
;
84
(
8
):
721
4
. .
7.
Knight
GM
,
McIntyre
JM
,
Mulyani
.
The effect of silver fluoride and potassium iodide on the bond strength of auto cure glass ionomer cement to dentine
.
Aust Dent J
.
2006
;
51
(
1
):
42
5
. .
8.
Patel
J
,
Anthonappa
RP
,
King
NM
.
Evaluation of the staining potential of silver diamine fluoride: in vitro
.
Int J Paediatr Dent
.
2018
;
28
(
5
):
514
22
. .
9.
Roberts
A
,
Bradley
J
,
Merkley
S
,
Pachal
T
,
Gopal
JV
,
Sharma
D
.
Does potassium iodide application following silver diamine fluoride reduce staining of tooth? A systematic review
.
Aust Dent J
.
2020
;
65
(
2
):
109
17
. .
10.
Haiat
A
,
Ngo
HC
,
Samaranayake
LP
,
Fakhruddin
KS
.
The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: a systematic review
.
PLoS One
.
2021
;
16
(
6
):
e0252734
. .
11.
Rumble
J
.
CRC handbook of chemistry and physics
:
CRC Press
;
2023
. p.
5
189
.
12.
Cury
JA
,
Tenuta
LMA
,
Tabchoury
CPM
.
Bioquímica oral
.
São Paulo
:
Editora Santos
;
2018
.
13.
Primus
C
,
Neil
C
,
Felsenfeld
J
,
Primus
C
.
Potassium iodide. The solution to silver diamine fluoride discoloration
.
Adv Dent Oral Health
.
2017
;
5
(
1
):
555655
. .
14.
Zhao
IS
,
Mei
ML
,
Burrow
MF
,
Lo
EC
,
Chu
CH
.
Effect of silver diamine fluoride and potassium iodide treatment on secondary caries prevention and tooth discolouration in cervical glass ionomer cement restoration
.
Int J Mol Sci
.
2017
;
18
(
2
):
340
. .
15.
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
;
17
(
1
):
300
7
. .
16.
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
;
22
(
1
):
347
. .
17.
Kuhnen
NC
,
Nones
J
,
Riella
HG
,
Nones
J
,
Trentin
A
.
Bentonite protects neural crest stem cells from death caused by aflatoxin B1: effects of bentonite on different cell types: a brief review
.
Appl Clay Sci
.
2015
;
104
(
1
):
119
27
. .
18.
Hefne
JA
,
Mekhemer
WK
,
Alandis
NM
,
Aldayel
OA
,
Alajyan
T
.
Removal of silver (I) from aqueous solutions by natural bentonite
.
Science
.
2010
;
22
(
1
):
155
76
. .
19.
Cantuaria
ML
,
de Almeida Neto
AF
,
Nascimento
ES
,
Vieira
MG
.
Adsorption of silver from aqueous solution onto pre-treated bentonite clay: complete batch system evaluation
.
J Clean Prod
.
2016
;
112
:
1112
21
. .
20.
Chowdhury
A
,
Bhowal
A
,
Datta
S
.
Equilibrium, thermodynamic and kinetic studies for removal of copper (II) from aqueous solution by onion and garlic skin
.
Water
.
2012
;
4
:
37
51
.
21.
Lippert
F
,
Butler
A
,
Lynch
RJM
,
Hara
AT
.
Effect of fluoride, lesion baseline severity and mineral distribution on lesion progression
.
Caries Res
.
2012
;
46
(
1
):
23
30
. .
22.
Al Dehailan
L
,
Martinez-Mier
EA
,
Lippert
F
.
The effect of fluoride varnishes on caries lesions: an in vitro investigation
.
Clin Oral Investig
.
2016
;
20
(
7
):
1655
62
. .
23.
Gronau
QF
,
Ly
A
,
Wagenmakers
EJ
.
Informed bayesian t tests
.
The Am Statistician
.
2020
;
74
(
2
):
137
43
. .
24.
Schüpbach
P
,
Lutz
F
,
Guggenheim
B
.
Human root caries: histopathology of arrested lesions
.
Caries Res
.
1992
;
26
(
3
):
153
64
. .
25.
Castillo
JL
,
Rivera
S
,
Aparicio
T
,
Lazo
R
,
Aw
TC
,
Mancl
LL
, et al
.
The short-term effects of diammine silver fluoride on tooth sensitivity: a randomized controlled trial
.
J Dent Res
.
2011
;
90
(
2
):
203
8
. .
26.
Bjørndal
L
,
Thylstrup
A
.
A structural analysis of approximal enamel caries lesions and subjacent dentin reactions
.
Eur J Oral Sci
.
1995
;
103
(
1
):
25
31
. .
27.
Al-Angari
SS
,
Lippert
F
,
Platt
JA
,
Eckert
GJ
,
González-Cabezas
C
,
Li
Y
, et al
.
Bleaching of simulated stained-remineralized caries lesions in vitro
.
Clin Oral Investig
.
2019
;
23
(
4
):
1785
92
. .
28.
Romero
MJRH
,
Lippert
F
.
Indirect caries-preventive effect of silver diamine fluoride on adjacent dental substrate: a single-section demineralization study
.
Eur J Oral Sci
.
2021
;
129
(
1
):
e12751
. .
29.
Lippert
F
,
Churchley
D
,
Lynch
RJ
.
Effect of lesion baseline severity and mineral distribution on remineralization and progression of human and bovine dentin caries lesions
.
Caries Res
.
2015
;
49
(
5
):
467
76
. .
30.
Ferreira
DG
.
Dentífricos branqueadores: composição, efeitos, eficácia e cosméticos de Venda livre em Portugal [tese]
.
Lisboa
:
Universidade Fernando Pessoa
;
2017
.
31.
Zhu
XY
,
Zeng
YR
.
Garlic extract in prosthesis-related infections: a literature review
.
J Int Med Res
.
2020
;
48
(
4
):
300060520913778
. .
32.
Briso
AL
,
Gonçalves
RS
,
Costa
FB
,
Gallinari
MO
,
Cintra
LT
,
Santos
PH
.
Demineralization and hydrogen peroxide penetration in teeth with incipient lesions
.
Braz Dent J
.
2015
;
26
(
2
):
135
40
. .
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