Effects of different denture cleaning methods to remove Candida albicans from acrylic resin denture based material

Feasibility of microencapsulated phytochemical as disinfectant for inhibition of Candida albicans proliferation on denture base produced by digital light processing

BACKGROUNDS

A proper disinfection of denture is vital to prevent a fungal infection. A study on the feasibility of microencapsulated phytochemical as complementary disinfectant and its interaction with effervescent tablet immersion on denture base resin is lacking.

OBJECTIVES

The aim of this study was to examine the feasibility of phytochemical-filled microcapsules as disinfectant for the inhibition of Candida albicans (C. albicans) attachment on the denture base produced by digital light processing (DLP).

METHODS

54 denture base specimens uniformly mixed with or without 5wt% phytochemical-filled microcapsules were prepared using DLP. Fungal cells were inoculated onto the surfaces of the specimens, which were divided into three different disinfection treatment groups (n = 9): 1) none, 2) sterile tap water immersion for 15 min, and 3) effervescent tablet immersion for 15 min. After each treatment, the biofilm on denture surface was stained with a crystal violet solution to measure the absorbance. The number of fungal colonies was counted as colony-forming units (CFU) per mL. Morphological changes were examined by microscopy. An aligned rank transform analysis of variance was performed to analyze the interaction of presence of microcapsule and disinfection condition, with statistical significance set at P < 0.05.

RESULTS

Both for the absorbance and CFU, there was no significant interaction between the presence of microcapsules and disinfection conditions (P = 0.543 and P = 0.077, respectively). The presence of microcapsules was statistically significant (both P < 0.001), while the effect of disinfection condition was not significant (P = 0.165 and P = 0.189, respectively). Morphological changes in fungi were detected in the groups containing microcapsules, whereas undamaged hyphal structures were found in those without microcapsules, irrespective of disinfection treatments.

CONCLUSIONS

The presence of phytochemical-filled microcapsules significantly reduced the adhesion of C. albicans and inhibited its proliferation on denture surfaces, regardless of disinfection conditions.

Evaluation of antibacterial activity against Candida albicans according to the dosage of various denture cleansers

PURPOSE

The purpose of this study is to compare the antibacterial activity of currently purchasable denture cleansers against Candida albicans.

MATERIALS AND METHODS

This study used tablet-type denture cleansers, Polident®, Coolingdent® and Fittydent®, along with liquid denture cleansers, Hexamedine®, Listerine® and Apple vinegar®. The antibacterial activities of denture cleansers were evaluated based on the number of C. albicans and concentrations of the denture cleansers.

RESULTS

In the 0.5 × 10⁶ cfu/ml culture medium, the C. albicans' death rate of Polident® was significantly lower than those of Fittydent®, Hexamedine®, Listerine®, and Apple vinegar®(P<.05). In the 0.5 × 10⁷ cfu/, the C. albicans' death rates of Polident® and Coolingdent® were significantly lower than those of Fittydent®, Hexamedine®, Listerine® and Apple vinegar®(P<.05). The C. albicans' death rates of Polident® and Coolingdent® were significantly decreased at 0.02 g and 0.01 g. The C. albicans' death rate of Fittydent® was significantly decreased at 0.005 g (P<.05). The C. albicans' death rate of Hexamedine® was significantly decreased at 1/16 dilution. The C. albicans' death rate of Listerine® was decreased at 1/8 dilution, and the antibacterial activity of Apple vinegar® was decreased at 1/4 dilution (P<.05).

CONCLUSION

As the number of C. albicans increased, the antibacterial activities of the denture cleansers decrease. In the tablet-type denture cleanser, all denture cleansers showed 100% C. albicans' death rate when used at a dose of 1 tablet. One denture cleanser showed the same antibacterial effect with only 1/3 of a tablet. In the liquid type denture cleanser, the level of dilution required was different for each denture cleanser.

Efficacy of low-molecular weight chitosan against Candida albicans biofilm on polymethyl methacrylate resin

BACKGROUND

Candida biofilm is a major cause of denture stomatitis. We aimed to compare the efficacy of low-molecular-weight chitosan solutions against Candida albicans biofilm on polymethyl methacrylate (PMMA) resin.

METHODS

Various types of chitosan were tested for anti-Candida activity by broth dilution. Two types were selected for further testing on 24-hour C.albicans biofilm formed on PMMA specimens. Specimens were randomly distributed among experimental groups, including 0.1% and 0.2% acetic acid, 3 and 6 mg/mL of oligomer chitosan and 30 kDa chitosan solutions, effervescent tablet (Polident), and 0.2% chlorhexidine, and immersed for 5 min to 12 h. The viability of C. albicans after cleansing were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Remaining viability was calculated into percentage relative to respective controls and analyzed using ANOVA with Tukey post-hoc tests. Live/dead fluorescence microscopy was also performed.

RESULTS

Chitosan solutions had high efficacy against C. albicans biofilm on PMMA. The mean relative viability compared to control after 12-h immersion was 6.60 ± 4.75% and 12.72 ± 6.96% for 3 and 6 mg/mL oligomer, respectively, and 11.68 ± 4.81% and 18.08 ± 6.20% for 3 and 6 mg/mL 30 kDa chitosan, respectively.

CONCLUSIONS

Low-molecular-weight chitosan solution is an effective antifungal denture cleanser that can significantly reduce C. albicans viability in biofilm on PMMA.

Evaluation of flexural strength and antibacterial effect of orthodontic acrylic resins containing Galla chinensis extract

Objective:

To evaluate different concentrations of Galla chinensis extract (GCE) added to poly(methyl methacrylate) (PMMA), which is widely used for fabrication of removable orthodontic appliances, regarding the effectiveness of this herbal extract on antimicrobial effect and flexural strength of PMMA.

Methods:

Acrylic resin samples containing 0.4%, 0.8% and 1.6% GCE were prepared. Flexural strength was investigated via three-point flexural strength test for the 15 acrylic resin blocks of each concentration. Disk diffusion test was used to evaluate antibacterial effects of incorporating the same concentrations of GCE into acrylic resin. All these three groups were compared with the control group, with no added GCE, regarding flexural strength and antibacterial properties.

Results:

Comparison of flexural strength between the three study groups and the control group showed significant differences between the groups (P=0.018). However, there was no significant difference between the groups containing GCE. There were significant differences in antimicrobial activity between the four groups (P=0.026).

Conclusion:

Within the limitations of this study, it is suggested that incorporation of GCE into PMMA would be beneficial for antimicrobial activity and flexural strength of PMMA, but further studies on other physical properties and antimicrobial effects on other bacterial strain would be beneficial prior to clinical investigations.

The Application Method of Nanobubble Conveyor on the Effect of Preventive Oral Hygiene

There are various methods to generate nanobubbles, and in this study, we experimented using a nanobubble generator with a high-density of stainless steel mesh nozzle to deliver nanobubble water (normal water and two kinds of mouthwash) stream through a tooth tray to clean bacteria coated on the denture. It showed that with various combinations of motor speed settings and pore diameters, a clearing rate of 95% or more could be achieved, while in some combinations, a clearing rate of 100% was possible. This confirmed the plaque removing the function of the nanobubble water streams. The motor speed setting of the nanobubble generator directly influenced the flow velocity and nanobubble diameter of the water stream. However, the nanobubble dimensions were found to have a significant impact on plaque removal. The bubble diameters and plaque removal efficacy were as follows: the smaller the diameter, the slower the flow velocity and the better the plaque removal. The nanobubble formation of mouthwash was better on plaque removal, compared with the soaking method. From these results, we theorized that plaque removal is influenced by the dimension of nanobubbles; smaller bubble diameter led to improved plaque removal efficacy.

Antimicrobial Effects against Oral Pathogens and Cytotoxicity of Glycyrrhiza uralensis Extract

We aimed to evaluate the antimicrobial effects of Glycyrrhiza uralensis extract on Streptococcus mutans and Candida albicans and its biocompatibility for dental applications. The antimicrobial activity of the G. uralensis extracts at concentrations of 50, 100, 150, and 200 µg/mL was assessed using agar disk diffusion tests, counting the total number of colony-forming units (CFUs), spectrophotometric growth inhibitory assays, and microbial morphology observations using scanning electron microscopy (SEM; Merin, Carl Zeiss, Oberkochen, Germany). We measured the polyphenol and flavonoid contents of G. uralensis extracts using ultraviolet–visible spectrometry and the cytotoxicity of these extracts using an MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. We identified that G. uralensis extracts had significant antimicrobial effects against S. mutans and C. albicans. The optical density of the experimental groups significantly decreased compared with that of the control group. SEM images revealed that the G. uralensis extract affected the morphology and density of S. mutans and C. albicans. The extract concentration of flavonoids, but not polyphenols, increased with increasing concentrations of the G. uralensis extract. Furthermore, cell viabilities were more than 70% for G. uralensis extracts with concentrations of 50 and 100 μg/mL. Naturally derived G. uralensis is biocompatible and exhibits an excellent antimicrobial effect against oral pathogens such as S. mutans and C. albicans. Thus, G. uralensis extracts can be used for the development of oral products that treat and prevent oral diseases.

The antimicrobial and antibiofilm properties of allicin against Candida albicans and Staphylococcus aureus - A therapeutic potential for denture stomatitis

The objective of this study is to determine the therapeutic efficacy of allicin against Candida albicans (C. albicans) and Staphylococcus aureus (S. aureus), the common etiological agents for denture stomatitis (DS). The minimum inhibitory concentration (MICs), minimum bactericidal concentrations (MBCs) and minimum fungicidal concentration (MFCs) of allicin were determined by the broth microdilution method followed by checkerboard microdilution method for a synergistic interaction between allicin + nystatin and allicin + CHX. The potential of allicin to eradicate C. albicans and S. aureus biofilms was assessed by treating biofilm formed on self- polymerized acrylic resin with allicin at a sub-MIC concentration for 5 min. The commercial denture cleanser (brand X) was used as a positive control. A Kruskal-Wallis test followed by the post-hoc Mann-Whitney U test was applied (SPSS 20.0), and the level of significance was set at P < 0.05. Allicin exhibited antimicrobial activity against C. albicans (MIC:8 µg/ml and MFC:16 µg/ml) and S. aureus (MIC:8 µg/ml and MBC:8 µg/ml). A synergistic interaction was observed between allicin + nystatin and allicin + CHX (FICI ≤ 0.5). Allicin exhibited significant biofilm eradication against C. albicans and S. aureus biofilms with percentages of 50.0% and 52.6%, respectively. The results of this study suggest a possible application of allicin in treating C. albicans and S. aureus infection in DS.

Efficacy of removing Candida albicans from orthodontic acrylic bases: an in vitro study

Background

This study evaluated the efficacy of four methods in removing Candida albicans from the acrylic base material used to fabricate removable orthodontic appliances.

Methods

Heat-processed bars of orthodontic acrylic were incubated in a suspension of C. albicans for 2 h at 37 °C. Samples were allocated into five groups (five bars per group) according to the cleaning method: (1) manual brushing using a toothbrush; (2) soaking in a commercial denture cleaning solution; (3) soaking in a commercial mouthwash solution; (4) using an ultrasonic cleaner; and (5) soaking in distilled water as a negative control. Yeast remaining attached to the bars after cleaning were removed by vortexing in growth medium and plated on Sabouraud dextrose agar. The reduction in yeast colony count after cleaning was calculated and expressed as the number of colony forming units per acrylic bar (CFU/bar). The experiment was carried out three times.

Results

All four cleaning methods resulted in a significant decrease in viable yeast cells associated with the acrylic bars compared to the control group. The mean percentage reduction in viable yeast cells affected by the cleaning methods was: brushing 89.9%; chlorhexidine 95.8%; ultrasonic cleaning 99.9%; and denture tablet 100%.

Conclusions

All four methods evaluated in this study were effective, to some extent, in removing C. albicans from orthodontic acrylic samples. The most effective, and readily available, cleaning method was the use of commercial denture sterilizing tablets.

Efficacy of using oxygen microbubble device for facultative anaerobe removal

Patients with serious gingivitis or periodontal diseases suffer from receding gums. Brushing teeth with a toothbrush may result in bleeding gums and new wounds, which increases the difficulty of removing facultative anaerobes from gum pockets, to decrease the damage inflicted on gums, this study proposed a cleaning device that can generate and emit oxygen microbubbles for eliminating facultative anaerobes in the mouth cavity. In this study, the authors conducted simulations with a denture to investigate the efficacy of using this method to remove facultative anaerobes. In this research for the optimal device design, several variables were manipulated including rotation speeds of the bubble generator, different nozzle diameters, and different numbers of nozzle holes. The results revealed that the device is effective in removing facultative anaerobes; moreover, of all design variables, the number of nozzle holes was the factor having the largest effect on anaerobe removal, as it influenced the flow volume and oxygen content of the discharge: the greater the number of nozzles, the greater the flow volume, oxygen content, and efficacy of anaerobe removal.

Application of micro-bubbles on oral care

OBJECTIVE

This study proposed a method of using a modified micro-bubble generator with its ejection nozzle connected to an ergonomically designed soft teeth-tray for plaque removal. The applicability of this method was verified and the influence on plaque removal efficacy of some parameters of this device was clarified.

METHODS

The micro-bubble generator used in this study has 5 rotation speed settings, 5 nozzle sizes, and a soft teeth-tray ejection pore diameters. These were used as independent variables to investigate their effect on the ejected flow volume, velocity and micro-bubble dimension, and how they eventually affect the plaque removal efficacy from a denture.

RESULTS

When the micro-bubble generator coupled with large (4.8 mm) ejection pore teeth-tray and the largest (1.2 mm) nozzle diameter more than 98% of plaque can be removed; its applicability on cleaning denture can be verified. In general, the larger nozzle diameter and teeth-tray ejection pore diameter will remove more plaques; while the higher the flow velocity and the smaller the micro-bubble of the ejected stream, better cleaning efficacy can be achieved.

CONCLUSION

The application of micro-bubble on plaque removal seems effective, although at this moment it is applied on denture cleaning. The finding of the influence of some critical design parameters of micro-bubble generator and variables of ejected stream can be referred to further design a new micro-bubble cleaner for effective plaque removal from the teeth in human oral cavity.

Antibacterial activity, cytotoxicity and mechanical behavior of nano-enhanced denture base resin with different kinds of inorganic antibacterial agents

Silanized aluminum borate whiskers (ABWs) of 4 wt%, silanized zirconium dioxide nanoparticles (nano-ZrO₂) of 2 wt% were mixed with polymethyl methacrylate (PMMA) powder to get ZrO₂-ABWs/PMMA composites. Titanium dioxide (TiO₂), silver-supported titanium dioxide (Ag/TiO₂), silver-supported zirconium phosphate (Novaron) and tetrapod-like zinc oxide whiskers (T-ZnOw) antibacterial agents of 3 wt% were mixed with ZrO₂-ABWs/PMMA composites respectively to fabricate standard specimens. Plaque biofilms on the specimens surface were investigated for colony-forming units (CFUs). In addition, cytotoxicity and mechanical behavior were evaluated. Results showed that the CFUs values of S. mutans and C. albican biofilms on the four antibacterial composites surface were all reduced (p<0.05) compared to the blank and control groups. The antibacterial composites did not have an adverse effect on fibroblast growth in this study (p>0.05) except TiO₂ and Ag/TiO₂ groups of undiluted extracts. The flexural strength and surface hardness of Novaron and T-ZnOw groups were increased (p<0.05) compared to the control group.

The effect of different chemical intra-oral prostheses cleansers on the surface properties of Parylene-coated PMMA

The purpose of this study was to investigate the effect of different chemical intra-oral prosthesis cleansers on the surface properties of Parylene-C coated and non-coated polymethyl methacrylate (PMMA). A total of 120 PMMA samples were prepared. Half of the samples were coated with 10 µm of Parylene-C. Samples were exposed to either air (control) or one of two types of denture cleansers, an alkaline peroxide cleanser (Steradent) or a neutral peroxide cleanser with enzyme (Poligrip). Surface roughness (Ra) and surface free energy (SFE) values were measured and compared between groups. Scanning electron microscopy was used for visual analysis. The samples coated with Parylene exhibited significantly lower mean Ra values compared to the non-coated samples (p<0.001). Immersion in Steradent increased the roughness of non-coated PMMA, but its effect was minimized on the coated surfaces. SFE increased for the samples exposed to air and Poligrip, but decreased for the samples exposed to Steradent.

The effect of eating sea cucumber jelly on Candida load in the oral cavity of elderly individuals in a nursing home

We conducted a double-blind randomized controlled study of elderly individuals in a nursing home to investigate the effect of the consumption of jelly containing sea cucumber on their oral Candida load. The jelly contained a hydrolysate of the sea cucumber Stichopus japonicus, which contained triterpene glycosides called holotoxins. The holotoxins worked as a fungicide, and their minimum inhibitory concentrations for Candida albicans were 7 µg/mL. Eight individuals in the nursing home took the sea cucumber jelly for a week and their oral Candida were counted before and after the intervention. Nine individuals took a control jelly without S. japonicus. The sea cucumber jelly showed inhibitory effects on the oral Candida. Thus, daily consumption of the S. japonicus jelly has the potential to reduce the oral Candida load in the elderly in nursing homes.