Dentin Discoloration and Pulpal Ion Concentrations Following Silver Diamine Fluoride and Potassium Iodide Treatment.

OBJECTIVE: The objective of this in vitro study was to evaluate the effects of potassium iodide on dentin discoloration and ion penetration into the pulp chamber after application of silver diamine fluoride (SDF). METHODS: Proximal surfaces of extracted one-rooted sound human teeth were polished to obtain flat dentin and treated with 17% EDTA for two minutes. Each tooth was then fixed to a test tube. The specimens were distributed into five groups according to the treatment: SDF (Advantage Arrest, Elevate Oral Care); SDF-KI (SSKI, Upsher-Smith); RV-SDF (Riva Star, SDI); and RV-SDFKI. The CIE L*a*b* color value for each proximal dentin was assessed using a colorimeter (CR200, Konica-Minolta) at baseline, after two minutes, 10 minutes, and 24 hours, and ΔE compared to baseline was calculated. Subsequently, the water-filled tube was inverted to collect the ions that had penetrated from the tooth surface into the pulp chamber. Silver, iodide, and fluoride in the pulp were measured using trace element analysis (ISMat) and fluoride ion-selective electrode (Orion, Thermo Scientific) at days 1, 2, 7, and 14. RESULTS: Dentin in both SDF-KI groups showed no visual change in color whereas the groups using only SDF exhibited gradual staining. The time, the treatment and their interaction had a significant effect on ΔE (p<0.001). The fluoride concentrations at day 1 and day 14 for group SDF and KI were significantly lower compared to SDF (p=0.044). There was a difference between control groups and other groups in silver and iodine (p<0.05), whereas there was no significant difference among groups with treatment after 14 days (p>0.05). CONCLUSION: The application of KI after SDF treatment could significantly reduce the dentin staining. The pulpal fluoride concentration in the groups using SDF-KI was lower compared to the ones using SDF only, whereas there was no difference observed in iodide and silver among the groups with treatment.

Potassium Iodide Reversal of Silver Diamine Fluoride Staining: A Case Report.

This article describes the clinical protocol of using potassium iodide (KI) to reverse staining caused by silver diamine fluoride (SDF). SDF contains silver, fluoride, and ammonia. It has been used to arrest dental caries mainly in pediatric applications. The major drawback of SDF application is the dark staining of both teeth and restorative materials. Hence, its use on adult dentition is limited. Improving the esthetic outcome by stain reduction would greatly enhance the opportunity for SDF's universal use. This case demonstrates how KI can effectively reverse the staining.

Evaluation of Bond Strength and Microleakage of a Novel Metal-titanate Antibacterial Agent.

OBJECTIVES: To evaluate the effect on both bond strength and microleakage of incorporation of a novel antibacterial nanoparticulate metal-titanate complex (nMT) into a dental adhesive system. MATERIALS AND METHODS: Eighty extracted human molars were prepared to determine whether incorporation of nMT into bonding agents can affect shear bond strength (SBS) and adhesive strength fatigue. SBS was measured with a universal testing machine, and the peak force at failure was recorded. An electromechanical fatigue machine was used for cyclic loading treatment of specimens. Differences in the SBS values among groups were identified using analysis of variance and Tukey post hoc analyses (α=0.05). Twenty standard Class V cavities were restored to examine microleakage when the primer/bonding resin was modified with 10 wt% nMT. Microleakage at the enamel and dentin margins was calculated as a percentage of the full length of the cavity. Results of the microleakage experiment were analyzed with paired and independent sample t-tests (α=0.05). RESULTS: The mean (± standard deviation) shear bond strength values of before fatigue and after fatigue ranged from 21.9 (2.5) MPa to 23.9 (3.8) MPa and from 17.1 (2.5) MPa to 17.7 (2.5) MPa respectively. No statistically significant differences in failure force were observed among groups (p=0.70). Microleakage under all conditions was significantly greater in the dentin margins than in the enamel margins (p<0.05). There was no evidence that microleakage differed between the experimental groups with modified primer and bonding resin. CONCLUSIONS: Incorporating nMT into a dental adhesive system will not compromise the resin composite's tooth bonding and sealing ability.