The antibacterial efficacy of silver diamine fluoride (SDF) is not modulated by potassium iodide (KI) supplements: A study on in-situ plaque biofilms using viability real-time PCR with propidium monoazide

PLoS One. 2020 Nov 3;15(11):e0241519. doi: 10.1371/journal.pone.0241519. eCollection 2020.

Abstract

Silver diamine fluoride (SDF) is commonly used to arrest caries lesions, especially in early childhood caries. Recently, it was suggested that SDF can be combined with potassium iodide (KI) to minimize the discoloration of demineralized dentine associated with SDF application. However, the antibacterial efficacy of SDF alone or combined with KI on in-situ biofilm is unknown. Hence, we compared the anti-plaque biofilm efficacy of two different commercially available SDF solutions, with or without KI, using an in-situ biofilm, analysed using viability real-time PCR with propidium monoazide (PMA). Appliance-borne in-situ biofilm samples (n = 90) were grown for a period of 6 h in five healthy subjects who repeated the experiment on three separate occasions, using a validated, novel, intraoral device. The relative anti-biofilm efficacy of two SDF formulations; 38.0% Topamine (SDFT) and 31.3%, Riva Star (SDFR), KI alone, and KI in combination with SDFR (SDFR+KI) was compared. The experiments were performed by applying an optimized volume of the agents onto the biofilm for 1min, mimicking the standard clinical procedure. Afterwards the viability of the residual biofilm bacteria was quantified using viability real-time PCR with PMA, then the percentage of viable from total bacteria was calculated. Both SDF formulations (SDFT and SDFR) exhibited potent antibacterial activities against the in-situ biofilm; however, there was non-significant difference in their efficacy. KI alone did not demonstrate any antibacterial effect, and there was non-significant difference in the antibacterial efficacy of SDF alone compared to SDF with KI, (SDFT v SDFR/KI). Thus, we conclude that the antibacterial efficacy of SDF against plaque biofilms is not modulated by KI supplements. Viability real-time PCR with PMA was successfully used to analyze the viability of naturally grown oral biofilm; thus, the same method can be used to test the antimicrobial effect of other agents on oral biofilms in future research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology*
  • Azides / pharmacology*
  • Biofilms / classification*
  • Biofilms / drug effects
  • Calibration
  • Female
  • Fluorides, Topical / pharmacology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Microbial Viability / drug effects
  • Potassium Iodide / pharmacology*
  • Propidium / analogs & derivatives*
  • Propidium / pharmacology
  • Quaternary Ammonium Compounds / pharmacology*
  • Real-Time Polymerase Chain Reaction*
  • Silver Compounds / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Azides
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • propidium monoazide
  • Potassium Iodide
  • Propidium
  • silver diamine fluoride

Grants and funding

This study was funded by the University of Sharjah, UAE. (Seed Grant number 170110022). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.