Prevention of secondary caries by silver diamine fluoride

Abstract

Purpose: This study aimed to investigate the use of 38% silver diamine fluoride (SDF) as a treatment for preventing secondary caries in glass ionomer cement (GIC) and composite resin (CR) restorations. Methods: Six extracted human sound premolars were collected. Four cavities (4 × 2 × 2 mm3) were prepared on each premolar and then allocated to the following restoration groups: group 1, SDF conditioning and GIC restoration; group 2, GIC restoration; group 3, SDF conditioning and CR restoration; and group 4, CR restoration. After thermal cycling and sterilisation, the teeth were soaked in a 5% sucrose solution containing Streptococcus mutans and Lactobacillus acidophilus for 28 days. Micro-computed tomography was used to study demineralisation. The outer lesion depth (OLD) and wall lesion depth (WLD) of the tooth–restoration interface were measured. The OLD and WLD were directly related to the extent of secondary caries. Two-way analysis of variance was used to analyse the effects of SDF conditioning and restorative materials on OLD. Results: The mean ± standard deviation OLD values were 156 ± 45 μm, 235 ± 33 μm, 153 ± 20 μm and 232 ± 24 μm for groups 1–4, respectively. The OLD was less in restorations with SDF conditioning (P < 0.001) than in those without SDF conditioning. No interaction effect on OLD was found between the restorative materials and SDF conditioning (P = 0.062). The WLD was detected only in groups 3 and 4. Clinical significance: Conditioning with 38% SDF can increase resistance of GIC and CR restorations to secondary caries.