Incorporation of antimicrobial materials into denture adhesives: A systematic review of in vitro studies

This systematic review identify the antimicrobial materials currently incorporated into denture adhesives and their efficacy. The protocol was registered with the Open Science Framework (https://osf.io/wb3uh/). Six databases, including PubMed, Lilacs, Scopus, Embase, Science Direct and Google Scholar, were accessed for the search of articles up to May 2024. Five groups of search terms was created. Eligibility criteria included: experimental studies incorporating antimicrobial agents into denture adhesives; evaluating antimicrobial activity; published articles in peer-reviewed journals and in the English language. Of the 20 articles selected, 16 used inorganic materials and 12 different materials were found, which were divided into 3 subgroups. Eleven articles evaluated antimicrobials medicines, including amphotericin B, chlorhexidine, cephalexin, fluconazole, nystatin, clotrimazole and miconazole. Six articles investigated nanomaterials, incorporating silver nanoparticles (AgNPs), zirconium oxide particles and nanoparticles, zinc oxide (ZnO), zinc oxide nanoparticles (ZnONPs), and nanostructured silver vanadate decorated with silver nanoparticles (AgVO₃) into denture adhesives. One study, classified as other, investigated denture adhesives incorporating pre-reacted glass ionomer particles (S-PRG). Only 8 selected articles used organic materials and 20 distinguishable materials were found, divided into 5 subgroups. Organic materials included different formulations of chitosan, antimicrobial peptides, lipids and extracts. One study, classified as other, investigated adhesives containing pyrazole. Based on the findings, the inorganic agents incorporated into denture adhesives can be divided into two main categories: nanomaterials or antimicrobial medicines. The minority of studies incorporated organic agents. All the inorganic agents promoted antimicrobial activity in denture adhesive. The organic agents were also effective, with the exception of grape seed extract, antimicrobial peptides and lipids. Therefore, is possible to increase the benefits promoted by the use of denture adhesives by incorporating antimicrobial agents.