The effect of antibacterial agents of composite resin materials in dental caries prevention and reduction of flexural strength of the material: Systematic review and meta-analysis

Background: The present study aimed to evaluate the antibacterial agents of composite resin materials, their efficacy in caries prevention, and their impact on the mechanical properties (flexural strength) of composite resin restorative materials. Methods: In this systematic review and meta-analysis, all published articles on the effects of antibacterial properties of composite resin materials in the prevention of dental caries (between 2005 to 2020) were evaluated using valid databases, including PubMed, Google Scholar, Web of Science, ISI, Scopus, Cochrane, ProQuest, and Embase, found by searching the keywords "anti-bacterial agents," "composite resins," "dental restoration," and "dental caries" according to the MeSH system. The context of the studies was extracted and subjected to modified CONSORT. The required data were extracted and analyzed with the Comprehensive Meta-Analysis software. Results: According to the results of the random effect model, the heterogeneity of biofilm colony forming unit (CFU) average was -1.90 (CI: -1.68 to -2.13). The mean value of the control group was higher than the intervention. The heterogeneity of flexural strength (FS) average was -11.92 (CI: -8.30 to -15.55). The mean value of the control group was higher than the intervention group. The heterogeneity of thiazolyl blue tetrazolium bromide (MTT) absorbance average was -0.90 (CI: -0.65 to -1.14). The mean value of the control group was higher than the intervention group. Conclusion: The results of the present study showed that the antibacterial agents had a significant effect on the caries prevention properties of the composite resin materials; however, due to the bias related to different control groups, laboratory conditions, and mismatch between in vitro and in vivo conditions, more studies are needed in this regard.