Arresting simulated dentine caries with adjunctive application of silver nitrate solution and sodium fluoride varnish: an in vitro study.

PURPOSE: The aim of this in vitro study was to assess the ability of silver nitrate solution, followed by sodium fluoride varnish, to arrest caries. METHODS: Dentine slices were prepared and demineralised. Each slice was cut into three specimens for three groups (SF, SDF and W). Specimens of the SF group received topical application of 25% silver nitrate solution followed by 5% sodium fluoride varnish. The SDF group received topical application of 38% silver diamine fluoride solution (positive control). Specimens of the W group received deionised water (negative control). All specimens were subjected to pH cycling for 8 days. Dentine surface morphology, crystal characteristics, carious lesion depth and collagen matrix degradation were evaluated by scanning electron microscopy, X-ray diffraction, X-ray microtomography and spectrophotometry with a hydroxyproline assay. RESULTS: Scanning electron microscopy showed that dentine collagen was exposed in group W, but not in groups SF and SDF, while clusters of granular spherical grains were formed in groups SF and SDF. The mean lesion depths (±standard deviation) of groups SF, SDF and W were 128 ± 19, 135 ± 24 and 258 ± 53 μm, respectively (SF, SDF < W; P < 0.001). The X-ray diffraction analysis indicated that silver chloride was formed in groups SF and SDF. The concentration of hydroxyproline released from the dentine matrix was significantly lower in groups SF and SDF than in group W (P < 0.05). CLINICAL SIGNIFICANCE: The results of this in vitro study indicate that the use of silver nitrate solution and sodium fluoride varnish is effective in inhibiting dentine demineralisation and dentine collagen degradation.