Comparative Effects of Silver Diamine Fluoride and Self-Assembling Peptide on Microhardness, Qualitative Surface Morphology, and Remineralization of Incipient Enamel Lesions in Primary Teeth: An in Vitro Study Publisher

Summary: Can peptides restore baby-tooth enamel? A lab study found SAP and silver fluoride improved hardness; SAP showed more organized mineral recovery. #Dentistry #Enamel

Moshkbouy E ; Mokhtari S ; Baniebrahimi G ; Davaie S ; Kharazifard M J
Source: Journal of Research in Dental and Maxillofacial Sciences Published:2026

Abstract

Background and Aim: This study compared the effects of silver diamine fluoride (SDF) and self-assembling peptide (SAP) on microhardness, qualitative surface morphology, and remineralization of artificially induced incipient enamel lesions in primary teeth. Materials and Methods: Sixty extracted primary molars were included in this in vitro study. Thirty-six teeth were selected for microhardness testing and exposed to a demineralizing solution for 36 hours to induce incipient enamel lesions. The samples were randomly assigned to SDF, SAP, and untreated control groups (n=12 each) and were subsequently stored in artificial saliva under pH-cycling conditions for 45 days. Vickers microhardness was recorded at baseline, after lesion formation, and after the remineralization period. Twenty-four other teeth underwent environmental scanning electron microscopy (ESEM) to examine their enamel surface morphology after the demineralization/remineralization cycles. Statistical analysis was performed with one-way ANOVA and a repeated-measures general linear model (alpha=0.05). Results: Baseline microhardness did not differ significantly among the groups (P=0.564). Demineralization significantly reduced enamel microhardness in all groups, without a significant intergroup difference (P=0.778). Following remineralization, microhardness differed significantly among the groups; both SAP (P<0.001) and SDF (P=0.004) produced higher values than the control. Time (P<0.001) and interaction of time and group (P<0.001) significantly affected the microhardness. ESEM observations showed the most organized mineral/crystal reformation in the SAP-treated samples, followed by those treated with SDF. Conclusion: In this in vitro study, SDF and SAP comparably improved the microhardness of demineralized primary enamel. ESEM findings suggested a more favorable structural reorganization and remineralization pattern after SAP application. © 2026 Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University.