Comparative Enamel Remineralization Using SDF, Fluoride Varnish, and Curodont™

Objectives: To compare the remineralization efficacy of 5% sodium fluoride varnish (FV), 38% silver diamine fluoride (SDF), and Curodont™ Repair on incipient enamel caries lesions in permanent teeth. Methods: Thirty-two enamel blocks were prepared from eight sound human permanent teeth. Artificial white spot lesions were induced using a Streptococcus mutans biofilm model over seven days with repetitive sucrose challenges. Specimens were randomly assigned to four groups (n=8): 38% silver diamine fluoride (SDF), Curodont™ Repair, 5% NaF fluoride varnish, and negative control (no caries; sound enamel). Following treatment application with SDF, Curodont™, and FV, specimens underwent a pH cycling for seven days to simulate a cariogenic environment. The treated specimens were sectioned and evaluation included cross-sectional Knoop microhardness (CSMH) testing at depths of 25–225 µm to assess mechanical properties. Additionally, micro-computed tomography (micro-CT) was performed to assess lesion depth and evaluate the mineral density of each treatment group. CSMH data and mineral density (MD) were analyzed using one-way ANOVA tests to evaluate the effect of the different treatments (α=0.05). Results: At superficial depths (25-5050 µm), Curodont™ exhibited the highest microhardness values (219.02 ± 68.35) compared with SDF (210.22 ± 86.81) and FV (179.80 ± 83.80). In contrast, at deeper depths (75–225 µm), SDF demonstrated a greater remineralization, achieving a maximum microhardness of 279.70 ± 47.65, approaching values of sound enamel (323.12 ± 50.27). SDF was the most successful at 225µm compared to FV (263.18 ± 61.09) and Curodont™ (226.75 ± 98.30). Curodont™ reached peak hardness at 125 µm (230.86 ± 89.44) followed by a progressive decline, whereas both SDF and FV exhibited increases in microhardness with increased depth. No statistically significant differences were observed among the three treatment groups for microhardness (p>0.05). Micro-CT analysis also demonstrated no statistically significant differences in either BMD (p=0.129) or TMD (p=0.426) among the treatment groups and the control. Conclusions: SDF showed the highest microhardness and greatest rate of remineralization, particularly at deeper lesion levels. Curodont™ was more effective at superficial depths, and fluoride varnish (FV) also contributed to deep-layer remineralization. Although SDF appeared most effective in this in vitro model, the overall findings indicate that all three minimally invasive treatments demonstrate comparable remineralization potential, supporting their use in the management of early carious lesions.

Author dc:creator

• Sydni Thomas (24400199)

• Basic Sciences
• Minimally Invasive Dentistry

Statement dc:rights

• In Copyright
• Open Access after 2028-05-01

DOI dc:identifier

https://doi.org/10.25417/uic.32995265.v1

OAI identifier oai:identifier

oai:figshare.com:article/32995265