Search Article 
 
Advanced search 
Official publication of the American Biodontics Society and the Center for Research and Education in Technology
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL RESEARCH
Year : 2022  |  Volume : 13  |  Issue : 4  |  Page : 145-148

Comparison of Microleakage of Composite and Glass Ionomer Restorations in Primary Molars Pretreated with Silver Diamine Fluoride at Two Time Intervals: An In Vitro study


Department of Pedodontics and Preventive Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq

Date of Submission22-Sep-2022
Date of Decision29-Oct-2022
Date of Acceptance31-Oct-2022
Date of Web Publication12-Dec-2022

Correspondence Address:
Mais Zubair Jasim
Department of Pedodontics and Preventive Dentistry, College of Dentistry, University of Baghdad, Baghdad
Iraq
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/denthyp.denthyp_118_22

Rights and Permissions
  Abstract 


Introduction: We aimed to evaluate the microleakage of composite resin and self-cure glass ionomer (GI) restorations in primary molars when the restorations were applied at the same day of silver diamine fluoride (SDF) treatment, and after 14 days. Methods: Class V cavities made at the buccal surface of 64 deciduous molars. For the experimental group of 32 teeth treated with SDF (eight teeth filled with composite and eight teeth filled with GI after 1 day and 14 days), the remaining 32 teeth without application of SDF served as a control group. All samples were then thermocycled and immersed in 2% methylene before being molded in epoxy resin to facilitate cutting into two sections. The dye penetration was then measured using a stereomicroscope at 20× magnification. Results: Overall model test showed statistical significant difference among study groups (P < 0.001). Post hoc test showed significant difference for usage of silver diamine fluoride (P < 0.001) and non-significant differences for type of restoration (P = 0.21) and time (P = 0.43). Conclusion: There was a significant reduction in microleakage following the usage of SDF before restoration over time.

Keywords: Composite resin, glass ionomer, microleakage, silver diamine fluoride


How to cite this article:
Jasim MZ, Khalaf MS. Comparison of Microleakage of Composite and Glass Ionomer Restorations in Primary Molars Pretreated with Silver Diamine Fluoride at Two Time Intervals: An In Vitro study. Dent Hypotheses 2022;13:145-8

How to cite this URL:
Jasim MZ, Khalaf MS. Comparison of Microleakage of Composite and Glass Ionomer Restorations in Primary Molars Pretreated with Silver Diamine Fluoride at Two Time Intervals: An In Vitro study. Dent Hypotheses [serial online] 2022 [cited 2023 Feb 5];13:145-8. Available from: http://www.dentalhypotheses.com/text.asp?2022/13/4/145/363433




  Introduction Top


Despite the fact that it is mostly avoidable, dental caries still is a significant oral health challenge in children.[1] Traditionally, carious lesions are treated clinically by removing the carious tissue and replacing it with an appropriate restorative material.[2] Silver diamine fluoride (SDF) is a topical fluoride which is often used in high concentration (38%) for preventing and halting dental caries.[3] It has been suggested that the chemical components of SDF give the following advantages: fluoride assists in remineralization and prevention, silver salts promote dentin sclerosis/calcification, and exhibit germicidal effect.[4] The dark staining effect on carious tissue is the most glaring drawback of silver compounds.[5] Applying a saturated solution of potassium iodide (KI) soon after the application of SDF has been recommended as a remedy to this issue.[6] The SDF at first applied to halt and prevent caries, after that the restoration is applied, which might be made of amalgam, composite, or glass ionomer (GI).[7] Thus, this in vitro study aimed to evaluate the microleakage of composite resin and self-cure glass ionomer restorations in primary molars when the restorations were applied at the same day of SDF treatment, and after 14 days.


  Materials and Methods Top


The ethical committee of the College of Dentistry/University of Baghdad (ref.no.553322 in Apr 17, 2022) approved the study protocol.

Sample preparation

By using G power 3.1.9.7 (http://www.gpower.hhu.de/) with 95% power, effect size of 0.61, and significance level at 0.05 the sample size was determined to be 64 primary molars. The teeth were numbered and randomly distributed by an independent person by using random number generator (TextMagic tool, https://freetools.textmagic.com/random-number-generator). The teeth were extracted for orthodontic reasons, late shedding, and should be with sound buccal and lingual surfaces.[8] Then they were placed in 0.1% thymol solution (M Dent, Nakhon Pathom, Thailand) for 24 hours[9] and stored for not more than 3 months in distilled water which was changed weekly.[10] An especially plastic mold was fabricated and elastomeric silicon impression material (HUGE Perfit, Rizhao, China) were placed inside it then teeth were mounted in the silicon with a level shorter than CEJ. Class V cavity with 3 mm width, 2 mm length, and 2 mm depth prepared on the buccal surface of these teeth by using a modified dental surveyor (Dentarum, Langhorne, PA, USA) with high speed handpiece attached to its arm in way that the bur (NTI, Kerr, CA, USA) perpendicular to the long axis of tooth. A digital caliper (Dentirak, Baghdad, Iraq) and periodontal probe were used to measure the depth and diameter of the cavity.[11]

Silver diamine fluoride treatment

For the experimental group 32 teeth treated with 38% silver diamine fluoride (Riva Star, SDI, Bayswater, Australia) according to the manufacturers instructions. All specimens were left for 3 minutes and then washed for 10 seconds with copious volumes of distilled water before being air dried for 10 seconds.[12] The remaining 32 teeth without application of 38% silver diamine fluoride served as control group.

Restorations placement

At first day, among 16 teeth that treated with SDF, 8 of them restored with composite (Aura bulk fill, SDI, Bayswater, Australia). Dentin bonding (self-etch universal, 3M, St. Paul, MN, USA) was applied according to manufacturer’s instructions, light cured for 20 seconds (Eighteeth, Changzhou, China) and then composite filling was applied and then cured for 40 seconds, after that the filling was finished and polished with a polishing bur (NTI CeraGlaze, Kerr, CA, USA). Another eight teeth restored with self-cure glass ionomer filling material (Riva, SDI, Bayswater, Australia) according to manufacturer’s instructions. Glass ionomer (GI) filling was also finished and polished. While the other 16 teeth not treated with SDF, eight of them restored with composite and eight restored with GI in the same manner. The remaining 16 teeth stored in artificial saliva which was refreshed daily. After 14 days, the teeth removed and cleaned and restored at the same manner.

Microleakage determination

A thermocycler device (Custom made, Baghdad, Iraq) was used for thermocycling to simulate the thermal changes that occur in the oral cavity and result in changes between cavity restoration and tooth surface. Thermocycling was carried out by soaking all specimens alternatively into (5–55 ± 1–2C) water bath chambers with 30 seconds immersion time in each bath and 10 seconds transition time for 500 cycles according to ISO/TS (E) 11405:2003.[13],[14] Then, all samples coated with two layers of nail polish (Golden rose, Istanbul, Turkey) except for 1 mm around the restoration margins, and submerged in 2% methylene blue dye (Zuhair Lab, Baghdad, Iraq) for 24 hours. The samples were then cleaned and dried under running water.[15] The samples were immersed in clear epoxy resin to form blocks with dimensions (3 × 2 × 1) cm; the teeth were then sectioned by using sectioning saw device (XP Precision sectioning saw, Ted Pella, CA, USA), and 0.01 mm disc (Ted Pella, CA, USA) with water coolant in bucco-lingual direction at the center of the filling into two sections.[16]

After that, microleakage represented by dye penetration was measured in millimeters (mm) by Optika Vision lite 2.1 software (OPTIKA, Ponteranica, Italy) using a stereomicroscope (KRÜSS, Hamburg, Germany) under (20×) magnification, the measurements were done by one calibrated operator blinded to treatment allocations. The image was taken for each tooth section by a camera (OPTIKA, Ponteranica, Italy) mounted on the stereomicroscope. Both sections were measured and the greatest microleakage was recorded.[17]

Statistical analysis

Data analysis was performed by the three-way ANOVA and the Tukey post hoc test using R software (R Foundation for Statistical Computing, Vienna, Austria). Data analysts were blinded to the type of restorations and time intervals.


  Results Top


Overall model test showed statistical significant difference among study groups (P < 0.001). Post hoc test showed significant difference for usage of SDF (P < 0.001) and non-significant differences for type of restoration (P = 0.21) and time (P = 0.43) [Figure 1].
Figure 1 Box and whisker plot showed microleakage (mm) among different study groups (SDF, silver diamine fluoride).

Click here to view



  Discussion Top


Because in vitro testing are still an essential tool for initial screening of dental materials and may establish a theoretical maximum amount of leakage that could be present in vivo, microleakage evaluation was carried out using an in vitro method.[18] Ideally, the preferred approach relies on multiple application of SDF, followed by placement of restoration, however there may be situations in which a practitioner will only be able to see the patient once.[19] If there is concern that the patient may not return to second visit for multiple application of SDF, or if a patient has large numbers of active lesion or particularly large lesion that is difficult to restore all teeth at single appointment, less time consuming techniques such as SDF with immediate filling placement may be considered.[20] Occluding dentinal tubules by the effect of SDF could explain why microleakage was reduced in experimental group, especially at 14 days’ interval that SDF had more time to work and occlude dentinal tubules and this came in agreement with Willershausen et al.,[21] who stated that pain was reduced after 1 week when they used SDF for dentin hypersensitivity when they measured the penetration of SDF by using scanning electron microscope (SEM).

However, the results of this study showed that there was significant reduction in microleakage following usage of SDF over time. This finding is in contrast with the report of Soliman et al.,[22] who found that there was no significant difference in microleakage of GI restorations between teeth treated and not treated with SDF when they use primary teeth in their study and Uzel et al.,[23] who also found that there was no significant difference in microleakage of composite resin restorations between teeth treated and not treated with SDF when they used third molars in their study. Likewise, Gupta et al.,[24] reported a non-significant difference in microleakage following usage of SDF for resin-modified glass ionomer restorations. Nevertheless, this controversy may be related to different formulations among commercially available SDF solutions. For instance, formulation of the Riva Star included potassium iodide in conjunction with SDF. Also in some studies such as Gupta et al.,[24] chlorhexidine gluconate was combined with SDF. Usage of negative ions of F in combination with positive ions of chlorhexidine is a controversial concern.[25]

Nevertheless, readers must note to the limitations of this study. The black staining after SDF treatment made a confusion during the microleakage measurement, it was hard to discarnate between black discoloration and methylene blue dye at tooth restoration interface. Other limitation of this study is limited sample size. Additionally, due to several factors relating to the oral environment, in vivo confirmation of the result is necessary.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pitts N, Amaechi B, Niederman R et al. Global oral health inequalities: dental caries task group-research agenda. Adv Dent Res 2011;23:211-20  Back to cited text no. 1
    
2.
Peng JJ, Botelho MG, Matinlinna JP. Silver compounds used in dentistry for caries management: a review. J Dent 2012;40:531-41.  Back to cited text no. 2
    
3.
Mei ML, Lo EC, Chu CH. Clinical use of silver diamine fluoride in dental treatment. Compend Contin Educ Dent 2016;37:93-8.  Back to cited text no. 3
    
4.
Rosenblatt A, Stamford TC, Niederman R. Silver diamine fluoride: a caries “ silver -fluoride bullet.” J Dent Res 2009;88:116-25.  Back to cited text no. 4
    
5.
Green E. A clinical evaluation of two methods of caries prevention in newly-erupted first permanent molars. Aust Dent J 1989;34:407-9.  Back to cited text no. 5
    
6.
Knight GM, McIntyre JM, Craig GG Mulyani. Ion uptake into demineralized dentine from glass ionomer cement following pretreatment with silver fluoride and potassium iodide. Aust Dent J 2006;51:237-41.  Back to cited text no. 6
    
7.
Zhao IS, Mei ML, Burrow MF, Lo EC, Chu CH. Effect of silver diamine fluoride and potassium iodide treatment on secondary caries prevention and tooth discolouration in cervical glass ionomer cement restoration. Int J Mol Sci 2017;18:340.  Back to cited text no. 7
    
8.
Nassaj AE, Ghadimi S, Seraj B, Chiniforush N. Effect of photodynamic therapy on microleakage of class V composite restorations in primary teeth. Photodiagnosis Photodyn Ther 2020;32:101964.  Back to cited text no. 8
    
9.
Lolayekar NV, Bhat SV, Bhat SS. Disinfection methods of extracted human teeth. J Oral Health Comm Dent 2007;1:27-9.  Back to cited text no. 9
    
10.
Alwan SQ, Al-Waheb AM. Effect of nano-coating on microleakage of different capsulated glass ionomer restoration in primary teeth: an in vitro study. Indian J Med Forensic Med Toxicol 2021;15:2674-84.  Back to cited text no. 10
    
11.
Masih S, Thomas AM, Koshy G, Joshi JL. Comparative evaluation of the microleakage of two modified glass ionomer cements on primary molars.An in vivo study. J Indian Soc Pedod Prev Dent 2011;29:135-9.  Back to cited text no. 11
[PUBMED]  [Full text]  
12.
Shimizu M, Matsui N, Sayed M et al. Micro-CT assessment of the effect of silver diammine fluoride on inhibition of root dentin demineralization. Dent Mater J 2021; 40:1041–48.  Back to cited text no. 12
    
13.
ISO I. TS 11405: 2015 Dentistry-Testing of Adhesion to Tooth Structure, Vol. 12. Geneva: International Organization for Standardization; 2015.  Back to cited text no. 13
    
14.
Pazinatto FB, Campos BB, Costa LC, Atta MT. Effect of the number of thermocycles on microleakage of resin composite restorations. Pesqui Odontol Bras 2003;17:337-41.  Back to cited text no. 14
    
15.
Abbood MH, Al-Hashimi RA. In vitro comparative assessment of composite nanoleakage using various dentine surface treatments. JBCD 2016;28:49-55.  Back to cited text no. 15
    
16.
Shruthi AS, Nagaveni NB, Poornima P, Selvamani M, Madhushankari GS, Subba Reddy F VV. Comparative evaluation of microleakage of conventional and modifications of glass ionomer cement in primary teeth: an in vitro study. J Indian Soc Pedod Prev Dent 2015;33:279-84.  Back to cited text no. 16
[PUBMED]  [Full text]  
17.
Bertrand MF, Semez G, Leforestier E, Muller-Bolla M, Nammour S, Rocca JP. Er: YAG laser cavity preparation and composite resin bonding with a single-component adhesive system: relationship between shear bond strength and microleakage. Lasers Surg Med 2006;38:615-23.  Back to cited text no. 17
    
18.
Fabianelli A, Pollington S, Davidson CL, Cagidiaco MC, Goracc C. "The relevance of microleakage studies. " Int Dent SA 2007;9:64-74.  Back to cited text no. 18
    
19.
Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc 2016;44:16-28.  Back to cited text no. 19
    
20.
Frachella JC. Stainless steel crowns. J Am Dent Assoc 2015;146:495-6.  Back to cited text no. 20
    
21.
Willershausen I, Schulte D, Azaripour A, Weyer V, Briseño B, Willershausen B. Penetration potential of a silver diamine fluoride solution on dentin surfaces. An ex vivo study. Clin Lab 2015;61:1695-1701.  Back to cited text no. 21
    
22.
Soliman Nada et al. Effect of silver diamine fluoride pretreatment on microleakage and shear bond strength of resin modified glass ionomer cement to primay dentin (in-vitro study). Alex Dent J 2021;46:151-6.  Back to cited text no. 22
    
23.
İlhan UZEL, Ozlem U, Dilsah C. The effect of silver diamine fluoride on microleakage of resin composite. J Int Dent Medical Res 2013;6:105-8.  Back to cited text no. 23
    
24.
Gupta J, Thomas MS, Radhakrishna M, Srikant N, Ginjupalli K. Effect of silver diamine fluoride-potassium iodide and 2% chlorhexidine gluconate cavity cleansers on the bond strength and microleakage of resin-modified glass ionomer cement. J Conserv Dent 2019;22:201.  Back to cited text no. 24
    
25.
Kolahi J, Soolari A. Rinsing with chlorhexidine gluconate solution after brushing and flossing teeth: a systematic review of effectiveness. Quintessence Int 2006;37:605-12.  Back to cited text no. 25
    


    Figures

  [Figure 1]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
References
Article Figures

 Article Access Statistics
    Viewed724    
    Printed26    
    Emailed0    
    PDF Downloaded71    
    Comments [Add]    

Recommend this journal