Effectiveness of Tooth-colored Restorative Materials in Masking Discoloration Caused by Silver Diamine Fluoride: A Systematic Review of In Vitro Studies

Aims and background: Silver diamine fluoride (SDF) is a minimally invasive and cost-effective agent widely used for caries arrest, particularly in pediatric dentistry. However, its primary drawback is the irreversible black discoloration it causes on the SDF-treated surfaces, limiting its acceptance in esthetically sensitive regions.The purpose of this systematic review was to examine and compare the effectiveness of different tooth-colored restorative materials in masking the discoloration on surfaces treated with SDF. Materials and methods: Studies (QUIN Tool). Results: studies fulfilled the inclusion criteria. Composite resins consistently demonstrated superior esthetic outcomes, especially when placed after a delay or combined with opaquer systems (ΔE = 1.66-8.01). GIC showed poor masking ability, with ΔE values as high as 105. Among GIC variants, zirconia-reinforced GIC performed better (ΔE = 6.00), while RMGIC showed variable results. The use of KI yielded mixed outcomes, improving esthetics with composites but often worsening them with RMGIC and Zr-GIC. Long-term stability of composites was confirmed through aging and thermocycling protocols. Conclusion: research to validate clinical application. Clinical significance: This study offers evidence-based insights into the most effective restorative material to mask SDF-induced discoloration without compromising the caries-arresting property of SDF, aiding clinicians in making well-informed decisions about the selection of restorative material and timing of restoration, ultimately improving patient acceptance of SDF treatment. How to cite this article: Studies. Int J Clin Pediatr Dent 2026;19(2):262-270.