Effects of silver diamine fluoride combined with potassium iodide and diode laser irradiation on antibacterial activity and microleakage: an in vitro study
Journal of Clinical Pediatric Dentistry, vol.50, no.5, pp.156-166, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 50 Issue: 5
- Publication Date: 2026
- Doi Number: 10.22514/jocpd.2026.125
- Journal Name: Journal of Clinical Pediatric Dentistry
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE, Health Research Premium Collection (ProQuest)
- Page Numbers: pp.156-166
- Keywords: Antibacterial efficacy, Diode laser, Glass hybrid, Microleakage, Potassium iodide, Silver diamine fluoride
- Open Archive Collection: AVESIS Open Access Collection
- Istanbul University Affiliated: Yes
Abstract
Background: Silver diamine fluoride (SDF) is widely used in minimally invasive caries management; however, limited evidence exists regarding the combined use of potassium iodide (KI) and diode laser irradiation, particularly concerning their effects on antibacterial efficacy and microleakage of glass hybrid restorations. Methods: This in vitro study included 144 sound permanent molars. For antibacterial evaluation, a dual-species biofilm of Streptococcus mutans and Lacticaseibacillus casei was established on 72 dentin disks (2 mm thick), randomly assigned to six groups (n = 12): SDF + KI, SDF only, SDF + KI + diode laser, SDF + diode laser, diode laser only, and control. Antibacterial activity was assessed using confocal laser scanning microscopy and scanning electron microscopy. For microleakage evaluation, 72 standardized Class V cavities were prepared and assigned to the same six experimental groups using identical treatment protocols. All cavities were restored with a glass-hybrid restorative material and subjected to thermocycling. Dye penetration was evaluated using basic fuchsin under stereomicroscopy. Antibacterial outcomes were analyzed using generalized estimating equations with pairwise comparisons, while microleakage outcomes were analyzed using the Kruskal-Wallis test. Results: A statistically significant difference in antibacterial activity was observed between the control group and all experimental groups (p < 0.05). The SDF + KI + diode laser group demonstrated significantly greater antibacterial activity than the SDF group and diode laser only group (p < 0.05). No statistically significant differences were detected among the groups with respect to microleakage; however, KI-containing groups showed higher median microleakage values, whereas the lowest median value was observed in the control group (p > 0.05). Conclusions: Within the limitations of this in vitro study, the combination of SDF, KI, and diode laser irradiation demonstrated the most pronounced antibacterial effect among the tested protocols, without significantly affecting microleakage performance of glass-hybrid restorations under the present experimental conditions.