Pretreating dentin with silver diamine fluoride (SDF) may not reduce the bonding strength of glass ionomer cement (GIC) or resin composites, according to a review published recently in the Journal of Dentistry.
While rinsed SDF may not affect the bonding of GIC, unrinsed SDF may increase GIC’s bond strength to sound dentin but decrease it on dentin with tooth decay, the authors wrote.
“Pretreatment with SDF does not compromise the adhesion of GIC and resin, but for GIC it may be affected depending on the dentin substrate and rinsing protocols,” wrote the authors, led by Reinaldo Adelino de Sales Junior of the Federal University of Rio Grande do Norte in Brazil (J Dent, March 8, 2026, 106617).
The goal of this systematic review and meta-analysis was to evaluate how SDF affects the bond strength of GIC and resin composites to sound and carious primary dentin. Researchers conducted an electronic search for in vitro studies published through July 2025 that assessed bonding to SDF-treated primary dentin. A total of 22 studies were included, with 19 contributing data to the meta-analysis, they wrote.
Carious dentin was the most used substrate, along with artificially created or chemically demineralized dentin produced through various laboratory protocols, while healthy dentin was often used as a control. Most studies used a 38% SDF solution, and although concentrations were generally consistent, application protocols varied, with some studies rinsing the SDF after application and others allowing it to air-dry before bonding procedures.
Rinsed SDF did not affect the bonding of GIC, while unrinsed SDF increased GIC’s bond strength to sound dentin but decreased it on carious dentin. For resin composites, SDF did not affect adhesion to either sound or carious dentin regardless of whether it was rinsed, although individual study results varied. Five studies reported no significant effect of SDF on resin composite adhesion, whereas six studies found reduced bond strength after SDF application, they wrote.
Furthermore, the meta-analysis showed that SDF pretreatment did not significantly change bond strength compared with untreated dentin (Z-score [Z] = 1.45; p = 0.15), though study results showed high variability (I² = 80%). Subgroup analyses found that rinsed SDF did not affect bond strength to sound dentin (Z = 0.11; p = 0.91) or carious dentin (Z = 1.06; p = 0.29), while unrinsed SDF increased bond strength to sound dentin (Z = 4.26; p < 0.01) but decreased it to carious dentin (Z = 1.98; p = 0.05).
The study, however, had limitations. Differences in restorative protocols and the types of GICs included in the review may have limited direct comparisons between studies, the authors added.
“Well-designed clinical trials are needed to confirm whether these laboratory findings are reproduced under clinical conditions, particularly regarding the long-term performance of restorations in primary teeth,” they concluded.
