Effect of Siwak Extract on the Microhardness and Microscopic Feature of Initial Caries-Like Lesion of Permanent Teeth, Compared to Fluoridated Agents

Abstract

Siwak is a chewing stick used to clean the teeth and message the gum. Theirroutine use was shown to be associated with the reduction in severity of dental caries.This study aimed to test the effect of water Siwak extract on the microhardness andmicroscopic features of artificially initiated carious lesion of the outer enamel surface,in comparison to stannous fluoride and sodium fluoride. Upper first premolars wereextracted and subjected to pH cycling procedure. Teeth immerged individually in 20ml of selected agents for four minutes then rinsed by de ionized water. Agentsinvolved were 5% and 10% water Siwak extract, 8% stannous fluoride and 0.05%sodium fluoride. Samples were subjected to Vickers microhardness test andmicroscopic examination before and after the pH cycling and following insertion inthe agents. Water Siwak extract, stannous fluoride and sodium fluoride were found toincrease the microhardness values of de mineralized enamel surfaces, this werestatistically highly significant for Siwak extract and stannous fluoride (P< 0.01) andsignificant for sodium fluoride. However none of the mentioned agents was able toincrease the micro hardness to approximate the original values of the sound enamel.Under polarized light results revealed that water Siwak extracts and stannous fluorideproduce the best remineralization surface zone. Water Siwak extracts is very effectivein remineralization of initial carious lesion.