European Archives of Paediatric Dentistry

, Volume 19, Issue 6, pp 411–416 | Cite as

Effect of silver diamine fluoride on adhesion and microleakage of a pit and fissure sealant to tooth enamel: in vitro trial

  • J. Pérez-Hernández
  • F. C. Aguilar-DíazEmail author
  • R. D. Venegas-Lancón
  • C. A. Á. Gayosso
  • M. C. Villanueva-Vilchis
  • J. de la Fuente-Hernández
Original Article



To identify the effect of silver diamine fluoride in adhesion and microleakage of a pit and fissure sealant to tooth enamel.


An in vitro study including 120 human molars without caries, and caries grade 1 was performed. Molars were randomly divided into four groups. Occlusal surfaces of groups 2 and 4 were sealed. In groups 1 and 3 silver diamine fluoride (SDF) was placed in the occlusal surface and then molars were sealed according to manufacturer’s instructions. Afterwards, all groups were submitted to the adhesion test. Groups 1 and 2 were placed in a forming cylinder and their roots were submerged in polymethyl methacrylate after that they were stored in deionised water (37 °C ± 1). Subsequently, they were tested by applying a tractional load (Instron machine, speed cross of 1 mm/min). Sealant adhesion was evaluated through: Resistance to the detachment (MPa), residues of sealant area (mm2) and adhesive remaining index (ARI) (0–3 interval). Microleakage test: Groups 3 and 4 were placed in a plastic container and subjected to 2000 cycles at different temperatures one at 6 °C ± 1 and the other at 60 °C ± 1. Later the occlusal surface was immersed for 24 h in 1% toluidine blue. Microleakage was observed by optical microscopy (10×) and was interpreted in micrometres.


Of the samples without SDF 18.1 and 23.0% of the sealant remaining and of the samples with SDF present 100% of sealant remaining on enamel. Samples with SDF obtained an average in the test of detachment of 6.89 ± 3.09 MPa, whereas in the group without SDF the average obtained was 6.42 ± 3.35 MPa. Differences were not statistically significant (p = 0.579). Most of the samples not treated with SDF (81.6%) showed microleakage than those treated with SDF in which 47% presented microleakage.


There is an improvement in the retention properties of a fissure sealant applied after treatment with silver diamine fluoride. The application of fissure sealant to improve the aesthetics of teeth treated with SDF is recommended.


Pit and fissure sealant Silver diamine fluoride Adhesion Microleakage 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Baroudi K, Rodrigues J. Flowable resin composites: a systemic review and clinical considerations. J Clin Diagn Res. 2015;9:ZE18–24.PubMedPubMedCentralGoogle Scholar
  2. Borsatto M, Yamamoto M, Gimatei M, et al. Bonding agent underneath sealant: shear bond strength to oil-contaminated enamel. Braz Den J. 2010;21:50–4.CrossRefGoogle Scholar
  3. Chu C-H, Lee AH, Zheng L, et al. Arresting rampant dental caries with silver diamine fluoride in young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report. BMC Res Notes. 2014;7:3.CrossRefGoogle Scholar
  4. Clu C, Lo E. Promoting caries arrest in children with silver diamine fluoride. Oral Health Prev Dent. 2015;6:315–21.Google Scholar
  5. Craig G, Knight G. Clinical evaluation of silver fluoride/ potassium iodide as a dentine desensitizing agent. A pilot study. Aust Dent J. 2012;57:308–11.CrossRefGoogle Scholar
  6. dos Santos VE, de Vasconcelos F, Ribeiro AG, et al. Paradigm Shift in the effective treatment of caries in school children at risk. Int Dent J. 2012;62:47–51.CrossRefGoogle Scholar
  7. Futatsuky M, Kubota K, Yeh YC, et al. Early loss of pit and fissure sealant: a clinical and SEM study. J Clin Pediatr Dent. 1995;19:99–104.Google Scholar
  8. Gao SS, Zhao IS, Hiraishi N, et al. Clinical trials of silver diamine fluoride in arresting caries among children: a systematic review. JDR Clin Transl Res. 2016;1:201–10.CrossRefGoogle Scholar
  9. Gotjamanos T, Alfonso F. Unacceptably high levels of fluoride in commercial preparations of silver fluoride. Aust Dent J. 1997;42:52–3.CrossRefGoogle Scholar
  10. Horst JA, Ellenikiotis H, Milgrom PL. UCSF Protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. J Calif Dent Assoc. 2016;44(1):16–28.PubMedPubMedCentralGoogle Scholar
  11. Joshi K, Dave B, Joshi N, et al. Comparative evaluation of two different pit and fissure sealants and a restorative material to check their microleakage- an in vitro study. J Int Oral Heath. 2013;5:35–9.Google Scholar
  12. Kassebaum N, Bernabé E, Dahiya M, et al. Global burden of untreated caries: a systematic review and metaregression. J Den Res. 2015;94:650–8.CrossRefGoogle Scholar
  13. Kenneth J. Anusavice. Ciencia de los materiales dentales. Madrid: Elsever; 2004. pp. 53–5.Google Scholar
  14. Komatsu H, Shimokobe H, Kawakami S, et al. Caries preventive effect of glass ionomer sealant reapplication; Study presents three-year results. J Am Dent Assoc. 1994;125:543–9.CrossRefGoogle Scholar
  15. Mei M, Chu C, Lo E. Fluoride and silver concentrations of silver diamine fluoride solutions for dental use. Int J Paediatr Dent. 2013a;23:279–85. Scholar
  16. Mei M, Chu C, Low K, et al. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cir Bucal. 2013b;1;18:e824–31.CrossRefGoogle Scholar
  17. Mei ML, Ito L, Cao Y, et al. Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent. 2013c;41(9):809–17. Scholar
  18. Mei M, Li Q, Chu C, et al. Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Ann Clin Microbiol Antimicrob. 2013d;26:12:4.CrossRefGoogle Scholar
  19. Mei M, Ito L, Cao Y, et al. The inhibitory effects of silver diamine fluoride on cysteine cathepsins. J Dent. 2014;42(3):329–35. Scholar
  20. Monse B, Heinrich- Weltzien R, Mulder J, et al. Caries preventive efficacy of silver diamine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines. BMC Oral Health. 2012;21:12:52. Scholar
  21. Morales E, Martinez A, Hernández J, et al. Evaluation of marginal seal and microleakage of a sealant modified with silver nanoparticles in primary molars in vitro study. ODOVTOS. Int J Dent. 2014;16:107–13. Scholar
  22. Nantanee R, Santiwong B, Trairatvoeakul C, et al. Silver diamine fluoride and glass ionomer differentially remineralize early caries lesions in situ. Clin Oral Investig. 2016;20(6):1151–7. Scholar
  23. O´Brien KD, Watts DC, Read MJ. Residual debris and bond strength- is there a relationship. Am J Orthod Dentofac Orthop. 1988;94:222–30.CrossRefGoogle Scholar
  24. Peg J, Botelho M, Matinlinna J. Silver compounds used in dentistry for caries management: a review. J Dent. 2012;40:531–41.CrossRefGoogle Scholar
  25. Quock RL, Barros JA, Yang SW, et al. Effect of silver diamine fluoride on microtensile bond strength to dentin. Oper Dent. 2012;37:610–6.CrossRefGoogle Scholar
  26. Rosenblatt A, Stamford TCM, Niederman R. Silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res. 2009;88(2):116–25.CrossRefGoogle Scholar
  27. Shama G, Puranik MP. KRS. Approaches to arresting dental caries: an update. J Clin Diagn Res. 2015;9:8–11.Google Scholar
  28. Soeno K, Taira Y, Matsumura H. Effect of desensitizers on bond strength of adhesive luting agents to dentin. J Oral Rehabilitation. 2001;28:1122–8.CrossRefGoogle Scholar
  29. Suzuki T, Nishida M, Sobue S, et al. Effects of diamine silver fluoride on tooth enamel. J Osaka Univ Dent Sch. 1974;14:61–72.PubMedGoogle Scholar
  30. Uzuel I, Ulukent O, Cogulu D. The effect of silver diamine fluoride on microleakage of resin composite. J Int Dent Med Res. 2013;6:105–8.Google Scholar
  31. World Health Organization. Oral health surveys. Basic methods. 3rd. Suiza: Geneve; 1987.Google Scholar
  32. Wu D, Velamakanni S, Denisson J, et al. Effect of silver diamine fluoride application on microtensile bonding strength of dentin in primary teeth. Pediatr Dent. 2016;38:148–53.PubMedGoogle Scholar
  33. Yee R, Holmgren C, Mulder J, et al. Efficacy of silver diamine fluoride for arresting caries treatment. J Dent Res. 2009;88:644–7.CrossRefGoogle Scholar
  34. Yeolekar T, Chowdhary N, Mukunda K, et al. Evaluation of microleakage and marginal ridge fracture resistence of primary molars restored with three restorative materials: a comparative study. Int J Clin Pediatr Dent. 2015;8:108–13.CrossRefGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  • J. Pérez-Hernández
    • 1
  • F. C. Aguilar-Díaz
    • 1
    Email author
  • R. D. Venegas-Lancón
    • 1
  • C. A. Á. Gayosso
    • 2
  • M. C. Villanueva-Vilchis
    • 1
  • J. de la Fuente-Hernández
    • 1
  1. 1.ENES Unidad LeónUniversidad Nacional Autónoma de MéxicoLeónMexico
  2. 2.Facultad de OdontologíaUniversidad Nacional Autónoma de MéxicoMexico CityMexico

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