380 - Clinical and Radiographic Effectiveness of Silver Diamine Fluoride with and without Potassium Iodide in Indirect Pulp Capping of Young Permanent Molars

Objective: To compare the effectiveness of 38% silver diamine fluoride (SDF) with and without potassium iodide (SDF+KI) under a resin modified glass ionomer cement (RMGIC) in indirect pulp capping of deep carious lesions in young permanent molars. 

Method: A total of 108 first permanent molars showing deep occlusal cavitated caries lesions in 68 (6-9 year old) children were randomly allocated into 3 groups (n=36) and treated with SDF, SDF+KI and RMGIC. RMGIC was used as a base followed by resin-based composite restoration. Postoperative pain, tooth vitality, restoration success rates according to modified USPHS criteria were performed after 3, 6 and 12 months. Cone beam computed tomography scans at 0 and 12 months to measure root length and reparative dentin volumes after manual approximation, segmentation and registration using Slicer and ITK-SNAP software. Data was analyzed using IBM SPSS (23.0) (P < .05). 

Results: No significant difference found among the three groups regarding postoperative pain, tooth vitality/abscess formation (P=1.00) and secondary caries (P=0.17). However, there was a significant difference between groups in restoration color (P < .001), marginal staining (P < .01) and restoration luster (P < .001) at all-time points, with the RMGIC only group performing significantly better than the 2 SDF groups. Staining still occurred in the SDF+KI group after 12 months (Bravo score=40%; Charlie score=24%). Mean values for reparative dentin volume (mm3) in SDF, SDF+KI, RMGIC were 7.37± 9.20, 9.24±10.23 and 9.73±10.81 respectively and for root lengthening (mm) in SDF, SDF+KI, RMGIC were 1.23± 0.73, 1.26±0.47 and 1.49±0.52, respectively.

Conclusion: All groups were equally successful at preserving pulp vitality and preventing pain. The RMGIC group showed better color, marginal staining, and restoration luster and slightly greater root lengthening and reparative dentin volume values.