Organic and inorganic antimicrobials incorporated into acrylic resin: antimicrobial efficacy and cytotoxicity: a systematic review.

This review aimed to investigate the literature systematically and answer the question "Does the processing method of organic and inorganic agents incorporated into PMMA influence antimicrobial activity and cytotoxicity?". This systematic review was registered in the OpenScience Framework (osf.io/7nc28) and PRISMA guidelines were followed. The study design (PICOS) framework applied was P = polymethylmethacrylate; I = incorporation of organic and inorganic antimicrobials; C = control group; O = antimicrobial activity and cytotoxicity; and S = experimental in vitro studies. A custom search strategy was performed in Embase, Scopus, PubMed, and Science Direct databases. Studies were selected according to eligibility criteria in two steps. The risk of bias was evaluated by Joanna Briggs Institute's quasi-experimental studies tool. A qualitative analysis of the data was performed addressing: incorporation and polymerization methods, antimicrobial activity, and cytotoxicity of organic and inorganic agents added into PMMA. From a total of 1959 results, 34 studies were included in this review. The 3 organic agents evaluated showed antimicrobial efficacy and 1 was cytotoxic. Of the 31 inorganics, 4 showed no antimicrobial activity, and 8 reduced cell viability. Processing methods influenced the results. The incorporation of organic and inorganic antimicrobial agents into PMMA, depending on the processing method, changes the antimicrobial efficacy and cytotoxicity of the modified material. [ABSTRACT FROM AUTHOR]