Diş çürüğü, bilinen en yaygın enfeksiyöz hastalık olup, diş sert dokularında kavitasyon evresine ulaştığında medikal ve restoratif yöntemlerle tedavi edilmesi gerekir. Çürüğün medikal yönetimi, hastalığı tedavi etmek için topikal ve minimal invaziv yaklaşımlar kullanan farklı bir tedavi felsefesidir ve genel anestezi altında kapsamlı operatif tedaviyi takiben hastalık nüks oranlarını önlemenin yanında, geleneksel bakımın bir alternatifi veya tamamlayıcısı olarak önerilmiştir. Gümüş diamin florür (GDF), noninvaziv tedavi sağlayabilen etkili bir ajandır. Gümüş diamin florür, florürün bilinen remineralize edici etkisini gümüşün antibakteriyel özelliği ile birleştirerek, aktif çürük lezyonlarının stabilize edilmesinde popülerliği gittikçe artan bir ajan hâline gelmiştir. Florür ve gümüşün etkileri uzun yıllardır bilinmekle birlikte, GDF formunda bir araya geldiklerinde, her yaştan bireyin aktif çürük lezyonlarına pratik, ucuz ve nonrestoratif bir müdahale seçeneği sunabilmektedir. Bu özelliği ile GDF, bazı bireylerde kalıcı tedavilere hazırlık döneminde hekim ve hastaya zaman kazandırabilirken, diğer bireylerde periyodik uygulamalarla restoratif tedavi gereksinimini ortadan kaldıran veya basitleştirebilen bir uygulamaya dönüşebilmektedir. Bu avantaj; yaş, sağlık durumu, ekonomik yetersizlikler gibi rutin diş tedavilerine engel olabilecek faktörlerin karşısında, GDF'nin temel dezavantajı olan kalıcı siyah renklenmeyi bile arka planda bırakabilmektedir. GDF, bazı uzun süreli geçici tedavi yöntemleri ile kombine de edilebilmektedir. Bu kısa literatür özetinde, GDF'nin etki mekanizması ve diş çürüğünün yönetimindeki yeri, mevcut literatür ışığında değerlendirilecektir.
Anahtar Kelimeler: Gümüş diamin florür; diş çürüğü
Dental caries is the most prevalent infectious disease and requires medical and operative treatment when cavitation occurs on dental hard tissues. The medical management of dental caries is an alternative treatment approach that utilizes topically-administered agents and minimal invasive interventions, and has been proposed as a preventive measure to halt recurrence of caries after comprehensive treatments under general anesthesia, besides being an alternative preventive approach. Silver diamine fluoride (SDF) is an effective agent that can provide a non-invasive treatment. Silver diamine fluoride has become increasingly popular for stabilizing active caries lesions by virtue of the remineralizing effect of fluoride and the antibacterial properties of silver. Although individual effects of the latter two components have been recognized for many years, their synergistic use in the form of silver diamine fluoride can provide a practical, inexpensive and non-surgical restorative alternative to active caries lesions in every age. SDF could not only help buy time before complex permanent treatments, but it also can be turned into a permanent, regular treatment modality that eliminates or simplifies the need for restorative treatment. These advantages outweigh permanent black staining of lesions, the main disadvantage of SDF, particularly when factors such as age, health problems and poverty is an obstacle to routine dental treatment. In this mini-review, the mechanism of SDF on dental caries management will be evaluated in light of the current literature.
Keywords: Silver diamine fluoride; dental caries
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