Abstract
BackgroundSilver diamine fluoride (SDF) has attracted attention because of its clinical success in arresting dentin caries. It has been shown that it can inhibit matrix metalloproteinases and cysteine cathepsins. These two properties might be beneficial in bonding to caries-affected dentin (CAD). Therefore, the present study aimed to investigate the effect of SDF on the durability and bond strength to the CAD. Material and MethodsForty-eight third molars with occlusal caries were used. The roots were cut, and the occlusal enamel was removed. The CAD area surrounded by the normal dentin (ND) was exposed. All the specimens were bonded with an etch-and-rinse adhesive, but half of them were treated with SDF after acid etching (NT or SDF). Two cylinders of composite (0.9 mm in diameter and 0.7 mm in height) were built-up on each specimen, one on the CAD and the other on the ND area. The specimens in each group (NT-ND, NT, CAD, SDF-ND, SDF-CAD) (n=24) were equally divided into two subgroups. One subgroup was tested for microshear bond strength 24 hours after bonding (T0), and the other subgroup was tested after six months of water storage (T6). The bond strength data were analyzed using three-way ANOVA. Subgroup analysis was performed using independent samples t-test. Fracture patterns were also evaluated. ResultsAt T0, the bond strength of NT-ND was higher than that of NT-CAD (p<0.00), but the bond strength of SDF-ND and SDF-CAD were not different (p=0.77). Comparison of the bond strength of the groups between the two time intervals yielded the following results: NT-ND-T0> NT-ND-T6 (p=0.04), SDF-ND-T0=SDF-ND-T6 (p=0.39), NT-CAD-T0=NT-CAD-T6 (p=0.51) and SDF-CAD-T0>SDF-CAD-T6 (p<0.00). ConclusionsThe SDF treatment increased the bond strength to CAD but did not affect the bond strength to the ND. SDF hindered the decrease in the bond strength to the ND caused by aging. However, the effect of SDF on increasing the bond strength to CAD disappeared after aging. Key words:Silver diamine fluoride, caries-affected dentin, bond strength.
Highlights
Invasive dentistry aims to arrest caries or remove as little tooth structure as possible
Previous studies have investigated the effect of Silver diamine fluoride (SDF) on the bond strength of glass-ionomer [16], etch-and-rinse and self-etch adhesive to normal dentin.[17] there is no study to evaluate the effect of SDF on the stability of the bond to the caries-affected dentin (CAD)
The null hypothesis ran as follows: Neither the SDF application nor the water storage period would have any effect on the bond strength to caries-affected and normal dentin
Summary
Invasive dentistry aims to arrest caries or remove as little tooth structure as possible. Silver compounds penetrate into the dentinal tubules, invading the cariogenic microorganisms [11] They can harden the carious lesion [5], inhibit degradation of the collagen in demineralized dentin [15] and exert an inhibitory effect on MMPs [7] and cysteine cathepsins [6]. This study aimed to investigate the effect of SDF on the immediate and mid-term bond strength to either normal or affected dentin. It has been shown that it can inhibit matrix metalloproteinases and cysteine cathepsins These two properties might be beneficial in bonding to caries-affected dentin (CAD). The present study aimed to investigate the effect of SDF on the durability and bond strength to the CAD. The effect of SDF on increasing the bond strength to CAD disappeared after aging
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