DOI: 10.4103/tdj.tdj_251_25 ISSN: 1687-8574

Comparative assessment of the antimicrobial efficacy of bioactive glass with conventionally used intracanal medicaments: a systematic review

Ammar Haideri, Pradeep Solete, Gargi Gandhi, Vasaki Arunachalam, Surendar Ramamoorthi, Ahmed El-Kabbaney
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Background

Elimination of intracanal microorganisms is critical for successful endodontic treatment. Persistent bacteria, particularly Enterococcus faecalis , are frequently associated with posttreatment disease and resistance to conventional intracanal medicaments. Bioactive glass has been proposed as an alternative or adjunctive intracanal medicament; however, evidence regarding its antimicrobial efficacy remains inconsistent.

Aim

To systematically evaluate and quantitatively synthesize available in vitro evidence comparing the antimicrobial efficacy of bioactive glass-based intracanal medicaments with conventionally used intracanal medicaments against E. faecalis .

Materials and methods

A systematic search of electronic databases was conducted in accordance with the PRISMA 2020 guidelines. In vitro studies evaluating the antimicrobial efficacy of bioactive glass against E. faecalis were included. Methodological quality was assessed using the Quality Assessment Tool for In Vitro Studies (QUIN). Where sufficient data were available, a meta-analysis was performed using standardized mean differences with a random-effects model. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD420250613452).

Results

The search identified 376 records, of which four studies met the eligibility criteria and were included in the qualitative synthesis. Three studies provided extractable quantitative data and were included in the meta-analysis. Pooled analysis was conducted to compare the antimicrobial efficacy of bioactive glass with calcium hydroxide and chlorhexidine, with heterogeneity assessed using the I 2 statistic.

Conclusion

Bioactive glass demonstrated antimicrobial activity against E. faecalis across the included studies; however, variability in formulation and experimental models contributed to heterogeneity in outcomes. Further standardized experimental and clinical investigations are required to clarify its role as an intracanal medicament.

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