Comparative evaluation of effect of natural collagen cross-linker and silver diamine fluoride pre-treatment before resin-modified glass ionomer cement restoration on dentin of primary teeth: An in vitro study

BACKGROUND: The longevity of resin-modified glass ionomer cement (RMGIC) restorations in primary teeth depends on the integrity of the dentin-restorative interface. Pre-treatment with collagen cross-linkers or silver diamine fluoride (SDF) may enhance bonding and remineralization potential. AIM: To comparatively evaluate the effect of a natural collagen cross-linker and SDF on the performance of RMGIC restorations in primary teeth based on shear bond strength (SBS), fluoride release, microleakage, and remineralization potential. METHODS: Ninety-six extracted primary molars were randomly divided into four groups with 24 samples in each group: Group I (polyacrylic acid + RMGIC), Group II (Proanthocyanidin + RMGIC), Group III (SDF + RMGIC), and Group IV (Proanthocyanidin + SDF + RMGIC). SBS was measured using a universal testing machine, fluoride release by ion-selective electrode, microleakage via dye penetration, and remineralization using SEM-EDX analysis. STATISTICAL ANALYSIS: Data were tabulated in Microsoft Excel 2010 and analyzed using SPSS version 21. One-way ANOVA was applied for intergroup comparison of quantitative variables (SBS, fluoride release, microleakage, and remineralization), and the Chi-square test was used for comparison of failure modes. RESULTS: Both collagen cross-linker and SDF groups showed significantly higher SBS and remineralization potential (P < 0.05) compared to the control. Group IV exhibited the highest bond strength, fluoride release, and least microleakage. CONCLUSION: Dentin pre-treatment with collagen cross-linker or SDF enhances RMGIC performance in primary teeth. SDF improves fluoride release and remineralization, while the collagen cross-linker offers superior bonding and sealing.