Optimal concentration of potassium iodide to reduce the black staining of silver diamine fluoride

Abstract

Background/purpose Potassium iodide (KI) is used for reducing the degree of black staining occurred after silver diamine fluoride (SDF) application. However, the optimal KI concentration remains unknown. This study aimed to identify the optimal concentration of KI that effectively reduces black staining after SDF application. Materials and methods Twenty-four extracted teeth with similar pattern of carious lesions were assigned into 6 groups as follows: 1) SDF only, 2) SDF+7.5%KI, 3) SDF+10%KI, 4) SDF+15%KI, 5) SDF+20%KI, and 6) SDF+saturated KI. The KI solution was applied immediately after SDF application. Tooth images were obtained for color measurement at different time points as followed; before SDF application, immediately after SDF application, immediately after KI application, 1, 3, 7 and 14 days after SDF+KI application. The photographs were analyzed for mean gray value using the ImageJ program. Results The KI groups demonstrated a dose-dependent significant immediate reduction in black staining after KI application, except the saturated KI group. The teeth in the 20% KI group had the highest Δ mean gray value compared with other groups immediately after KI application, whereas a reduction in black staining in the saturated KI group appeared 1 day after KI application. The Δ mean gray value in all groups decreased over time. After 7 and 14 days, the reduction in black staining was not clearly different between KI groups. Conclusion KI application was able to reduce the degree of black staining in a dose-dependent manner, but the subsequent color change was minimal over the period of 14 days.

A Review of the Protocol of SDF Therapy for Arresting Caries

“… 26 A laboratory study showed that potassium iodide application could reduce the intensity of staining in a dose-dependent manner. 27 However, no significant difference was found 14 days after SDF application. A 30-month clinical trial found that potassium iodide application did not reduce the staining of SDF-treated lesions in the long term.…”

Surface Roughness of Dentin and Formation of Early Cariogenic Biofilm after Silver Diamine Fluoride and Potassium Iodide Application

“…When immediately after SDF, KI reacts with the free silver ions in SDF and prevents the formation of silver phosphate [19]. Detsombonnrat et al [20] observed a significant immediate reduction in staining due to SDF following application of KI in a dose dependent manner [20].…”

Effectiveness of Silver Diamine Fluoride in Arresting Caries in Primary and Early Mixed Dentition: A Systematic Review

“…Many studies have reported different solutions to overcome this disadvantage and decreasing the staining of the treated teeth such as the application of potassium iodide following the application of SDF [ 23 , 24 , 25 , 26 ]. In terms of parental acceptance, several studies have reported that SDF black staining of teeth was accepted by parents in posterior compared to anterior teeth in addition to other reasons as the child’s cooperation, socioeconomic status, and the need of using sedation or referral to general anesthesia to receive dental treatment [ 12 , 16 , 20 ].…”