Systematic Review and Meta-Analysis on Antimicrobial Effectiveness of Herbal-Modified Glass Ionomer Cements

This systematic review with meta-analysis was registered in PROSPERO (CRD42024522010) and conducted according to PRISMA guidelines. Searches were performed in PubMed/MEDLINE, Scopus, and Web of Science. In vitro studies comparing conventional and phytotherapeutic-modified glass ionomer cements were included. Antimicrobial activity was assessed mainly using agar diffusion and minimum inhibitory concentration assays against cariogenic and opportunistic microorganisms. Of 34 records identified, eight studies met the eligibility criteria for qualitative synthesis, and two provided sufficiently comparable inhibition zone data against Streptococcus mutans for meta-analysis. Herbal-modified glass ionomer cements demonstrated increased antimicrobial activity against Streptococcus mutans, Candida albicans, and Staphylococcus aureus under laboratory conditions. The exploratory meta-analysis showed a statistically significant increase in inhibition zone diameter favoring herbal-modified cements (mean difference = 6.08 mm; 95% CI: 0.50 to 11.67; p = 0.03), with substantial heterogeneity (I² = 98%). Several studies also evaluated mechanical and physicochemical properties, including compressive strength, microhardness, and fluoride release, which were generally comparable to those of conventional glass ionomer cements.本项整合Meta分析的系统综述已在PROSPERO（注册号CRD42024522010）注册，并严格遵循PRISMA报告规范开展研究。研究在PubMed/MEDLINE、Scopus及Web of Science三大数据库中完成文献检索，纳入对比传统玻璃离子水门汀与植物药修饰型玻璃离子水门汀的体外实验研究。研究主要采用琼脂扩散法与最低抑菌浓度试验，针对致龋微生物及机会致病性微生物评估材料的抗菌活性。本次检索共识别出34篇文献记录，其中8项研究符合定性综合分析的纳入标准，另有2项研究提供了可用于Meta分析的、针对变形链球菌（Streptococcus mutans）的可比抑菌圈数据。实验室条件下，植物药修饰型玻璃离子水门汀对变形链球菌、白色念珠菌（Candida albicans）及金黄色葡萄球菌（Staphylococcus aureus）均展现出更强的抗菌活性。探索性Meta分析结果显示，植物药修饰型水门汀的抑菌圈直径较对照组存在统计学意义上的显著提升（均数差=6.08 mm；95%置信区间：0.50~11.67 mm；p=0.03），且研究间存在显著异质性（I²=98%）。另有多项研究评估了该类材料的力学与理化性能，包括抗压强度、显微硬度及氟离子释放量，其结果总体与传统玻璃离子水门汀相当。