Comparative Efficacy of Chemical and Plant-Based Disinfectants on Maxillofacial Silicone Elastomers: A Comprehensive Narrative Review

Abstract

Background:

Maxillofacial silicone prostheses are prone to microbial colonization due to their long-term use and exposure to the oral and facial environment, especially in immunocompromised patients. Effective disinfection is essential to maintain hygiene without compromising the material’s physical and esthetic properties. This review aims to evaluate the effect of plant-based and chemical disinfectants on the physical properties and antimicrobial performance of silicone elastomers used in maxillofacial prostheses.

Methods:

An extensive search was conducted across electronic databases, including Google Scholar, ScienceDirect, and PubMed, as well as journals related to maxillofacial surgery and prosthodontics. The search covered literature up to February 2025. All relevant English-language in vitro studies published up to February 2025 were considered, with no time restrictions applied. A total of 14 studies were included based on pre-established inclusion and exclusion criteria.

Results:

The findings indicate that both chemical and plant-based disinfectants demonstrated antimicrobial efficacy against commonly colonizing organisms. However, many chemical agents, such as sodium hypochlorite and chlorhexidine, were associated with changes in surface roughness, hardness, and color degradation of silicone elastomers. In contrast, plant-based agents such as neem extract, tea tree oil, and Thymus vulgaris extract showed comparable antimicrobial performance with fewer adverse effects on material properties.

Conclusions:

Overall, the need for biocompatible and non-damaging disinfection methods, especially for patients with compromised immunity, plant-based disinfectants offer a promising and safer alternative for maintaining prosthesis hygiene. Their efficacy, combined with lower cytotoxicity and better material compatibility, supports their consideration in clinical cleaning protocols for maxillofacial prostheses.