International journal of clinical pediatric dentistry · 2026
Effectiveness of Tooth-colored Restorative Materials in Masking Discoloration Caused by Silver Diamine Fluoride: A Systematic Review of In Vitro Studies.
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Mathur Anmol, Chaudhary Yeshtha, Shekhar Soumya
Аннотация
AIMS AND BACKGROUND: Silver diamine fluoride (SDF) is a minimally invasive and cost-effective agent widely used for caries arrest, particularly in pediatric dentistry. However, its primary drawback is the irreversible black discoloration it causes on the SDF-treated surfaces, limiting its acceptance in esthetically sensitive regions.The purpose of this systematic review was to examine and compare the effectiveness of different tooth-colored restorative materials in masking the discoloration on surfaces treated with SDF.
MATERIALS AND METHODS: A thorough literature search was performed using Google Scholar, PubMed Central (PMC), and Scopus databases up to March 2025. In vitro studies evaluating color masking using restorative materials such as glass ionomer cement (GIC), resin-modified GIC (RMGIC), composite resin, Cention N, giomer, and combinations with potassium iodide (KI) or opaquer systems over SDF-treated teeth were included. The primary outcomes assessed were ΔE (CIELAB), ΔL (brightness), and gray values. Risk of bias was evaluated using the Quality Assessment Tool for In Vitro Studies (QUIN Tool).
RESULTS: A total of nine in vitro studies fulfilled the inclusion criteria. Composite resins consistently demonstrated superior esthetic outcomes, especially when placed after a delay or combined with opaquer systems (ΔE = 1.66-8.01). GIC showed poor masking ability, with ΔE values as high as 105. Among GIC variants, zirconia-reinforced GIC performed better (ΔE = 6.00), while RMGIC showed variable results. The use of KI yielded mixed outcomes, improving esthetics with composites but often worsening them with RMGIC and Zr-GIC. Long-term stability of composites was confirmed through aging and thermocycling protocols.
CONCLUSION: Composite resin, especially when combined with opaquer or used with delayed placement, appears to be the most effective material for masking SDF-induced discoloration. However, findings are based on in vitro studies, highlighting the need for well-designed in vivo research to validate clinical application.
CLINICAL SIGNIFICANCE: This study offers evidence-based insights into the most effective restorative material to mask SDF-induced discoloration without compromising the caries-arresting property of SDF, aiding clinicians in making well-informed decisions about the selection of restorative material and timing of restoration, ultimately improving patient acceptance of SDF treatment.
HOW TO CITE THIS ARTICLE: Mathur A, Chaudhary Y, Shekhar S. Effectiveness of Tooth-colored Restorative Materials in Masking Discoloration Caused by Silver Diamine Fluoride: A Systematic Review of In Vitro Studies. Int J Clin Pediatr Dent 2026;19(2):262-270.
MATERIALS AND METHODS: A thorough literature search was performed using Google Scholar, PubMed Central (PMC), and Scopus databases up to March 2025. In vitro studies evaluating color masking using restorative materials such as glass ionomer cement (GIC), resin-modified GIC (RMGIC), composite resin, Cention N, giomer, and combinations with potassium iodide (KI) or opaquer systems over SDF-treated teeth were included. The primary outcomes assessed were ΔE (CIELAB), ΔL (brightness), and gray values. Risk of bias was evaluated using the Quality Assessment Tool for In Vitro Studies (QUIN Tool).
RESULTS: A total of nine in vitro studies fulfilled the inclusion criteria. Composite resins consistently demonstrated superior esthetic outcomes, especially when placed after a delay or combined with opaquer systems (ΔE = 1.66-8.01). GIC showed poor masking ability, with ΔE values as high as 105. Among GIC variants, zirconia-reinforced GIC performed better (ΔE = 6.00), while RMGIC showed variable results. The use of KI yielded mixed outcomes, improving esthetics with composites but often worsening them with RMGIC and Zr-GIC. Long-term stability of composites was confirmed through aging and thermocycling protocols.
CONCLUSION: Composite resin, especially when combined with opaquer or used with delayed placement, appears to be the most effective material for masking SDF-induced discoloration. However, findings are based on in vitro studies, highlighting the need for well-designed in vivo research to validate clinical application.
CLINICAL SIGNIFICANCE: This study offers evidence-based insights into the most effective restorative material to mask SDF-induced discoloration without compromising the caries-arresting property of SDF, aiding clinicians in making well-informed decisions about the selection of restorative material and timing of restoration, ultimately improving patient acceptance of SDF treatment.
HOW TO CITE THIS ARTICLE: Mathur A, Chaudhary Y, Shekhar S. Effectiveness of Tooth-colored Restorative Materials in Masking Discoloration Caused by Silver Diamine Fluoride: A Systematic Review of In Vitro Studies. Int J Clin Pediatr Dent 2026;19(2):262-270.