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Green-synthesized nanoparticles have improved antibacterial activity and selected mechanical properties of glass ionomer cement (GIC) in some laboratory studies—but the findings do not show that these materials work better in patients. A systematic review published in BMC Oral Health on 3 October 2026 included 25 studies: 24 in vitro investigations and one animal study. Its authors called for clinical validation.
What the 2026 review found
Mohamed and colleagues reviewed studies of nanoparticles made through green-synthesis methods and added to GIC, a dental restorative material. The review’s database search covered studies published from database inception through January 2025. Its publication date is recent, but its evidence cutoff precedes publication.
The review found generally favorable antibacterial results and improvements in some mechanical measures, but effects depended on the particle, cement formulation, concentration, and test method. The authors did not pool results in a meta-analysis because the studies varied substantially in their materials, preparation methods, outcomes, and protocols.
| Evidence measure | What the review reported |
|---|---|
| Studies included | 25 total: 24 in vitro studies and one animal study |
| Antibacterial activity | Assessed in 16 of the 25 studies |
| Mechanical outcomes | Assessed in 11 studies |
| Fluoride release | Assessed in two studies |
| Color stability | Assessed in four studies |
| Nanoparticle loading | 0.05% to 10% by weight across included studies; this is a range across different formulations, not a recommended dose |
In its risk-of-bias assessment, the review classified 11 of the 24 in vitro studies as low risk and 13 as medium risk. The single animal study was rated as having moderate overall risk of bias. These assessments do not turn laboratory outcomes into evidence of clinical effectiveness.
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Which nanoparticles and formulations have been tested?
The review covered a range of experimental systems, including silver, copper, zirconia, hydroxyapatite, gold, chitosan-based hybrids, and multicomponent particles. “Green-synthesized nanoparticle cement” is not one standardized product: studies differed in the particles used, how they were made, how much was added, and how the resulting cement was tested.
Hydroxyapatite made with plant-mediated methods
One laboratory study describes hydroxyapatite nanoparticles made using calcium oxide derived from eggshells and Moringa oleifera leaf extract, then incorporated into GIC. Researchers tested antimicrobial activity and compressive strength. The available evidence does not establish a precise effect size or demonstrate patient benefit.
Titanium dioxide made with citrus seed extract
A 2026 study in Scientific Reports tested GIC modified with titanium dioxide nanoparticles prepared using Citrus aurantium seed extract. It included in vitro mechanical and physical tests as well as preliminary in silico safety screening. Computer-based screening is not a clinical safety trial.
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Zinc oxide, silver, and other systems
A separate study evaluated GIC reinforced with zinc oxide and hydroxyapatite for mechanical strength, biological activity, and antibacterial properties; its available indexed summary does not support claims about outcomes in patients. The review also covered green-synthesized silver, copper, zirconia, gold, and chitosan-based hybrid systems.
Do the nanoparticles make GIC stronger?
Some formulations improved measured mechanical properties, but the review does not support a general claim that nanoparticle-modified GIC is stronger. Selected hydroxyapatite and chitosan–titania–zirconia–hydroxyapatite formulations showed favorable mechanical findings. Results varied across materials and tests, and some silver nanoparticle formulations had lower microhardness or surface irregularities.
Compressive strength, flexural strength, and microhardness are distinct laboratory measures. A favorable result in one does not establish better performance in every mechanical property, longer restoration survival, or resistance to wear in a patient’s mouth. The review reported no pooled effect size that would allow readers to quantify a single overall improvement.
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Can modified GIC fight oral bacteria better?
Antibacterial activity was the most frequently examined outcome: 16 of the 25 studies assessed it. The review reported generally favorable antibacterial findings, with plant-mediated silver particles showing comparatively consistent enhancement. That trend does not mean every silver formulation improved every outcome; some had unfavorable mechanical findings.
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What remains unknown about fluoride release, color, and safety?
Only two studies examined fluoride release, so the review offers limited evidence on that property. Four assessed color stability. Higher nanoparticle loadings sometimes produced noticeable discoloration, an important consideration for a visible restoration. These small evidence bases do not establish how a particular formulation will behave over time in clinical use.
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Green synthesis refers to how nanoparticles are prepared. It does not, by itself, prove that the finished dental material is safer, more sustainable at commercial scale, or clinically effective. The included evidence was overwhelmingly laboratory-based, and preliminary in silico screening cannot replace clinical safety evaluation.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How to judge a claim about nanoparticle-modified GIC
When comparing a reported result with another study or a future product claim, check whether the studies tested comparable materials and outcomes. Useful details include:
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- Particle and synthesis source: Identify the nanoparticle and the material or biological source used to prepare it.
- Loading and incorporation: Check the concentration and whether particles were added to the GIC powder, liquid, or both.
- Outcome measured: Distinguish antibacterial activity, compressive or flexural strength, microhardness, fluoride release, color stability, and biocompatibility.
- Study design and conditions: Note the test method, duration, cement formulation, and whether the result came from an in vitro, animal, or clinical study.
- Clinical endpoint: Look for evidence of patient outcomes, such as restoration performance over time, rather than inferring them from a laboratory measurement.
Because formulations and methods differed, a concentration or result from one study should not be treated as directly comparable to a different formulation. The review does not identify one universally superior nanoparticle-modified GIC.
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What this means for patients and clinicians
The evidence supports continued investigation of green-synthesized nanoparticles as GIC additives, not a conclusion that patients should seek out a modified cement or that existing GIC restorations are inferior. The review’s 24 in vitro studies and one animal study do not establish clinical effectiveness. Standardized methods and clinical studies are needed to determine whether laboratory improvements translate into meaningful benefits for restoration longevity, recurrent caries, safety, or appearance.
Source: Mohamed et al., systematic review, BMC Oral Health, published 3 October 2026; search through January 2025. https://doi.org/10.1186/s12903-026-09657-w.
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