Dental Pulp Response to Silver-Containing Solutions: A Scoping Review

Area of Science:

• Dentistry
• Biomaterials
• Endodontics

Background:

• Silver-containing solutions have been historically used for deep cavity disinfection.
• Understanding their impact on dental pulp is crucial for safe clinical application.

Purpose of the Study:

• To review and summarize silver-containing solutions used for deep cavity disinfection.
• To analyze the reported effects of these solutions on dental pulp tissue.

Main Methods:

• Systematic literature search using keywords '(silver) AND (dental pulp OR pulp)' in major databases.
• Inclusion of English publications detailing silver solutions for cavity conditioning and their pulpal effects.
• Synthesis of pulpal responses from 14 selected studies.

Main Results:

• Silver fluoride, silver nitrate, silver diamine nitrate, silver diamine fluoride, and nano-silver fluoride were identified.
• Indirect silver fluoride caused inflammation and reparative dentine, sometimes necrosis.
• Direct silver nitrate caused significant pulp damage; indirect application led to hypoplasia or necrosis.
• Direct silver diamine fluoride induced necrosis, while indirect application caused mild inflammation and reparative dentine.
• No pulpal response data was found for silver diamine nitrate or nano-silver fluoride.

Conclusions:

• The pulpal response to silver-containing solutions is compound- and application-dependent.
• Silver diamine fluoride shows a milder pulpal response with indirect application compared to direct.
• Further research is needed for silver diamine nitrate and nano-silver fluoride pulpal effects.