ReviewJournal of oral biology and craniofacial research
The cytotoxic and biological effects of silver diamine fluoride on human dental pulp cells: A systematic review and meta-analysis.
Review in Journal of oral biology and craniofacial research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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0 citing papers in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Silver diamine fluoride is widely used for non-invasive caries management; however, its biological safety near the dental pulp remains controversial. Objective: To systematically evaluate and quantitatively synthesize evidence on the cytotoxic and biological effects of SDF on human dental pulp cells. Methods: This PRISMA-compliant systematic review and meta-analysis (PROSPERO: CRD420251166805) included in vitro and ex vivo studies assessing SDF effects on human dental pulp cells. Searches were conducted in PubMed, Scopus, Cochrane CENTRAL, and Google Scholar without date restrictions. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Cell viability outcomes were pooled using random-effects models. Results: Seven in vitro studies (2022-2024) were included. Qualitative synthesis demonstrated a consistent dose-dependent cytotoxic effect of SDF. Clinically used and high concentrations (≥3.8-38%) caused marked reductions in cell viability. Meta-analysis showed minimal cytotoxicity at very low concentrations (0.00001-0.0005%; pooled effect = 0.99, 95% CI: 0.97-1.00), a significant decline in viability at 0.001-0.005% (pooled effect = 0.73, 95% CI: 0.46-0.93), and severe toxicity at concentrations ≥0.008% (pooled effect = 0.14, 95% CI: 0.00-0.41). Most studies reported IC Conclusion: SDF exhibits strong dose-dependent cytotoxicity, with biological safety restricted to very low concentrations. Direct or near-pulpal application of conventional SDF concentrations may pose a risk of pulpal toxicity and should be approached cautiously. Clinical significance: Direct or near-pulpal application of standard SDF concentrations should be avoided. Clinicians should exercise caution in deep carious lesions.
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