Dentin Discoloration and Pulpal Ion Concentrations Following Silver Diamine Fluoride and Potassium Iodide Treatment
The objective of this in vitro study was to evaluate the effects of potassium iodide on dentin discoloration and ion penetration into the pulp chamber after application of silver diamine fluoride (SDF). Proximal surfaces of extracted one-rooted sound human teeth were polished to obtain flat dentin and treated with 17% EDTA for two minutes. Each tooth was then fixed to a test tube. The specimens were distributed into five groups according to the treatment: SDF (Advantage Arrest, Elevate Oral Care); SDF-KI (SSKI, Upsher-Smith); RV-SDF (Riva Star, SDI); and RV-SDFKI. The CIE L*a*b* color value for each proximal dentin was assessed using a colorimeter (CR200, Konica-Minolta) at baseline, after two minutes, 10 minutes, and 24 hours, and ΔE compared to baseline was calculated. Subsequently, the water-filled tube was inverted to collect the ions that had penetrated from the tooth surface into the pulp chamber. Silver, iodide, and fluoride in the pulp were measured using trace element analysis (ISMat) and fluoride ion-selective electrode (Orion, Thermo Scientific) at days 1, 2, 7, and 14. Dentin in both SDF-KI groups showed no visual change in color whereas the groups using only SDF exhibited gradual staining. The time, the treatment and their interaction had a significant effect on ΔE (p<0.001). The fluoride concentrations at day 1 and day 14 for group SDF and KI were significantly lower compared to SDF (p=0.044). There was a difference between control groups and other groups in silver and iodine (p<0.05), whereas there was no significant difference among groups with treatment after 14 days (p>0.05). The application of KI after SDF treatment could significantly reduce the dentin staining. The pulpal fluoride concentration in the groups using SDF-KI was lower compared to the ones using SDF only, whereas there was no difference observed in iodide and silver among the groups with treatment.SUMMARY
Objective
Methods
Results
Conclusion
Methodology of the study. A. Color measurement. B. Evaluation of fluoride, iodine, and silver in the pulp.
Photographs of color change of treated dentin of the groups.
Color change ΔE of the groups. There was a significant difference between the groups using SDF and the ones using both SDF and KI (p<0.05).
Pulp fluoride concentrations in the groups.
Contributor Notes
Clinical Relevance
Potassium iodide (KI) significantly decreased dentin discoloration and pulpal fluoride concentration during use of silver diamine fluoride (SDF). Silver and iodide were detected in the pulp of the treatment groups. The range of pulpal ion concentration in this in vitro study is within the safety limit.