Anjali Ann Cherian, Lakshmi Nidhi Rao, Aditya Shetty, Shishir Shetty, Lavanya Anumula, Krishna Prasad Shetty
Current in vitro evidence suggests that bioactive glass nanoparticles and chitosan nanoparticle-based materials possess promising biological properties relevant to pulp-dentin regeneration. Nevertheless, the evidence base remains limited because of the small number of eligible studies, methodological heterogeneity, and the absence of animal and clinical investigations. Consequently, these findings should be interpreted cautiously, and well-designed standardized preclinical and clinical studies are required before the translational potential and clinical applicability of these nanoparticle-based biomaterials can be established.
INTRODUCTION: Regenerative endodontics aims to restore the structure and function of the pulp-dentin complex through biologically based therapeutic approaches. Among the various biomaterials investigated, bioactive glass (BG) nanoparticles and chitosan nanoparticles have emerged as promising candidates due to their favourable physicochemical and biological properties. BG nanoparticles can release calcium and phosphate ions that support mineralization and stimulate odontogenic differentiation. Chitosan nanoparticles have the ability to release bioactive molecules. Both have demonstrated promising biological properties associated with pulp-dentin regeneration in in vitro studies.
OBJECTIVE: To systematically evaluate and critically appraise experimental in vitro studies investigating the effects of bioactive glass nanoparticles and chitosan nanoparticles on pulp-dentin regeneration.
METHODOLOGY: A systematic literature search was conducted in PubMed, Scopus, and Web of Science following PRISMA 2020 guidelines. Experimental in vitro studies evaluating bioactive glass nanoparticles or chitosan nanoparticles for pulp-dentin regeneration were selected according to predefined eligibility criteria. Risk of bias was assessed using the Quality Assessment Tool for in vitro Studies (QUIN). Due to substantial heterogeneity in biomaterial formulations, cell types, experimental protocols, and outcome measures, the findings were synthesized qualitatively.
RESULTS: Four studies fulfilled the predefined eligibility criteria. Despite the limited number of eligible studies, the available evidence consistently demonstrated that bioactive glass nanoparticles enhanced odontogenic differentiation, mineralization, and expression of odontogenic markers in human dental pulp stem cells, whereas chitosan nanoparticle-based materials promoted cell viability, proliferation, and odontogenic differentiation under experimental laboratory conditions. However, considerable methodological heterogeneity and the exclusive inclusion of in vitro investigations precluded quantitative synthesis and limit the certainty of the available evidence.
CONCLUSION: Current in vitro evidence suggests that bioactive glass nanoparticles and chitosan nanoparticle-based materials possess promising biological properties relevant to pulp-dentin regeneration. Nevertheless, the evidence base remains limited because of the small number of eligible studies, methodological heterogeneity, and the absence of animal and clinical investigations. Consequently, these findings should be interpreted cautiously, and well-designed standardized preclinical and clinical studies are required before the translational potential and clinical applicability of these nanoparticle-based biomaterials can be established.
SYSTEMATIC REVIEW REGISTRATION: https://osf.io/upksf.