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

Abstract

<h4>Aim</h4>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).<h4>Methods</h4>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 (<i>P</i> < 0.05).<h4>Results</h4>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.<h4>Conclusion</h4>It was observed that CH-loaded PLGA NPs showed improved antibacterial properties, greater dentinal tubule penetration, and a significant microbial load reduction.