SEM-EDS Analysis of Primary Teeth Treated with SDF and GIC

Objectives: To evaluate the interface of caries-affected primary teeth treated with silver diamine fluoride and glass ionomer cement.
Methods: 30 participants age between 5 and 10 years old with carious lesions in deciduous teeth soon to exfoliate and without pulpal complications that seek dental services at the clinic of the Residency Program of Pediatric Dentistry at the Universidad Autónoma de Baja California, Tijuana, México, were recruited. After initial examination, patients who agreed to participate and fulfilled the inclusion criteria were assigned to the silver diamine fluoride (Topamine silver diamine fluoride 38%, Pharmadesign corporation Australia) group or the silver diamine fluoride restored with glass ionomer cement (GIC, GC Fuji IX Gold Label, GC Corporation Tokyo, Japan) group. The exfoliated primary teeth were then sectioned perpendicular to the treated interface with a water cooled slow-speed diamond saw (Isomet) to produce four slices. For scanning electron microscopy (SEM) analyses, one slice was acid-etched with HCl and NaOCl and rinsed thoroughly with distilled water to reveal any kind of hybrid layer (HL) and the other half was not treated. All slices were then dehydrated with ethanol. The specimens were viewed at several magnifications (500X, 1000X, 2500X, 5000X, 10000X) and various tilt angles in a XL30 ESEM-FEG 515 field emission microscope at 15kV (Hitachi S-3400N VP-SEM, Hitachi High Technologies Europe GmbH, Krefeld, Germany). Analyses of the interface microstructure (hybrid layer, resin tag quality, crosslinking layer, and compactness of the different layers) were based on at least 20 images taken along the length of the dentin-adhesive interface.
Results: SEM evaluation showed that the caries-affected lesions were arrested. EDS evaluation detected a higher intensity of calcium and phosphate.
Conclusions: The primary teeth treated with SDF and SDF+GIC showed arrested areas in their interface. The EDS analysis showed a remineralized interface with calcium and phosphate elements.