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Remineralization of carious enamel and dentin with 38% silver diamine fluoride: A systematic review
Gerana Araujo de Lucena Lira1, Suzana Cavalcanti Monteiro de Oliveira1, Kelly Maria Silva Moreira1
1Graduate Program in Pediatric Dentistry, Institute and Research Center São Leopoldo Mandic, São Leopoldo Mandic Faculty, Campinas, São Paulo, Brazil.
Background:
The authors aimed to evaluate the remineralizing effect of 38% silver diamine fluoride on carious enamel and dentin of primary and young permanent teeth.
Types Of Studies Reviewed:
The authors searched PubMed, Scopus, and Embase, including randomized clinical trials and in vitro, in vivo, and cohort studies on the efficacy of 38% silver diamine fluoride in enamel and dentin remineralization. The literature search was conducted on August 8, 2025, and 29 articles were selected for inclusion in this systematic review.
Results:
For randomized crossover clinical trials, the Cochrane risk-of-bias tool Version 2 was used to identify concerns related to randomization. For in vitro studies, an adapted tool from the Checklist for Reporting In vitro Studies was used for bias evaluation; most studies had a high risk of bias. In addition, the Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the reliability of the findings.
Conclusions And Practical Implications:
Results of in vitro studies and a crossover clinical trial were positive for silver diamine fluoride in remineralization. However, further clinical studies are needed to strengthen this evidence. This systematic review was registered with PROSPERO, the International Prospective Register of Systematic Reviews, under protocol number CRD42023408194.
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