Comparative evaluation of antimicrobial properties of calcium hydroxide-loaded polylactic-co-glycolic acid nanoparticles and calcium hydroxide: A systematic review and meta-analysis.

AIM

The aim of the study was to evaluate the antimicrobial properties of calcium hydroxide (CH)-loaded polylactic-co-glycolic acid (PLGA) nanoparticles (NPs) and CH when used as an intracanal medicament (ICM).

METHODS

Adhering guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis, the review was registered in the Prospective Registration of Systematic Review-CRD42023454265. Databases from January 2000 to December 2023 were examined for studies evaluating the various properties of CH-loaded PLGA NPs compared to conventional ICM-CH. Using the Cochrane risk of bias (ROB)-2 tool for randomized clinical trials (RCTs) through its domains using Review Manager (RevMan) software version 5.3, quality assessment was evaluated. Standardized mean difference (SMD) was used as a summary statistic measure with a random effect model ( < 0.05).

RESULTS

To fulfill eligibility criteria, six studies were included in qualitative synthesis, from which three were fit for meta-analysis. The quality assessment revealed a moderate to low ROB. The pooled estimate through SMD (0.45 [-1.17-0.27]) and the favored intervention group (CH-loaded PLGA NPs) showed that the reduction in smear layer/biofilm was more significant in the intervention group. Indicating the absence of publication bias, no presence of any heterogeneity was revealed by the funnel plot.

CONCLUSION

It was observed that CH-loaded PLGA NPs showed improved antibacterial properties, greater dentinal tubule penetration, and a significant microbial load reduction.