Does silver diamine fluoride compromise adhesion of restorative materials in dentin of primary teeth? A systematic review and meta-analysis.

OBJECTIVES

This systematic review and meta-analysis evaluated the influence of silver diamine fluoride (SDF) on the bond strength of glass ionomer cement (GIC) and resin composites to sound and carious primary dentin.

MATERIALS AND

METHODS

In vitro studies assessing the bond strength of GIC or resin composites to SDF-treated primary dentin were included. Risk of bias was evaluated using the Quality Assessment Tool for In Vitro Studies. Standardized mean difference (SMD) was calculated using RevMan 5.3, with heterogeneity assessed via Q and I² statistics. Subgroup analyses investigated rinsing protocols and dentin conditions.

RESULTS

Twenty-two studies were included, of which 19 contributed to the meta-analysis. Overall, SDF had no effect on the bond strength of GIC and resin composite. Rinsed SDF did not influence the bonding of GIC. Unrinsed SDF increased the bond strength of GIC to sound dentin and decreased the bond strength to carious dentin. For resin composites, SDF did not affect adhesion to sound dentin or carious dentin, regardless of rinsing.

CONCLUSIONS

Pretreatment with SDF does not compromise the adhesion of GIC and resin, but for GIC it may be affected depending on the dentin substrate and rinsing protocols.