Effect of the addition of nanoparticles on setting time and solubility of mineral trioxide aggregate: A systematic review and meta-analysis

Abstract

Aim: This systematic review and meta-analysis aims to assess and compare the solubility and setting time of mineral trioxide aggregate (MTA) by the addition of nanoparticles. Methods: This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The online databases used for searches were PubMed, Directory of Open Access Journals, and Google Scholar. In this review, in vitro studies conducted till May 2024 in the English language were incorporated. The inclusion criteria were entrenched using the PICOS strategy. a. P (Population): The use of extracted teeth, cylinders, or tubes containing experimental materials b. I (Intervention): Studies including MTA with the addition of nanoparticles such as silica, silver, titanium, etc. c. C (Comparison): Studies including comparison MTA with and without nanoparticles d. O (Outcome): Physical properties, solubility, and setting time of the MTA e. S (Study Design): in vitro or laboratory studies. In vitro studies without a valid comparison group or addition of materials other than nanoparticles in MTA or nonavailability of full texts or studies with outcomes not included in the inclusion criteria were excluded from the analysis. The risk of bias assessment used the QUIN tool. The statistical heterogeneity was assessed using χ² and I² values. A random-effects model was used for meta-analysis. RevMan software (5.4 version) was used for meta-analysis. Results: After the application of the inclusion and exclusion criteria, seven studies were included in the final analysis. The addition of nanoparticles significantly reduced the setting time (Pooled Odds ratios for setting time and solubility were 2.17 [-14.03, 9.70]) and 1.41 (-0.26, 3.09), respectively. Among the included studies, 5 showed a low risk of bias and 2 showed a medium risk. Information about sample size calculation, sampling technique, randomization, and blinding was not mentioned in any of the included studies. Conclusion: The addition of nanoparticles increased the solubility and shortened the setting time.