The effect of silver diamine fluoride and cleaning methods on bond strength of glass-ionomer cements to caries-affected dentin.

PURPOSE: To evaluate the effect of silver diamine fluoride (SDF) application on the microshear bond strength (MBS) of glass-ionomer cements (GIC) to caries-affected dentin (Part 1) and dentin cleaning methods to reduce SDF's potential effect on MBS (Part 2). METHODS: For Part 1, 56 extracted human teeth were randomly divided into eight groups with GIC, 38% SDF application and dentin substrate. Samples of artificial caries-affected human dentin were treated or not with 38% SDF and restored with conventional or resin-modified GIC. The same procedures were performed in sound dentin tested for MBS test after 24 hours. In Part 2, different dentin cleaning agents (water, aluminum oxide, and pumice slurry) were tested after SDF application. The procedure was performed on the group that presented the worst values for MBS in Part 1. Fracture mode was evaluated under scanning electron microscope. Data were statistically analyzed by ANOVA. RESULTS: MBS was affected by the presence of caries and the type of material, with the conventional GIC the most affected (P< 0.05). Pumice slurry was superior in comparison to the other agents in cleaning SDF-treated dentin. Fracture evaluation showed more mixed failures in all the groups. CLINICAL SIGNIFICANCE: Clinicians should have caution when selecting the glass-ionomer cement (GIC) for restorations in silver diamine fluoride (SDF)-treated dentin. The mechanical properties of conventional GIC restorations were more affected than resin-modified GICs. Pumice slurry was the most effective cleaning method to minimize the negative effect of SDF on dentin.

Silver diamine fluoride and cleaning methods effects on dentin bond strength.

PURPOSE: To assess the effect of silver diamine fluoride (SDF) application on bond strength of current adhesive systems to caries-affected dentin and cleaning procedures to overcome SDF's influence on adhesion to dentin. METHODS: 64 human third molars were randomly divided in eight groups for microshear bond strength testing (MBS). Samples of sound and artificial caries-affected human dentin were treated or not with 38% SDF and restored with an etch-and-rinse or a self-etch bonding system. For the cleaning part, water, aluminum oxide, and pumice paste were used after SDF application to determine whether SDF affected the bond strength to dentin. Fracture mode was evaluated under scanning electron microscope. Data were statistically analyzed by ANOVA. RESULTS: SDF application resulted in the lowest MBS for the self-etching adhesive system on caries-affected dentin (P< 0.05). Cleaning with pumice slurry maintained the MBS in SDF groups when compared to the control groups (not treated with SDF). Fracture evaluation showed more adhesive failures on adhesive systems groups. EDX analysis showed no silver particles when pumice paste was used for cleaning. CLINICAL SIGNIFICANCE: Self-etch adhesive systems do not seem appropriate for bonding SDF-treated dentin restorations. Cleaning SDF-treated dentin with pumice paste reduced the negative effect of SDF on resin-dentin bond strength. Etch-and-rinse adhesive systems seemed not be affected by 38% SDF.