ISSN - 0975-7058 Vol 9, Special Issue 2, 2017 ISSN - 0975-7058 COMPARISON OF THE POTENCY OF SEVERAL FLUORIDE-BASED VARNISHES AS AN ANTICARIOGENIC ON CALCIUM, PHOSPHATE, AND FLUORIDE ION LEVELS SRI ANGKY SOEKANTO 1 *, NAMIRA ROSITHAHAKIKI 1 , DEWI FATMA SUNIARTI 1 , MOHAMAD SAHLAN 2 1 Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia. 2 Department of Chemical Engineering, Faculty of Engineering, Universitas Indonesia, Jakarta, Indonesia. Email: sriangky@ui.ac.id Received: 16 September 2017, Received and Accepted: 06 November 2017 ABSTRACT Objectives: The purpose of this present study was to analyze several fluoride-based varnishes: Silver diamine fluoride (SDF), nanosilver fluoride (NSF), and propolis fluoride (PPF). Fluoride-based varnish is proven to act as antibacterial and remineralization agents that arrested caries progression with minimal side effects. SDF, the golden standard for this study, was compared to NSF and PPF, which were made in our own laboratory, to evaluate their ability to release calcium, phosphate, and fluoride ions and act as anticariogenic agents. Methods: Human dentin discs were prepared and divided into control groups and treatment groups with SDF (38%), NSF (3.16%, 3.66%, and 4.16%), and PPF (3%, 6%, and 10%). The dentin discs were demineralized using a demineralization solution (pH 4.4) for 96 h. Each dentin disc in the treatment group received a topical application of various fluoride-based varnishes and then was subjected to pH-cycling for 8 days. The quantity of calcium, phosphate, and fluoride ions on the dentin discs surface was compared after being detected using energy dispersive X-ray spectroscopy. Results: The result revealed that the calcium ion levels in groups NSF and PPF increased significantly compared to SDF. The levels of phosphate ions and fluoride ions in groups NSF and PPF increased significantly compared to SDF. Conclusion: The study concluded that, in contrast to SDF, the prepared NSF and PPF fluoride-based varnishes were shown to release calcium, phosphate, and fluoride ions in this study. Hence, NSF and PPF fluoride-based varnishes are promising as anticariogenic agents. Keywords: Caries, Calcium ion, Phosphate ion, Fluoride ion, Silver diamine fluoride, Nano silver fluoride, Propolis fluoride, Demineralization, Remineralization. INTRODUCTION Dental caries is the most common oral health problem worldwide. Around 60–90% of school children in the world experience dental caries, and most of them do not have proper treatment [1]. Dental caries is represented microscopically as the demineralization of the hard tissue of the teeth. Caries is a multifactorial disease with factors that include a host (saliva and teeth structure), cariogenic microorganism (Streptococcus mutans), diet (carbohydrate), and time [2]. When caries reaches dentin, there are two different surfaces microscopically: Infected dentin and affected dentin. Infected dentin affects the outer surface and is irreversible, infected, unable to remineralize, and must be cleaned. Affected dentin affects the inner surface and is reversible, uninfected, and can be left. Affected dentin does not have to be excavated because it has the ability to be remineralized if there are enough fluoride, calcium, and phosphate ions on the environment [3]. Silver diamine fluoride (SDF) [Ag(NH 3 ) 2 F] has an anticariogenic effect because it releases fluoride ions rapidly to help remineralization. SDF is recommended by dentist to prevent the progress of caries mostly in Japan, Australia, and the United States. The product was cleared for sale in the United States in August 2014 by the Food and Drug Administration as a Class II medical device [4]. Fluoride and silver interact to form fluorapatite, hydroxyapatite, and silver phosphate, which increases mineral density, increases the hardness of hydroxyapatite and fluorapatite crystals, and decreases the depth of the cavity. Unfortunately, this product stains the teeth and has a metallic taste. One study states that calcium fluoride and silver phosphate cannot be dissolved and precipitated at the dentin surface, hence acting as tooth surface protector [5,6]. Nanosilver fluoride (NSF) is another anticariogenic agent formulated to diminish the weakness of SDF. It forms black stains on the caries lesion and could irritate soft tissue. The black stain is due to the oxidation of silver ions on SDF, and the soft tissue irritation is reversible but may cause pain. There has not been any research about the side effects of NSF, but there are some studies regarding nanosilver, which is the main component of NSF. A study by Braydich-Stolle et al. stated that there was a change in the mitochondria function of a rat liver in a cytotoxicity test using silver nanoparticles. Another study stated that silver nanoparticles could have serious toxic effects on the human male’s reproductive system [7-9]. NSF was made in our laboratory, following the formula that has been reported, comparing to propolis fluoride (PPF) and SDF in their ability to release calcium, phosphate, and fluoride ions as a parameter to remineralize the tooth that was analyzed [10]. Propolis was chosen in this study as a natural product and is expected to be safer than the silver or nanosilver used in SDF and NSF. This study was also to observe the stability of the PPF mixture when used as a fluoride varnish. PPF consists mainly of propolis and fluoride made in the Laboratory of Bioprocessing in the Faculty of Chemical Engineering, Universitas Indonesia. It contains flavonoid and cinnamic acid, which act as antibacterial, antivirus, and antifungal agents. Research Article © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ijap.2017.v9s2.14 International workshop on Dental Research hosted by Faculty of Dentistry Universitas Indonesia, Jakarta, 2017