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<p><b>Background</b> Silver diamine fluoride (SDF) is a topical solution of silver (Ag<sup>+</sup>), and fluoride (F<sup>−</sup>) ions stabilised with ammonia. Despite excellent antibacterial efficacy and remineralisation potential, its clinical use is limited due to the staining of the carious tooth structure caused by silver compound deposition, creating an aesthetic concern among the patients. Hence, there is a need to develop non-staining SDF modifications or alternatives.</p><p><b>Aim</b> To investigate the effect of incorporating tannic acid (TA) and glutathione (G) (5%, 10%, 15% w/v) into 38% SDF on dentine staining-minimisation, antibacterial efficacy (AE), and micromorphological/compositional changes.</p><p><b>Methods</b> Colour change (ΔE) in ethylenediaminetetraacetic acid-demineralised bovine dentine specimens (n = 15) was recorded spectrophotometrically until day 90. The mean zones of inhibition (ZOI) for SDF, TA- and G-modified SDF solutions against <i>Streptococcus mutans</i> were measured using agar well diffusion test (n = 8). Micromorphological/compositional changes were evaluated using field emission scanning electron microscope (FESEM) (n = 3) and energy-dispersive xray (EDX) (n = 3) until day 90.</p><p><b>Results</b> At day 90, TA- and G-modified SDF-treated specimens exhibited significantly lower ΔE than SDF (<i>p</i> &lt;0.05) with TA15 showing the lowest ΔE (29.29 ± 2.4) and SDF with highest ZOI (16.03 ± 1.1 mm). Increased TA significantly decreased ZOI (<i>p</i> &lt;0.05) while G incorporation did not affect ZOI significantly (<i>p</i> &gt;0.05). FESEM imaging showed micro sized Ag deposits (1–2 μm) on SDF-treated and nanosized Ag on TA5- and G5-treated dentine specimens. EDX analysis showed Ag as a major constituent in SDF and G5 at all timepoints, while TA5 mainly contained calcium and phosphate.</p><p><b>Conclusion</b> TA-modified SDF-treated specimens had superior stain-minimisation among all groups due to effective Ag-capping and resistance against Ag particle size increase. However, this occurred at the trade-off of AE. In conclusion, 5% TA and 10% G (w/v) incorporation could overcome SDF-mediated staining.</p>

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The effect of tannic acid and glutathione incorporation on dentine stain minimisation and antibacterial efficacy of 38% silver diamine fluoride

  • 期刊论文

  • 发表日期：

    2026年3月6日

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  • Mehmood Asghar,
  • Rosiyah Yahya,
  • Adrian Ujin Yap,
  • Ahmad Danial Azzahari,
  • Ros Anita Omar

摘要

Background Silver diamine fluoride (SDF) is a topical solution of silver (Ag+), and fluoride (F−) ions stabilised with ammonia. Despite excellent antibacterial efficacy and remineralisation potential, its clinical use is limited due to the staining of the carious tooth structure caused by silver compound deposition, creating an aesthetic concern among the patients. Hence, there is a need to develop non-staining SDF modifications or alternatives.

Aim To investigate the effect of incorporating tannic acid (TA) and glutathione (G) (5%, 10%, 15% w/v) into 38% SDF on dentine staining-minimisation, antibacterial efficacy (AE), and micromorphological/compositional changes.

Methods Colour change (ΔE) in ethylenediaminetetraacetic acid-demineralised bovine dentine specimens (n = 15) was recorded spectrophotometrically until day 90. The mean zones of inhibition (ZOI) for SDF, TA- and G-modified SDF solutions against Streptococcus mutans were measured using agar well diffusion test (n = 8). Micromorphological/compositional changes were evaluated using field emission scanning electron microscope (FESEM) (n = 3) and energy-dispersive xray (EDX) (n = 3) until day 90.

Results At day 90, TA- and G-modified SDF-treated specimens exhibited significantly lower ΔE than SDF (p <0.05) with TA15 showing the lowest ΔE (29.29 ± 2.4) and SDF with highest ZOI (16.03 ± 1.1 mm). Increased TA significantly decreased ZOI (p <0.05) while G incorporation did not affect ZOI significantly (p >0.05). FESEM imaging showed micro sized Ag deposits (1–2 μm) on SDF-treated and nanosized Ag on TA5- and G5-treated dentine specimens. EDX analysis showed Ag as a major constituent in SDF and G5 at all timepoints, while TA5 mainly contained calcium and phosphate.

Conclusion TA-modified SDF-treated specimens had superior stain-minimisation among all groups due to effective Ag-capping and resistance against Ag particle size increase. However, this occurred at the trade-off of AE. In conclusion, 5% TA and 10% G (w/v) incorporation could overcome SDF-mediated staining.