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

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 reminer-alized in simulated body fluid for 2 weeks. The mineral precipitation in the specimens was exam-ined 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 an-alyzed using an MTT assay. The increase in FTIR spectra attributable to apatite formation in demin-eralized 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.