Microbial Adhesion to Poly Methyl Methacrylate (PMMA) Denture Base Resins Containing Zinc Oxide (ZnO) Nanostructures: A Systematic Review of In Vitro Studies

Abstract

Background: Denture stomatitis is an inflammatory condition involving swelling and redness of the oral mucosa beneath a denture. Among various available treatments, zinc oxide nanoparticles (ZnONPs) and nano-wire nanostructures have been suggested as potential future therapies. However, there is a lack of information in the literature about the effectiveness of ZnONPs regarding microbial adhesion to different denture base resins. Here, we review studies on the effect of ZnONP use on microbial adhesion to denture base resins to answer the following study question: “Does incorporating ZnONPs into denture base resins reduce microbial adhesion?” Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic and manual search ranging from Jan 2000 to May 2024 was performed using PubMed, Web of Science, and Scopus databases to answer the study question. All full-length English-language articles investigating the effects of ZnO nanostructures on Candida albicans adhesion to polymethyl methacrylate (PMMA) denture base resins were included. The extracted data were tabulated for qualitative and quantitative analysis of the included studies. Results: Of the 479 studies reviewed, 7 studies successfully met the eligibility criteria. All included studies utilized PMMA as the denture base material with different polymerization methods. C. albicans was the most extensively studied microbial species, with various count methods used. Six studies concluded a statistically significant impact of ZnONPs on decreasing C. albicans adhesion to the denture base. However, one study reported the opposite. Conclusions: Incorporating ZnONPs into PMMA denture base resin has a positive impact on reducing C. albicans adherence and could be recommended for denture stomatitis treatment. However, further studies are needed to cover the notable gap in data regarding the safety and effectiveness of ZnO nanostructures.