Antibacterial Effect of Silver Diamine Fluoride Incorporated in Fissure Sealants
Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop® 12% and 30%) into a commercially available fissure sealant (Fissurit®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group. Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.
[1] A. Ahovuo-Saloranta, H. Forss, T. Walsh, A. Hiiri, A. Nordblad, M. Mäkelä, et al. "Sealants for preventing dental decay in the permanent teeth," Cochrane Database Syst Rev., vol. 3, pp. CD001830, 2013.
[2] P. Axelsson P, "Preventive Materials, Methods and Programs," 1st ed. Slovakia: Quintessence Books, 2004.
[3] R. Burgers, A. Eidt, R. Frankenberger, M. Rosentritt, H. Schweikl, G. Handel, et al. "The anti-adherence activity and bactericidal effect of microparticulate silver additives in composite resin materials," Arch Oral Biol., vol. 54, pp. 595-601, 2009.
[4] J. Avinash, C. Marya, S. Dhingra, P. Gupta, S. Kataria, H. Meenu. "Pit and fissure sealants: na unused caries prevention tool," J Oral Health Comm Dent., vol. 4, no. 1, pp. 1-6, 2010.
[5] S. Daniel, S. Harfst, R. Wilder, B. Francis, S. Mitchell. "Mosby´s Dental Hygiene: Concepts, Cases and Competencies," 2nd ed. St. Louis, USA: Mosby Elvesier, 2008.
[6] G. Rose. "Sick individuals and sick populations. Reiteration," Int J Epidemiol., vol. 30, pp. 427-32, 2001.
[7] A. Pereira, V. Pardi, F. Mialhe, C. Meneghim, G. Ambrosano. "A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants," Am J Dent., vol. 16, no. 1, pp. 23-7, 2003.
[8] A. Hiiri, A. Ahovuo-Saloranta, A. Nordblad, M. Makela. "Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents," Cochrane Database Syst Rev., vol. 3, pp. CD003067, 2010.
[9] F. Li, F. Li, D. Wu, S. Ma, J. Gao, Y. Li, et al. "The effect of an antibacterial monomer on the antibacterial activity and mechanical properties of a pit-and-fissure sealant," J Am Dent Assoc., vol 142, no. 2, pp. 184-93, 2011.
[10] A. Koyuturk, A. Kusgoz, M. Ulker, C. Yeşilyurt. "Effects of mechanical and thermal aging on microleakage of different fissure sealants," Dent Mater J., vol. 27, no. 6, pp. 795-801, 2008.
[11] Irish Oral Health Services Guideline Initiative. "Pit and Fissure Sealants: Evidence-based guidance on the use of sealants for the prevention and management of pit and fissure caries," Guideline and supplementary data available at: http://ohsrc.ucc.ie/html/guidelines.html2010. doi:10.1038/sj.ebd.6400591.
[12] E. Hook, O. Owen, C. Bellis, J. Holder, D. O`Sullivan, M. Barbour. "Development of a novel antimicrobial-releasing glass ionomer cement functionalized with chlorhexidine hexametaphosphate nanoparticles," J Nanobiotechnol., vol. 12, pp. 3, 2014.
[13] Y. Xiao, S. Ma, J. Chen, Z. Chai, F. Li, Y. Wang. "Antibacterial activity and bonding ability of an adhesive incorporating an antibacterial monomer DMAE-CB," J Biomed Mater Res B Appl Biomater., vol. 90, no. 2, pp. 813-7, 2009.
[14] W. Siqueira, M. Bakkal, Y. Xiao, J. Sutton, F. Mendes. "Quantitative proteomic analysis of the effect of fluoride on the acquired enamel pellicle," PloS ONE., vol. 7, no. 8, pp. e42204, 2012.
[15] J. Loyola-Rodriguez, F. Garcia-Godoy. "Antibacterial activity of fluoride release sealants on mutans streptococci," J Clin Pediatr Dent., vol. 20, no. 2, pp. 109-11, 1996.
[16] S. Matalon, B. Peretz, R. Sidon, E. Weiss, H. Slutzky. "Antibacterial properties of pit and fissure sealants combined with daily fluoride mouth rinse," Pediatr Dent., vol. 32, no. 1, pp. 9-13, 2010.
[17] T. Morphis, J. Toumba. "Fluoride pit and fissure sealants: a review," Int J Paediatr Dent., vol. 10, no. 2, pp. 90-8, 2000.
[18] S. Naorungroj, H. Wei, R. Arnold, E. Swift, R. Walter. "Antibacterial surface properties of fluoride containing resin-based sealants," J Dent., vol. 38, no. 5, pp. 387-91, 2010.
[19] T. Alves, C. Silva, N. Silva, E. Medeiros, A. Valença. "A Antimicrobial activity of fluoridated products on biofilm-forming bactéria: na in vitro study," Pesq Bras Odontoped Clin Integr, João Pessoa., vol. 10, no. 2, pp. 209-16, 2010.
[20] Q. Feng, J. Wu, G. Chen, F. Cui, T. Kim, J. Kim. "A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus," J Biomed Mater Res., vol. 52, pp. 662-8, 2000.
[21] A. Rosenblatt, T. Stamford, R. Niederman. "Silver Diamine Fluoride: A Caries ''Silver-Fluoride Bullet," J Dent Res., vol. 88, pp. 116-25, 2009.
[22] R. Kumar, H. Munstedt. "Silver ion release from antimicrobial polyamide/silver composites," Biomaterials., vol. 26, pp. 2081-8, 2005.
[23] M. Kostić, N. Radić, B. Obradović, S. Dimitrijević, M. Kuraica, P. Škundrić. "Silver-Loaded Cotton/Polyester Fabric Modified by Dielectric Barrier Discharge Treatment," Plasma Processes Polym., vol. 6, no. 1, pp. 58-67, 2009.
[24] W. Jung, H. Koo, K. Kim, S. Shin, S. Kim, Y. Park. "Antibacterial Activity and Mechanism of Action of the Silver Ion in Staphylococcus aureus and Escherichia coli," Appl Environ Microbiol. vol. 74, no. 7, pp. 2171-8, 2008.
[25] K. Yamamoto, S. Ohashil, M. Aonol, T. Kokuboz, I. Yamada, J. Yamauchid. "Antibacterial activity of silver ions implanted in filler on oral streptococci," J Dent Mater., vol. 12, pp. 227-9, 1996.
[26] S. Shah, V. Bhaskar, K. Venkataraghavan, P. Choudhary, M. Ganesh, K. Trivedi. "Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an vivo study," Indian J Dent Res., vol. 24, no. 5, pp. 575-81, 2013.
[27] R. Ditterich, M. Romanelli, M. Rastelli, G. Czlusniak, D. Wambier. "Diamino Fluoreto de Prata: uma revisão de literatura," Biol Saúde Ponta Grossa., vol. 12, no. 2, pp. 45-52, 2006.
[28] R. Yee, C. Holmgren, J. Mulder, D. Lama, D. Walker, W. Helderman. "Efficacy of Silver Diamine Fluoride for Arresting Caries Treatment," J Dent Res., vol. 88, pp. 644-8, 2009.
[29] J. Llodra, A. Rodriguez, B. Ferrer, V. Menardia, T. Ramos, M. Morato. "Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial," J Dent Res., vol. 84, no. 8, pp. 721-4, 2005.
[30] J. Peng, M. Botelho. "Silver compounds used in dentistry for caries management: A review," J Dent., vol. 40, pp. 531-41, 2012.
[31] S. Kim, D. Shin. "Antibacterial effect of self-etching adhesive systems on Streptococcus mutans," Restor Dent Endod., vol. 39, n0. 1, pp. 32-8, 2014.
[32] T. Chaitra, R. Subba, G. Devarasa, T. Ravishankar. "Microleakage and SEM analysis of flowable resin used as a sealant following three fissure preparation techniques – an in vitro study," J Clin Pediatr Dent. vol. 35, no. 3, pp. 277-82, 2011.
[33] M. Mahesh, B. Mithun, G. Prashant, V. Reddy, M. Usha, C. Madura, et al. "Antibacterial properties of fluoride releasing glass ionomer cements (GICs) and pit and fissure sealants on Streptococcus mutans," Int J Clin Pediatr Dent. vol. 3, no. 2, pp. 93-6, 2010.
[34] M. Mei, Q. Li, C. Chu, E. Lo, L. Samaranayake. "Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries," Ann of Clin Microbiol Antimicrob., vol. 12, pp. 4, 2013.
[35] G. Knight, J. McIntyre. "The effect of silver fluoride and potassium iodide on the bond strength of auto cure glass ionomer cement to dentine," Aust Dent J., vol. 51, no. 1, pp. 42-5, 2006.
[1] A. Ahovuo-Saloranta, H. Forss, T. Walsh, A. Hiiri, A. Nordblad, M. Mäkelä, et al. "Sealants for preventing dental decay in the permanent teeth," Cochrane Database Syst Rev., vol. 3, pp. CD001830, 2013.
[2] P. Axelsson P, "Preventive Materials, Methods and Programs," 1st ed. Slovakia: Quintessence Books, 2004.
[3] R. Burgers, A. Eidt, R. Frankenberger, M. Rosentritt, H. Schweikl, G. Handel, et al. "The anti-adherence activity and bactericidal effect of microparticulate silver additives in composite resin materials," Arch Oral Biol., vol. 54, pp. 595-601, 2009.
[4] J. Avinash, C. Marya, S. Dhingra, P. Gupta, S. Kataria, H. Meenu. "Pit and fissure sealants: na unused caries prevention tool," J Oral Health Comm Dent., vol. 4, no. 1, pp. 1-6, 2010.
[5] S. Daniel, S. Harfst, R. Wilder, B. Francis, S. Mitchell. "Mosby´s Dental Hygiene: Concepts, Cases and Competencies," 2nd ed. St. Louis, USA: Mosby Elvesier, 2008.
[6] G. Rose. "Sick individuals and sick populations. Reiteration," Int J Epidemiol., vol. 30, pp. 427-32, 2001.
[7] A. Pereira, V. Pardi, F. Mialhe, C. Meneghim, G. Ambrosano. "A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants," Am J Dent., vol. 16, no. 1, pp. 23-7, 2003.
[8] A. Hiiri, A. Ahovuo-Saloranta, A. Nordblad, M. Makela. "Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents," Cochrane Database Syst Rev., vol. 3, pp. CD003067, 2010.
[9] F. Li, F. Li, D. Wu, S. Ma, J. Gao, Y. Li, et al. "The effect of an antibacterial monomer on the antibacterial activity and mechanical properties of a pit-and-fissure sealant," J Am Dent Assoc., vol 142, no. 2, pp. 184-93, 2011.
[10] A. Koyuturk, A. Kusgoz, M. Ulker, C. Yeşilyurt. "Effects of mechanical and thermal aging on microleakage of different fissure sealants," Dent Mater J., vol. 27, no. 6, pp. 795-801, 2008.
[11] Irish Oral Health Services Guideline Initiative. "Pit and Fissure Sealants: Evidence-based guidance on the use of sealants for the prevention and management of pit and fissure caries," Guideline and supplementary data available at: http://ohsrc.ucc.ie/html/guidelines.html2010. doi:10.1038/sj.ebd.6400591.
[12] E. Hook, O. Owen, C. Bellis, J. Holder, D. O`Sullivan, M. Barbour. "Development of a novel antimicrobial-releasing glass ionomer cement functionalized with chlorhexidine hexametaphosphate nanoparticles," J Nanobiotechnol., vol. 12, pp. 3, 2014.
[13] Y. Xiao, S. Ma, J. Chen, Z. Chai, F. Li, Y. Wang. "Antibacterial activity and bonding ability of an adhesive incorporating an antibacterial monomer DMAE-CB," J Biomed Mater Res B Appl Biomater., vol. 90, no. 2, pp. 813-7, 2009.
[14] W. Siqueira, M. Bakkal, Y. Xiao, J. Sutton, F. Mendes. "Quantitative proteomic analysis of the effect of fluoride on the acquired enamel pellicle," PloS ONE., vol. 7, no. 8, pp. e42204, 2012.
[15] J. Loyola-Rodriguez, F. Garcia-Godoy. "Antibacterial activity of fluoride release sealants on mutans streptococci," J Clin Pediatr Dent., vol. 20, no. 2, pp. 109-11, 1996.
[16] S. Matalon, B. Peretz, R. Sidon, E. Weiss, H. Slutzky. "Antibacterial properties of pit and fissure sealants combined with daily fluoride mouth rinse," Pediatr Dent., vol. 32, no. 1, pp. 9-13, 2010.
[17] T. Morphis, J. Toumba. "Fluoride pit and fissure sealants: a review," Int J Paediatr Dent., vol. 10, no. 2, pp. 90-8, 2000.
[18] S. Naorungroj, H. Wei, R. Arnold, E. Swift, R. Walter. "Antibacterial surface properties of fluoride containing resin-based sealants," J Dent., vol. 38, no. 5, pp. 387-91, 2010.
[19] T. Alves, C. Silva, N. Silva, E. Medeiros, A. Valença. "A Antimicrobial activity of fluoridated products on biofilm-forming bactéria: na in vitro study," Pesq Bras Odontoped Clin Integr, João Pessoa., vol. 10, no. 2, pp. 209-16, 2010.
[20] Q. Feng, J. Wu, G. Chen, F. Cui, T. Kim, J. Kim. "A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus," J Biomed Mater Res., vol. 52, pp. 662-8, 2000.
[21] A. Rosenblatt, T. Stamford, R. Niederman. "Silver Diamine Fluoride: A Caries ''Silver-Fluoride Bullet," J Dent Res., vol. 88, pp. 116-25, 2009.
[22] R. Kumar, H. Munstedt. "Silver ion release from antimicrobial polyamide/silver composites," Biomaterials., vol. 26, pp. 2081-8, 2005.
[23] M. Kostić, N. Radić, B. Obradović, S. Dimitrijević, M. Kuraica, P. Škundrić. "Silver-Loaded Cotton/Polyester Fabric Modified by Dielectric Barrier Discharge Treatment," Plasma Processes Polym., vol. 6, no. 1, pp. 58-67, 2009.
[24] W. Jung, H. Koo, K. Kim, S. Shin, S. Kim, Y. Park. "Antibacterial Activity and Mechanism of Action of the Silver Ion in Staphylococcus aureus and Escherichia coli," Appl Environ Microbiol. vol. 74, no. 7, pp. 2171-8, 2008.
[25] K. Yamamoto, S. Ohashil, M. Aonol, T. Kokuboz, I. Yamada, J. Yamauchid. "Antibacterial activity of silver ions implanted in filler on oral streptococci," J Dent Mater., vol. 12, pp. 227-9, 1996.
[26] S. Shah, V. Bhaskar, K. Venkataraghavan, P. Choudhary, M. Ganesh, K. Trivedi. "Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an vivo study," Indian J Dent Res., vol. 24, no. 5, pp. 575-81, 2013.
[27] R. Ditterich, M. Romanelli, M. Rastelli, G. Czlusniak, D. Wambier. "Diamino Fluoreto de Prata: uma revisão de literatura," Biol Saúde Ponta Grossa., vol. 12, no. 2, pp. 45-52, 2006.
[28] R. Yee, C. Holmgren, J. Mulder, D. Lama, D. Walker, W. Helderman. "Efficacy of Silver Diamine Fluoride for Arresting Caries Treatment," J Dent Res., vol. 88, pp. 644-8, 2009.
[29] J. Llodra, A. Rodriguez, B. Ferrer, V. Menardia, T. Ramos, M. Morato. "Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial," J Dent Res., vol. 84, no. 8, pp. 721-4, 2005.
[30] J. Peng, M. Botelho. "Silver compounds used in dentistry for caries management: A review," J Dent., vol. 40, pp. 531-41, 2012.
[31] S. Kim, D. Shin. "Antibacterial effect of self-etching adhesive systems on Streptococcus mutans," Restor Dent Endod., vol. 39, n0. 1, pp. 32-8, 2014.
[32] T. Chaitra, R. Subba, G. Devarasa, T. Ravishankar. "Microleakage and SEM analysis of flowable resin used as a sealant following three fissure preparation techniques – an in vitro study," J Clin Pediatr Dent. vol. 35, no. 3, pp. 277-82, 2011.
[33] M. Mahesh, B. Mithun, G. Prashant, V. Reddy, M. Usha, C. Madura, et al. "Antibacterial properties of fluoride releasing glass ionomer cements (GICs) and pit and fissure sealants on Streptococcus mutans," Int J Clin Pediatr Dent. vol. 3, no. 2, pp. 93-6, 2010.
[34] M. Mei, Q. Li, C. Chu, E. Lo, L. Samaranayake. "Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries," Ann of Clin Microbiol Antimicrob., vol. 12, pp. 4, 2013.
[35] G. Knight, J. McIntyre. "The effect of silver fluoride and potassium iodide on the bond strength of auto cure glass ionomer cement to dentine," Aust Dent J., vol. 51, no. 1, pp. 42-5, 2006.
@article{"International Journal of Medical, Medicine and Health Sciences:76006", author = "Nélio Veiga and Paula Ferreira and Tiago Correia and Maria J. Correia and Carlos Pereira and Odete Amaral and Ilídio J. Correia", title = "Antibacterial Effect of Silver Diamine Fluoride Incorporated in Fissure Sealants", abstract = "Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop® 12% and 30%) into a commercially available fissure sealant (Fissurit®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group. Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.
", keywords = "Biomaterial, fissure sealant, primary prevention, silver diamine fluoride, S. mutans.", volume = "11", number = "5", pages = "316-5", }
