Antimicrobial properties of nano-poly (d,l- lactic acid) [poly lactic acid] and zinc oxide nanofiller denture base resins: a systematic review and meta-analysis
Purpose: This systematic review and meta-analysis aimed to evaluate the antimicrobial properties and mechanical performance of denture base resins incorporating nano-poly (D,Llactic acid) (PLA) and zinc oxide (ZnO) nanofillers compared to conventional denture base materials.
Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, Embase, and Google Scholar for studies published between 2017 and 2024. The PICOS framework guided study selection:P: PMMA-based denture base resins; I: PLA/ZnO nanocomposite denture base resins; C: Conventional denture base resins; O: Antimicrobial efficacy, mechanical properties; S: Randomized controlled trials, cohort studies, case-control studies, and in vitro studies. Studies were screened according to PRISMA guidelines. Relevant data were extracted on study design, interventions, antimicrobial testing, microorganisms tested, mechanical outcomes, and biocompatibility. Quality was assessed using the QUIN tool, and risk of bias was evaluated for each domain.
Results: From an initial 438 records, 11 studies met inclusion criteria and 8 were eligible for quantitative analysis. The included studies demonstrated that PLA/ZnO nanocomposites significantly reduced microbial growth and biofilm formation against common oral pathogens (Streptococcus mutans, Candida albicans, Escherichia coli). Higher ZnO concentrations correlated with larger inhibition zones and increased antibacterial efficacy. Mechanical properties, including flexural strength and impact strength, were notably improved in PLA/ZnO composites compared to conventional resins, with flexural strength values reaching up to 103.8 MPa. Biocompatibility assessments indicated minimal cytotoxicity and favourable tissue compatibility, with controlled degradation rates between 2–10% over six months. Quality assessment rated most studies as moderate to good quality, although some risk of bias was present.
Conclusion: PLA/ZnO nanofiller denture base resins exhibit promising antimicrobial properties and enhanced mechanical performance compared to conventional materials. These findings support their potential for improving denture hygiene, durability, and patient outcomes. Further well-designed clinical trials are needed to confirm long-term safety and effectiveness.