IADR Abstract Archives
SMART: Microtensile Bond Strength of GIC to SDF-Treated Dentine
Objectives: Silver modified atraumatic restorative technique (SMART), involving silver diamine fluoride (SDF) application to a cavity with caries-affected dentine (CAD) and immediate restoration with glass ionomer cement (GIC), has been proposed as a minimally-invasive restorative method in underserved and pediatric populations. This study aimed to determine if SDF application to sound and artificial caries-affected dentine (ACAD) immediately prior to restoration with GIC affected microtensile bond strength (µTBS).
Methods: Forty sound permanent molars were randomly allocated into four groups (N=10 each): Sound dentine and water (Sound-W), sound dentine and SDF (Sound-SDF), ACAD and water (Carious-W), ACAD and SDF (Carious-SDF). After exposing occlusal dentine, caries was induced in ACAD groups using a pH-cycling protocol; which was validated against natural CAD. SDF groups were treated with 38% SDF for one minute, and non-SDF groups treated with de-ionized water for one minute. Teeth were immediately restored with a 4-mm high GIC core and sectioned into beam-shaped specimens 48 hours later. Specimens were aged for 24 hours, subjected to tensile forces for µTBS determination, and examined under stereomicroscope to determine failure mode.
Results: The µTBS of ACAD to GIC was similar to natural CAD. 287 specimens from 40 teeth were tested. Using a mixed model analysis, Sound-W (19.00±8.20MPa) had significantly higher mean µTBS (p<0.001) than Sound-SDF (14.60±6.68MPa). There was no significant difference (p>0.05) between Carious-W (7.36±4.05MPa) and Carious-SDF (7.95±5.24MPa). Sound dentine groups (Sound-W, Sound-SDF) had significantly higher mean µTBS (p<0.001) than ACAD groups (Carious-W, Carious-SDF). No difference was found in the failure mode among groups.
Conclusions: Clinicians should avoid SDF application on sound dentine portions as SDF-treated sound dentine had lower µTBS to immediate GIC restoration compared to non-treated sound dentine. SMART restorations are not compromised by SDF application based on this study’s finding that µTBS of SDF-treated ACAD to immediate GIC restoration is not different from non-treated ACAD.
Methods: Forty sound permanent molars were randomly allocated into four groups (N=10 each): Sound dentine and water (Sound-W), sound dentine and SDF (Sound-SDF), ACAD and water (Carious-W), ACAD and SDF (Carious-SDF). After exposing occlusal dentine, caries was induced in ACAD groups using a pH-cycling protocol; which was validated against natural CAD. SDF groups were treated with 38% SDF for one minute, and non-SDF groups treated with de-ionized water for one minute. Teeth were immediately restored with a 4-mm high GIC core and sectioned into beam-shaped specimens 48 hours later. Specimens were aged for 24 hours, subjected to tensile forces for µTBS determination, and examined under stereomicroscope to determine failure mode.
Results: The µTBS of ACAD to GIC was similar to natural CAD. 287 specimens from 40 teeth were tested. Using a mixed model analysis, Sound-W (19.00±8.20MPa) had significantly higher mean µTBS (p<0.001) than Sound-SDF (14.60±6.68MPa). There was no significant difference (p>0.05) between Carious-W (7.36±4.05MPa) and Carious-SDF (7.95±5.24MPa). Sound dentine groups (Sound-W, Sound-SDF) had significantly higher mean µTBS (p<0.001) than ACAD groups (Carious-W, Carious-SDF). No difference was found in the failure mode among groups.
Conclusions: Clinicians should avoid SDF application on sound dentine portions as SDF-treated sound dentine had lower µTBS to immediate GIC restoration compared to non-treated sound dentine. SMART restorations are not compromised by SDF application based on this study’s finding that µTBS of SDF-treated ACAD to immediate GIC restoration is not different from non-treated ACAD.