Silver Diamine Fluoride: A Successful Anticarious Solution with Limits.
Silver Diamine Fluoride: A Successful Anticarious Solution with Limits.
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DOI：
10.1177/0022034517740123
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发表时间：
2018-02-01
影响因子：
--
通讯作者：
Vaghela, P M
中科院分区：
文献类型：
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作者：
Burgess, J O;Vaghela, P M
银二胺氟化物（SDF）是一种含有离子银、氟化物和氨的溶液，可阻止龋齿病变的进展并防止未来龋齿的发展。银颗粒延伸到牙本质小管中，并可能为随后放置在SDF处理的变暗牙齿结构上的复合树脂涂层产生一些粘合问题。与其他氟化物溶液相比，SDF中的氟化物更深地渗透到牙齿中，在牙齿结构中形成氟化物库。SDF的氟化物成分有助于矿化和氟磷灰石的形成，产生更坚硬、更防龋的牙齿结构。银为材料提供抗微生物活性并抑制生物膜形成。它已经在超过20项临床研究中进行了评估，并在系统综述中进行了审查。这种材料最近被食品和药物管理局批准用于使冷敏感牙齿脱敏，并已被用于治疗龋齿。SDF会产生比原来更深的龋齿病变（棕色到黑色），这是该材料的主要批评。最近开发了一种纳米颗粒尺寸的银材料，其可以保留较大尺寸的离子银材料的抗微生物性质而没有变色效应。SDF的应用很容易适应现场使用。分离病变，将溶液涂在干净的龋齿病变上并干燥。这种简单的应用过程需要很少的设备，其每次应用的低成本使该材料成为大量人口的理想选择。
Silver diamine fluoride (SDF) is a solution containing ionic silver, fluoride, and ammonia that arrests the progress of carious lesions and prevents the development of future caries. The silver particle extends into the dentin tubules and could create some bonding problems for subsequent composite resin restorations placed over SDF-treated darkened tooth structures. The fluoride penetrates deeper into the tooth with SDF as compared with other fluoride solutions, creating a fluoride reservoir in the tooth structure. The fluoride component of SDF contributes to remineralization and fluorapatite formation, producing harder, more caries-resistant tooth structures. The silver provides the antimicrobial activity for the material and inhibits biofilm formation. It has been evaluated in >20 clinical studies and reviewed in systemic reviews. The material was recently approved by the Food and Drug Administration for desensitizing cold-sensitive teeth and has been used off-label to treat carious lesions. SDF will produce a caries lesion darker (brown to black) than the original, which is the major criticism of the material. A nanoparticle-sized silver material was recently developed that may retain the antimicrobial properties of the larger-sized ion silver material without the discoloring effects. The application of SDF is easily adapted for field use. The lesion is isolated, and the solution is painted onto the clean caries lesion and dried. This simple application process requires little equipment, and its low cost per application makes the material ideal for large populations.