Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial

Abstract The aim of the study was to examine the mean mineral density (MD) change in early proximal enamel caries lesions after applying silver diamine fluoride (SDF) using digital subtraction radiographic analysis at 6 and 12 months. A split-mouth, triple-blind, randomized controlled trial was cond...

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Main Authors: Rinrada Pirompak, Chutima Trairatvorakul, Suchaya Pornprasertsuk-Damrongsri, Thipawan Tharapiwattananon, Pornkawee Charoenlarp, Ratichanok Nantanee
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Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07764-2
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author Rinrada Pirompak
Chutima Trairatvorakul
Suchaya Pornprasertsuk-Damrongsri
Thipawan Tharapiwattananon
Pornkawee Charoenlarp
Ratichanok Nantanee
author_facet Rinrada Pirompak
Chutima Trairatvorakul
Suchaya Pornprasertsuk-Damrongsri
Thipawan Tharapiwattananon
Pornkawee Charoenlarp
Ratichanok Nantanee
author_sort Rinrada Pirompak
collection DOAJ
description Abstract The aim of the study was to examine the mean mineral density (MD) change in early proximal enamel caries lesions after applying silver diamine fluoride (SDF) using digital subtraction radiographic analysis at 6 and 12 months. A split-mouth, triple-blind, randomized controlled trial was conducted with thirty healthy participants aged 13–30 years old. Two active non-cavitated proximal caries lesions in different quadrants of each participant were randomly sampled and allocated to a test (38% SDF) and a control group (deionized water). Digital radiographs at baseline, 6 and 12 months were taken, and digital subtraction radiographic analysis was performed. The SDF group demonstrated a significantly higher mean MD on subtraction radiographs compared with the control group, after adjusting for baseline lesion depth and time, and for clustering within participants over time. The adjusted mean difference was 1.0 [95% CI 0.2, 1.9]. Therefore, applying SDF at baseline and 6 months resulted in significant remineralization compared with the control group over the 12-month period. These findings suggested that applying SDF can serve as an effective alternative treatment option for remineralizing early caries lesions on proximal surfaces.
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spelling doaj-art-911ebf94150f40afb51c6f3af7eb499b2025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-07764-2Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trialRinrada Pirompak0Chutima Trairatvorakul1Suchaya Pornprasertsuk-Damrongsri2Thipawan Tharapiwattananon3Pornkawee Charoenlarp4Ratichanok Nantanee5Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn UniversityDepartment of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn UniversityDepartment of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol UniversityDepartment of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn UniversityDepartment of Radiology, Faculty of Dentistry, Chulalongkorn UniversityDepartment of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn UniversityAbstract The aim of the study was to examine the mean mineral density (MD) change in early proximal enamel caries lesions after applying silver diamine fluoride (SDF) using digital subtraction radiographic analysis at 6 and 12 months. A split-mouth, triple-blind, randomized controlled trial was conducted with thirty healthy participants aged 13–30 years old. Two active non-cavitated proximal caries lesions in different quadrants of each participant were randomly sampled and allocated to a test (38% SDF) and a control group (deionized water). Digital radiographs at baseline, 6 and 12 months were taken, and digital subtraction radiographic analysis was performed. The SDF group demonstrated a significantly higher mean MD on subtraction radiographs compared with the control group, after adjusting for baseline lesion depth and time, and for clustering within participants over time. The adjusted mean difference was 1.0 [95% CI 0.2, 1.9]. Therefore, applying SDF at baseline and 6 months resulted in significant remineralization compared with the control group over the 12-month period. These findings suggested that applying SDF can serve as an effective alternative treatment option for remineralizing early caries lesions on proximal surfaces.https://doi.org/10.1038/s41598-025-07764-2Silver diamine fluorideFluoridesDental cariesClinical trialsDigital subtraction radiographyRemineralization
spellingShingle Rinrada Pirompak
Chutima Trairatvorakul
Suchaya Pornprasertsuk-Damrongsri
Thipawan Tharapiwattananon
Pornkawee Charoenlarp
Ratichanok Nantanee
Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
Scientific Reports
Silver diamine fluoride
Fluorides
Dental caries
Clinical trials
Digital subtraction radiography
Remineralization
title Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
title_full Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
title_fullStr Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
title_full_unstemmed Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
title_short Digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions: a 12-month randomized controlled trial
title_sort digital subtraction analysis after application of silver diamine fluoride on early proximal caries lesions a 12 month randomized controlled trial
topic Silver diamine fluoride
Fluorides
Dental caries
Clinical trials
Digital subtraction radiography
Remineralization
url https://doi.org/10.1038/s41598-025-07764-2
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