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<p>Glass ionomer cement (GIC) is commonly used in restorative dentistry because of its fluoride release, chemical adhesion and biocompatibility. However, its low mechanical strength limits its use in high-stress situations. Incorporation of titanium dioxide (TiO₂) nanoparticles has emerged as a promising strategy to develop a nanostructured biomedical composite with enhanced mechanical reliability. This systematic review and meta-analysis evaluated the influence of TiO₂ nanoparticle incorporation on the mechanical performance of GIC and identified the optimal nanoparticle concentration for strengthening this material as a restorative dental material. A comprehensive electronic search was conducted from January 2000 and updated to March 2026 across Scopus, Web of Science, Science Direct, Semantic Scholar, PubMed, and Google Scholar. In vitro studies comparing conventional GIC with TiO<sub>2</sub>-modified GIC were selected following PRISMA guidelines. Risk of bias was assessed using modified CRIS criteria. Of 77 retrieved studies, 12 met the inclusion criteria for qualitative analysis, and five provided quantitative data suitable for meta-analysis. Standardized mean differences (SMD) and heterogeneity were calculated using a random-effects model. Incorporation of 5% TiO<sub>2</sub> nanoparticles significantly increases the mechanical properties of GIC (SMD = − 1.05, 95% CI: −1.480 to − 0.628, <i>P</i> &lt; 0.001) with minimal heterogeneity (I<sup>2</sup> = 3.07%), indicating consistent reinforcement across studies. In contrast, 3% TiO<sub>2</sub> showed no statistically significant improvement (SMD = 0.639, <i>P</i> = 0.551) and demonstrated substantial heterogeneity (I<sup>2</sup> = 94.84%). GIC reinforced with 5% TiO<sub>2</sub> nanoparticles demonstrate a consistent improvement in mechanical performance under laboratory conditions. This enhancement may broaden the scope of conventional GIC for moderate stress bearing applications, including preventive, pediatric and geriatric restorative indications. However, further standardized in vitro testing and long-term clinical studies are required before definitive clinical recommendations can be made. TiO<sub>2</sub> modified GIC at 5% concentration may offer potential advantages in restorative dentistry by improving mechanical properties while retaining the biological advantages of conventional GIC. however, further well-designed laboratory and clinical studies are required to confirm its clinical applicability.</p>

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TiO2 Nanoparticle-Reinforced Glass Ionomer Cement as a Nanostructured Dental Biomaterial for Enhanced Mechanical Strength: A Systematic Literature Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Suankit Harane,
  • M. Pharm,
  • Vinita Kale,
  • Vaibhav Borkar,
  • Milind Umekar

摘要

Glass ionomer cement (GIC) is commonly used in restorative dentistry because of its fluoride release, chemical adhesion and biocompatibility. However, its low mechanical strength limits its use in high-stress situations. Incorporation of titanium dioxide (TiO₂) nanoparticles has emerged as a promising strategy to develop a nanostructured biomedical composite with enhanced mechanical reliability. This systematic review and meta-analysis evaluated the influence of TiO₂ nanoparticle incorporation on the mechanical performance of GIC and identified the optimal nanoparticle concentration for strengthening this material as a restorative dental material. A comprehensive electronic search was conducted from January 2000 and updated to March 2026 across Scopus, Web of Science, Science Direct, Semantic Scholar, PubMed, and Google Scholar. In vitro studies comparing conventional GIC with TiO2-modified GIC were selected following PRISMA guidelines. Risk of bias was assessed using modified CRIS criteria. Of 77 retrieved studies, 12 met the inclusion criteria for qualitative analysis, and five provided quantitative data suitable for meta-analysis. Standardized mean differences (SMD) and heterogeneity were calculated using a random-effects model. Incorporation of 5% TiO2 nanoparticles significantly increases the mechanical properties of GIC (SMD = − 1.05, 95% CI: −1.480 to − 0.628, P < 0.001) with minimal heterogeneity (I2 = 3.07%), indicating consistent reinforcement across studies. In contrast, 3% TiO2 showed no statistically significant improvement (SMD = 0.639, P = 0.551) and demonstrated substantial heterogeneity (I2 = 94.84%). GIC reinforced with 5% TiO2 nanoparticles demonstrate a consistent improvement in mechanical performance under laboratory conditions. This enhancement may broaden the scope of conventional GIC for moderate stress bearing applications, including preventive, pediatric and geriatric restorative indications. However, further standardized in vitro testing and long-term clinical studies are required before definitive clinical recommendations can be made. TiO2 modified GIC at 5% concentration may offer potential advantages in restorative dentistry by improving mechanical properties while retaining the biological advantages of conventional GIC. however, further well-designed laboratory and clinical studies are required to confirm its clinical applicability.