Abstract
This study investigated the effect of silver diamine fluoride (SDF) and potassium iodide (KI) treatment on secondary caries prevention and tooth discolouration in glass ionomer cement (GIC) restoration. Cervical GIC restorations were done on 30 premolars with: Group 1, SDF + KI; Group 2, SDF (positive control); Group 3, no treatment (negative control). After cariogenic biofilm challenge, the demineralisation of dentine adjacent to the restoration was evaluated using micro-computed tomography (micro-CT) and Fourier transform infrared (FTIR) spectroscopy. The colour of dentine adjacent to the restoration was assessed using CIELAB system at different time points. Total colour change (∆E) was calculated and was visible if ∆E > 3.7. Micro-CT showed the outer lesion depths for Groups 1, 2 and 3 were 91 ± 7 µm, 80 ± 7 µm and 119 ± 8 µm, respectively (p < 0.001; Group 2 < Group 1 < Group 3). FTIR found that there was a significant difference in amide I-to-hydrogen phosphate ratio among the three groups (p < 0.001; Group 2 < Group 1 < Group 3). ∆E of Groups 1, 2 and 3 after biofilm challenge were 22.5 ± 4.9, 70.2 ± 8.3 and 2.9 ± 0.9, respectively (p < 0.001; Group 3 < Group 1 < Group 2). SDF + KI treatment reduced secondary caries formation on GIC restoration, but it was not as effective as SDF treatment alone. Moreover, a perceptible staining on the restoration margin was observed, but the intensity of discolouration was less than that with solely SDF treatment.
Highlights
Secondary caries, which refers to the carious lesions affecting the margins of an existing restoration [1], is regarded as the most common reason for re-restoration of teeth in the long term [2]
Glass ionomer cements (GICs) can release fluoride ions to enhance remineralisation, and their abilities in fluoride release and recharge are superior to other restorative materials, such as compomers and giomers [4]
It has been reported that prior treatment with silver diamine fluoride (SDF) can increase resistance of cavity margins around GIC restorations to secondary caries development [5]
Summary
Secondary (recurrent) caries, which refers to the carious lesions affecting the margins of an existing restoration [1], is regarded as the most common reason for re-restoration of teeth in the long term [2]. It was reported that the application of SDF + KI to dentine surfaces before the placement of GIC restorations did not affect the bond strength of GIC to dentine [16], and did not adversely interfere with the fluoride uptake into the adjacent demineralised dentine [15]. It would be desirable if KI could inhibit the staining formation associated with SDF without diminishing its effectiveness in preventing and arresting dental caries. The second null hypothesis was that SDF + KI treatment has no staining effect on dentine along the restoration margin
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