In vitro remineralization effectiveness of grape seed extract on primary tooth: A systematic review and meta-analysis

Aim: Grape seed extract (GSE) is considered a herbal alternative and has been noted for its remineralization potential. Thus, this systematic review is to analyze the in-vitro remineralization effectiveness of the natural remineralizing agent, GSE, helping to reinstate new investigative possibilities in the field of restorative dentistry. Materials and Methods: This systematic review was undertaken using objectives and transparent methods as per the PRISMA guideline and was registered with PROSPERO (CRD42021269585). Studies that had assessed the remineralizing efficacy of GSE on human primary teeth for the past 20 years published in English language were included. Electronic and manual searches were conducted to identify suitable citations, and electronic search was performed using various databases such as PubMed, Trip Database, Google Scholar, EBSCOhost Database, Scopus, and Web of Science. Those articles that were written in English and those that had full text available were considered because of its use in dentistry, whereas unpublished data and literature written in other languages and articles with only abstracts were excluded. The search was focussed on the effect of GSEs on primary teeth. Results: The search identified 446 citations, and 12 articles were chosen and reviewed in full texts, among which 2 relevant citations met the eligibility criteria for the final inclusion in the systematic review. The studies were of good quality and meta-analyses showed inconsistent evidence on the remineralization potential of GSE when compared with fluoride [mean difference: 16.63 (95% confidence interval: -62.48, 95.73); P = 0.004]. Conclusion: Within the limitations of the present study, the findings of this systematic review suggest that GSE has a remineralizing effect on primary teeth but strong literature-based clinical evidence in favor of GSE is lacking and also the remineralizing effectiveness is lesser when compared with fluoride. This reinforces the need for further in-vivo, in-vitro, and comparative clinical studies.