Comparative evaluation of effect of silver diamine fluoride with different anti-staining agents on shear bond strength of universal adhesive to dentin: An in vitro study
Geetika Dixit, Naveen Manuja, Seema Chaudhary, T. R. Chaitra, Ashish Amit Sinha, Nida NaimBackground:
Dental caries is one of the most widespread chronic diseases, impacting over 2.4 billion people globally. Silver diamine fluoride (SDF) is a minimally invasive treatment known for its strong antimicrobial and remineralizing effects. However, the primary esthetic drawback of SDF is the black staining it causes on the treated tooth structure. To address this issue, adjunctive anti-staining agents such as potassium iodide (KI), glutathione (GSH), and tannic acid (TA) have been explored. These agents may not only mitigate discoloration but also affect the bonding efficiency of restorative materials applied afterward.
Materials and Methods:
Forty extracted permanent posterior teeth were collected, debrided, cleaned, and stored in normal saline. Each tooth was embedded in acrylic resin, and flat dentin surfaces were prepared by grinding the occlusal surface. The samples were randomly divided into four groups: Group 1 – 38% SDF only; Group 2 – SDF + 10% KI; Group 3 – SDF + 10% GSH; and Group 4 – SDF + 10% TA. Treatments were applied to dentin surfaces using a microbrush following standard protocols. A universal adhesive was then applied and light-cured, followed by the placement of composite resin. All specimens underwent shear bond strength (SBS) testing using a universal testing machine to evaluate the adhesive performance of each combination.
Results:
The mean SBS values (±standard deviation) for Group 1, Group 2, Group 3, and Group 4 were 10.32 ± 0.56, 14.08 ± 0.70, 18.24 ± 0.81, and 17.05 ± 0.47 MPa, respectively. The highest bond strength was observed in Group 3 (GSH), followed by Group 4 (TA), Group 2 (KI), and Group 1 (SDF alone).
Conclusion:
Pretreatment of dentin with GSH before SDF application significantly enhanced SBS when used with universal adhesive and composite resin.