The effect of antifungal agents on surface properties of poly(methyl methacrylate) and its relation to adherence of Candida albicans

In vitro antifungal and physicochemical properties of polymerized acrylic resin containing strontium-modified phosphate-based glass

Acrylic resins are widely used as the main components in removable orthodontic appliances. However, poor oral hygiene and maintenance of orthodontic appliances provide a suitable environment for the growth of pathogenic microorganisms. In this study, strontium-modified phosphate-based glass (Sr-PBG) was added to orthodontic acrylic resin at 0% (control), 3.75%, 7.5%, and 15% by weight to evaluate the surface and physicochemical properties of the novel material and its in vitro antifungal effect against Candida albicans (C. albicans). Surface microhardness and contact angle did not vary between the control and 3.75% Sr-PBG groups (p > 0.05), and the flexural strength was lower in the experimental groups than in the control group (p < 0.05), but no difference was found with Sr-PBG content (p > 0.05). All experimental groups showed an antifungal effect at 24 and 48 h compared to that in the control group (p < 0.05). This study demonstrated that 3.75% Sr-PBG exhibits antifungal effects against C. albicans along with suitable physicochemical properties, which may help to minimize the risk of adverse effects associated with harmful microbial living on removable orthodontic appliances and promote the use of various materials.

Evaluation of the influence of different build angles on the surface characteristics, accuracy, and dimensional stability of the complete denture base printed by digital light processing

Purpose

This study aims to investigate the influence of the build angle on the surface characteristics, accuracy, and dimensional stability of digital light processing (DLP) printed resin bases.

Material and methods

Rectangular and complete denture base samples were fabricated at 0, 45, and 90-degree angles (n = 5 for rectangular samples; n = 10 for maxillary and mandibular denture base samples) using a DLP printer. Surface morphology and roughness were assessed using a profilometer, followed by measuring hydrophilicity with a contact angle meter. Accuracy (trueness and precision) and dimensional stability were evaluated at intervals of 1, 3, 7, 14, 28, and 42 days after base printing using best-fit-alignment and deviation analysis in 3D software. Statistical analysis was performed using one-way ANOVA for surface characteristics (α = 0.05), multi-way ANOVA for accuracy and dimensional stability data, and Tukey's test for post-hoc comparisons.

Results

The 0-degree group exhibited significantly lower mean roughness (1.27 ± 0.19 μm) and contact angle (80.50 ± 3.71°) (P < 0.001) compared to the 90-degree and 45-degree groups. The 0-degree build angle led to superior trueness (maxilla: 77.80 ± 9.35 μm, mandible: 61.67 ± 10.32 μm) and precision (maxilla: 27.51 ± 7.43 μm, mandible: 53.50 ± 15.16 μm) compared to other groups (P < 0.001). Maxillary base precision was superior to mandibular base precision (P < 0.001). The maxillary base exhibited less dimensional deviation than the mandibular base. The 90-degree group showed the highest deviation compared to the other two groups, and all groups' deviations increased over time (P < 0.001).

Conclusions

The build angle significantly influences the surface characteristics, accuracy, and dimensional stability of DLP-printed denture bases. A 0-degree build angle provides the most favorable performance. The maxillary base displayed superior precision and dimensional stability than the mandibular base.

Comparison of mechanical properties, surface roughness, and color stability of 3D-printed and conventional heat-polymerizing denture base materials

STATEMENT OF PROBLEM

Studies on the mechanical, optical, and surface properties of 3-dimensionally (3D) printed denture base materials are scarce, and those available have reported conflicting results.

PURPOSE

The purpose of this in vitro study was to compare the mechanical properties, surface roughness, and color stability of 3D-printed and conventional heat-polymerizing denture base materials.

MATERIAL AND METHODS

A total of 34 rectangular specimens (64×10×3.3 mm) were fabricated from each of the conventional (SR Triplex Hot; Ivoclar AG) and 3D-printed (Denta base; Asiga) denture base materials. All specimens underwent coffee thermocycling for 5000 cycles, and half in each group (n=17) were evaluated in terms of color parameters, color change (ΔE00), and surface roughness (Ra) before and after coffee thermocycling. The specimens then underwent a 3-point bend test. The remaining specimens in each group (n=17) underwent impact strength and Vickers hardness testing. Data were analyzed by the paired samples, independent samples, and Wilcoxon signed rank tests (α=.05).

RESULTS

The color change caused by coffee thermocycling in the 3D-printed group was higher than that in the conventional group (P<.001). Surface roughness significantly increased in both groups after coffee thermocycling (P<.001). The conventional group had higher surface roughness before coffee thermocycling, while the 3D-printed group had higher surface roughness after coffee thermocycling (P<.001). The flexural strength, flexural modulus, and surface hardness in the conventional group were significantly higher than those in the 3D-printed group (P<.001). However, the impact strength of the conventional group was lower than that of the 3D-printed group (P<.001).

CONCLUSIONS

The 3D-printed denture base material showed higher impact strength and surface roughness than the conventional heat-polymerizing acrylic resin. However, flexural strength and modulus, surface hardness, and color stability were lower in the 3D-printed group.

A Comparison of the Surface and Mechanical Properties of 3D Printable Denture-Base Resin Material and Conventional Polymethylmethacrylate (PMMA)

PURPOSE

To study the surface and mechanical properties of 3D printed denture-base resin materials and compare them with conventional heat-cured polymethylmethacrylate (PMMA).

MATERIALS AND METHODS

Three brands of 3D printed denture-base resin materials and one conventional heat-cured PMMA were tested in this study: NextDent 3D printed resin, Dentona 3D printed resin, ASIGA 3D printed resin, and Meliodent conventional PMMA. Sixty specimens (25 × 25 × 3 mm) were fabricated (n=15 per group) to perform the following tests: wettability, surface roughness, and microhardness. One hundred twenty specimens (65 × 10 × 3 mm) were fabricated (n=30 per group) and stored in distilled water at (37 ±1°C) for 7 days. Specimens (N = 15) in each group were subjected to the three-point bending test and impact strength test, employing the Charpy configuration on un-notched specimens. The morphology of the fractured specimens was studied under scanning electron microscope (SEM). Statistical analysis was performed using one-way ANOVA and Tukey-pairwise multiple comparisons with 95% confidence interval. P-values of ≤0.05 were considered significant.

RESULTS

The conventional heat-cured specimens demonstrated the highest means of surface roughness (0.23 ± 0.07 μm), Vickers hardness number (18.11 ±0.65) and flexural strength (92.44 ±7.91 MPa), and the lowest mean of contact angle (66.71° ±3.38°). ASIGA group showed the highest mean of contact angle (73.44° ±2.74°) and the lowest mean of surface roughness (0.19 ±0.03 μm). The highest mean of impact strength was recorded in the Dentona group (17.98 ±1.76 kg/m² ). NextDent specimens showed the lowest means of Vickers hardness number (16.20 ±0.93), flexural strength (74.89 ±8.44 MPa), impact strength (15.20 ±0.69 kg/m² ), and recorded the highest mean of bending modulus (2,115.80 ±178.95 MPa).

CONCLUSIONS

3D printed resin exhibited noticeable differences in surface and mechanical properties between different brands and with conventional heat-polymerized PMMA.

Evaluation of the Effect of Different Construction Techniques of CAD-CAM Milled, 3D-Printed, and Polyamide Denture Base Resins on Flexural Strength: An In Vitro Comparative Study

PURPOSE

To compare the flexural strength of computer-aided design and computer-aided manufacturing (CAD-CAM) milled denture base resin (DBR), 3D-printed DBR, polyamide, and conventional compression-molded DBR.

MATERIALS AND METHODS

Six denture base resins were used, one conventional heat-polymerized (Vertex), two milled CAD-CAM (AvaDent and Polident), two 3D-printed (Harz and NextDent), and one flexible polyamide (Polyamide). According to ISO 20795-1:2013, 60 specimens (65×10×3 mm) were constructed and divided into six groups (n = 10), according to DBR type. The flexural strength was measured using a universal testing machine and three-point loading test. Data were collected and analyzed using one-way ANOVA and Tukey's pair-wise post hoc tests (α = 0.05).

RESULTS

One-way ANOVA results showed significant differences in flexural strengths between the tested DBRs (p˂0.001). Milled denture base resins (AvaDent and Polident) had significantly higher flexural strength values than the other groups (p˂0.001) and were followed by Vertex and NextDent, while Polyamide and Harz had the lowest values. Polyamide and Harz denture base resins had significantly lower flexural strength values than conventional denture base resin (p˂0.001).

CONCLUSION

CAD-CAM milled DBRs showed the highest flexural strength when compared with conventional compression-molded or 3D-printed DBRs, while 3D-printed DBRs and polyamide showed the lowest flexural strengths.

Efficacy of chemical and Photoactivated disinfectants against Candida Albicans and assessment of hardness, roughness, and mass loss of acrylic denture base resin

AIM

The present study aimed to assess the antimicrobial efficacy of hematoporphyrin derivative, sodium hypochlorite (NaOCl), glutaraldehyde (GaH), and a chlorhexidine (CHX) on mass loss (ML), microhardness, and surface roughness (Ra) of acrylic denture base colonized with C. Albicans.

MATERIAL AND METHODS

A total of 40 heat cure acrylic resin dentures were fabricated and inoculated by the American Type Culture Collection (ATCC) of C. Albicans in an in-vitro situation. Specimens were divided into four groups (n=10) based on the method of disinfection. Hematoporphyrin derivatives, 1% NaOCl, 2% GaH, and 4% CHX.The pre and post candida (CFU/ml) counts were recorded before and after immersion. ML, microhardness, and Ra of acrylic denture were also assessed. Statistical analysis was executed for CFU/mL (log10) for exposed C. Albicans by two-way ANOVA and Tukey's multiple tests (p>0.05). For normality of the data, Dunnet's Simultaneous test was performed.

RESULTS

In terms of candida strain analysis, pretreatment to posttreatment comparisons revealed a reduction in mean Candida count in all groups (p<0.05). The highest ML value after post candida disinfection of acrylic denture was observed in 2% GaH (1.587 ± 0.25) treated specimens. The least microhardness value was found in group 1 when treated with hematoporphyrin (0.97 ± 0.22 VHN) which was significantly different from other groups (p<0.05). Group 1 surface treated with hematoporphyrin derivate (1.84 ± 0.22 μm) showed the highest Ra values (p<0.05).

CONCLUSION

Acrylic denture base resin colonized with C. Albicans when treated with a chemical disinfectant of 4% chlorhexidine displayed the highest antimicrobial efficacy with reduced mass loss, less surface roughness, and maximum denture hardness.

Comparison of the flexural and surface properties of milled, 3D-printed, and heat polymerized PMMA resins for denture bases: an in vitro study

PURPOSE

To compare the flexural properties and the adhesion of Lactobacillus salivarius (LS), Streptococcus mutans (SM), and Candida albicans (CA) on heat-polymerized (CV), CAD-CAM milled (CAD), or 3D-printed (3D) Poly (methylmethacrylate) (PMMA).

METHODS

Ultimate Flexural Strength (UFS), Flexural Strain (FS) (%) at Flexural Strength, and Flexural Modulus (FM) of specimens (65.0×10.0×3.3 mm) from each PMMA group (n=6) were calculated by using the 3-point bending test. The surface roughness profiles (R) were measured before and after polishing with a contact profilometer. LS, SM, and CA adhesion on PMMA specimens (n=18) (10 mm in diameter, 3 mm in height) was assessed after 90 minutes and 16 hours by using scanning electron microscopy. The Kruskal-Wallis test with post hoc analysis was performed to compare the groups (alpha=0.05).

RESULTS

Mean UFS values were 80.79±7.64 MPa for CV, 110.23±5.03 MPa for CAD, and 87.34±6.39 MPa for 3D. Mean FS values were 4.37±1.04% for CV, 4.71±0.62% for CAD, and 6.19±0.13 % for 3D. Mean FM values were 2542±301 MPa for CV, 3435±346 MPa for CAD, and 2371±197 MPa for 3D. CAD had the lowest average R value (0.29±0.16 µm) before polishing, and bacterial adhesion after 90 minutes of incubation. R value and microbial adhesion were not different amongst groups after polishing and 16 hours of incubation, respectively.

CONCLUSION

The CAD group displayed the best flexural properties, except for FS, the lowest roughness before polishing and bacterial adhesion after 90 minutes of incubation. All tested PMMAs had similar surface roughness after polishing, and microbial adhesion after 16 hours of incubation.

Therapeutic Role of Nystatin Added to Tissue Conditioners for Treating Denture-Induced Stomatitis: A Systematic Review

Denture-induced stomatitis (DIS) represents a pathological condition caused by ill-fitting dentures trauma, manifested as inflammation of the palatal tissue beneath the denture. The fungal infections are the principal contributory factors to DIS. Although the aetiology of DIS is multifactorial, the Candida albicans fungal infection remains the main cause. The objective of the present systematic review was to evaluate the latest literature on the addition of nystatin into the tissue conditioners (TCs) in the management of DIS. To search the published literature about “the addition of nystatin in TCs for treating DIS”, electronic databases (PubMed (National library of medicine) and Cochrane Library (Wiley)) were searched (from 1975 until December 2020) using different keywords. Various studies described the effectiveness and efficacy of incorporating nystatin into several TCs. The present systematic review reported that the addition of nystatin is beneficial, with slight or no consequences on both the mechanical and physical features of TCs. Adding nystatin to various TCs for treating DIS can be suggested.

Properties of silver contained coatings on CoCr alloys prepared by vacuum plasma spraying

The silver contained coatings on cast Cobalt Chrome (CoCr) alloys were prepared by vacuum plasma spraying technique. The Scanning Electron Microscopy (SEM), X-ray photoelectron spectroscopy (XPS), X-ray Diffraction (XRD), energy dispersive spectrometry (EDS), properties of corrosion resistance, wear resistance and effect of vitro antibacterial on the surface of silver contained coating were investigated. The cytotoxicity of the coatings was performed with L-929 fibroblasts by MTT assay. SEM showed that the surfaces of the coatings were dense, smooth, no obvious cracks except only a few pores. XRD analysis indicated that the contents of the surface were mainly Ag and Cr except a small amount of Ag₂O, Cr₂O₃. EDS analysis indicated that the distributions of Cr and Ag were uniform without any large-scale clustering. The wear resistance of silver coatings is similar to that of CoCr alloys, and the corrosion resistance is slightly better than that of CoCr alloys. The Ag coating had no significant effect on the proliferation of L929 cells. The antibacterial results indicated that the number of S. mutans and C. albicans were significantly reduced on the surface of silver contained coating than that of CoCr alloys. All the results indicated that the silver contained coatings can be achieved by vacuum plasma spraying technique with good surface characteristic and antibacterial properties and have promising applications in biomedical area.

A Comparison of the Surface Properties of CAD/CAM and Conventional Polymethylmethacrylate (PMMA)

PURPOSE

To compare surface properties of 2 brands of pre-polymerized resin blocks for complete dentures (CAD/CAM PMMA) to conventional heat-polymerized PMMA.

MATERIALS AND METHODS

A total of 45 rectangular specimens (25 × 25 × 3 mm) were fabricated from 3 brands of PMMA (n = 15/group): AvaDent CAD/CAM PMMA, Tizian-Schütz CAD/CAM PMMA, Meliodent conventional PMMA. Specimens were examined for wettability using the sessile drop method, surface roughness using a digital contact profilometer, and microhardness using Vickers hardness number. Statistical analysis was performed using one-way ANOVA and Tukey pairwise multiple comparisons. p-Values of ≤0.05 were considered significant.

RESULTS

AvaDent specimens demonstrated the highest mean contact angle (72.87 ± 48°) and the highest mean Vickers hardness number (20.62 ± 0.33). The conventional heat-polymerized specimens showed the highest mean surface roughness (0.22 ± 0.071 μm). Tizian-Schütz specimens showed the lowest mean surface roughness (0.12 ± 0.02 μm).

CONCLUSIONS

As CAD/CAM PMMA groups exhibited significantly more favorable surface properties in comparison to the conventional heat-polymerized groups, CAD/CAM dentures are expected to be more durable. Different brands of CAD/CAM PMMA may have inherent variations in surface properties.

A Comparison of the Flexural and Impact Strengths and Flexural Modulus of CAD/CAM and Conventional Heat-Cured Polymethyl Methacrylate (PMMA)

PURPOSE

The introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) technology to the field of removable prosthodontics has recently made it possible to fabricate complete dentures of prepolymerized polymethyl methacrylate (PMMA) blocks, which are claimed to be of better mechanical properties; however, no published reports that have evaluated mechanical properties of CAD/CAM PMMA. The purpose of this study was to compare flexural strength, impact strength, and flexural modulus of two brands of CAD/CAM PMMA and a conventional heat-cured PMMA.

MATERIALS AND METHODS

45 rectangular specimens (65 mm × 10 mm × 3 mm) were fabricated (15 CAD/CAM AvaDent PMMA specimens from AvaDent, 15 CAD/CAM Tizian PMMA specimens from Shütz Dental, 15 conventional Meliodent PMMA specimens from Heraeus Kulzer) and stored in distilled water at (37  ± 1°C) for 7 days. Specimens (N = 15) in each group were subjected to the three-point bending test and impact strength test, employing the Charpy configuration on unnotched specimens. The morphology of the fractured specimens was studied under a scanning electron microscope (SEM). Statistical analysis was performed using one-way ANOVA and Tukey pairwise multiple comparisons with 95% confidence interval.

RESULTS

The Schütz Dental specimens showed the highest mean flexural strength (130.67 MPa) and impact strength (29.56 kg/m² ). The highest mean flexural modulus was recorded in the AvaDent group (2519.6 MPa). The conventional heat-cured group showed the lowest mean flexural strength (93.33 MPa), impact strength (14.756 kg/m² ), and flexural modulus (2117.2 MPa). Differences in means of flexural properties between AvaDent and Schütz Dental specimens were not statistically significant (p > 0.05).

CONCLUSIONS

As CAD/CAM PMMA specimens exhibited improved flexural strength, flexural modulus, and impact strength in comparison to the conventional heat-cured groups, CAD/CAM dentures are expected to be more durable. Different brands of CAD/CAM PMMA may have inherent variations in mechanical properties.

Rosemary, Castor Oils, and Propolis Extract: Activity Against Candida Albicans and Alterations on Properties of Dental Acrylic Resins

PURPOSE

To evaluate the in vitro activity of 8% rosemary, 2% castor oils, and 12% propolis glycolic extract against Candida albicans, as well as the physical changes of properties in colorless and pink acrylic resins after immersion in these liquids.

MATERIALS AND METHODS

Colorimetric, roughness, and Knoop microhardness assays were evaluated in 25 specimens distributed into five groups (3 test groups and 2 control groups - distilled water and hypochlorite 1%), totaling five specimens per group for each acrylic resin (colorless and pink). The specimens were individually immersed for 30 minutes in 10 mL of these liquids, washed, and dried once a week. They were maintained in distilled water at 37°C between processes during all experiments. The analyses were performed before immersion and in the 4th and/or 12th month. In vitro, 18 acrylic resins were exposed to C. albicans and, after a process of 30 minutes in immersion in the five groups cited and oil vehicle control of vesicle (liquid Vaseline), the specimens were washed and incubated for 24 hours in 37°C. The growth was determined by colony counting. For comparisons between the groups in each trial and the disinfection test, paired Student's t-tests and ANOVA with post hoc Tukey were performed by the SPSS program, considering α = 0.05.

RESULTS

None of the liquids altered the microhardness, but all the natural compounds and 1% sodium hypochlorite (control) altered color and roughness after the 12th month of immersion in these agents. In the colorless specimens, 8% rosemary oil caused a color change similar to water, and less color and roughness alterations when compared to 2% castor oil and 1% sodium hypochlorite, respectively. There was no growth of yeast colonies after immersion in rosemary oil, propolis glycolic extract, and 1% sodium hypochlorite.

CONCLUSION

Eight percent rosemary oil has the potential to be used as an acrylic resin disinfectant.

Equisetum giganteum influences the ability of Candida albicans in forming biofilms over the denture acrylic resin surface

CONTEXT

Equisetum giganteum L. (Equisetaceae) is an endemic plant of Central and South America used in traditional medicine. Natural drugs have been frequently used in the treatment of a myriad of diseases, proving to be an alternative to synthetic chemicals, and have been intensively studied in the prevention of sicknesses, including oral diseases.

OBJECTIVE

This study evaluated the in vitro antiadherent activity of E. giganteum extract against Candida albicans biofilms.

MATERIALS AND METHODS

Crystal violet and colony-forming units assays were used to quantify the total biofilm biomass and biofilm living cells on a denture base acrylic resin pretreated with hydroethanolic extract of E. giganteum in different concentrations (50, 25, 16, 8, and 4 mg/mL), after 24 h of biofilm development.

RESULTS

Equisetum giganteum affected biofilms by reduction of biomass and living cells per area of acrylic specimens. The results revealed reduction of 15-44% of the biofilm mass and reduction of numbers of colony-forming units (CFUs) present in biofilms (79%) compared to the untreated control (CTRL/PBS). At all concentrations, it demonstrated important antiadherent activity on Candida albicans biofilms, the main microbe in denture stomatitis.

DISCUSSION AND CONCLUSION

The present findings show that E. giganteum antimicrobial effects may qualify the extract as a promising natural alternative for topical treatment or prevention of denture stomatitis. The usage of drugs made of natural products shows advantages in relation to synthetic drugs on the market, such as lower cost, lower toxicity, and in relation to the occurrence of microbial resistance.

Effectiveness of disinfectants on the adherence of Candida albicans to denture base resins with different surface textures

The aim of the present study was to compare the effects of some disinfectants, including ethanol extract of propolis (EEP), on the adhesion of Candida albicans to denture base resins. Seventy-two acrylic resin samples were prepared, half of which was polished and the other half was roughened. C. albicans strain ATCC 10231 was incubated on Sabouraud dextrose agar (SDA) at 37°C for 48 h. The adhesion period was completed by keeping the cells in this suspension for 90 min at 37°C. Specimens were then immersed in the following solutions: 1%, 2%, and 5% sodium hypochlorite; 4% chlorhexidine gluconate; and 10% EEP. Quantification of the antifungal activity of the chemical solutions was performed using the colorimetric MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay test. One-way ANOVA and post-hoc Tukey tests were performed to evaluate the effectiveness of chemical agents. Polished and roughened surfaces were compared using independent sample t-test. The mean surface roughness value was 0.35 (±0.04) µm for the polished group and 1.2 (±0.2) µm for the roughened group. The contact angles of both surfaces showed statistically significant difference, and 10% EEP solution exhibited significantly less removal of adherent viable C. albicans cells in both groups. All forms of sodium hypochlorite solutions yielded higher efficiency than 4% chlorhexidine gluconate and EEP solutions (P < 0.05). (J Oral Sci 58, 431-437, 2016).

The Beneficial Effect of Equisetum giganteum L. against Candida Biofilm Formation: New Approaches to Denture Stomatitis

Equisetum giganteum L. (E. giganteum), Equisetaceae, commonly called “giant horsetail,” is an endemic plant of Central and South America and is used in traditional medicine as diuretic and hemostatic in urinary disorders and in inflammatory conditions among other applications. The chemical composition of the extract EtOH 70% of E. giganteum has shown a clear presence of phenolic compounds derived from caffeic and ferulic acids and flavonoid heterosides derived from quercitin and kaempferol, in addition to styrylpyrones. E. giganteum, mainly at the highest concentrations, showed antimicrobial activity against the relevant microorganisms tested: Escherichia coli, Staphylococcus aureus, and Candida albicans. It also demonstrated antiadherent activity on C. albicans biofilms in an experimental model that is similar to dentures. Moreover, all concentrations tested showed anti-inflammatory activity. The extract did not show cytotoxicity in contact with human cells. These properties might qualify E. giganteum extract to be a promising alternative for the topic treatment and prevention of oral candidiasis and denture stomatitis.

Denture polymers with antimicrobial properties: a review of the development and current status of anionic poly(methyl methacrylate) polymers

The denture base polymer poly(methyl methacrylate) (PMMA) is highly susceptible for microbial colonization resulting in denture-associated infections. Over the years research has focused on ways to modify the PMMA properties via surface and chemical modification. These studies led to the development of new denture polymers that include anionic PMMA polymers. The new anionic polymers presented the possibility of compromising the physical and mechanical properties required for denture fabrication. These obstacles were overcome by generating anionic PMMA polymers with physical and mechanical properties suitable for denture fabrication. A large body of literature is available on the anionic PMMA polymers, their antimicrobial properties and their potential for the commercial and clinical application as dental biomaterials. This article describes a review and evaluation of the anionic PMMA polymers for their suitability to serve as denture base polymers, their antimicrobial properties, their efficacy to prevent denture-induced infection and their safety in the oral environment.