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Ribeiro AB, Pizziolo PG, Clemente LM, Aguiar HC, Poker BDC, Silva AAME, Makrakis LR, Fifolato MA, Souza GC, Oliveira VDC, Watanabe E, Lovato da Silva CH. Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review. Antibiotics (Basel) 2024; 13:273. [PMID: 38534708 DOI: 10.3390/antibiotics13030273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/01/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Pillar Gonçalves Pizziolo
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Helena Cristina Aguiar
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Beatriz de Camargo Poker
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Arthur Augusto Martins E Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Laís Ranieri Makrakis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Marco Aurelio Fifolato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Giulia Cristina Souza
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
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An S, Evans JL, Hamlet S, Love RM. Overview of incorporation of inorganic antimicrobial materials in denture base resin: A scoping review. J Prosthet Dent 2023; 130:202-211. [PMID: 34756425 DOI: 10.1016/j.prosdent.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Dental hygiene for institutionalized patients and recurring Candida-associated denture stomatitis remain problematic because of a patient's limited dexterity or inability to eliminate Candida from denture surfaces. Although there has been extensive research into antimicrobial modification of denture base resins with inorganic materials, scoping reviews of the literature to identify knowledge gaps or efficacy of inorganic antimicrobial materials in denture base resins are lacking. PURPOSE The purpose of this scoping review was to provide a synopsis of the efficacy of the major classes of inorganic antimicrobial materials currently incorporated into denture base resins. MATERIAL AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was applied. Four electronic databases, including Embase, PubMed, Web of Science, and Google Scholar, were accessed for articles in the English language, up to February 2019, without restrictions on the date of publication. RESULTS From the 53 articles selected, 25 distinguishable inorganic materials were found and divided into 3 subgroups. Forty-three articles evaluated nanomaterials, where mostly silver ion nanoparticles and/or titanium dioxide nanoparticles were incorporated into denture base resins. Fourteen articles examined antimicrobial drugs and medications, including azole group medications, amphotericin-B, Bactekiller, chlorhexidine, Novaron, and Zeomic. Two articles classified as others explored hydroxyapatite- and fiber-incorporated denture base resins. CONCLUSIONS Although nanotechnology and antimicrobial medications or drugs have been successfully used to reduce Candida-associated denture stomatitis, long-term solutions are still lacking, and their disadvantages continue to outweigh their advantages.
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Affiliation(s)
- Steve An
- Lecturer, School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
| | - Jane L Evans
- Associate Professor, School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Stephen Hamlet
- Senior Lecturer, School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Robert M Love
- Professor, School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
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Maluf CV, Janott-Sarlo CA, Bertolini MDM, Menezes LR, Lourenço EJV, Telles DDM. In vitro evaluation of physicochemical properties of soft lining resins after incorporation of chlorhexidine. J Prosthet Dent 2020; 124:615.e1-615.e7. [PMID: 32540125 DOI: 10.1016/j.prosdent.2020.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM Incorporating chlorhexidine into soft lining materials has been suggested to reduce biofilm development on the material surface and treat denture stomatitis. However, evaluation of the physicochemical properties of this material is necessary. PURPOSE The purpose of this in vitro study was to evaluate the physicochemical properties of resin-based denture soft lining materials modified with chlorhexidine diacetate (CDA). MATERIAL AND METHODS Two soft lining resins were tested, one based on polymethyl methacrylate (PMMA) and the other on polyethyl methacrylate (PEMA), into which 0.5%, 1.0%, or 2.0% of CDA was incorporated; the control group had no CDA. The specimens were stored for 2 hours, 48 hours, 7, 14, 21, and 28 days and then analyzed for polymer crystallinity, Shore A hardness, degree of monomer conversion, residual monomer leaching, and CDA release. Data were analyzed by using a 3-way ANOVA and the Tukey HSD test (α=.05). RESULTS The polymer crystallinity of PEMA and PMMA did not change after CDA incorporation. Shore A hardness increased over time, but not for any CDA concentrations tested after 28 days (P>.05). Considering the degree of conversion, PMMA-based resin showed no statistically significant difference (P>.05). However, PEMA-based resin showed a significant decrease (P<.05), which was reflected in a significant increase in residual monomer leaching from PEMA-based resin with the incorporation of 0.5% and 1.0% CDA (P<.05), mainly in the first 48 hours. PMMA-based resin showed no change in monomer leaching (P>.05). For both resins, the CDA release kinetics were related to monomer leaching; for PEMA-based resin, the values were significantly higher in the first 48 hours (P<.05), and for PMMA-based resin, the values were more sustained up to the last day of analysis. CONCLUSIONS The incorporation of CDA did not affect the physicochemical properties of soft resins. The properties of PMMA were better than those of PEMA.
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Affiliation(s)
- Caroline Vieira Maluf
- Postdoctoral student, Department of Prosthodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Lívia Rodrigues Menezes
- Adjunct Professor, Institute of Macromolecules Eloisa Mano, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Daniel de Moraes Telles
- Full Professor, Department of Prosthodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil.
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Maluf CV, Peroni LV, Menezes LR, Coutinho W, Lourenço EJV, Telles DDM. Evaluation of the physical and antifungal effects of chlorhexidine diacetate incorporated into polymethyl methacrylate. J Appl Oral Sci 2020; 28:e20190039. [PMID: 31939520 PMCID: PMC6919199 DOI: 10.1590/1678-7757-2019-0039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/12/2019] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate the physical properties and antifungal activities of polymethyl methacrylate (PMMA) acrylic resins after the incorporation of chlorhexidine diacetate salt (CDA).
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Affiliation(s)
- Caroline Vieira Maluf
- Universidade do Estado do Rio de Janeiro, Departamento de Prótese Dentária, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Luciana Vieira Peroni
- Universidade do Estado do Rio de Janeiro, Departamento de Prótese Dentária, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Lívia Rodrigues Menezes
- Universidade Federal do Rio de Janeiro, Instituto de Macromoléculas Eloisa Mano, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Wagner Coutinho
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Eduardo José Veras Lourenço
- Universidade do Estado do Rio de Janeiro, Departamento de Prótese Dentária, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Daniel de Moraes Telles
- Universidade do Estado do Rio de Janeiro, Departamento de Prótese Dentária, Rio de Janeiro, Rio de Janeiro, Brasil
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Wijetunge SS, Wen J, Yeh CK, Sun Y. Wheat germ agglutinin liposomes with surface grafted cyclodextrins as bioadhesive dual-drug delivery nanocarriers to treat oral cells. Colloids Surf B Biointerfaces 2019; 185:110572. [PMID: 31654890 DOI: 10.1016/j.colsurfb.2019.110572] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/12/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
Topical management of oral infection requires combined use of multiple classes of drugs and frequent dosing due to low drug retention rates. The sustained, co-delivery of drugs with different solubilities to cells using nanoparticle drug delivery systems remains a challenge. Here, we developed wheat germ agglutinin (WGA) conjugated liposomes with surface grafted cyclodextrin (WGA-liposome-CD) as bioadhesive dual-drug nanocarriers. We effectively encapsulated two physiochemically different drugs (ciprofloxacin and betamethasone) and demonstrated sustained co-drug release in saliva over a 24 h period in vitro. As proof of therapeutic utility in oral cells, we infected oral keratinocytes with Aggregatibacter actinomycetemcomitans, a bacterial pathogen responsible for chronic periodontal disease. Drug release, resulting from nanocarrier cell binding, produced a significant increase in oral cell survival and synergistically reduced inflammation. These results suggest that WGA-liposome-CD nanocarriers are novel cyto-adhesive candidates for delivering multiple drugs with sustained therapeutic activity for localized drug delivery to oral cells.
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Affiliation(s)
- Sashini S Wijetunge
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States
| | - Jianchuan Wen
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio and Geriatric Research Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229, United States
| | - Yuyu Sun
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States.
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Wijetunge SS, Wen J, Yeh CK, Sun Y. Lectin-Conjugated Liposomes as Biocompatible, Bioadhesive Drug Carriers for the Management of Oral Ulcerative Lesions. ACS APPLIED BIO MATERIALS 2018; 1:1487-1495. [DOI: 10.1021/acsabm.8b00425] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Sashini S. Wijetunge
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, Massachusetts 01854, United States of America
| | - Jianchuan Wen
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, Massachusetts 01854, United States of America
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio and Geriatric Research Education and Clinical Center, Audie L. Murphy Division, South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, Texas 78229, United States of America
| | - Yuyu Sun
- Department of Chemistry, University of Massachusetts Lowell, 1 University Avenue, Lowell, Massachusetts 01854, United States of America
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Synthesis, Antifungal Activity, and Biocompatibility of Novel 1,4-Diazabicyclo[2.2.2]Octane (DABCO) Compounds and DABCO-Containing Denture Base Resins. Antimicrob Agents Chemother 2017; 61:AAC.02575-16. [PMID: 28115357 DOI: 10.1128/aac.02575-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/14/2017] [Indexed: 01/28/2023] Open
Abstract
The fungal pathogen Candida albicans causes a variety of oral infections, including denture stomatitis, which is characterized by inflammation of the oral mucosa in direct contact with dentures and affects a significant number of otherwise healthy denture wearers. While antifungal treatment reduces symptoms, infections are often recurrent. One strategy to address this problem is to incorporate compounds with fungicidal activities into denture materials to prevent colonization. Our laboratory synthesized novel derivatives of 1,4-diazabicyclo[2.2.2]octane (DABCO), which is an organic compound typically used as a catalyst in polymerization reactions. DABCO derivatives with different aliphatic chain lengths (DC16, DC16F, DC18, and C6DC16), as well as methacrylate monomers conjugated to DABCO compounds (DC11MAF and C2DC11MAF), were synthesized and tested for antimicrobial activity. All the compounds exhibited fungicidal activity against several Candida species at concentrations ranging between 2 and 4 μg/ml. Moreover, acrylic denture base resins fabricated to contain 1, 2, or 4 wt% DABCO compounds inhibited surface C. albicans biofilm formation, as well as fungal growth, in disc diffusion assays. Remarkably, discs (4 wt%) aged for 2 months also exhibited approximately 100% growth-inhibitory activity. While some DABCO compounds exerted intermediate to high cytotoxicity against mammalian oral cell types, DC11MAF and denture base resin discs containing 2 or 4 wt% C2DC11MAF exhibited relatively low cytotoxicity against periodontal ligament (PDL) cell and gingival fibroblast (GF) lines, as well as primary oral epithelial cells. These studies demonstrate that DABCO derivatives can be incorporated into denture materials and exert fungicidal activity with minimal cytotoxicity to mammalian cells. DC11MAF and C2DC11MAF are considered strong candidates as therapeutic or preventive alternatives against Candida-associated denture stomatitis.
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Malakhov A, Wen J, Zhang BX, Wang H, Geng H, Chen XD, Sun Y, Yeh CK. Rechargeable anticandidal denture material with sustained release in saliva. Oral Dis 2016; 22:391-8. [PMID: 26855200 DOI: 10.1111/odi.12456] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/20/2016] [Accepted: 02/02/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Candida-induced denture stomatitis is a common debilitating problem among denture wearers. Previously, we described the fabrication of a new denture material that released antifungal drugs when immersed in phosphate buffered saline. Here, we use more clinically relevant immersion conditions (human saliva; 37°C) and measure miconazole release and bioactivity. MATERIALS AND METHODS Disks were prepared by grafting PNVP [poly(N-vinyl-2-pyrrolidinone)] onto PMMA [poly(methylmethacrylate)] using plasma initiation (PMMA-g-PNVP) and then loaded with miconazole. Drug-loaded disks were immersed in 10-100% human saliva (1-30 days). Miconazole release was measured and then tested for bioactivity vs miconazole-sensitive and miconazole-resistant Candida isolates. RESULTS HPLC was used to quantify miconazole levels in saliva. Miconazole-loaded disks released antifungal drug for up to 30 days. Higher drug release was found with higher concentrations of saliva, and, interestingly, miconazole solubility was increased with higher saliva concentrations. The released miconazole retained its anticandidal activity. After immersion, the residual miconazole could be quenched and the disks recharged. Freshly recharged disks displayed the same release kinetics and bioactivity as the original disks. Quenched disks could also be charged with chlorhexidine that displayed anticandidal activity. CONCLUSIONS These results suggest that PMMA-g-PNVP is a promising new denture material for long-term management of denture stomatitis.
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Affiliation(s)
- A Malakhov
- Geriatric Research, Education and Clinical Center and Research Service, Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - J Wen
- Department of Chemistry, University of Massachusetts, Lowell, MA, USA
| | - B-X Zhang
- Geriatric Research, Education and Clinical Center and Research Service, Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - H Wang
- Geriatric Research, Education and Clinical Center and Research Service, Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - H Geng
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - X-D Chen
- Geriatric Research, Education and Clinical Center and Research Service, Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Y Sun
- Department of Chemistry, University of Massachusetts, Lowell, MA, USA
| | - C-K Yeh
- Geriatric Research, Education and Clinical Center and Research Service, Audie L Murphy Division, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Tsutsumi C, Takakuda K, Wakabayashi N. Reduction of Candida biofilm adhesion by incorporation of prereacted glass ionomer filler in denture base resin. J Dent 2015; 44:37-43. [PMID: 26655872 DOI: 10.1016/j.jdent.2015.11.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/28/2015] [Accepted: 11/30/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES This study investigated the influence of surface reaction-type prereacted glass ionomer (S-PRG) fillers on Candida albicans adhesion on denture base resin. METHODS Discs were prepared by incorporating the S-PRG filler into the polymer powder of a polymethyl methacrylate (PMMA)-based, heat-polymerizing resin at 0 (control), 5%, 10%, and 20% (w/w). The surface roughness of all disc surfaces was measured. Elemental analysis of released Na(+), Sr(2+), SiO3(2-), Al(3-), BO3(3-), and F(-) was performed after water immersion. Each disc was placed in a well with artificial saliva to form acquired pellicle, incubated, washed with phosphate-buffered saline, and immersed in a C. albicans (JCM2085) cell suspension standardized at 10(4) cells/ml. After aerobic incubation at 37 °C for 24 h, the metabolic mitochondrial activity, total biofilm biomass, and biofilm thickness were evaluated. The morphogenetic transition of C. albicans in the early culture stage (1 and 3 h) was observed. RESULTS There was a slight but significant increase in the surface roughness with an increase in the filler content. The metabolic activity and total biomass volume were significantly lower in all filler groups than in the control group, although there were no significant differences among the filler groups. Groups with at least 5% filler content exhibited a thinner biofilm compared with the control group. All filler groups showed hyphal forms at 3 h, with the length of the hyphae being lesser than those in the control group. CONCLUSIONS Although the incorporation of S-PRG filler slightly increases the surface roughness of denture base resin, it reduces the adhesion of C. albicans. CLINICAL SIGNIFICANCE The S-PRG filler has the potential to reduce Candida albicans adhesion on denture base resin and may lower the risk of denture stomatitis. However, filler incorporation can increase the surface roughness of heat-polymerizing denture base resin.
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Affiliation(s)
- Chiaki Tsutsumi
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazuo Takakuda
- Medical and Dental Device Technology Incubation Center, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
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Jiang F, Yeh CK, Wen J, Sun Y. N-trimethylchitosan/alginate layer-by-layer self assembly coatings act as "fungal repellents" to prevent biofilm formation on healthcare materials. Adv Healthc Mater 2015; 4:469-75. [PMID: 25295485 DOI: 10.1002/adhm.201400428] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/28/2014] [Indexed: 12/18/2022]
Abstract
Fungal biofilm formation on healthcare materials is a significant clinical concern, often leading to medical-device-related infections, which are difficult to treat. A novel fungal repellent strategy is developed to control fungal biofilm formation. Methylacrylic acid (MAA) is grated onto poly methyl methacrylate (PMMA)-based biomaterials via plasma-initiated grafting polymerization. A cationic polymer, trimethylchitosan (TMC), is synthesized by reacting chitosan with methyl iodide. Sodium alginate (SA) is used as an anionic polymer. TMC/SA multilayers are coated onto the MAA-grafted PMMA via layer-by-layer self-assembly. The TMC/SA multilayer coatings significantly reduce fungal initial adhesion, and effectively prevent fungal biofilm formation. It is concluded that the anti-adhesive property of the surface is due to its hydrophilicity, and that the biofilm-inhibiting action is attributed to the antifungal activity of TMC as well as the chelating function of TMC and SA, which may have acted as fungal repellents. Phosphate buffered saline (PBS)-immersion tests show that the biofilm-modulating effect of the multilayer coatings is stable for more than 4 weeks. Furthermore, the presence of TMC/SA multilayer coatings improves the biocompatibility of the original PMMA, offering a simple, yet effective, strategy for controlling fungal biofilm formation.
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Affiliation(s)
- Fuguang Jiang
- Department of Chemistry; University of Massachusetts; Lowell MA 01854 USA
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry; University of Texas Health Science Center at San Antonio and Geriatric Research; Education and Clinical Center; Audie L. Murphy Division; South Texas Veterans Health Care System; San Antonio TX 78229 USA
| | - Jianchuan Wen
- Department of Chemistry; University of Massachusetts; Lowell MA 01854 USA
| | - Yuyu Sun
- Department of Chemistry; University of Massachusetts; Lowell MA 01854 USA
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