Evaluation of the effectiveness of modified atraumatic restorative treatment with silver daimine fluoride under In Vitro conditions

This thesis aimed to investigate, under in vitro conditions, the effects of different formulations of silver diamine fluoride (SDF) on microleakage and shear bond strength in teeth restored with glass ionomer cement (GIC) one week after SDF application. The study was conducted on third molars extracted due to orthodontic indications or impaction, with the ultimate goal of contributing to clinical practice. A total of 56 extracted third molars were included: 28 for shear bond strength (SBS) testing and 28 for microleakage assessment. For the SBS test, samples were divided into four subgroups: Group 1: 38% SDF gel + Equia Forte; Group 2: 38% SDF solution + Equia Forte; Group 3: 38% SDF + Potassium iodide (KI) + Equia Forte; Group 4: Negative control (Equia Forte only). Artificial dentin caries were created in all samples, restorations were placed one week after SDF application, and samples were stored in artificial saliva at 37°C. SBS was measured 24 hours post-restoration using a universal testing machine on 3×4 mm restorations. Fracture types were evaluated under a stereomicroscope, and failure surfaces were analyzed via Scanning Electron Microscopy (SEM). For microleakage analysis, standardized Class V cavities (4×3×2 mm) were prepared on the buccal surfaces. After restoration, samples underwent 500 thermocycles and were immersed in 0.5% basic fuchsin dye for 24 hours. Longitudinal sections were taken through the center of each restoration, and dye penetration scores were recorded under a stereomicroscope. No statistically significant differences were observed among the groups in SBS values (p = 0.259) or fracture types (p> 0.05). Occlusal microleakage differences were also not significant (p = 0.723). Although gingival microleakage levels approached significance, no statistical difference was found (p = 0.059). In conclusion, different formulations of SDF had no significant effect on the bond strength or microleakage of restorations. Keywords: Silver Diamine Fluoride, Shear Bond Strength, Remineralization, Early Childhood Caries, Glass İonomer Cement.