Evaluation of the Effect of Silver Diamine Fluoride Treatment with and without Glutathione and Potassium Iodide on the Micro-shear Bond Strength of CR to Primary Tooth Dentin: -

TL;DR

This study examines how silver diamine fluoride and additives like glutathione and potassium iodide affect bonding strength in children's teeth.

Contribution

The study evaluates the impact of SDF with or without KI/GSH on bond strength to primary dentin, addressing esthetic concerns.

Findings

SDF-treated dentin showed significantly higher bond strength than untreated dentin.

Adding KI or GSH to SDF did not reduce bond strength, suggesting they can mitigate discoloration without compromising adhesion.

Abstract

Silver diamine fluoride (SDF) is widely employed to halt caries in juvenile
or uncooperative children due to its antimicrobial and remineralizing
properties. Despite its effectiveness, SDF causes dark discoloration of
treated dentin, raising esthetic concerns. Potassium iodide (KI) and
glutathione (GSH) have been proposed as adjuncts to reduce discoloration;
however, their influence on subsequent adhesive bonding to primary dentin
remains unclear. This study evaluated and compared the micro-shear bond
strength (μSBS) of composite resin (CR) to demineralized primary tooth
dentin treated with SDF alone, SDF combined with KI or GSH, and untreated
dentin.

Fifty-two sound primary teeth were prepared to obtain flat mid-coronal dentin
surfaces and artificially demineralized. Specimens were randomly assigned to
four groups (n=13): control (no SDF), SDF, SDF+KI, and SDF+20% GSH. After
pretreatment, all samples underwent phosphoric acid etching, application of
a total-etch adhesive, and restoration with CR using standardized molds.
μSBS was measured with a universal testing machine operating at a crosshead
displacement rate of 1 mm/min. Statistical evaluation of the data was
conducted via one-way analysis of variance (ANOVA) followed by Tukey’s
post-hoc comparisons, with the significance level set at 0.05.

SDF-treated groups demonstrated significantly higher μSBS values compared
with the control group (P0.001). Mean bond strengths were highest for SDF
alone, followed closely by SDF+KI and SDF+GSH. The data revealed no
meaningful divergence in the outcomes of the three SDF-based treatments.

Pretreatment of demineralized primary dentin with SDF significantly enhanced
CR bond strength. The addition of potassium iodide or glutathione did not
adversely affect bonding performance, suggesting these agents may be used to
reduce discoloration without compromising adhesive outcomes.

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