Dentaltown July 2024 - 40

Figs. 4 and 5: Clinical aspect of the reminiscent aff ected
tissues before and after treatment with SDF.
A possibility to avoid or minimize
stained margins when opting for a
glass ionomer restoration would be to
use a chemically cured glass ionomer
instead of a light-cured one.
Th ere are two primary strategies for
combining SDF treatment with resin
composite restoration:
* Multiple-appointment
approach. Th is involves waiting
two to four weeks after the fi nal
SDF application before proceeding
with resin composite restoration.
To mask the darkened
dentin in aesthetically sensitive
areas, an opaque restorative
material such as traditional GIC
can be used either for the entire
restoration or as a base layer in a
sandwich technique. An opaque
resin-modifi ed glass ionomer
liner is another option to cover
dark axial or pulpal dentin before
applying a more translucent resin
composite.
* Same-day SDF-resin approach.
In this scenario, SDF treatment
and resin composite restoration
occur in the same appointment.
It's crucial to rinse off the SDF
before proceeding with bonding
to prevent silver staining,
especially near the margins.
Employing a short burst (1-2 seconds)
of a " tac " -style curing light
after SDF application and rinsing
can help reveal and then selectively
and conservatively remove
residual silver-stained areas at the
enamel margins while keeping the
internally stained arrested dentin
on axial/pulpal walls. Th is step
may need to be repeated to eliminate
visible silver staining at the
preparation's margins before proceeding
with opaque layering and
restoration as described (Figs. 4
and 5). A 2018 study by Mei et al.2
investigated the discoloration of
dental hard tissues and restorative
materials after SDF application.
Th e research highlighted the
importance of clean margins in
preventing discoloration, supporting
the proposed strategy.
When choosing resin composite
as the restorative material on an
aesthetic display area, it's generally
recommended to arrest caries with
SDF fi rst and restore in a subsequent
appointment for optimal results.
For immediate restorations after
SDF application, a chemically cured
GIC might be preferred because of its
JULY 2024 | 40 | DENTALTOWN.COM
compatibility and the aesthetic considerations
detailed earlier.
Concluding remarks
When deciding between GIC and
composite restorations after SDF
treatment, it's crucial to approach
the process with a comprehensive
understanding of the clinical scenario.
Th is entails a thorough assessment
that considers several key factors,
ultimately guiding us toward the most
appropriate choice for optimal patient
outcomes. Th e evaluation should consider
the restoration's location within
the oral cavity, the aesthetic requirements
desired, the patient's specifi c
caries risk profi le and the functional
demands placed on the restoration.
Each element plays a pivotal role in
determining the most suitable material
for the restoration.
GICs present advantages in scenarios
where moisture control poses
challenges, particularly in patients
at high risk for caries development.
Additionally, their fl uoride-release
properties and biocompatibility
make them advantageous for nonload-bearing
areas, contributing to
preventive eff orts and promoting a
healthy oral environment.
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