Geçmişten günümüze birçok farklı meslekte ve sağlık sektöründe kullanılmakta olan gümüşün diş hekimliğindeki endikasyonları ve popülerliği giderek artmaktadır. Sahip olduğu antibakteriyel özelliği, karyojenik bakteriler üzerindeki bakteriostatik ve bakterisidal etkinliği çürük tedavisindeki kullanımını desteklemektedir. Florür ile bir arada kullanımı sinerjitik etki oluşturabilmektedir. İdeal özellikte bir ürün geliştirebilmek için farklı içeriklerde, kombinasyonlarda ve miktarlarda gümüş bulunduran materyallerle ilgili çok sayıda çalışma ve araştırma yapılmaktadır. Gümüş ve florür iyonlarını bir arada bulunduran gümüş florür ve gümüş diamin florür (GDF) içerikli ticari ürünler piyasada mevcuttur. Dünya Sağlık Örgütü, küçük çocuklarda oldukça sık görülebilen erken çocukluk çağı çürüklerinin tedavisinde GDF solüsyonunun kullanımını desteklediklerini belirterek, hem erişkinler hem de çocuklar için ilaç kategorisine aldıklarını açıklamışlardır. Ancak bu solüsyonların diş dokusunda siyah renklenmeye neden olabilmesi potasyum iyodür ve glutatyon gibi bileşiklerle birlikte kullanımını gündeme getirmiştir. Son dönemde nanoteknolojideki gelişmeler ışığında nanopartikül boyutunda gümüş bulundurduğu için renklenmeye neden olmadığı ve yüksek antibakteriyel etkinliğe sahip olduğu belirtilen ve deneysel bir solüsyon olan nanogümüş florürün standardizasyonunu sağlayabilmek için çalışmalar devam etmektedir. Bu derlemede, gümüşün diş hekimliğindeki kullanım alanlarından, yer aldığı farklı bileşiklerden ve kombinasyonlarından, tedavi aşamalarında dikkat edilmesi gereken önemli detaylardan, güncel gelişmelerden, avantaj ve dezavantajlarından bahsedilmesi amaçlanmıştır.
Anahtar Kelimeler: Gümüş; gümüş diamin florür; potasyum iyodür; nanopartiküller
The indications and popularity of silver in dentistry which has been used in many different professions and health sectors from past to present, are increasing. Its antibacterial properties, bacteriostatic and bactericidal activity on cariogenic bacteria support its use in caries treatment. It can create a synergistic effect when used together with fluoride. In order to develop an ideal product, many studies and researches are carried out on materials containing silver in different contents, combinations and amounts. Commercial products containing silver fluoride and silver diamine fluoride (SDF), which contain silver and fluoride ions, are commercially available. The World Health Organization stated that they support the use of SDF solution in the treatment of early childhood caries, which can be seen quite frequently in younger children, and announced that they included it in the category of drugs for both adults and children. However, the fact that these solutions can cause black discoloration in the dental tissue has led to the use of compounds such as potassium iodide and glutathione. Recently, in consideration of developments in nanotechnology, studies are continuing to standardize nanosilver fluoride, which is an experimental solution that is stated to have high antibacterial activity and does not cause coloration because it contains silver in nanoparticle size. In this review, it is aimed to mention the usage areas of silver in dentistry, the different compounds and combinations it takes place, important details to be considered in the treatment stages, current developments, advantages and disadvantages.
Keywords: Silver; silver diamine fluoride; potassium iodide; nanoparticles
- Barillo DJ, Marx DE. Silver in medicine: a brief history BC 335 to present. Burns. 2014;40 Suppl 1:S3-8. [Crossref] [PubMed]
- Greenwall-Cohen J, Greenwall L, Barry S. Silver diamine fluoride - an overview of the literature and current clinical techniques. Br Dent J. 2020;228(11):831-8. [Crossref] [PubMed]
- Burgess JO, Vaghela PM. Silver diamine fluoride: a successful anticarious solution with limits. Adv Dent Res. 2018;29(1):131-4. [Crossref] [PubMed]
- Mei ML, Lo EC, Chu CH. Clinical use of silver diamine fluoride in dental treatment. Compend Contin Educ Dent. 2016;37(2):93-8; quiz100. [PubMed]
- Yan IG, Zheng FM, Gao SS, Duangthip D, Lo ECM, Chu CH. Ion concentration of silver diamine fluoride solutions. Int Dent J. 2022;72(6):779-84. [Crossref] [PubMed] [PMC]
- Crystal YO, Niederman R. Evidence-based dentistry update on silver diamine fluoride. Dent Clin North Am. 2019;63(1):45-68. [Crossref] [PubMed] [PMC]
- Seifo N, Cassie H, Radford JR, Innes NPT. Silver diamine fluoride for managing carious lesions: an umbrella review. BMC Oral Health. 2019;19(1):145. [Crossref] [PubMed] [PMC]
- Timms L, Sumner O, Deery C, Rogers HJ. Everyone else is using it, so why isn't the UK? Silver diamine fluoride for children and young people. Community Dent Health. 2020;37(2):143-9. [PubMed]
- Zheng FM, Yan IG, Duangthip D, Gao SS, Lo ECM, Chu CH. Silver diamine fluoride therapy for dental care. Jpn Dent Sci Rev. 2022;58:249-57. [Crossref] [PubMed] [PMC]
- Seifo N, Robertson M, MacLean J, Blain K, Grosse S, Milne R, et al. The use of silver diamine fluoride (SDF) in dental practice. Br Dent J. 2020;228(2):75-81. [Crossref] [PubMed]
- Huang WT, Shahid S, Anderson P. Applications of silver diamine fluoride in management of dental caries. Advanced Dental Biomaterials. 2019;675-99. [Crossref]
- 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. [Crossref] [PubMed] [PMC]
- Tirupathi S, Svsg N, Rajasekhar S, Nuvvula S. Comparative cariostatic efficacy of a novel Nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial. J Clin Exp Dent. 2019;11(2):e105-e12. [Crossref] [PubMed] [PMC]
- Patel J, Foster D, Smirk M, Turton B, Anthonappa R. Acidity, fluoride and silver ion concentrations in silver diamine fluoride solutions: a pilot study. Aust Dent J. 2021;66(2):188-93. [Crossref] [PubMed]
- 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. English. [Crossref] [PubMed] [PMC]
- Mei ML, Chu CH, Low KH, Che CM, Lo EC. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal. 2013;18(6):e824-31. [Crossref] [PubMed] [PMC]
- Targino AG, Flores MA, dos Santos Junior VE, de Godoy Bené Bezerra F, de Luna Freire H, Galembeck A, et al. An innovative approach to treating dental decay in children. A new anti-caries agent. J Mater Sci Mater Med. 2014;25(8):2041-7. [Crossref] [PubMed]
- Mei ML, Li QL, Chu CH, Yiu CK, Lo EC. The inhibitory effects of silver diamine fluoride at different concentrations on matrix metalloproteinases. Dent Mater. 2012;28(8):903-8. [Crossref] [PubMed]
- Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting dentine caries with different concentration and periodicity of silver diamine fluoride. JDR Clin Trans Res. 2016;1(2):143-52. [Crossref] [PubMed] [PMC]
- Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized clinical trial of 12% and 38% silver diamine fluoride treatment. J Dent Res. 2018;97(2):171-8. [Crossref] [PubMed] [PMC]
- Tolba ZO, Hamza HS, Moheb DM, Hassanein HE. Effectiveness of two concentrations 12% versus 38% of silver diamine fluoride in arresting cavitated dentin caries among children: a systematic review. Egypt Pediatric Association Gaz. 2019;67(1):2-7. [Crossref]
- Horst JA, Heima M. Prevention of dental caries by silver diamine fluoride. Compend Contin Educ Dent. 2019;40(3):158-63; quiz 164. [PubMed]
- Crystal YO, Niederman R. Silver diamine fluoride treatment considerations in children's caries management. Pediatr Dent. 2016;38(7):466-71. [PubMed] [PMC]
- Mabangkhru S, Duangthip D, Chu CH, Phonghanyudh A, Jirarattanasopha V. A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride. J Dent. 2020;99:103375. [Crossref] [PubMed]
- Mei ML, Ito L, Cao Y, Li QL, Chu CH, Lo EC. The inhibitory effects of silver diamine fluorides on cysteine cathepsins. J Dent. 2014;42(3):329-35. [Crossref] [PubMed]
- 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. [Crossref] [PubMed] [PMC]
- Yu OY, Mei ML, Zhao IS, Li QL, Lo EC, Chu CH. Remineralisation of enamel with silver diamine fluoride and sodium fluoride. Dent Mater. 2018;34(12):e344-e52. [Crossref] [PubMed]
- American Academy of Pediatric Dentistry. Policy on the use of silver diamine fluoride for pediatric dental patients. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023:103-5.
- Knight GM, McIntyre JM, Craig GG, Mulyani, Zilm PS, Gully NJ. Inability to form a biofilm of Streptococcus mutans on silver fluoride- and potassium iodide-treated demineralized dentin. Quintessence Int. 2009;40(2):155-61. [PubMed]
- Horst JA, Ellenikiotis H, Milgrom PL. UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications and Consent. J Calif Dent Assoc. 2016;44(1):16-28. [Crossref] [PubMed] [PMC]
- Korwar A, Sharma S, Logani A, Shah N. Pulp response to high fluoride releasing glass ionomer, silver diamine fluoride, and calcium hydroxide used for indirect pulp treatment: An in-vivo comparative study. Contemp Clin Dent. 2015;6(3):288-92. [Crossref] [PubMed] [PMC]
- Zaeneldin A, Yu OY, Chu CH. Effect of silver diamine fluoride on vital dental pulp: A systematic review. J Dent. 2022;119:104066. [Crossref] [PubMed]
- Shafi N, Kaur H, Choudhary R, Yeluri R. Dilute silver diamine fluoride (1:10) versus light cure calcium hydroxide as indirect pulp capping agents in primary molars - a randomized clinical trial. J Clin Pediatr Dent. 2022;46(4):273-9. [Crossref] [PubMed]
- Kiesow A, Menzel M, Lippert F, Tanzer JM, Milgrom P. Dentin tubule occlusion by a 38% silver diamine fluoride gel: an in vitro investigation. BDJ Open. 2022;8(1):1. [Crossref] [PubMed] [PMC]
- Crystal YO, Marghalani AA, Ureles SD, Wright JT, Sulyanto R, Divaris K, et al. Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needs. Pediatr Dent. 2017;39(5):135-45. [PubMed]
- Shah S, Bhaskar V, Venkatraghavan K, Choudhary P, Ganesh M, Trivedi K. Silver diamine fluoride: a review and current applications. Journal of Advanced Oral Research. 2014;5(1):25-35. [Crossref]
- Hu S, Meyer B, Duggal M. A silver renaissance in dentistry. Eur Arch Paediatr Dent. 2018;19(4):221-7. [Crossref] [PubMed]
- Jiang M, Mei ML, Wong MCM, Chu CH, Lo ECM. Effect of silver diamine fluoride solution application on the bond strength of dentine to adhesives and to glass ionomer cements: a systematic review. BMC Oral Health. 2020;20(1):40. [Crossref] [PubMed] [PMC]
- Decisiondentistry.com. [Internet]. © 2023 - Decisions in Dentistry [Cited: November 6, 2018]. Minimally invasive treatment for molar incisor hypomineralization. Avaliable from: [Link]
- Ballikaya E, Ünverdi GE, Cehreli ZC. Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig. 2022;26(2):2197-205. [Crossref] [PubMed] [PMC]
- Lutgen P, Chan D, Sadr A. Effects of silver diammine fluoride on bond strength of adhesives to sound dentin. Dent Mater J. 2018;37(6):1003-9. [Crossref] [PubMed]
- 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. [Crossref] [PubMed]
- Zhao IS, Chu S, Yu OY, Mei ML, Chu CH, Lo ECM. Effect of silver diamine fluoride and potassium iodide on shear bond strength of glass ionomer cements to caries-affected dentine. Int Dent J. 2019;69(5):341-7. [Crossref] [PubMed] [PMC]
- Puwanawiroj A, Trairatvorakul C, Dasanayake AP, Auychai P. Microtensile bond strength between glass ıonomer cement and silver diamine fluoride-treated carious primary dentin. Pediatr Dent. 2018;40(4):291-5. [PubMed]
- Khurshid Z, Shabbir J, Al-Otaibi AK, Alsalem AM, Alhamdan AA, Jouhar R, et al. Role of silver diamine fluoride in dentistry. european dental research and biomaterials Journal. 2020;1(1):27-31. [Crossref]
- Tsai AT, Chan HC, Chang YH, Kupietzky A. Staining outcomes of silver diamine fluoride as an adjunct in caries risk assessment: a case series evaluation. J Clin Pediatr Dent. 2022;46(1):6-11. [Crossref] [PubMed]
- Garg S, Sadr A, Chan D. Potassium iodide reversal of silver diamine fluoride staining: a case report. Oper Dent. 2019;44(3):221-6. [Crossref] [PubMed]
- Gotjamanos T, Ma P. Potential of 4 per cent silver fluoride to induce fluorosis in rats: clinical implications. Aust Dent J. 2000;45(3):187-92. [Crossref] [PubMed]
- Ellenikiotis H, Chen KF, Soleimani-Meigooni DN, Rothen ML, Thompson B, Lin YS, et al. Pharmacokinetics of 38 Percent Silver Diamine Fluoride in Children. Pediatr Dent. 2022;44(2):114-21. [PubMed] [PMC]
- Duangthip D, Fung MHT, Wong MCM, Chu CH, Lo ECM. Adverse effects of silver diamine fluoride treatment among preschool children. J Dent Res. 2018;97(4):395-401. [Crossref] [PubMed]
- Kamble AN, Chimata VK, Katge FA, Nanavati KK, Shetty SK. Comparative evaluation of effect of potassium iodide and glutathione on tooth discoloration after application of 38% silver diamine fluoride in primary molars: an in vitro study. Int J Clin Pediatr Dent. 2021;14(6):752-6. [Crossref] [PubMed] [PMC]
- Nguyen V, Neill C, Felsenfeld J, Primus C. Potassium iodide. The solution to silver diamine fluoride discoloration? Adv Dent Oral Health. 2017;5(1):1e6. [Crossref]
- 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. [Crossref] [PubMed]
- 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. [Crossref] [PubMed] [PMC]
- Vinson LA, Gilbert PR, Sanders BJ, Moser E, Gregory RL. Silver diamine fluoride and potassium iodide disruption of in vitro streptococcus mutans biofilm. J Dent Child (Chic). 2018;85(3):120-4. [PubMed]
- Knight GM, McIntyre JM, Craig GG, Mulyani. Ion uptake into demineralized dentine from glass ionomer cement following pretreatment with silver fluoride and potassium iodide. Aust Dent J. 2006;51(3):237-41. [Crossref] [PubMed]
- Yin IX, Zhang J, Zhao IS, Mei ML, Li Q, Chu CH. The antibacterial mechanism of silver nanoparticles and its application in dentistry. Int J Nanomedicine. 2020;15:2555-62. [Crossref] [PubMed] [PMC]
- Bapat RA, Chaubal TV, Joshi CP, Bapat PR, Choudhury H, Pandey M, et al. An overview of application of silver nanoparticles for biomaterials in dentistry. Mater Sci Eng C Mater Biol Appl. 2018;91:881-98. [Crossref] [PubMed]
- Pushpalatha C, Bharkhavy KV, Shakir A, Augustine D, Sowmya SV, Bahammam HA, et al. The Anticariogenic Efficacy of Nano Silver Fluoride. Front Bioeng Biotechnol. 2022;10:931327. [Crossref] [PubMed] [PMC]
- Arnaud M, Junior PC, Lima MG, E Silva AV, Araujo JT, Gallembeck A, et al. Nano-silver fluoride at higher concentration for caries arrest in primary molars: a randomized controlled trial. Int J Clin Pediatr Dent. 2021;14(2):207-11. [Crossref] [PubMed] [PMC]
- Espíndola-Castro LF, Rosenblatt A, Galembeck A, Monteiro G. Dentin staining caused by nano-silver fluoride: a comparative study. oper Dent. 2020;45(4):435-41. [Crossref] [PubMed]
- Santos VE Jr, Vasconcelos Filho A, Targino AG, Flores MA, Galembeck A, Caldas AF Jr, et al. A new "silver-bullet" to treat caries in children--nano silver fluoride: a randomised clinical trial. J Dent. 2014;42(8):945-51. [Crossref] [PubMed]
- Noronha VT, Paula AJ, Durán G, Galembeck A, Cogo-Müller K, Franz-Montan M, et al. Silver nanoparticles in dentistry. Dent Mater. 2017;33(10):1110-26. [Crossref] [PubMed]
- Vijayakumar M, Sabari Lavanya SJ, Ponnudurai Arangannal JJ, AarthiJ AS. Nano silver fluoride-overview. European Journal of Molecular & Clinical Medicine. 2020;7(2):6573-80. [Link]
- Al-Nerabieah Z, Arrag EA, Rajab A. Cariostatic efficacy and children acceptance of nano-silver fluoride versus silver diamine fluoride: a randomized controlled clinical trial. Journal of Stomatology. 2020;73(3):100-6. [Crossref]
- Ammar N, El-Tekeya MM, Essa S, Essawy MM, El Achy SN, Talaat DM. The antibacterial effect of nanosilver fluoride in relation to caries activity in primary teeth: a protocol for a randomized controlled clinical trial. Trials. 2022;23(1):558. [Crossref] [PubMed] [PMC]
- Ammar N, El-Tekeya MM, Essa S, Essawy MM, Talaat DM. Antibacterial effect and impact on caries activity of nanosilver fluoride and silver diamine fluoride in dentin caries of primary teeth: a randomized controlled clinical trial. BMC Oral Health. 2022;22(1):657. [Crossref] [PubMed] [PMC]
- El Habashy L, El Tekeya M. The effect of enamel pre-treatment with silver diamine fluoride versus nano silver fluoride on the microleakage of fissure sealant: in vitro study. Egyptian Dental Journal. 2020;66(4):1931-8. [Crossref]
- Freire PL, Stamford TC, Albuquerque AJ, Sampaio FC, Cavalcante HM, Macedo RO, et al. Action of silver nanoparticles towards biological systems: cytotoxicity evaluation using hen's egg test and inhibition of Streptococcus mutans biofilm formation. Int J Antimicrob Agents. 2015;45(2):183-7. [Crossref] [PubMed]
.: Process List