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. Their
routine 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 and
microscopic features of artificially initiated carious lesion of the outer enamel surface,
in comparison to stannous fluoride and sodium fluoride. Upper first premolars were
extracted and subjected to pH cycling procedure. Teeth immerged individually in 20
ml of selected agents for four minutes then rinsed by de ionized water. Agents
involved were 5% and 10% water Siwak extract, 8% stannous fluoride and 0.05%
sodium fluoride. Samples were subjected to Vickers microhardness test and
microscopic examination before and after the pH cycling and following insertion in
the agents. Water Siwak extract, stannous fluoride and sodium fluoride were found to
increase the microhardness values of de mineralized enamel surfaces, this were
statistically highly significant for Siwak extract and stannous fluoride (P< 0.01) and
significant for sodium fluoride. However none of the mentioned agents was able to
increase the micro hardness to approximate the original values of the sound enamel.
Under polarized light results revealed that water Siwak extracts and stannous fluoride
produce the best remineralization surface zone. Water Siwak extracts is very effective
in remineralization of initial carious lesion.