Recently, the use of silver modified atraumatic restorative treatment (SMART) has proved to be an effective restoration strategy for carious teeth in pediatric dentistry. This technique involves an application of Silver Diamine Fluoride (SDF) after caries excavation and restoration with a Glass Ionomer Cement (GIC). Though effective, it is not a durable option in “load bearing" molar teeth where the predominant functions are biting and chewing. The composite restorations have largely replaced GIC as the material of choice in permanent teeth. Hence, it may also be assumed that they can be a better alternative to GIC in SMART in primary molars in clinical settings. Further, composite resin is more workable and allows the operator to adapt, shape, and finish the restoration closer to its original form and function. A roadblock in complete replacement of GIC by composite in SMART is due to the micromechanical bonding of the latter to enamel and dentin which can be a concern when the carious dentin has been treated with SDF application.

The inherent disadvantage of SDF is also due to its discoloration of teeth and margins of an esthetic restorative material. Several researchers have tried to counter this by applying a super saturated solution of potassium iodide to reduce the dark color of the dentin. This has been efficacious but can alter the properties of the dentin and bonding potential of the restorative materials.

Several in vitro studies have evaluated the effect of SDF on the bond strength of composite restorations and showed conflicting evidence. To the best of our knowledge, no clinical study has evaluated this aspect.

Hence, this study has been planned to evaluate the retention of composite resin-restoration in carious primary molars after application of SDF alone and with Potassium iodide after caries excavation,  in a randomised controlled trial setting.