In Vitro Antifungal Susceptibility of Candida Species Isolated from Iranian Patients with Denture Stomatitis.

BACKGROUND: Candida-associated denture stomatitis (CADS) is a common fungal infection in people who wear dentures. The main objective of this study was to make molecular identification of causative agents of CADS and in vitro antifungal susceptibility testing (AFST) in the Iranian patients with denture stomatitis. METHODS: A total of 134 Candida spp. were obtained from patients with denture stomatitis. The Candida spp. were identified using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) involving the universal internal transcribed spacer (ITS1 and ITS4) primers, which were subjected to digestion with MspI and BlnI restriction enzymes. The in vitro antifungal susceptibility of Candida spp. to fluconazole (FLC), terbinafine (TRB), itraconazole (ITC), voriconazole (VRC), posaconazole (POS), ketoconazole (KET), amphotericin B (AMB), and caspofungin (CAS) was evaluated using the Clinical and Laboratory Standards Institute M27-A3 and M27-S4 guidelines. RESULTS: Overall, C. albicans was the most commonly isolated species (n = 84; 62.6%), followed by C. glabrata (n = 23; 17.2%), C. tropicalis (n = 16; 12%), and C. parapsilosis (n = 11; 8.2%). Posaconazole had the lowest geometric mean minimum inhibitory concentration (MIC) (0.03 µg/ml), followed by AMB (0.05 µg/ml), ITC (0.08 µg/ml), VRC (0.11 µg/ml), CAS (0.12 µg/ml), KET (0.15 µg/ml), and FLC (0.26 µg/ml). DISCUSSION: Our study showed that C. albicans was most prevalent in Iranian patients with CADS and was susceptible to both azoles and amphotericin B. In addition, POS could be an appropriate alternative to the current antifungal agents used for the treatment of CADS, as well as in the treatment of recurrent candidiasis.

Effect of untreated zirconium oxide nanofiller on the flexural strength and surface hardness of autopolymerized interim fixed restoration resins.

OBJECTIVE: Autopolymerized poly methyl methacrylate (PMMA) resin is commonly used for the construction of interim restorations; however, it has less than optimal mechanical properties. In this article, we evaluated the reinforcing effect of adding untreated zirconia nanoparticles on the flexural strength and surface hardness of this resin. METHODS: A total of 80 specimens were fabricated. Forty each were used for the flexural strength test and for the surface hardness test. The specimens were categorized into four groups of 10 specimens each as follows: pure PMMA, PMMA with 1%, PMMA with 2.5%, and PMMA with 5% weight of untreated zirconia nanofillers. The flexural strength of the specimens was evaluated by the three-point bending test, and the surface hardness was assessed by micro Vickers hardness test. The data obtained from these tests were statistically analyzed using one-way ANOVA and Tukey tests. In addition, the fracture surface characteristics were assessed using scanning electron microscopy. RESULTS: Flexural strength testing showed a significant increase in the group with 2.5% zirconia nanofillers, but not in the groups with 1% and 5% nanofillers. Surface hardness was also significantly increased in the groups with 2.5% and 5% nanofillers, but not in the 1% group. The SEM images showed a highly brittle fracture in the pure PMMA group and noticeably less brittle fracture in the group with PMMA with 2.5% weight of zirconia nanofillers. Several cracks and void were also observed in the group with 5% weight of nanofillers. CONCLUSION: Reinforcement of the autopolymerized acrylic resin with 2.5% weight of untreated zirconia nanofillers significantly increased its flexural strength and surface hardness. CLINICAL SIGNIFICANCE: The interim restorations play an important role in protection of hard and soft oral tissue and providing the critical function and esthetics before the final restoration replacing. Temporary restorations must have sufficient flexural strength to resist deformation during mastication force. Moreover, sufficient surface hardness is also necessary to resist abrasion. The color stability of materials is considered as an important clinical criterion, specifically in esthetics zone. Several materials have been applied to improve the flexural strength and surface hardness for representing clinical success. Zirconia nanoparticles show desirable features, such as high hardness, biocompatibility, and favorable color because of its white color. It seems that the addition of the nano zirconia to acrylic resins can be the appropriate method for improving interim restoration.

Fracture resistance of upper central incisors restored with different posts and cores.

OBJECTIVES: To determine and compare the fracture resistance of endodontically treated maxillary central incisors restored with different posts and cores. MATERIALS AND METHODS: Forty-eight upper central incisors were randomly divided into four groups: cast post and core (group 1), fiber-reinforced composite (FRC) post and composite core (group 2), composite post and core (group 3), and controls (group 4). Mesio-distal and bucco-lingual dimensions at 7 and 14 mm from the apex were compared to ensure standardization among the groups. Twelve teeth were prepared for crown restoration (group 4). Teeth in other groups were endodontically treated, decoronated at 14 mm from the apex, and prepared for posts and cores. Resin-based materials were used for cementation in groups 1 and 2. In group 3, composite was used directly to fill the post space and for core build-up. All samples were restored by standard metal crowns using glass ionomer cement, mounted at 135° vertical angle, subjected to thermomechanical aging, and then fractured using a universal testing machine. Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. RESULTS: Fracture resistance of the groups was as follows: Control (group 4) > cast post and core (group 1) > fiber post and composite core (group 2) > composite post and core (group 3). All samples in groups 2 and 3 fractured in restorable patterns, whereas most (58%) in group 1 were non-restorable. CONCLUSIONS: Within the limitations of this study, FRC posts showed acceptable fracture resistance with favorable fracture patterns for reconstruction of upper central incisors.