SMART: Silver diamine fluoride reduces microtensile bond strength of glass ionomer cement to sound and artificial caries-affected dentin

Dent Mater J. 2022 Oct 2;41(5):698-704. doi: 10.4012/dmj.2021-319. Epub 2022 May 27.

Abstract

Silver-modified atraumatic restorative technique (SMART) is an emerging restorative technique; however, the effect of silver diamine fluoride (SDF) application on the bond strength of glass ionomer cement (GIC) is unknown. This study aimed to determine if SDF application to sound and artificial caries-affected dentin (ACAD) immediately prior to GIC restoration affected microtensile bond strength (µTBS). Caries was induced on extracted molars using a pH-cycling protocol that was validated against natural caries (similar µTBS). Dentin surfaces were treated with 38% SDF, control groups with de-ionized water and immediately restored. Beam-shaped specimens were sectioned and subjected to tensile forces for µTBS determination. Two hundred and eighty-seven specimens from 40 teeth were tested. SDF application significantly (p<0.001) reduced µTBS in sound dentin (19.00±8.20 MPa vs. 14.60±6.68 MPa), while no difference was found in ACAD. No difference was found in failure mode among groups. For SMART, SDF application on sound dentin before immediate GIC restoration may decrease bond strength.

Keywords: Dental atraumatic restorative treatment; Dental bonding; Glass ionomer cement; Minimally invasive dentistry; Silver diamine fluoride.

MeSH terms

  • Dental Bonding*
  • Dental Caries Susceptibility
  • Dental Caries* / therapy
  • Dentin
  • Fluorides, Topical
  • Glass Ionomer Cements / chemistry
  • Humans
  • Materials Testing
  • Quaternary Ammonium Compounds
  • Silver Compounds / chemistry
  • Tensile Strength
  • Water

Substances

  • Fluorides, Topical
  • Glass Ionomer Cements
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • Water
  • silver diamine fluoride