Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

Abstract

Background The importance of Silver diamine fluoride (SDF) as a minimally invasive and nonaerosolizing management during COVID-19 pandemic has highly increased. SDF is a caries-arresting agent that causes staining of tooth structure. Managing this discoloration will increase its acceptance in treating primary teeth. The main aim of this study was to quantify the color change associated with the application of SDF on extracted carious primary molars, the potential masking of this color change by potassium iodide (KI), composite (CMP) and glass ionomer cement (GI) and the effect of aging on this color masking effect. Methods An in-vitro study in which 52 carious primary molars were collected, prepared, and distributed randomly into four groups equally as follows: Group A: SDF 38%; Group B: SDF 38% + KI; Group C: SDF 38% + CMP; Group D: SDF 38% + GI. Color changes were recorded for each sample at baseline, and after application of the tested materials. Moreover, all samples had undergone Suntest aging followed by a third color reading. CIELAB values L*, a*, b*, ΔL, Δa, and Δb were measured, ΔE was calculated, and data were analyzed using multivariate analysis of variance (MANOVA) and post-Hoc Scheffé test (p < 0.05). Results MANOVA revealed the significant influence of the factor ‘material’. SDF caused an obvious color change compared to the color of carious dentin. Regarding ΔL, the color change of groups C and D was not significant directly after application of the tested materials. After aging, it was significant among all groups, including groups C and D. In Δa there was a difference between SDF and groups B and C after application of the tested materials, and aging produced the same results. The color shifts of Δb of all tested groups varied significantly from one another. After aging, there was no difference between group D and either group A or B. Conclusions Treatment with SDF caused obvious discoloration of carious dentin. Directly after SDF application, all tested materials could effectively mask the color change associated with the application of SDF. CMP was the only material whose color masking effect was not completely reversed by aging.

Peptide-Enabled Nanocomposites Offer Biomimetic Reconstruction of Silver Diamine Fluoride-Treated Dental Tissues

“…Previously, our group has demonstrated bifunctional capabilities of our solid binding peptides in the oral cavity acting to combat oral bacteria, direct remineralization of dentin and enamel, and as bioactive components of engineered dental biomaterials to improve binding and native tissue integration [ 44 , 45 , 46 , 47 , 50 , 51 , 52 ]. Limited studies have been published to date focused on masking or reducing the staining of SDF on carious dentin and enamel; they have thus far involved using potassium iodide, composites, or glass ionomer cements to address this [ 84 , 85 , 86 ]. Hamdy et al used a calibrated spectrophotometer to monitor changes in tooth color following SDF treatment and found a composite coating was the most successful masking agent at baseline and after an aging protocol of the three treatments [ 85 ].…”

“…Limited studies have been published to date focused on masking or reducing the staining of SDF on carious dentin and enamel; they have thus far involved using potassium iodide, composites, or glass ionomer cements to address this [ 84 , 85 , 86 ]. Hamdy et al used a calibrated spectrophotometer to monitor changes in tooth color following SDF treatment and found a composite coating was the most successful masking agent at baseline and after an aging protocol of the three treatments [ 85 ]. However, the composite treatment that immediately followed SDF application required an etching step and multiple coats of dental composite on the affected surface and the effectiveness of the initial SDF treatment after the composite coverage was not reported.…”

Evaluation of Acid Resistance of Demineralized Dentin after Silver Diamine Fluoride and Potassium Iodide Treatment

“…The recently released Riva Star™ compensates for this drawback by reducing staining by applying KI. Several studies have shown that the application of KI is effective in reducing discoloration after SDF [29][30][31].…”

Silver Diamine Fluoride Applications in Dentistry: Review Article

“…The traditional treatment of DC demands great skill of the clinician, good patient cooperation besides the cost of expensive materials, different restorative equipment, and instrumentation (5) . The prevalent approaches implemented in developed countries for the treatment and prevention of DC are neither available nor affordable in developing countries where there are insufficient health providers, financial supplies, and modern facilities however, these traditional approaches have changed over time and replaced by minimally invasive non-restorative intervention to prevent and control DC (6) .…”