Clinical and Radiographic Evaluation of Deep Occlusal Carious Molars Treated with Partial Caries Removal with And Without Using Silver Diamine Fluoride (SDF) + Potassium Iodine (KI) Prior to Resin Composite Restoration. A Randomized Clinical Trial

mai Mamdouh Akah,*
laila akmal elokaly,
heba salah eldien Hamza,
essam abdelhafez naguib

Abstract

Background: Dental caries is considered the most widespread human disease. Caries arrest therapy is now being marketed as a component of the essential dental care regimen. Researchers and dental clinicians are paying close attention to silver diamine fluoride (SDF), one of the antibacterial agents, for its ability to stop active caries. Aim: This study aimed to evaluate the effect of SDF+KI in maintaining pulp health, dentin bridge formation, and remineralization after partial caries removal in permanent teeth that were evaluated clinically and radiographically after different follow-up periods. Methods and Materials: Eighty teeth having deep occlusal carious lesions from 70 participants between the age 18-50 years were randomly divided into two groups: Group 1 (n= 40) using 38 %SDF+KI, while Group 2 (n= 40) using Resin Modified Glass Ionomer Cement (RMGIC). Soft deep caries was removed by low-speed handpiece and spoon excavators, then the teeth were evaluated radiographically. The teeth were evaluated at baseline and were compared at 6,12 months after the application to assess the vitality of the pulp, postoperative pain, dentin bridge formation, and remineralization by using intraoral periapical radiograph using Diagora TM Optime, and pixel grey values were measured using Diagora for window software. Results: There was no statistically significant difference between the two groups in success rate and remineralization after a 6,12-month follow-up period (P ≤ 0.05). Regarding the dentin bridge formation, the SDF +KI showed better results, but there wasn't a significant difference between the two groups. Conclusion: With or without 38% SDF+ KI application, the glass ionomer had remineralization potentials on the carious dentine and tertiary dentine formation. SDF gave better dentin bridge formation, indicating a good future in caries arrest.