Eficácia de agentes químicos na redução de manchas de lesões cariosas dentinárias remineralizadas com diamino fluoreto de prata

Abstract

Introduction: Silver diamino fluoride (SDF) is an effective alternative for inactivation of carious lesions, including those with dentin involvement. However, there is an adverse effect of dental staining, which may contraindicate its use. Objective: To evaluate in vitro the efficacy of three different chemical agents in stain removal and remineralization of dentin artificial caries lesions (CAD) treated with silver diamino fluoride (SDF). Methodology: Basic L*a*b* values were determined on polished human dentin blocks, and CAD lesions were induced with an acid gel for one week. The samples were divided into four groups, each receiving the application of 30% SDF for 3 minutes. Half of each specimen was subjected to a bleaching treatment protocol using garlic extract (group I), bentonite (group II) or 35% hydrogen peroxide (group III), while the other half was left with no bleaching treatment. A negative control group (group IV) of samples with one half treated with SDF and the other half without SDF was also tested. Color changes (ΔE) were measured by spectrometry, and cross-sectional microradiography was used to quantify integrated mineral loss (ΔZ) 24 hours after treatment (SDF or SDF+whitening). A two-way mixed ANOVA test was applied. Results: The application of 30% SDF remineralized the CAD lesions (p = 0.001). The type of chemical agent evaluated (p<0.0001), time (p=0.01) and their interaction (p<0.0001) whitened the CAD lesions treated with SDF. However, 35% hydrogen peroxide was the only compound with bleaching effect (p < 0.001), without returning to the initial color. None of the compounds altered the remineralizing properties of SDF (p = 0.30). Conclusion: This study provides evidence of the in vitro remineralizing effect on CAD lesions within 24 hours after SDF application, as well as the ability of hydrogen peroxide to partially remove (24% reduction) the staining caused by SDF treatment, without affecting remineralization. The other quimical agents evaluated were not able to alter the color or the remineralization.