Effect of silver diamine fluoride with or without potassium iodide treatment on retention of composite resin restorations in carious primary molars- a randomized clinical trial.

OBJECTIVE: To compare the retention of composite resin restorations (CRR) in carious primary molars after application of silver diamine fluoride (SDF) with and without potassium iodide (SSKI oral solution).

METHODS: 150 children (age 4-9 years) with carious primary molars were randomised to one of the three interventions-Group A: 38% SDF application followed by KI and CRR; Group B: only 38% SDF application followed by CRR; Group C: CRR alone. Restorations were evaluated at 6 and 12 months using modified USPHS criteria. Primary outcome was the retention of restorations, while colour match, marginal discoloration and secondary caries were the secondary outcomes. Fisher's exact test was used for the comparison of the outcomes between the groups.

RESULTS: 150 restorations (50 in each group) were performed. At 12 months, completely retained restorations were observed in 38 (76%), 37 (74%) and 36 (72%) teeth in Group A, B and C respectively, with no significant difference between the groups (p = 0.53). Colour match and marginal discoloration differed significantly between groups (p < 0.001). No significant difference was observed with respect to secondary caries (p = 0.78).

CONCLUSION: SDF application with or without KI did not adversely affect the retention of composite resin restorations in primary molars over a 12-month period. Restorations after application of SDF with KI demonstrated better aesthetics as compared to SDF treated teeth.

CLINICAL SIGNIFICANCE: SDF may be incorporated into caries management protocols prior to composite restoration in primary molars without compromising the retention. The use of SSKI following SDF application can improve the aesthetics.