Nano-Silver Fluoride versus SDF/KI on Caries-Affected Dentin: Bond Strength of a Universal Adhesive and a Glass-Hybrid Restorative, and Color Change
Abstract
Silver diamine fluoride (SDF) arrests caries but blackens dentin and may weaken adhesion; potassium iodide (KI) only partly prevents the stain. Nano-silver fluoride (NSF) has been proposed as a non-staining alternative, yet little is known about how it affects bonding to caries-affected dentin (CAD). This in vitro study compared SDF/KI and NSF pretreatment of CAD in terms of micro-shear bond strength (µSBS) of a universal adhesive with resin composite (UA) and a glass-hybrid restorative (GH), and of color change. NSF was characterized by XRD, FTIR and FESEM. Dentin discs from human molars were left sound (SD) or pH-cycled for 14 days to produce CAD, which was left untreated or treated with SDF/KI or NSF (n = 10 per subgroup). Micro-cylinders of UA or GH were tested after 24 h or after 10,000 thermal cycles, and the color change (ΔE00) of treated CAD discs was followed for four weeks. Pretreatment, material, aging and their two-way interactions were all significant (three-way ANOVA, p ≤ 0.013). With UA at 24 h, NSF (17.68 ± 2.44 MPa) did not differ from untreated CAD (16.00 ± 2.82 MPa), whereas SDF/KI was lower (13.67 ± 2.53 MPa; p = 0.024 versus NSF). With GH, the three CAD pretreatments did not differ. Thermocycling reduced all bonds by 10–25%. ΔE00 of SDF/KI rose from 3.70 to 12.94 over four weeks, far beyond the acceptability threshold of 1.8, while NSF stayed between 1.59 and 2.81. NSF therefore preserves bonding to CAD and avoids the progressive darkening seen with SDF/KI.
Downloads
References
2. Zou J, Du Q, Ge L, Wang J, Wang X, Li Y, Song G, Zhao W, Chen X, Jiang B, Mei Y, Huang Y, Deng S, Zhang H, Li Y, Zhou X. Expert consensus on early childhood caries management. International Journal of Oral Science. 2022;14(1):35. https://doi.org/10.1038/s41368-022-00186-0
3. Karadas M, Bedir F, Demirbuga S. The role of etching protocols on bond strength of universal adhesives applied to caries affected dentin: a systematic review and meta-analysis. Clinical Oral Investigations. 2024;28(12):683. https://doi.org/10.1007/s00784-024-06089-0
4. Cetin Tuncer N, Barutcugil C. One-year evaluation of microtensile bond strength of universal adhesives in self-etch or etch and rinse modes to dentin groups at different caries-affected degree. International Journal of Adhesion and Adhesives. 2025;138:103919. https://doi.org/10.1016/j.ijadhadh.2024.103919
5. Jamal D, AlMushayt A, Abujamel T, Bamashmous S, Bamashmous N, Alamoudi N. Silver diamine fluoride: the science behind the action – a narrative review. BMC Oral Health. 2025;25(1):1195. https://doi.org/10.1186/s12903-025-06107-x
6. Haiat A, Ngo HC, Samaranayake LP, Fakhruddin KS. The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: a systematic review. PLOS ONE. 2021;16(6):e0252734. https://doi.org/10.1371/journal.pone.0252734
7. Detsomboonrat P, Thongmak P, Lertpayab P, Aiemsri W, Sooampon S. Optimal concentration of potassium iodide to reduce the black staining of silver diamine fluoride. Journal of Dental Sciences. 2022;17(1):300-307. https://doi.org/10.1016/j.jds.2021.03.014
8. Xu GY, Yin IX, Zhao IS, Lung CYK, Lo ECM, Chu CH. Minimizing tooth discoloration caused by topical silver diamine fluoride application: a systematic review. Journal of Dentistry. 2024;150:105353. https://doi.org/10.1016/j.jdent.2024.105353
9. Jiang M, Mei ML, Wong MCM, Chu CH, Lo ECM. Effect of silver diamine fluoride solution application on the bond strength of dentine to adhesives and to glass ionomer cements: a systematic review. BMC Oral Health. 2020;20(1):40. https://doi.org/10.1186/s12903-020-1030-z
10. Fröhlich TT, Rocha RO, Botton G. Does previous application of silver diammine fluoride influence the bond strength of glass ionomer cement and adhesive systems to dentin? Systematic review and meta-analysis. International Journal of Paediatric Dentistry. 2020;30(1):85-95. https://doi.org/10.1111/ipd.12571
11. Arnaud M, Junior PCM, Lima MGS, e Silva AVC, Araújo JT, Galembeck A, de França Caldas Júnior A, Rosenblatt A. Nano-silver fluoride at higher concentration for caries arrest in primary molars: a randomized controlled trial. International Journal of Clinical Pediatric Dentistry. 2021;14(2):207-211. https://doi.org/10.5005/jp-journals-10005-1920
12. Quritum M, Abdella A, Amer H, El Desouky LM, El Tantawi M. Effectiveness of nanosilver fluoride and silver diamine fluoride in arresting early childhood caries: a randomized controlled clinical trial. BMC Oral Health. 2024;24(1):701. https://doi.org/10.1186/s12903-024-04406-3
13. Shetty PJ, Mithra P, Minhaz R, Shetty P, Nanukuttan A. Effectiveness of nanosilver fluoride in arresting dental caries in children with one-year follow-up – a systematic review. Evidence-Based Dentistry. 2024;25(3):164. https://doi.org/10.1038/s41432-024-00995-8
14. Espíndola-Castro LF, Rosenblatt A, Galembeck A, Monteiro GQM. Dentin staining caused by nano-silver fluoride: a comparative study. Operative Dentistry. 2020;45(4):435-441. https://doi.org/10.2341/19-109-l
15. Yin IX, Zhao IS, Mei ML, Lo ECM, Tang J, Li Q, So LY, Chu CH. Synthesis and characterization of fluoridated silver nanoparticles and their potential as a non-staining anti-caries agent. International Journal of Nanomedicine. 2020;15:3207-3215. https://doi.org/10.2147/ijn.s243202
16. Silva LAS, Santos ACL, Espíndola-Castro LF, Alves ALC, de Almeida Durão M, de Andrade MCM, Galembeck A, de Melo Monteiro GQ. Effect of nano silver fluoride pre-treatment on the microtensile bond strength of a universal adhesive to dentin: an in vitro study. Biomaterial Investigations in Dentistry. 2026;13:198-205. https://doi.org/10.2340/biid.v13.45648
17. Das A, Ramamurthy N, Srinivasan I, Milit Y. Assessment of nanosilver fluoride application on the microtensile bond strength of glass ionomer cement and resin-modified glass ionomer cement on primary carious dentin: an in vitro study. International Journal of Clinical Pediatric Dentistry. 2024;17(5):565-569. https://doi.org/10.5005/jp-journals-10005-2863
18. Mubarak MK, Allam GG, Aboushady NA. Effect of nanosilver fluoride versus silver diamine fluoride on shear bond strength and color change of resin-modified glass ionomer cement bonded to artificial dentin caries: an in-vitro study. BMC Oral Health. 2026;26(1):742. https://doi.org/10.1186/s12903-026-08294-7
19. Zuluaga-Morales JS, Bolaños-Carmona MV, Cifuentes-Jiménez CC, Álvarez-Lloret P. Chemical, microstructural and morphological characterisation of dentine caries simulation by pH-cycling. Minerals. 2021;12(1):5. https://doi.org/10.3390/min12010005
20. Rinsathon J, Wiriyasuebpong S, Thariya K, Jiradechochai P, Phetsuk P, Bouanil S, Saikaew P, Pawaputanon Na Mahasarakham C. Bonding performance of glass ionomer cement to carious dentin treated with different surface treatment protocols using silver diamine fluoride. Scientific Reports. 2023;13(1):14371. https://doi.org/10.1038/s41598-023-41511-9
21. Szczesio-Wlodarczyk A, Sokolowski J, Kleczewska J, Bociong K. Ageing of dental composites based on methacrylate resins—a critical review of the causes and method of assessment. Polymers. 2020;12(4):882. https://doi.org/10.3390/polym12040882
22. Bakhsh TA, Turkistani A. The effect of thermocycling on interfacial bonding stability of self-etch adhesives: OCT study. BioMed Research International. 2021;2021:5578539. https://doi.org/10.1155/2021/5578539
23. Ismail AM, Bourauel C, ElBanna A, Salah Eldin T. Micro versus macro shear bond strength testing of dentin-composite interface using chisel and wireloop loading techniques. Dentistry Journal. 2021;9(12):140. https://doi.org/10.3390/dj9120140
24. Tejada-Casado M, Herrera LJ, Carrillo-Perez F, Ruiz-López J, Ghinea RI, Pérez MM. Exploring the CIEDE2000 thresholds for lightness, chroma, and hue differences in dentistry. Journal of Dentistry. 2024;150:105327. https://doi.org/10.1016/j.jdent.2024.105327
25. Pérez MM, Carrillo-Perez F, Tejada-Casado M, Ruiz-López J, Benavides-Reyes C, Herrera LJ. CIEDE2000 lightness, chroma and hue human gingiva thresholds. Journal of Dentistry. 2022;124:104213. https://doi.org/10.1016/j.jdent.2022.104213
26. Bharathi D, Nandagopal JGT, Lee J, Ranjithkumar R. Facile synthesis and characterization of chitosan functionalized silver nanoparticles for antibacterial and anti-lung cancer applications. Polymers. 2023;15(12):2700. https://doi.org/10.3390/polym15122700
27. Ediyilyam S, Lalitha MM, George B, Shankar SS, Wacławek S, Černík M, Padil VVT. Synthesis, characterization and physicochemical properties of biogenic silver nanoparticle-encapsulated chitosan bionanocomposites. Polymers. 2022;14(3):463. https://doi.org/10.3390/polym14030463
28. Alvarez-Marín CA, Robles-Bermeo NL, Scougall-Vilchis RJ, Morales-Luckie RA, González-Pedroza MG, Lovera-Rojas N. Antibacterial effect of nanosilver fluoride and silver diamine fluoride against Streptococcus mutans: an in vitro study. Applied Nano. 2026;7(2):14. https://doi.org/10.3390/applnano7020014
29. Matijević J, Ivanišević A, Janković B, NujićRadin I, Lerotić J, Klarić E. The effect of silver diamine fluoride and potassium iodide on the bond strength of self-etch and universal adhesives on sound dentin. Applied Sciences. 2026;16(3):1520. https://doi.org/10.3390/app16031520
30. Shirani F, Ravanbod S, Sehat MS. Impact of silver diamine fluoride on composite resin bond strength: an in vitro study with various adhesive systems. Heliyon. 2025;11(2):e41731. https://doi.org/10.1016/j.heliyon.2025.e41731
31. Piyasanti A, Thariya K, Jiradechochai P, Saikaew P, Pawaputanon Na Mahasarakham C. The performance of silver diamine fluoride on bond strength and ultramorphology of universal adhesive to artificial carious dentin under thermocycling conditions. Clinical Oral Investigations. 2025;29(5):225. https://doi.org/10.1007/s00784-025-06304-6
32. Keskin G, UçarGündoğar Z, Yaman M, Tek GB. Bond strength of ion-releasing restorative materials to sound and caries-affected dentin. Journal of Clinical Pediatric Dentistry. 2021;45(1):29-34. https://doi.org/10.17796/1053-4625-45.1.6
33. AbedinzadeZare A, Vafadar M, Behroozibakhsh M, Hashemian A, Lari M, Abtahi S. Effect of ammonia-free silver fluoride and silver diammine fluoride on immediate microshear bond strength of resin-modified glass ionomer to demineralised primary tooth dentine. European Archives of Paediatric Dentistry. 2026;27(5):1573-1583. https://doi.org/10.1007/s40368-026-01242-7
34. Abdelshafi MA, Soliman HAN, Abdelaziz D. Bond strength durability of three bioactive restorative materials to silver diamine fluoride treated artificially demineralized dentine. BMC Oral Health. 2025;25(1):1193. https://doi.org/10.1186/s12903-025-06552-8
35. Šalinović I, Bilić-Prcić M, Bota M, Ivica A, Miletić I. Microhardness recovery and micromorphology of demineralized dentin restored with modified glass hybrid material. Materials. 2026;19(9):1733. https://doi.org/10.3390/ma19091733
36. Kitahara S, Shimizu S, Takagaki T, Inokoshi M, Abdou A, Burrow MF, Nikaido T. Dentin bonding durability of four different recently introduced self-etch adhesives. Materials. 2024;17(17):4296. https://doi.org/10.3390/ma17174296
37. Ashour DG, Ashour AG, El Naggar R. Evaluation of microtensile bond strength and failure type analysis of two different types of universal dental adhesives. In vitro study. BMC Oral Health. 2026;26(1):1195. https://doi.org/10.1186/s12903-026-08772-y
38. Hamdy D, Giraki M, Abd Elaziz A, Badran A, Allam G, Ruettermann S. Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars. BMC Oral Health. 2021;21(1):337. https://doi.org/10.1186/s12903-021-01697-8
39. Sabbagh S, Movahhed T, Bagheri H, Sadeghi M, Shahid S, Mohammadi H. Color change of tooth-colored restorative materials bonded to silver diamine fluoride-treated dentine: a systematic review. BMC Oral Health. 2024;24(1):737. https://doi.org/10.1186/s12903-024-04487-0
40. Kongyodsueb P, Poolthong S, Chumprasert S, Sae-ear P, Tantilertanant Y. The effect of silver nanoparticles in addition to sodium fluoride on remineralization of artificial root dentin caries. Australian Dental Journal. 2024;69(1):56-66. https://doi.org/10.1111/adj.12985
41. Bolenwar A, Reche A, Dhamdhere N, Rathi S. Applications of silver nanoparticles in dentistry. Cureus. 2023;15(8):e44090. https://doi.org/10.7759/cureus.44090
42. Bona Matos A, Reis M, Alania Y, Wu CD, Li W, Bedran-Russo AK. Comparison of collagen features of distinct types of caries-affected dentin. Journal of Dentistry. 2022;127:104310. https://doi.org/10.1016/j.jdent.2022.104310

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

.