Effect of Silver Diamine Fluoride, Fluoride Varnish and Casein Phosphopeptide –Amorphous Calcium Phosphate on Biofilm Growth Kinetics of Streptococcus Mutans Induced Dentine Carious Lesions in Primary Teeth :An In-Vitro Study

Aim: Considering the prevalence of dental caries and the preference for minimally invasive treatment to preserve healthy tooth structure, this study compared the effects of 38% silver diamine fluoride (SDF), 5% sodium fluoride (NaF) varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on dentin carious lesions in primary teeth. Minimally invasive techniques, including SDF and remineralizing agents, are favored in caries management.Materials and methods: Twenty-four extracted primary molars were embedded in resin blocks and sectioned into approximately 5x5 mm specimens using a slow-speed, water-cooled diamond saw (Isomet 4000). Streptococcus mutans was cultured anaerobically on blood agar at 37°C for 48 h. Single colonies were then inoculated into BMG (basal medium supplemented with 5% glucose) and incubated anaerobically at 37°C for 24 h to prepare inoculum for biofilm formation. Specimens were then incubated for 7 days to allow for biofilm development. Subsequently, specimens were divided into four treatment groups: Group A (Control, distilled water), Group B (38% SDF), Group C (5% NaF varnish), and Group D (CPP-ACP). After a further 7-day incubation period, bacterial growth on all specimens was assessed using confocal laser scanning microscopy.Results: Statistically significant differences were found between the groups (p<0.001). Group B (SDF) demonstrated a substantially higher ratio (12.02±2.80) compared to Group C (NaF) (3.75±0.55), Group D (CPP-ACP) (1.87±0.49), and Group A (Control) (0.07±0.03).Conclusion: 38% SDF provides better remineralization and anti-cariogenic effect compared to a 5% NAF and CPP-ACP; CPP-ACP had a minimal effect on reducing Streptococcus mutans bacteria.