Effects of Silver Diamine Nitrate and Silver Diamine Fluoride on Dentin Remineralization and Cytotoxicity to Dental Pulp Cells: An In Vitro Study.

Surapong Srisomboon,Piyaphong Panpisut,Matana Kettratad,Andrew Stray,Somying Patntirapong,Phakkhananan Pakawanit,Catleya Rojviriya

doi:10.3390/jfb13010016

Abstract

Silver diamine nitrate (SDN) is expected to help control caries similar to silver diamine fluoride (SDF). The aim of this study was to determine the mineral precipitation in demineralized dentin and the cytotoxicity of SDN and SDF to dental pulp cells. Demineralized dentin specimens were prepared, and SDF, SDN, or water (control) was applied. The specimens were then remineralized in simulated body fluid for 2 weeks. The mineral precipitation in the specimens was examined using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). Additionally, the cytotoxicity of SDF and SDN to human dental pulp stem cells was analyzed using an MTT assay. The increase in FTIR spectra attributable to apatite formation in demineralized dentin in the SDF group was significantly higher compared to the SDN and control groups (p < 0.05). Dentinal tubule occlusion by the precipitation of silver salts was detected in both SDF and SDN groups. The mineral density as shown in SRXTM images and cytotoxicity of both SDN and SDF groups were comparable (p > 0.05). In conclusion, SDF demonstrated superior in vitro apatite formation compared to SDN. However, the degree of mineral precipitation and cytotoxic effects of both were similar.

Highlights

Academic Editors: Cristian Scheau, Department of Oral Health Care, Lamlukka Hospital, Pathum Thani 12150, Thailand; Synchrotron Light Research Institute (Public Organization), Nakhon Ratchasima 30000, Thailand; Thammasat University Research Unit in Dental and Bone Substitute Biomaterials, Thammasat University, Pathum Thani 12120, Thailand
The FTIR-ATR results of the current study indicate that the increase in peaks representing apatite formation was greater in the silver diamine fluoride (SDF) group than the silver diamine nitrate (SDN) group
The current study demonstrated that cell viability was reduced after treatment with SDF and SDN by approximately 8%

Summary

Introduction

The aim of this study was to determine the mineral precipitation in demineralized dentin and the cytotoxicity of SDN and SDF to dental pulp cells. Demineralized dentin specimens were prepared, and SDF, SDN, or water (control) was applied. The increase in FTIR spectra attributable to apatite formation in demineralized dentin in the SDF group was significantly higher compared to the SDN and control groups (p < 0.05). The mineral density as shown in SRXTM images and cytotoxicity of both SDN and SDF groups were comparable (p > 0.05). The most common non-invasive materials for controlling dental caries are professionally applied fluoride materials such as silver diamine fluoride (SDF) [4] and NaF varnish [5]. The use of SDF is a cost-effective method of arresting dental caries [6,7]. It was demonstrated that biannual application of SDF led to a higher level of prevention of caries progression than NaF varnish [8]

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Conclusion