Effect of three silver diamine fluoride application protocols on the microtensile bond strength of resin-modified glass ionomer cement to carious dentin in primary teeth

Assessing the Effects and Acceptance of Silver Diamine Fluoride Treatment in Early Childhood Caries

BACKGROUND

 Early childhood caries (ECC) is a widespread dental problem that impacts children below the age of six years. Traditional restorative treatments like fillings are often challenging and invasive for young children. Silver diamine fluoride (SDF) offers a minimally invasive and cost-effective alternative for managing ECC. However, the effects, acceptance, and understanding of this treatment by parents remain crucial for its successful implementation.

AIM

To evaluate the impact and level of acceptance of SDF treatment in ECC.

MATERIALS AND METHODS

Thirty-two children from an Anganwadi center aged between two to five years suffering from ECC were selected. A 38% SDF was applied for 3 minutes on the identified carious lesion, and the arrest percentage was checked after a recall period of three weeks and three months. The Likert scale was used for the questionnaire regarding parental feedback about the ease of application procedure, tooth discoloration, possible pain associated with the procedure, and the taste of SDF.

RESULTS

In the present study, a total of 75 surfaces were subjected to the application of SDF. After a period of three weeks, it was observed that 64 of these surfaces had successfully undergone the process of caries arrest. This finding was deemed to be statistically significant, with a P value of 0.021. Furthermore, the remaining surfaces that had not achieved caries arrest were subsequently treated at three months. The results of this subsequent treatment were also found to be statistically significant, with a P value of 0.027. These findings highlight the efficacy of both caries treatment and caries arrest in relation to the utilization of SDF.

CONCLUSION

SDF was found to be minimally invasive, easy to administer, inexpensive, highly efficient, and effective treatment in arresting caries in the primary dentition of young children, particularly in patients lacking cooperation.

Influence of silver fluoride plus potassium iodine on adhesive properties of primary carious dentin-resin interface: An in vitro study

This paper evaluated the influence of different protocols of silver fluoride (SF) pretreatment of artificial carious lesions on the adhesive interface of composite resin restorations and remineralization of deciduous dentin compared to silver diamine fluoride (SDF). Sixty-four deciduous molar teeth were randomly divided into 8 groups (n = 8) according to the restoration time (immediately - IM; 30 days after SDF/SF treatment - 30 D) and treatment before restoration (SDF 38 %; SDF 38 % + potassium iodide - KI; SF 38 %; SF 38 % +KI). After SDF/SF application, teeth in the IM group were restored with self-etch universal adhesive system/composite resin. Samples in the 30D groups were stored in artificial saliva (37 °C) for 30 days before receiving the same restoring protocol. Beams were obtained from all groups and subjected to bond strength tests (µTBS), ultrastructural qualitative analysis (FEG) and mineral analysis (SEM/EDX; Micro-Raman spectroscopy). The µTBS data were subjected to three-factor ANOVA and multiple comparisons (Holm-Sidak method). Bond strength values (MPa) for IM groups were 16.9 ± 2.7 (SDF); 17.6 ± 3.5 (SDF + KI); 16.8 ± 5.5 (SF); 18.4 ± 4.1 (SF + KI); and 14.9 ± 4.2 (SDF); 16.0 ± 5.4 (SDF + KI); 14.1 ± 3.6(SF); 16.4 ± 5.4 (SF + KI) for 30D groups. Bond strength wasn't influenced by the moment of restoration (IM or 30D); the use of KI didn't alter adhesion characteristics; SDF/SF solutions resulted in similar adhesive strength; calcium and phosphate expressions were identified at the interfaces on IM and 30D moments. However, 30D presented qualitative increase in these ions, compatible with remineralization. It was concluded that the adhesion of composite resin restorations in artificial caries lesions of deciduous teeth treated with SDF (38 %) and SF (38 %) had similar effects in vitro; the use of KI or the moment when restorations were accomplished did not influence the adhesion and all tested protocols promoted remineralization of carious dentin.

Evaluation of Microtensile Bond Strength between SMART Technique and Conventional Glass Ionomer Cement-treated Carious Primary Dentin

Background

Silver diamine fluoride (SDF) solution has been used clinically to prevent and arrest dental caries. To evaluate the microtensile bond strength between silver-modified atraumatic restorative technique (SMART) and glass ionomer cement (GIC) applied to carious primary teeth and also the mode of restoration failure.

Materials and methods

A total of 40 carious primary molars were equally allocated into test and control groups after sectioning through the middle of the carious lesion. The test specimens were treated with one drop of 38% SDF and the control with deionized water. The samples were stored in artificial saliva for 14 days at 37° C and the dentin surfaces were conditioned and restored with Fuji IX GP Extra. After 24 hours storage in artificial saliva, the specimens were prepared for testing of microtensile bond strength. Paired t-test was used to compare the mean bond strengths. The mode of failure was assessed with a stereomicroscope under 40× magnification.

Results

The mean microtensile strength for the test group was 7.39 MPa [standard deviation (SD ± 2.3)] and 7.20 MPa (SD ± 1.98) for the control group (p > 0.05). The most common mode of failure was the mixed failure mode in both groups.

Conclusion

Silver diamine fluoride (SDF) does not adversely affect the bond strength between GIC applied to carious dentin.

How to cite this article

Velagala D, Reddy A, Reddy VN, et al. Evaluation of Microtensile Bond Strength between SMART Technique and Conventional Glass Ionomer Cement-treated Carious Primary Dentin. Int J Clin Pediatr Dent 2023;16(4):582-586.

Evaluation of bleaching agent effects on color and microhardness change of silver diamine fluoride-treated demineralized primary tooth enamel: An in vitro study

Background

The present study aimed to assess the impact of application of fluoridated- 10% carbamide peroxide (CP) with or without potassium iodide (KI) on silver diamine fluoride (SDF)-treated enamel surface in the primary teeth.

Methods

After stained-remineralized caries lesions (s-RCLs) creation, 96 teeth were randomly allocated to four experimental groups: Group 1:SDF-treated enamel followed by 8-h/day application of 10% CP for 2 weeks; Group 2: SDF-treated enamel followed by 15-min/day application of 10% CP for 3 weeks; Group 3: SDF + KI-treated enamel followed by 8-h/day application of 10% CP for 2 weeks; and Group 4: SDF + KI-treated enamel followed by 15-min/day application of 10% CP for 3 weeks. Enamel microhardness (EMH) test (n = 12) and spectrophotometric color assessment (n = 12) was performed at four stages: baseline (intact enamel), demineralized enamel, aged remineralized-stained enamel, and after final intervention. Sixteen samples were used for SEM evaluation. Data were analyzed with the paired t-test, one-way ANOVA, and Tukey’s post-hoc test (p < 0.05).

Results

EMH values in all groups showed significant decrease after demineralization (all, p < 0.00001). All samples showed complete recovery of EMH values (%REMH) after SDF application compared to demineralization (%REMH_SDF) (p = 0.971). Bleaching caused a slight decrease in %REMH for all groups. However, the differences were not statistically significant (p = 0.979). SEM findings revealed no changes in enamel porosity after bleaching. Bleaching application ameliorated the discoloration in all groups (all, p < 0.00001). All samples in Groups 2 and 4 had significantly lighter color after 21 days as compared to 14-day exposure to the bleaching material (both, p < 0.00001).

Conclusions

SDF application on demineralized primary tooth enamel completely recovered enamel microhardness. 10% carbamide peroxide effectively bleached SDF stain without causing significant decrease in EMH values. Color improvement was more evident with the use of KI immediately after SDF application. Both 15-min and 8-h application of fluoridated CP resulted in statistically similar color enhancement in primary teeth.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02371-3.

Evaluation of the Effect of the Loading Time on the Microtensile Bond Strength of Various Restorative Materials Bonded to Silver Diamine Fluoride-Treated Demineralized Dentin

The aim of this study was to evaluate the effect of immediate versus delayed loading times on the microtensile bond strength (μTBS) of restorative materials, including resin-based composite (RBC), resin-modified glass ionomer cement (RMGIC) and glass ionomer cement (GIC), that were bonded to silver diamine fluoride (SDF)-treated demineralized dentin. Ninety caries-free extracted premolar teeth were assigned to three groups (n = 30) loaded with RBC, RMGIC and GIC restorative materials. Each group was further divided into three subgroups (n = 10): subgroup A (control specimens), immediate loading of the restorative material on sound dentin; subgroup B, demineralized dentin, SDF treatment and immediate loading of the restorative material; and subgroup C, demineralized dentin, SDF treatment and restorative material loading a week later. One-way ANOVA and Tukey’s post-hoc tests were performed to compare the μTBS values. The RBC exhibited the highest µTBS, followed by RMGIC and GIC. Multiple comparisons showed an increase in the µTBS in the delayed loading groups irrespective of the restorative material used. The majority of the failure modes were adhesive. Delayed loading of RMGIC for 1 week after SDF application showed significantly higher µTBS than that of immediate loading.

Optimal concentration of potassium iodide to reduce the black staining of silver diamine fluoride

BACKGROUND/PURPOSE

Potassium iodide (KI) is used for reducing the degree of black staining occurred after silver diamine fluoride (SDF) application. However, the optimal KI concentration remains unknown. This study aimed to identify the optimal concentration of KI that effectively reduces black staining after SDF application.

MATERIALS AND METHODS

Twenty-four extracted teeth with similar pattern of carious lesions were assigned into 6 groups as follows: 1) SDF only, 2) SDF+7.5%KI, 3) SDF+10%KI, 4) SDF+15%KI, 5) SDF+20%KI, and 6) SDF+saturated KI. The KI solution was applied immediately after SDF application. Tooth images were obtained for color measurement at different time points as followed; before SDF application, immediately after SDF application, immediately after KI application, 1, 3, 7 and 14 days after SDF+KI application. The photographs were analyzed for mean gray value using the ImageJ program.

RESULTS

The KI groups demonstrated a dose-dependent significant immediate reduction in black staining after KI application, except the saturated KI group. The teeth in the 20% KI group had the highest Δ mean gray value compared with other groups immediately after KI application, whereas a reduction in black staining in the saturated KI group appeared 1 day after KI application. The Δ mean gray value in all groups decreased over time. After 7 and 14 days, the reduction in black staining was not clearly different between KI groups.

CONCLUSION

KI application was able to reduce the degree of black staining in a dose-dependent manner, but the subsequent color change was minimal over the period of 14 days.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.