Biofilm inhibition of denture cleaning tablets and carvacrol on denture bases produced with different techniques.

OBJECTIVES: This study compares the biofilm inhibition effects of denture cleaning tablets, carvacrol, and their combined use against Candida albicans on denture bases produced with different techniques. Additionally, the surface roughness and contact angles of these denture bases were evaluated. MATERIALS AND METHODS: Test samples were prepared from four different denture base materials (cold-polymerized, heat-polymerized, CAD/CAM milling, and 3D-printed). The surface roughness and contact angles of the test samples were measured using a profilometer and goniometer, respectively. For the evaluation of biofilm inhibition, samples were divided into 5 subgroups: Corega and carvacrol, separately and combined treatments, positive (inoculated with C. albicans) and negative control (non-inoculated with C. albicans, only medium). Biofilm mass was determined using the crystal violet method. An additional prepared test sample for each subgroup was examined under scanning electron microscopy (SEM). RESULTS: The surface roughness values of the 3D-printed test samples were found to be statistically higher than the other groups (P < .001). The water contact angle of all test materials was not statistically different from each other (P > .001). Corega and carvacrol, separately and combined, significantly decreased the amount of biofilm on all surfaces (P < .0001). Treatment of corega alone and in combination with carvacrol to the 3D-printed material caused less C. albicans inhibition than the other groups (P < .001; P < .05). CONCLUSIONS: The surface roughness values of all test groups were within the clinically acceptable threshold. Although Corega and carvacrol inhibited C. albicans biofilms, their combined use did not show a synergistic effect. CLINICAL RELEVANCE: Carvacrol may be used as one of the disinfectant agents for denture cleaning due to its biofilm inhibition property.

The antimicrobial activity of an antiseptic soap against Candida Albicans and Streptococcus Mutans single and dual-species biofilms on denture base and reline acrylic resins.

To evaluate the effect of antiseptic soap on single and dual-species biofilms of Candida albicans and Streptococcus mutans on denture base and reline resins. Samples of the resins were distributed into groups (n = 9) according to the prevention or disinfection protocols. In the prevention protocol, samples were immersed in the solutions (Lifebuoy, 0.5% sodium hypochlorite solution and PBS) for 7, 14 and 28 days before the single and dual-species biofilms formation. Overnight denture disinfection was simulated. In the disinfection protocol, samples were immersed in the same solutions during 8 hours after the single and dual-species biofilms formation. Antimicrobial activity was analyzed by counting colony-forming units (CFU/mL) and evaluating cell metabolism. Cell viability and protein components of the biofilm matrix were evaluated using confocal laser scanning microscopy (CLSM). Data were submitted to ANOVA, followed by Tukey's post-test (α = 0.05) or Dunnett's T3 multiple comparisons test. In the prevention protocol, Lifebuoy solution effectively reduced the number of CFU/mL of both species. In addition, the solution decreased the cell metabolism of the microorganisms. Regarding disinfection protocol, the Lifebuoy solution was able of reduce approximately of 2-3 logs for all the biofilms on the denture base and reline resin. Cellular metabolism was also reduced. The images obtained with CLSM corroborate these results. Lifebuoy solution was effective in reducing single and dual-species biofilms on denture base and reline resins.

Efficacy of denture cleansers on Candida albicans adhesion and their effects on the properties of conventional, milled CAD/CAM, and 3D-printed denture bases.

OBJECTIVES: Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for conventional, milled, and 3D-printed denture bases. MATERIALS AND METHODS: A total of 240 resin samples were made, 120 for testing Candida albicans adhesion, optical stabilities (ΔE00), roughness (Ra), hydrophilicity (°), surface free energy (Owens-Wendt) and 120 samples for testing Candida albicans adhesion, surface microhardness (Knoop), flexural strength and modulus of elasticity in a three-point test, in which they were divided into 3 groups of denture resin (n = 40) and subdivided into 5 cleaners of dentures (n = 8). Data were evaluated by two-way ANOVA and Tukey's test for multiple comparisons (α = 0.05). RESULTS: Denture cleaners with an alkaline solution and dilute acid composition were those that showed the greatest effectiveness in reducing Candida albicans (P < 0.001), however 1% NaOCl significantly affected the properties of the resins (P < 0.05). Denture 3D-printed showed that the surface microhardness was significantly lower for all cleansers (P < 0.05). CONCLUSIONS: Listerine demonstrated superior efficacy in reducing Candida albicans with minimal effect on denture properties, whereas 1% NaOCl had a significant negative impact on the properties. The mechanical properties were significantly lower in 3D-printed resin than in other resins for all denture cleansers. CLINICAL RELEVANCE: Denture base materials are being sold to adapt to the CAD/CAM system, increasing the number of users of dentures manufactured with this system. Despite this, there is little investigation into denture cleaners regarding the adhesion capacity of microorganisms and the optical, surface and mechanical properties of dentures, thus requiring further investigation.

Assessing the suitability of fused deposition modeling to produce acrylic removable denture bases.

OBJECTIVE: To study the feasibility of using poly methyl methacrylate (PMMA) filament and fused deposition modeling (FDM) to manufacture denture bases via the development of a study that considers both conventional and additive-based manufacturing techniques. MATERIALS AND METHODS: Five sample groups were compared: heat and cold cured acrylic resins, CAD/CAM milled PMMA, 3D-printed PMMA (via FDM), and 3D-printed methacrylate resin (via stereolithography, SLA). All groups were subjected to mechanical testing (flexural strength, impact strength, and hardness), water sorption and solubility tests, a tooth bonding test, microbiological assessment, and accuracy of fit measurements. The performance of sample groups was referred to ISO 20795-1 and ISO/TS 19736. The data was analyzed using one-way ANOVA. RESULTS: Samples manufactured using FDM performed within ISO specifications for mechanical testing, water sorption, and solubility tests. However, the FDM group failed to achieve the ISO requirements for the tooth bonding test. FDM samples presented a rough surface finish which could ultimately encourage an undesirable high level of microbial adhesion. For accuracy of fit, FDM samples showed a lower degree of accuracy than existing materials. CONCLUSIONS: Although FDM samples were a cost-effective option and were able to be quickly manufactured in a reproducible manner, the results demonstrated that current recommended testing regimes for conventionally manufactured denture-based polymers are not directly applicable to additive-manufactured denture base polymers. Therefore, new standards should be developed to ensure the correct implementation of additive manufacturing techniques within denture-based fabrication workflow.

Antimicrobial activity of cleanser tablets against S. mutans and C. Albicans on different denture base materials.

BACKGROUND: In this study, the antimicrobial activity of three different cleanser tablets on S. mutans and C. albicans adhesion to PMMA, polyamide and 3D printed resin was investigated. METHODS: 40 samples were prepared for PMMA (SR Triplex Hot), polyamide (Deflex) and 3D printed resin (PowerResins Denture) materials and divided into four subgroups for cleansers (Aktident™, Protefix™, Corega™ tablets and distilled water) (n = 5). After the surface preparations were completed, the samples were immersed separately in tubes containing the prepared microorganism suspension and incubated at 37˚C for 24 h. After the incubation, the samples were kept in the cleanser solutions. The samples were then transferred to sterile saline tubes. All the tubes were vortexed and 10 µl was taken from each of them. Sheep blood agar was inoculated for colony counting. The inoculated plates were incubated for 48 h for S. mutans and 24 h for C. albicans. After incubation, colonies observed on all plates were counted. Statistical analyses were done with three-way ANOVA and Tukey's multiple comparison test. RESULTS: Polyamide material registered the highest colony count of S. mutans, whereas PMMA registered the lowest. Significant differences in S. mutans adherence (p = 0.002) were found between the three denture base materials, but no such difference in C. albicans adherence (p = 0.221) was identified between the specimens. All three cleanser tablets eliminated 98% of S. mutans from all the material groups. In all these groups, as well, the antifungal effect of Corega™ on C. albicans was significantly higher than those of the other two cleanser tablets. CONCLUSIONS: According to the study's results, it may be better to pay attention to surface smoothness when using polyamide material to prevent microorganism retention. Cleanser tablets are clinically recommended to help maintain hygiene in removable denture users, especially Corega tablets that are more effective on C. albicans.

Silver vanadate nanomaterial incorporated into heat-cured resin and coating in printed resin - Antimicrobial activity in two multi-species biofilms and wettability.

OBJECTIVES: To incorporate the nanostructured silver vanadate decorated with silver nanoparticles (AgVO3) into denture base materials: heat-cured (HC) and 3D printed (3DP) resins, at concentrations of 2.5 %, 5 %, and 10 %; and to evaluate the antimicrobial activity in two multi-species biofilm: (1) Candida albicans, Candida glabrata, and Streptococcus mutans, (2) Candida albicans, Pseudomonas aeruginosa, and Staphylococcus aureus, and the wettability. METHODS: The AgVO3 was added to the HC powder, and printed samples were coated with 3DP with AgVO3 incorporated. After biofilm formation, the antimicrobial activity was evaluated by colony forming units per milliliter (CFU/mL), metabolic activity, and epifluorescence microscopy. Wettability was assessed by the contact angles with water and artificial saliva. RESULTS: In biofilm (1), HC-5 % and HC-10 % showed activity against S. mutans, HC-10 % against C. glabrata, and HC-10 % and 3DP-10 % had higher CFU/mL of C. albicans. 3DP-5 % had lower metabolic activity than the 3DP control. In biofilm (2), HC-10 % reduced S. aureus and P. aeruginosa, and HC-5 %, 3DP-2.5 %, and 3DP-5 % reduced S. aureus. 3DP incorporated with AgVO3, HC-5 %, and HC-10 % reduced biofilm (2) metabolic activity. 3DP-5 % and 3DP-10 % increased wettability with water and saliva. CONCLUSION: HC-10 % was effective against C. glabrata, S. mutans, P. aeruginosa, and S. aureus, and HC-5 % reduced S. mutans and S. aureus. For 3DP, 2.5 % and 5 % reduced S. aureus. The incorporation of AgVO3 into both resins reduced the metabolic activity of biofilms but had no effect on C. albicans. The wettability of the 3DP with water and saliva increased with the addition of AgVO3. CLINICAL SIGNIFICANCE: The incorporation of silver vanadate into the denture base materials provides antimicrobial efficacy and can prevent the aggravation of oral and systemic diseases. The incorporation of nanomaterials into printed resins is challenging and the coating is an alternative to obtain the inner denture base with antimicrobial effect.

Evaluation of surface roughness, wettability and adhesion of multispecies biofilm on 3D-printed resins for the base and teeth of complete dentures.

OBJECTIVE: This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth). METHODOLOGY: Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%). RESULTS: The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin. CONCLUSION: The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

Development of an antimicrobial, 3D printable denture base material with K18 quaternary ammonium silane-functionalized methyl methacrylate and filler.

STATEMENT OF PROBLEM: Denture base materials are highly susceptible to microbial colonization, which can lead to denture stomatitis. In addition, patients who sleep with their dentures have an increased chance of contracting pneumonia. Commercially available antimicrobial denture base materials to prevent or combat microbial colonization are lacking. PURPOSE: The purpose of this in vitro study was to determine the effects of K18 quaternary ammonium methacryloxy silane-functionalized filler (K18-Filler) and methyl methacrylate (K18-MMA) on the polymerization of 3D printed denture base material and its esthetic, mechanical, and antimicrobial properties. MATERIAL AND METHODS: K18-Filler (0%, 10%, 20% w/w) and K18-MMA (0%, 5%, 12.5% w/w) were added to a 3D printable denture base resin (Denture Base Resin, Original Pink; Formlabs Inc) and 3D printed. Specimens were tested by using the Rockwell15T hardness, near infrared FTIR monomer-to-polymer degree of conversion (DoC), transparency parameter (TP), color shift, and 3-point bend and by counting colony forming units against Streptococcus aureus, Streptococcus sanguinis and Candida albicans tests. Data were analyzed using analysis of variance with the Tukey-Kramer HSD post hoc test. RESULTS: Control resins had significantly higher Rockwell15T hardness than most of the K18 groups (P<.05) but had comparable DoC with all K18 groups except one, showing that all groups were well polymerized. Controls had significantly higher TP than most K18 groups, but most K18 groups had ΔE<3.3, so the color shift was not noticeable. However, the 12.5% K18-MMA with 10% and 20% K18-Filler groups, which were also the groups used to test for antimicrobial activity, had ΔE>8. All K18 groups had comparable or greater moduli than the controls, but the controls had significantly higher ultimate transverse strengths than most K18 groups (P<.05). All 12.5% K18-MMA with K18-Filler groups had significant antimicrobial activity against S. aureus, S. sanguinis, and C. albicans. CONCLUSIONS: 12.5% K18-MMA and K18-Filler produced 3D printable denture materials with comparable polymerization properties and significant antimicrobial properties against S. mutans, S. sanguinis, and C. albicans. High K18-MMA and K18-Filler concentrations caused significant color shifts and reductions in ultimate strengths.

Development of novel antimicrobial acrylic denture modified with copper nanoparticles.

PURPOSE: This study aimed to synthesize heat-cured poly(methyl methacrylate) (PMMA) acrylic formulated with copper nanoparticles (nCu) for producing dentures with antimicrobial properties and ability to prevent denture stomatitis (DS). METHODS: nCu/PMMA nanocomposites were prepared through in situ formation of nCu into methyl methacrylate (MMA). The fabricated material was characterized using scanning electron microscopy, spectroscopy (energy-dispersive X-ray, attenuated total reflectance-Fourier-transform infrared, and X-ray photoelectron spectroscopy), X-ray diffraction analysis, and mechanical flexural tests (ISO 20795-1:2008). Antimicrobial activity against Candida albicans and oral bacteria was determined. MTS assay (ISO 10993-5:2009) and copper release experiments were conducted to assess cytotoxicity. In the clinical trial, participants wearing nCu/PMMA (n=25) and PMMA (n=25) dentures were compared; specifically, DS incidence and severity and Candida species proliferation were assessed for 12 months. Data were analyzed using analysis of variance with Tukey's post hoc test (α=0.05). RESULTS: nCu/PMMA nanocomposite loaded with 0.045% nCu exhibited the maximum antimicrobial activity against C. albicans and other oral bacteria without producing cytotoxicity in the wearer. nCu/PMMA dentures retained their mechanical and aesthetic properties as well as inhibited the growth of Candida species on both denture surface and patient palate. DS incidence and severity were lower in the nCu/PMMA denture group than in the PMMA denture group. CONCLUSIONS: PMMA acrylic produced with copper nanotechnology is antimicrobial, biocompatible, and aesthetic and can reduce DS incidence. Thus, this material may act as a novel preventive alternative for oral infections associated with denture use.

In vitro comparison of antifungal activity of conventional alcohol sprays and antimicrobial photodynamic therapy on acrylic denture resin.

BACKGROUND: Traditionally, alcohol sprays are used for disinfection of acrylic-base denture surfaces. A limited number of studies have assessed the role of antimicrobial photodynamic therapy (aPDT) in this regard; however, it remains debatable whether conventional alcohol sprays are superior to aPDT in terms of antifungal activity or vis versa. OBJECTIVE: The aim of the present in vitro study is to compare the antifungal activity of conventional alcohol sprays and aPDT on acrylic denture resin. METHODS: Individuals wearing complete dentures at least on one arch were included. Dentures were randomly divided into three groups. Groups 1-3 were disinfected with an alcohol-based antiseptic spray and aPDT, respectively. Assessment of oral yeast growth was done using swab samples. The culture mediums were incubated at 37∘C for 72 hours and viewed through a microscope. The numbers of colony forming units (CFU/ml) were determined. P< 0.05 were considered statistically significant. RESULTS: At baseline, the mean CFU/ml in Groups 1-3 were comparable. After disinfection, a statistically significant reduction in microbial CFU/ml was observed in Groups 1 (P< 0.05) and 2 (P< 0.05) compared with baseline. In Group 3, there was no difference in CFU/ml throughout the study. After disinfection, there was no difference in microbial CFU/ml in dentures in Groups 1 and 2. CONCLUSION: Conventional alcohol sprays are as effective as aPDT towards reducing oral yeasts CFU/ml on acrylic denture resin.

Microbial adhesion and biofilm formation by Candida albicans on 3D-printed denture base resins.

This study evaluated surface properties and adhesion/biofilm formation by Candida albicans on 3D printed denture base resins used in 3D printing. Disc-shaped specimens (15 mm x 3 mm) of two 3D-printed resins (NextDent Denture 3D+, NE, n = 64; and Cosmos Denture, CO, n = 64) and a heat-polymerized resin (Lucitone 550, LU, control, n = 64) were analyzed for surface roughness (Ra µm) and surface free energy (erg cm-2). Microbiologic assays (90-min adhesion and 48-h biofilm formation by C. albicans) were performed five times in triplicate, with the evaluation of the specimens' surface for: (i) colony forming units count (CFU/mL), (ii) cellular metabolism (XTT assay), and (iii) fluorescence and thickness of biofilm layers (confocal laser scanning microscopy). Data were analyzed using parametric and nonparametric tests (α = 0.05). LU presented higher surface roughness Ra (0.329±0.076 µm) than NE (0.295±0.056 µm) (p = 0.024), but both were similar to CO (0.315±0.058 µm) (p = 1.000 and p = 0.129, respectively). LU showed lower surface free energy (47.47±2.01 erg cm-2) than CO (49.61±1.88 erg cm-2) and NE (49.23±2.16 erg cm-2) (p<0.001 for both). The CO and NE resins showed greater cellular metabolism (p<0.001) and CO only, showed greater colonization (p = 0.015) by C. albicans than LU in the 90-min and 48-hour periods. It can be concluded that both 3D-printed denture base resins are more prone to colonization by C. albicans, and that their surface free energy may be more likely associated with that colonization than their surface roughness.

Sargassum polycystum and Turbinaria conoides Seaweed-based Novel Denture Cleanser: An In Vitro Study.

AIM: The study ventures into evaluating the antifungal and antibacterial efficacy of commercially available denture cleanser with Sargassum polycystum, Turbinaria conoides seaweeds, and the combination of seaweeds. MATERIALS AND METHODS: Poly(methyl methacrylate) disks measuring 10 × 2 mm were fabricated. The samples are divided into four groups of 21 samples each. The denture base was coated with Candida albicans and Streptococcus mutans individually. Group I was treated with Fittydent, group II (S. polycystum and T. conoides seaweeds combination), group III (S. polycystum), and group IV (T. conoides). The colony-formation units present on the surface of the denture were evaluated before and after treatment with different denture cleansers using the serial dilution method. Statistical analysis was done using descriptive statistics, analysis of variance, and post hoc Bonferroni analysis. RESULTS: At 10-5 dilution, T. conoides (group IV) was statistically significant in reducing both C. albicans and S. mutans. At 10-10 dilution, T. conoides (group IV) and S. polycystum and T. conoides combination (group II) had high antibacterial efficacy and were statistically significant. Fittydent (group I) had higher antifungal efficacy and was statistically significant in comparison to S. polycystum (group III) alone. At 10-10 dilution, the T. conoides (group IV), S. polycystum, and T. conoides combination (group II) showed no evidence of a significant difference in comparison to Fittydent (group I). Fittydent had higher antibacterial efficacy and was statistically significant in comparison to S. polycystum (group III) alone. CONCLUSION: Sargassum polycystum and T. conoides combination and T. conoides were found to have higher antibacterial efficacy in comparison to commercially available denture cleanser and also were found to have equal antifungal efficacy in comparison to commercially available denture cleanser.

Anti-fungal efficacy of Miswak Extract (Salvadora Persica) and commercial cleaner against Candida albicans on heat cured polymethylmethacrylate denture base.

AIM: The aim of the study was to compare the antifungal efficacy between commercial cleaner (Corega) and Miswak extract (Salvadora persica) against Candida albicans on heat cured Polymethyl methacrylate (PMMA) acrylic denture base resin. MATERIALS AND METHODS: Forty-eight samples of heat cured PMMA acrylic denture base resin were fabircated in the study. The sterile acrylic resin specimens were immersed in standardized cell suspension of Candida albicans and incubated for 60 min at 370°C for cell adhesion and 2 h at 370°C for biofilm formation. After 24 h biofilm was evaluated by cell viability (CFUs) on SDA and cell counting of Candida albicans under light microscope at 400× magnification. The fungicidal effect of commercial cleaner and Miswak extract on Candida albicans biofilm was then evaluated by colony-forming units on SDA and cell counting under light microscope at 400× magnification. RESULTS: Screening test agar disk-diffusion assay showed mean inhibitory zone of 3 mm for commercial cleaner as compared to Miswak extract, which showed mean inhibitory zone of 2 and 1 mm for different concentrations. Broth microdilution method showed 31 mg/ml MIC and 62.5 mg/ml Minimal Fungicidal Concentration (MFC) values for commercial cleaner as compared to Miswak extract that showed 125 mg/ml MIC and 250 mg/ml MFC values against Candida albicans. A significant difference (p < 0.05) was observed between pre and post treatment of both commercial cleaner and Miswak extract, for CFUs and cell count for Candida albicans. CONCLUSION: Commercial denture cleaner (Corega) showed better antifungal (C albicans) activity than Miswak extract (Salvadora persica) on heat cured PMMA acrylic denture base resin.

Comparison of antifungal efficacy of commercially available denture cleanser and the extract of Turbinaria conoides seaweed against Candida albicans adherent to acrylic denture base resin: An in vitro study.

Aim: One of the main factors responsible for the development of Candida albicans on the surface of denture is improper maintenance of dentures. Denture hygiene can be achieved by regular cleansing of dentures using an appropriate denture cleanser. The aim of the study is to evaluate the antifungal efficacy of commercially available denture cleanser and the extract of Turbinaria conoides seaweed against C. albicans adherent to the surface of denture base resin. Settings and Design: This was an in vitro experimental study. Materials and Methods: Twenty-four Acrylic resin samples of dimension 10-mm radius and 2-mm thickness was randomly divided into two groups. The denture base resin was coated with C. albicans. The colonies present on the surface of each denture base resin were evaluated by serial dilution method. Group A was treated with commercially available denture cleanser and Group B was treated with extract of seaweed T. conoides. The colonies were then evaluated using serial dilution. Statistical Analysis Used: The colony count values obtained by serial dilution were tabulated. These values were statistically analysed using t-test. Results: Reduction of colony count is more in T. conoides than commercially available Fittydent; the difference was statistically significant with a mean difference of 65 at dilution 10-2 and 29.25 at dilution 10-3 using t-test with P < 0.001. Conclusion: Within the limitations of this in vitro study, it was proved that the extract of T. conoides seaweed and commercially available denture cleanser Fittydent was effective in reducing the colony count of C. albicans. T. conoides seaweed is statistically significant than commercially available Fittydent.

Silver nanoparticles in denture adhesive: An antimicrobial approach against Candida albicans.

OBJECTIVE: To evaluate the antimicrobial potential of silver nanoparticles (Ag NPs) synthesized using three different routes (ultraviolet light, Turkevich, and green chemistry method using Glycine max extract) associated with COREGA® denture powder adhesive. METHODS: Heat-cured acrylic resin specimens were treated with different Ag NPs associated with the adhesive (AD + Ag UV, AD + Ag Turk, and AD + Ag Gm groups). As controls, the specimens were treated with a combination of adhesive and nystatin (AD + Nyst group), only adhesive (AD group), or submerged on the surface of the specimens (PBS group). After the treatments, biofilms of C. albicans developed for 3, 6, and 12 h on the specimen surfaces. The biofilm was quantified using colony-forming units per milliliter, colorimetric assay, and confocal laser scanning microscopy. RESULTS: Regardless of the period, we observed an inhibition of fungal load and a reduction in metabolic activity and biofilm mass in the resin specimens treated with the combinations AD/Ag NPs, compared to AD and PBS. The antimicrobial action of the AD + Turk and AD + Ag Gm groups was similar than that for the AD + Nyst group in all periods and viability tests, except for the biofilm mass (12 h). CONCLUSIONS: The COREGA® adhesive with Ag NPs, mainly those synthesized using the Turkevich and Glycine max methods, showed excellent antimicrobial activity against C. albicans biofilms, maintained for up to 12 h. CLINICAL SIGNIFICANCE: The association of Ag NPs to the adhesive can add preventive or therapeutic effects against denture stomatitis, to this prosthetic material.

Antimicrobial surface processing of polymethyl methacrylate denture base resin using a novel silica-based coating technology.

OBJECTIVES: This study investigated the surface characteristics of denture base resin coatings prepared using a novel silica-based film containing hinokitiol and assessed the effect of this coating on Candida albicans adhesion and growth. METHODS: Silica-based coating solutions (control solution; CS) and CS containing hinokitiol (CS-H) were prepared. C. albicans biofilm formed on denture base specimens coated with each solution and these uncoated specimens (control) were analyzed using colony-forming unit (CFU) assay, fluorescence microscopy, and scanning electron microscopy (SEM). Specimen surfaces were analyzed by measuring the surface roughness and wettability and with Fourier-transform infrared (FT-IR) and proton nuclear magnetic resonance (1H NMR). Stability of coated specimens was assessed via immersion in water for 1 week for each group (control-1w, CS-1w, and CS-H-1w) followed by CFU assay, measurement of surface roughness and wettability, and FT-IR. RESULTS: CS-H and CS-H-1w contained significantly lower CFUs than those present in the control and control-1w, which was also confirmed via SEM. Fluorescence microscopy from the CS-H group identified several dead cells. The values of surface roughness from coating groups were significantly less than those from the control and control-1w. The surface wettability from all coating groups exhibited high hydrophobicity. FT-IR analyses demonstrated that specimens were successfully coated, and 1H NMR analyses showed that hinokitiol was incorporated inside CS-H. CONCLUSIONS: A silica-based denture coating that incorporates hinokitiol inhibits C. albicans growth on denture. CLINICAL RELEVANCE: We provide a novel antifungal denture coating which can be helpful for the treatment of denture stomatitis.

Surface Characteristics and Microbial Adhesion in Polymethylmethacrylate for Denture Base Submitted to Antimicrobial Agents and Cleaning Agents: A Systematic Review.

This review aimed to identify the influence of antimicrobial and cleaning agents on surface characteristics such as surface free energy (SFE) and wettability, and microbial adhesion in polymethylmethacrylate (PMMA) for denture base. The review question, based on PICO, was: "Does intervention with antimicrobial and cleaning agents in PMMA influence the surface free energy, wettability, and consequently the microbial adhesion?" and the protocol was registered in Open Science Framework (osf. io/v3xgn). The search was performed in PubMed, Lilacs, Embase, Scopus, and Science Direct databases, using the terms: ("acrylic resin" OR PMMA) AND (antimicrobial OR antibacterial) AND ("electrostatic interaction" OR surface free energy) AND (biofilm OR "bacteria adhesion"), and resulted in 462 articles, of which 7 were included. The antimicrobials polypara-xylylene, carboxybetaine methacrylate, ethylene glycol methacrylate phosphate, and deposition of F and Ag ions in PMMA influenced the SFE and wettability. Denture cleaners reduced microbial adhesion. Five of the included studies evaluated the microbial adhesion, however, only two observed a direct relationship between SFE, wettability, and microbial adhesion. It was concluded that the intervention with antimicrobial and cleaning agents in PMMA can interfere in SFE and surface wettability, but no correlation was observed between microbial adhesion and these surface characteristics in PMMA.

Molecular weight tuning optimizes poly(2-methoxyethyl acrylate) dispersion to enhance the aging resistance and anti-fouling behavior of denture base resin.

Poly(methyl methacrylate) (PMMA)-based denture base resins easily develop oral bacterial and fungal biofilms, which may constitute a significant health risk. Conventional bacterial-resistant additives and coatings often cause undesirable changes in the resin. Reduced bacterial resistance over time in the harsh oral environment is a major challenge in resin development. Poly(2-methoxyethyl acrylate) (PMEA) has anti-fouling properties; however, due to the oily/rubbery state of this polymer, and its surface aggregation tendency in a resin mixture, its direct use as a resin additive is limited. This study aimed to optimize the use of PMEA in dental resins. Acrylic resins containing a series of PMEA polymers with various molecular weights (MWs) at different concentrations were prepared, and the mechanical properties, surface gloss, direct transmittance, and cytotoxicity were evaluated, along with the distribution of PMEA in the resin. Resins with low-MW PMEA (2000 g mol-1) (PMEA-1) at low concentrations satisfied the clinical requirements for denture resins, and the PMEA was homogeneously distributed. The anti-fouling performance of the resin was evaluated for protein adsorption, bacterial and fungal attachment, and saliva-derived biofilm formation. The PMEA-1 resin most effectively inhibited biofilm formation (∼50% reduction in biofilm mass and thickness compared to those of the control). Post-aged resins maintained their mechanical properties and anti-fouling activity, and polished surfaces had the same anti-biofilm behavior. Based on wettability and tribological results, we propose that the PMEA additive creates a non-stick surface to inhibit biofilm formation. This study demonstrated that PMEA additives can provide a stable and biocompatible anti-fouling surface, without sacrificing the mechanical properties and aesthetics of denture resins.

Antifungal effect, surface roughness, and cytotoxicity of three-dimensionally printed denture base with phytoncide-filled microcapsules: An in-vitro study.

OBJECTIVES: To produce three-dimensionally (3D) printed removable denture bases with antifungal activity using microencapsulation of phytochemicals that inhibit Candida albicans growth. METHODS: Two types of phytoncide oil extract A and B were micro-encapsulated. The phytoncide-filled microcapsules were mixed with denture base resin for 3D printing with various concentration conditions, and manufactured into the discs by digital light processing. The microcapsule concentrations in 3D-printed discs were 2, 4, 6 and 8wt% for the phytoncide oil A, and 5, 10, 15, 20, and 25wt% for the phytoncide oil B. Nine groups with different microcapsule concentrations and a control group were prepared (n = 5). Microcapsule-containing 3D-printed denture base resin discs were evaluated in terms of surface roughness, polymerization, antifungal activity, and its persistence against C. albicans, and cytotoxicity. RESULTS: There was no significant difference amongst the surface roughness values of all discs. The polymerization of 3D-printed resin disc with microcapsule was different between phytoncide type A and B. The discs with phytoncide-filled microcapsules at 6wt% for type A and 15wt% for type B showed significant antifungal activities against C. albicans at 4 weeks. All discs were reported to be non-cytotoxic to human gingival fibroblasts. CONCLUSIONS: Denture base resin discs with antifungal activities were successfully manufactured using phytoncide micro-encapsulation and digital light processing. Considering the antifungal effect and its persistence, surface roughness, polymerization, and cytotoxicity, the optimal microcapsule concentrations for 3D-printed denture bases were 6wt% and 15wt% for phytoncide A and B, respectively. CLINICAL SIGNIFICANCE: Using micro-encapsulation of phytochemicals such as phytoncide oil, denture base resin materials with antifungal activities can be successfully fabricated by digital light processing.

Novel cinnamon-laden nanofibers as a potential antifungal coating for poly(methyl methacrylate) denture base materials.

OBJECTIVES: To modify the surface of denture base material by coating it with cinnamon-laden nanofibers to reduce Candida albicans (C. albicans) adhesion and/or proliferation. MATERIALS AND METHODS: Heat-cured poly(methyl methacrylate) (PMMA) specimens were processed and coated, or not, with cinnamon-laden polymeric nanofibers (20 or 40 wt.% of cinnamon relative to the total polymer weight). Scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR) analyses of the nanofibers were performed. Antifungal activity was assessed through agar diffusion and colony-forming unit (CFU/mL) assays. Representative SEM morphological analysis was carried out to observe the presence/absence of C. albicans on the fibers. Alamar blue assay was used to determine cell toxicity. Analysis of variance and the Tukey's test were used to analyze the data (α = 0.05). RESULTS: SEM imaging revealed nanofibers with adequate (i.e., bead-free) morphological characteristics and uniform microstructure. FTIR confirmed cinnamon incorporation. The cinnamon-laden nanofibers led to growth inhibition of C. albicans. Viable fungal counts support a significant reduction on CFU/mL also directly related to cinnamon concentration (40 wt.%: mean log 6.17 CFU/mL < 20 wt.%: mean log 7.12 CFU/mL), which agrees with the SEM images. Cinnamon-laden nanofibers at 40 wt.% led to increased cell death. CONCLUSIONS: The deposition of 20 wt.% cinnamon-laden nanofibers onto PMMA surfaces led to a significant reduction of the adhesive and/or proliferative ability of C. albicans, while maintaining epithelial cells' viability. CLINICAL RELEVANCE: The high recurrence rates of denture stomatitis are associated with patient non-adherence to treatments and contaminated prostheses use. Here, we provide the non-patients' cooperation sensible method, which possesses antifungal action, hence improving treatment effectiveness.