Effects of silver nanoparticle-based antimicrobial formulations on the properties of denture polymer: A systematic review and meta-analysis of in vitro studies

Statement of problem: Denture stomatitis and other oral infections are prevalent in denture wearers and can be treated effectively with an antimicrobial agent such as a silver nanoparticle-based polymer. However, the physical properties of the denture should not be adversely affected by the addition. Purpose: The purpose of this systematic review and meta-analysis of in vitro studies was to analyze the effects of a silver nanoparticle-based antimicrobial resin on the properties of polymethyl methacrylate(PMMA)–based denture resin. Material and methods: Full-length English language articles reporting silver nanoparticle-based PMMA resin were included in the review, with no limitation on the year till May 2020. Scopus, Web of Sciences, and PubMed databases were accessed for the literature survey. The review was formulated based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. A meta-analysis of flexural strength was performed by using a random-effects model at a 95% confidence interval. The other properties were analyzed descriptively. Results: Silver nanoparticle reinforcement caused considerable differences in the inherent physical material properties of PMMA. Conclusions: An antimicrobial polymer nanocomposite formulation can either negatively affect or bring no improvement to the physical properties of denture resin.