Antimicrobial and mechanical properties of acrylic resins with incorporated silver-zinc zeolite - part I

Intake of probiotics as an option for reducing oral and prosthetic microbiota: A clinical study

STATEMENT OF PROBLEM

The accumulation of microorganisms on complete dentures has adverse effects on general health. Precautions should be taken to prevent colonization by these harmful pathogens, but whether an intake of probiotics effectively reduces microbiota is unclear.

PURPOSE

The purpose of this clinical study was to examine the effectiveness of probiotics against the microbial colonization of dentures and the oral regions.

MATERIAL AND METHODS

Sixty-one edentulous participants with dentures were recruited, and samples were collected from the palate, cheek, tongue, and denture surface using sterile erasers before and after applying probiotics containing Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus casei, and Bifidobacterium bifidum. The count of bacterial species in the original culture was calculated by multiplying the number of colonies by the dilution factor of cells per mL [log10 (CFU/mL)] for different media. Spread plating was used to colonize in vitro. A Wilcoxon test was used to compare the groups according to time reveal. Kruskal-Wallis and Mann-Whitney U tests were performed to compare the values in the various regions studied (α=.05).

RESULTS

A statistical difference in microbial count was found before and after probiotic intake (P<.05). For each medium, the microbial count values were statistically lower on the tongue, palate, dentures, and cheek after probiotic intake (P<.05), except for in malt medium on dentures (P>.05).

CONCLUSIONS

Probiotics reduced the microbial count in the oral region and showed promising results for oral health and denture hygiene. Since the oral microbiota has among the highest levels of species diversity in the human body, further studies are needed.

Green synthesis of silver nanoparticles and evaluation of their effects on the Porphyromonas gingivalis bacterial biofilm formation

OBJECTIVE

This study aimed to evaluate the impact of silver nanoparticles (AgNPs) synthesized from propolis on the formation of Porphyromonas gingivalis biofilms.

MATERIAL AND METHODS

AgNPs were synthesized from propolis, and their inhibitory effect on P. gingivalis biofilm formation was assessed. Different concentrations of AgNPs (0.1%, 0.3%, and 0.5%) were tested to determine the dose-dependent antibacterial activity.

RESULTS

The results of this study indicated that AgNPs exhibited an inhibitory effect on P. gingivalis biofilm formation. The antibacterial activity of AgNPs was dose-dependent, with concentrations of 0.1%, 0.3%, and 0.5% showing effectiveness. Notably, the concentration of 0.5% demonstrated the most significant anti-biofilm formation activity.

CONCLUSION

The results of this study suggest that AgNPs synthesized from propolis have potential as an effective option for enhancing periodontal treatment outcomes. The inhibitory effect of AgNPs on P. gingivalis biofilm formation highlights their potential as alternative antimicrobial agents in the management of periodontal diseases.

Mapping the research landscape of nanoparticles and their use in denture base resins: a bibliometric analysis

BACKGROUND

Nanoparticles are increasingly used in dentistry for various applications, including enhancing the mechanical properties of denture base resins. This study aimed to comprehensively review and analyze the research landscape of nanoparticles and their effect on the flexural strength of denture base resins to identify key research areas and trends and to highlight the importance of collaboration between authors and institutions.

METHODS

A Bibliometric Analysis was conducted using the Keywords "Nanoparticle*" AND "Denture*" OR "CAD/CAM." The literature search from the WOS database was restricted to the publication years 2011 to 2022.

RESULTS

Key findings encompass an increase in research publications but a decline in citations. Saudi Arabia, China, and Iraq led this research, with specific institutions excelling. Notable journals with high impact factors were identified. Authorship patterns show variations in citation impact. Additionally, keyword analysis revealed that current research trends offer insights into influential authors and their networks.

CONCLUSIONS

The analysis of nanoparticles and denture base resins reveals a dynamic and evolving landscape that emphasizes the importance of collaboration, staying current with research trends, and conducting high-quality research in this ever-evolving domain.

Evaluating the antifungal effectiveness, leaching characteristics, flexural strength, and impact strength of polymethyl methacrylate added with small-scale silver nanoparticles - An in vitro study

AIM

(1) To assess the release of stable silver nanoparticles (AgNPs) of small scale dimension added to heat polymerized polymethyl methacrylate (PMMA) in 6 months. (2) Assessing the influence of incorporating minimal concentrations of stable AgNPs with nanoscale dimensions into heat polymerized PMMA over a 6 month period on its antifungal efficacy (AF), flexural strength (FS), and impact strength (IS).

SETTINGS AND DESIGN

Incorporating nanoparticles with a very small scale may have minimal impact on mechanical properties due to their diminutive size. However, the influence of these small scaled nanoparticles on antimicrobial efficacy and potential escalation in toxicity to host cells through leaching remains unexplored. AgNPs were prepared using an Ultrasonic Probe sonicator and the addition of ammonia to obtain stabilized AgNPs (< 0.01 nm) of small scale dimension. The characterization of these AgNPs involved ultraviolet visible spectroscopy, X ray diffraction, Zetasizer, and transmission electron microscopy with energy dispersive spectroscopy (TEM).

MATERIALS AND METHODS

The prepared AgNPs were then added in various percentages by weight (0%-0.5%) to fabricate 252 modified PMMA samples of sizes 10 mm × 3 mm (AF, n = 108), 65 mm × 10 mm × 3 mm (FS, n = 72), and 65 mm × 10 mm × 2.5 mm (IS, n = 72) as per ADA specification no. 12. These samples underwent testing for leaching out of AgNPs and efficacy against Candida albicans for 6 months. The effect on FS and IS was evaluated using the three point bending test and Charpy's Impact Tester, respectively.

STATISTICAL ANALYSIS USED

Intergroup comparison of CFU between various concentrations of AgNP was done using the Kruskal-Wallis ANOVA test succeeded by Mann-Whitney test for pair wise comparisons. Difference in CFU of various concentrations over 6 months was seen using one way ANOVA test. Intergroup comparison of FS and IS was performed using a one way ANOVA test, followed by a post hoc Tukey's test for pair wise comparisons.

RESULTS

Repeated tests showed no leaching out of AgNPs from the denture base resin into the storage medium. All concentrations of AgNPs incorporated in resin showed inhibition of Candida growth. Intergroup comparison of FS and IS revealed highly statistically significant differences (F = 15.076, P < 0.01 and F = 28.266, P < 0.01) between the groups showing a reduction in strength.

CONCLUSION

The AgNPs of small scale dimension incorporated into the denture base resin imparted a strong antifungal effectiveness against C. albicans, which did not decline during the study period and did not cause any release of nanoparticles. 0.5% showed the best antifungal efficacy. This may prove to be a viable and highly effective treatment for the prevention of Candida associated denture stomatitis. However, the inclusion of these particles resulted in a decrease in both FS and IS, and this reduction was directly proportional to the percentage of added AgNPs, with 0.5% demonstrating the least IS and FS.

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.

Different Polymers for the Base of Removable Dentures? Part II: A Narrative Review of the Dynamics of Microbial Plaque Formation on Dentures

This review focuses on the current disparities and gaps in research on the characteristics of the oral ecosystem of denture wearers, making a unique contribution to the literature on this topic. We aimed to synthesize the literature on the state of current knowledge concerning the biological behavior of the different polymers used in prosthetics. Whichever polymer is used in the composition of the prosthetic base (poly methyl methacrylate acrylic (PMMA), polyamide (PA), or polyether ether ketone (PEEK)), the simple presence of a removable prosthesis in the oral cavity can disturb the balance of the oral microbiota. This phenomenon is aggravated by poor oral hygiene, resulting in an increased microbial load coupled with the reduced salivation that is associated with older patients. In 15-70% of patients, this imbalance leads to the appearance of inflammation under the prosthesis (denture stomatitis, DS). DS is dependent on the equilibrium-as well as on the reciprocal, fragile, and constantly dynamic conditions-between the host and the microbiome in the oral cavity. Several local and general parameters contribute to this balance. Locally, the formation of microbial plaque on dentures (DMP) depends on the phenomena of adhesion, aggregation, and accumulation of microorganisms. To limit DMP, apart from oral and lifestyle hygiene, the prosthesis must be polished and regularly immersed in a disinfectant bath. It can also be covered with an insulating coating. In the long term, relining and maintenance of the prosthesis must also be established to control microbial proliferation. On the other hand, several general conditions specific to the host (aging; heredity; allergies; diseases such as diabetes mellitus or cardiovascular, respiratory, or digestive diseases; and immunodeficiencies) can make the management of DS difficult. Thus, the second part of this review addresses the complexity of the management of DMP depending on the polymer used. The methodology followed in this review comprised the formulation of a search strategy, definition of the inclusion and exclusion criteria, and selection of studies for analysis. The PubMed database was searched independently for pertinent studies. A total of 213 titles were retrieved from the electronic databases, and after applying the exclusion criteria, we selected 84 articles on the possible microbial interactions between the prosthesis and the oral environment, with a particular emphasis on Candida albicans.

Application of Zeolites and Zeolitic Imidazolate Frameworks in Dentistry-A Narrative Review

Zeolites and zeolitic imidazolate frameworks (ZIFs) are crystalline aluminosilicates with porous structure, which are closely linked with nanomaterials. They are characterized by enhanced ion exchange capacity, physical-chemical stability, thermal stability and biocompatibility, making them a promising material for dental applications. This review aimed to provide an overview of the application of zeolites and ZIFs in dentistry. The common zeolite compounds for dental application include silver zeolite, zinc zeolite, calcium zeolite and strontium zeolite. The common ZIFs for dental application include ZIF-8 and ZIF-67. Zeolites and ZIFs have been employed in various areas of dentistry, such as restorative dentistry, endodontics, prosthodontics, implantology, periodontics, orthodontics and oral surgery. In restorative dentistry, zeolites and ZIFs are used as antimicrobial additives in dental adhesives and restorative materials. In endodontics, zeolites are used in root-end fillings, root canal irritants, root canal sealers and bone matrix scaffolds for peri-apical diseases. In prosthodontics, zeolites can be incorporated into denture bases, tissue conditioners, soft denture liners and dental prostheses. In implantology, zeolites and ZIFs are applied in dental implants, bone graft materials, bone adhesive hydrogels, drug delivery systems and electrospinning. In periodontics, zeolites can be applied as antibacterial agents for deep periodontal pockets, while ZIFs can be embedded in guided tissue regeneration membranes and guided bone regeneration membranes. In orthodontics, zeolites can be applied in orthodontic appliances. Additionally, for oral surgery, zeolites can be used in oral cancer diagnostic marker membranes, maxillofacial prosthesis silicone elastomer and tooth extraction medicines, while ZIFs can be incorporated to osteogenic glue or used as a carrier for antitumour drugs. In summary, zeolites have a broad application in dentistry and are receiving more attention from clinicians and researchers.

Overview of incorporation of inorganic antimicrobial materials in denture base resin: A scoping review

STATEMENT OF PROBLEM

Dental hygiene for institutionalized patients and recurring Candida-associated denture stomatitis remain problematic because of a patient's limited dexterity or inability to eliminate Candida from denture surfaces. Although there has been extensive research into antimicrobial modification of denture base resins with inorganic materials, scoping reviews of the literature to identify knowledge gaps or efficacy of inorganic antimicrobial materials in denture base resins are lacking.

PURPOSE

The purpose of this scoping review was to provide a synopsis of the efficacy of the major classes of inorganic antimicrobial materials currently incorporated into denture base resins.

MATERIAL AND METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was applied. Four electronic databases, including Embase, PubMed, Web of Science, and Google Scholar, were accessed for articles in the English language, up to February 2019, without restrictions on the date of publication.

RESULTS

From the 53 articles selected, 25 distinguishable inorganic materials were found and divided into 3 subgroups. Forty-three articles evaluated nanomaterials, where mostly silver ion nanoparticles and/or titanium dioxide nanoparticles were incorporated into denture base resins. Fourteen articles examined antimicrobial drugs and medications, including azole group medications, amphotericin-B, Bactekiller, chlorhexidine, Novaron, and Zeomic. Two articles classified as others explored hydroxyapatite- and fiber-incorporated denture base resins.

CONCLUSIONS

Although nanotechnology and antimicrobial medications or drugs have been successfully used to reduce Candida-associated denture stomatitis, long-term solutions are still lacking, and their disadvantages continue to outweigh their advantages.

Polymeric Denture Base Materials: A Review

An ideal denture base must have good physical and mechanical properties, biocompatibility, and esthetic properties. Various polymeric materials have been used to construct denture bases. Polymethyl methacrylate (PMMA) is the most used biomaterial for dentures fabrication due to its favorable properties, which include ease of processing and pigmenting, sufficient mechanical properties, economy, and low toxicity. This article aimed to comprehensively review the current knowledge about denture base materials (DBMs) types, properties, modifications, applications, and construction methods. We searched for articles about denture base materials in PubMed, Scopus, and Embase. Journals covering topics including dental materials, prosthodontics, and restorative dentistry were also combed through. Denture base material variations, types, qualities, applications, and fabrication research published in English were considered. Although PMMA has several benefits and gained popularity as a denture base material, it has certain limitations and cannot be classified as an ideal biomaterial for fabricating dental prostheses. Accordingly, several studies have been performed to enhance the physical and mechanical properties of PMMA by chemical modifications and mechanical reinforcement using fibers, nanofillers, and hybrid materials. This review aimed to update the current knowledge about DBMs' types, properties, applications, and recent developments. There is a need for specific research to improve their biological properties due to patient and dental staff adverse reactions to possibly harmful substances produced during their manufacturing and use.

Obturator Manufacturing for Oronasal Fistula after Cleft Palate Repair: A Review from Handicraft to the Application of Digital Techniques

An oronasal fistula (ONF) is an abnormal structure between the oral and nasal cavities, which is a common complication of cleft palate repair due to the failure of wound healing. When some patients with ONF are unsuitable for secondary surgical repair, the obturator treatment becomes a potential method. The objectives of the obturator treatment should be summarized as filling the ONF comfortably and cosmetically restoring the dentition with partial function. The anatomy of patients with cleft palate is complex, which may lead to a more complex structure of the ONF. Thus, the manufacturing process of the obturator for these patients is more difficult. For performing the design and fabrication process rapidly and precisely, digital techniques can help, but limitations still exist. In this review, literature searches were conducted through Medline via PubMed, Wiley Online Library, Science Direct, and Web of Science, and 122 articles were selected. The purpose of this review was to introduce the development of the obturator for treating patients with ONF after cleft palate repair, from the initial achievement of the obstruction of the ONF to later problems such as fixation, velopharyngeal insufficiency, and infection, as well as the application of digital technologies in obturator manufacturing.

PMMA-Based Nanocomposites for Odontology Applications: A State-of-the-Art

Polymethyl methacrylate (PMMA), a well-known polymer of the methacrylate family, is extensively used in biomedicine, particularly in odontological applications including artificial teeth, dentures and denture bases, obturators, provisional or permanent crowns, and so forth. The exceptional PMMA properties, including aesthetics, inexpensiveness, simple manipulation, low density, and adjustable mechanical properties, make it a perfect candidate in the field of dentistry. However, it presents some deficiencies, including weakness regarding hydrolytic degradation, poor fracture toughness, and a lack of antibacterial activity. To further enhance its properties and solve these drawbacks, different approaches can be performed, including the incorporation of nanofillers. In this regard, different types of metallic nanoparticles, metal oxide nanofillers, and carbon-based nanomaterials have been recently integrated into PMMA matrices with the aim to reduce water absorption and improve their performance, namely their thermal and flexural properties. In this review, recent studies regarding the development of PMMA-based nanocomposites for odontology applications are summarized and future perspectives are highlighted.

Evaluation and comparison of flexural strength, surface roughness and porosity percentage of denture base resins incorporated with Thymoquinone and silver nano-antimicrobial agents-an in vitro study

Aim

To evaluate and compare the flexural strength, surface roughness and porosity percentage of acrylic denture base material modified with two antimicrobial agents, Thymoquinone (TQ) and Silver nanoparticles (AgNP).

Materials and methods

A total of 90 specimens were fabricated and divided into groups A, B and C with 30 specimens each. Of the 30 specimens, 10 specimens measuring 65mmx 10mmx 2.5 mm were used to study the flexural strength, 10 specimens measuring 10 mm × 20 mm × 3 mm to study surface roughness and 10 specimens measuring 10 mm × 20 mm × 3 mm to study porosity percentage. Group A specimens were made of unmodified denture base resin, group B and C were modified with 2.5% AgNP and 1% TQ respectively. The specimens were processed in the conventional manner. A universal testing machine was used to measure flexural strength and a profilometer was used to measure surface roughness. Porosity percentage was evaluated with help of a desiccator. The data obtained was subjected to statistical analyses using One-way ANOVA and the Tukey-post hoc test, with statistical significance at p ≤ 0.05.

Results

Addition of 2.5% AgNP and 1% TQ to acrylic denture base resin significantly reduced flexural strength and increased the porosity percentage (p < 0.01) but within clinically acceptable limits. No significant difference was found in the surface roughness between the various groups tested.

Conclusions

Heat cured acrylic denture base resins modified with 2.5% AgNPs,1% TQ exhibited clinically acceptable flexural strength and surface properties and could be incorporated into the denture base material as an antimicrobial agent.

Antimicrobial and Mechanical Properties of Orthodontic Acrylic Resin Containing Zinc Oxide and Titanium Dioxide Nanoparticles Supported on 4A Zeolite

Polymethyl methacrylate (PMMA) is widely used to manufacture removable orthodontic appliances. However, since the porous structure, cold-curing acrylic resins are susceptible to bacterial adhesion and colonization. The aim of this study was to investigate the antibacterial and mechanical properties of a cold-curing PMMA resin containing ZnO and TiO₂ nanoparticles supported on the 4A zeolite. ZnO and TiO₂ nanoparticles supported on the 4A zeolite were synthesized. Nanoparticles were added in three compositions as ZnO/4A, TiO₂/4A, and ZnO/TiO₂/4A at 2wt% and 4wt% concentrations to cold-curing acrylic resin powder (SR Triplex® Cold Ivoclar Vivadent AG, FL-9494 Schaan/Liechtenstein). X-ray diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), energy dispersive X-ray (EDX), transmission electron microscopy (TEM), and dynamic light scattering (DLS) were performed to investigate the nanocomposite characteristics. A direct test method was used to assess the antibacterial properties against Streptococcus mutans, Klebsiella pneumoniae, and Escherichia coli. The surface roughness of acrylic samples was measured with a profilometer. Flexural strength was evaluated by a three-point bending test, and one-way ANOVA and Tukey's post hoc tests were used for statistical evaluation of the data. A p value of less than 0.05 was considered statistically significant. XRD confirmed the accurate crystalline structure of synthesized nanoparticles; FE-SEM images showed nanoparticle dispersion within polymerized acryl. The addition of 2 and 4 wt% of ZnO/4A, TiO₂/4A, and ZnO/TiO₂/4A caused colony reduction in all types of tested microorganisms more than 99% and 100%, respectively. The mean flexural strengths of acrylic specimens containing 2wt% and 4wt% of synthesized nanoparticles were significantly lower than those of the resin without nanoparticles. Fabricated samples showed favorable antibacterial properties but decreased flexural strength.

The Effects of Incorporating Ag-Zn Zeolite on the Surface Roughness and Hardness of Heat and Cold Cure Acrylic Resins

One of the most widely used materials for the fabrication of prosthetic dental parts is acrylic resin. Its reasonable mechanical and physical properties make it a popular material for a wide range of dental applications. Recently, many attempts have been made to improve the mechanical and biological properties of this material, such as by adding fibres, nanoparticles, and nanotubes. The current study aimed to evaluate the effects of adding an antimicrobial agent, Ag-Zn zeolite, on the surface roughness and hardness of the denture base resins. Ag-Zn zeolite particles were chemically prepared and added at different concentrations (0.50 wt.% and 0.75 wt.%) to the heat cure (HC) and cold cure (CC) acrylic resins. Zeolite particles were characterized and confirmed using X-ray diffraction (XRD) and Energy-Dispersive X-ray Spectroscopy (EDX) attached with a Scanning Electron Microscope (SEM). Sixty disk shape specimens (40 mm diameter and 2 mm thickness) were fabricated from the HC and CC resins with and without the zeolite. All the specimens were divided into two main groups based on the acrylic resins, then each was subdivided into three groups (n = 10) according to the concentration of the Ag-Zn zeolite. A surface roughness and a hardness tester were used to measure the surface finish and hardness of the specimens. The analysed data showed that the surface roughness values significantly decreased when 0.50 wt.% and 0.75 wt.% zeolite were incorporated in the HC resin specimens compared to the control group. However, this reduction was not significant in the case of CC resin, while the surface hardness was significantly improved after incorporating 0.50 wt.% and 0.75 wt.% zeolite for both the CC and HC resins. Incorporating Ag-Zn zeolite with acrylic resin materials could be beneficial for improving their surface finish and resistance to surface damage as defined by the higher hardness.

Long term antifungal efficacy of silver-zinc zeolite nanoparticles incorporated in two soft denture liners - An in vitro assessment

Background

There is generally a lack of compliance in patients who report with oral candidiasis, as they are advised to temporarily stop wearing the prosthesis and are prescribed topical antifungals which are generally unpleasant to taste and follow a rigorous schedule. Furthermore, with the alarming evidence of drug resistance, there is a need for an enhanced drug and drug delivery system. The aim of the study was to determine the dose-dependent antifungal efficacy of silver-zinc zeolite nanoparticles (SZZ-NPs) when incorporated in two brands of soft denture liners against Candida albicans.

Materials and Methods

A total of 72 samples were made to determine the in vitro antifungal efficacy of SZZ-NPs and fluconazole by measuring the mean inhibition diameter (MID). Two concentrations of SZZ-NPs were compared (0.5%, 2% w/w) with fluconazole 5%w/w which is routinely prescribed. The antifungals were incorporated in two types of commercially available soft denture liners (Visco gel, GC soft denture liner). The MIDs were measured at day 1, day 7, day 15, and day 30. The values obtained (P < 0.001) were analyzed with one-way ANOVA, Tukey's post hoc, and independent t-test.

Results

A statistically significant difference (P < 0.001) was noted among all the antifungal agents at all the time intervals tested. The anti-fungal efficacy of SSZ-NPs 2% w/w incorporated in GC soft denture liner was significantly superior (P < 0.001) to all groups tested and it retained its antifungal efficacy even on day 30 (MID: 18.33 ± 2.44).

Conclusion

SZZ-NPs 0.5%w/w, 2%w/w, and fluconazole 5%w/w can be incorporated with soft denture liners against C. albicans. Fluconazole 5%w/w is the recommended choice for short-term antifungal efficacy, while SZZ-NPs 2%w/w is recommended when long-term antifungal efficacy is needed. GC soft denture liner was the recommended choice.

How Effective Are Antimicrobial Agents on Preventing the Adhesion of Candida albicans to Denture Base Acrylic Resin Materials? A Systematic Review

Denture stomatitis is a common oral infection caused by Candid albicans. It occurs under removable dentures due to several causative and contributing factors. If not treated, it can lead to fatal systemic candida infections. Different materials and techniques have been used to treat denture stomatitis; however, no single treatment has succeeded. The purpose of this study was to review novel techniques for incorporating antimicrobial and protein repellent agents into denture acrylic resin materials and their effect on the adhesion of Candida albicans to denture base acrylic resin materials to prevent and/or treat denture stomatitis. A systematic review was conducted in which an electronic search was undertaken using different databases and relevant keywords. The literature search revealed numerous studies describing different antifungal materials incorporated into different denture acrylic resin materials. The investigated materials showed significant antimicrobial activity with slight or no effect on the physical and mechanical properties; however, the optical properties were particularly affected with higher concentrations. The incorporation of antimicrobial agents to reduce or prevent Candida albicans biofilm formation on acrylic resin proved to be very effective, and this effect was found to be proportional to the percentage of the material used. The latter should be considered carefully not to alter the physical, mechanical or optical characteristics of the denture base material.

Nanoparticles in Prosthetic Materials: A Literature Review

The commonly used prosthodontic materials are resins, ceramics, metals and silicones. A comprehensive review of literature was completed about the incorporation of nanomaterials in prosthetic dentistry using PubMed and Google Scholar databases. This was supplemented with a manual search of selected journals. English language articles in peer- reviewed journals were selected. Current literature reveals that incorporation of nanomaterials has significantly improved the properties of the prosthetic materials within the clinically acceptable ranges. There appears to be a need for a standardization for these in vitro studies carried out to evaluate their physical, mechanical and antimicrobial properties

Efficacy of MTA Modified by Nanosilver for the Prevention of Coronal Leakage

Background:

Numerous materials have been introduced as coronal barriers, however, they have shown various degrees of microleakage. Therefore, attempts are undertaken to introduce more reliable materials with the potential to provide a long-term coronal seal.

Introduction:

This in vitro study aimed to assess the efficacy of gray ProRoot Mineral Trioxide Aggregate (MTA) modified by a suspension of silver nanoparticles (AgNPs) as an orifice plug using a bacterial leakage method.

Methods:

40 extracted human teeth were prepared and filled (except for the negative control group) using the lateral compaction technique. The coronal 2 mm of the root filling was removed in the experimental groups. The teeth were randomly divided into two experimental (n = 15) and two control (n = 5) groups. In the experimental group 1 (MTA group) and the experimental group 2 (Ag-MTA group), MTA modified by a suspension of AgNPs was used as an orifice plug. In the negative control group, the entire root surfaces were covered with two layers of nail varnish. In the positive control group, the root canals were filled with a single gutta-percha cone without a sealer and no orifice plug. Bacterial leakage was assessed using a two-chamber system. The teeth were incubated at 37°C and 100% humidity for 120 days, and human saliva was added to the samples every 3 days. Bacterial microleakage was assessed by daily monitoring and observating the turbidity of the Brain Heart Infusion (BHI) broth. The data were analyzed using the log-rank test.

Results:

All positive controls showed contamination after 5 days. None of the negative controls were contaminated during the experiment. The Ag-MTA group demonstrated a significantly better coronal seal than the MTA group (p = 0.031).

Conclusion:

Gray ProRoot MTA modified by AgNPs has the potential for being used as an orifice plug in endodontically treated teeth.

Antimicrobial and Mechanical Effects of Zeolite Use in Dental Materials: A Systematic Review

Objective

Ion-incorporated zeolite is a widely used antimicrobial material studied for various dental applications. At present, there is no other systematic review that evaluates the effectiveness of zeolite in all dental materials. The purpose of this study was to review all available literature that analyzed the antimicrobial effects and/or mechanical properties of zeolite as a restorative material in dentistry.

Material and Methods

Following PRISMA guidelines, an exhaustive search of PubMed, Ovid Medline, Scopus, Embase, and the Dentistry & Oral Sciences Source was conducted. No language or time restrictions were used and the study was conducted from June 1, 2020 to August 17, 2020. Only full text articles were selected that pertained to the usage of zeolite in dental materials including composite resin, bonding agents, cements, restorative root material, cavity base material, prosthesis, implants, and endodontics.

Results

At the beginning of the study, 1534 studies were identified, of which 687 duplicate records were excluded. After screening for the title, abstract, and full texts, 35 articles remained and were included in the qualitative synthesis. An Inter-Rater Reliability (IRR) test, which included a percent user agreement and reliability percent, was conducted for each of the 35 articles chosen.

Conclusion

Although ion-incorporated zeolite may enhance the antimicrobial properties of dental materials, the mechanical properties of some materials, such as MTA and acrylic resin, may be compromised. Therefore, since the decrease in mechanical properties depends on zeolite concentration in the restorative material, it is generally recommended to add 0.2-2% zeolite by weight.

Prosthodontic Applications of Polymethyl Methacrylate (PMMA): An Update

A wide range of polymers are commonly used for various applications in prosthodontics. Polymethyl methacrylate (PMMA) is commonly used for prosthetic dental applications, including the fabrication of artificial teeth, denture bases, dentures, obturators, orthodontic retainers, temporary or provisional crowns, and for the repair of dental prostheses. Additional dental applications of PMMA include occlusal splints, printed or milled casts, dies for treatment planning, and the embedding of tooth specimens for research purposes. The unique properties of PMMA, such as its low density, aesthetics, cost-effectiveness, ease of manipulation, and tailorable physical and mechanical properties, make it a suitable and popular biomaterial for these dental applications. To further improve the properties (thermal properties, water sorption, solubility, impact strength, flexural strength) of PMMA, several chemical modifications and mechanical reinforcement techniques using various types of fibers, nanoparticles, and nanotubes have been reported recently. The present article comprehensively reviews various aspects and properties of PMMA biomaterials, mainly for prosthodontic applications. In addition, recent updates and modifications to enhance the physical and mechanical properties of PMMA are also discussed.

Nanomaterials in Dentistry: State of the Art and Future Challenges

Nanomaterials are commonly considered as those materials in which the shape and molecular composition at a nanometer scale can be controlled. Subsequently, they present extraordinary properties that are being useful for the development of new and improved applications in many fields, including medicine. In dentistry, several research efforts are being conducted, especially during the last decade, for the improvement of the properties of materials used in dentistry. The objective of the present article is to offer the audience a complete and comprehensive review of the main applications that have been developed in dentistry, by the use of these materials, during the last two decades. It was shown how these materials are improving the treatments in mainly all the important areas of dentistry, such as endodontics, periodontics, implants, tissue engineering and restorative dentistry. The scope of the present review is, subsequently, to revise the main applications regarding nano-shaped materials in dentistry, including nanorods, nanofibers, nanotubes, nanospheres/nanoparticles, and zeolites and other orders porous materials. The results of the bibliographic analysis show that the most explored nanomaterials in dentistry are graphene and carbon nanotubes, and their derivatives. A detailed analysis and a comparative study of their applications show that, although they are quite similar, graphene-based materials seem to be more promising for most of the applications of interest in dentistry. The bibliographic study also demonstrated the potential of zeolite-based materials, although the low number of studies on their applications shows that they have not been totally explored, as well as other porous nanomaterials that have found important applications in medicine, such as metal organic frameworks, have not been explored. Subsequently, it is expected that the research effort will concentrate on graphene and zeolite-based materials in the coming years. Thus, the present review paper presents a detailed bibliographic study, with more than 200 references, in order to briefly describe the main achievements that have been described in dentistry using nanomaterials, compare and analyze them in a critical way, with the aim of predicting the future challenges.

Incorporation of antimicrobial agents in denture base resin: A systematic review

STATEMENT OF PROBLEM

Denture base resins (DBRs), such as polymethyl methacrylate, are commonly used in the fabrication of removable dentures because of their physical, mechanical, and esthetic properties. However, the denture base acts as a substrate for microorganism adherence and biofilm formation, which may lead to denture stomatitis and be further complicated by fungal infections, of especial importance with geriatric and immunosuppressed patients. Therefore, methods to enhance the antimicrobial property of DBRs will be beneficial.

PURPOSE

The purpose of this systematic review was to evaluate the literature on the antimicrobial activity of DBRs incorporating antimicrobial agents or materials.

MATERIAL AND METHODS

A search of English peer-reviewed literature up to February 2019 reporting on antimicrobial activity of DBRs with respect to antimicrobial agents or materials, antimicrobial test effects and methods, and conclusion or knowledge gaps was conducted by using Embase, Google Scholar, PubMed, and Web of Science databases. Search terms included denture base resin and antibacterial, denture base resin and antifungal, and denture base resin and antimicrobial. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied for subsequent data analysis.

RESULTS

Of 2536 identified articles, 28 met the inclusion criteria for the systematic review. Antimicrobial materials were divided into 3 groups: antimicrobial monomer or copolymer, phytochemical or phytomedical components, and other compounds. Strategies on how to incorporate these substances into DBRs and their impact on the reduction and prevention of the growth of microorganisms were identified.

CONCLUSIONS

Although many efforts have been made to improve the antimicrobial ability of DBRs, this systematic review found that the effectiveness of incorporating of antimicrobial agents into DBRs has not been demonstrated conclusively.

Microporous Frameworks as Promising Platforms for Antibacterial Strategies Against Oral Diseases

Nowadays, the heavy burden of oral diseases such as dental caries, periodontitis, endodontic infections, etc., and their consequences on the patients' quality of life indicate a strong need for developing effective therapies. Bacterial infections played an important role in the field of oral diseases, in-depth insight of such oral diseases have given rise to the demand for antibacterial therapeutic strategies. Recently, microporous frameworks have attracted tremendous interest in antibacterial application due to their well-defined porous structures for drug delivery. In addition, intensive efforts have been made to enhance the antibacterial performance of microporous frameworks, such as ion doping, photosensitizer incorporation as building blocks, and surface modifications. This review article aims on the major recent developments of microporous frameworks for antibacterial applications against oral diseases. The first part of this paper puts concentration on the cutting-edge researches on the versatile antibacterial strategies of microporous materials via drug delivery, inherent activity, and structural modification. The second part discusses the antibacterial applications of microporous frameworks against oral diseases. The applications of microporous frameworks not only have promising therapeutic potential to inhibit bacterial plaque-initiated oral infectious diseases, but also have a wide applicability to other biomedical applications.

Bimetallic Nanoparticles for Antimicrobial Applications

Highly effective antimicrobial agents are needed to control the emergence of new bacterial strains, their increased proliferation capability, and antibacterial resistance that severely impact public health, and several industries including water, food, textiles, and oil and gas. Recently, bimetallic nanoparticles, formed via integration of two different metals, have appeared particularly promising with antibacterial efficiencies surpassing that of monometallic counterparts due to synergistic effects, broad range of physiochemical properties, and diverse mechanisms of action. This work aims to provide a review on developed bimetallic and supported bimetallic systems emphasizing in particular on the relation between synthesis routes, properties, and resulting efficiency. Bimetallic nanostructures on graphene, zeolites, clays, fibers, polymers, as well as non-supported bimetallic nanoparticles are reviewed, their synthesis methods and resulting properties are illustrated, along with their antimicrobial activity and potential against different strains of microbes.

Zeolite in tissue engineering: Opportunities and challenges

Tissue engineering and regenerative medicine follow a multidisciplinary attitude to the expansion and application of new materials for the treatment of different tissue defects. Typically, proper tissue regeneration is accomplished through concurrent biocompatibility and positive cellular activity. This can be resulted by the smart selection of platforms among bewildering arrays of structural possibilities with various porosity properties (ie, pore size, pore connectivity, etc). Among diverse porous structures, zeolite is known as a microporous tectosilicate that can potentially provide a biological microenvironment in tissue engineering applications. In addition, zeolite has been particularly appeared promising in wound dressing and bone‐ and tooth‐oriented scaffolds. The wide range of composition and hierarchical pore structure renders the zeolitic materials a unique character, particularly, for tissue engineering purposes. Despite such unique features, research on zeolitic platforms for tissue engineering has not been classically presented. In this review, we overview, classify, and categorize zeolitic platforms employed in biological and tissue engineering applications.

Evaluation of antibacterial and antifungal properties of a tissue conditioner used in complete dentures after incorporation of ZnO‒Ag nanoparticles

Background. Incorporation of antifungal and antimicrobial agents into tissue conditioners might inhibit the formation of microbial plaque and prevent complications such as denture stomatitis. The present study was carried out to evaluate the antibacterial and antifungal properties of a tissue conditioner after incorporation of ZnO‒Ag nanoparticles into their structure.

Methods. In this in vitro study, 4 microorganisms were evaluated at 6 concentrations of ZnO‒Ag nanoparticles at 24- and 48-hour intervals, using 168 samples. The nanoparticles were mixed at a ratio of 50% Ag and 50% ZnO and were homogenized with the tissue conditioner at 0.625, 1.25, 2.5, 5, 10 and 20 wt% according to the MIC technique principles. After culturing the microorganisms, a spectrophotometer was used for determining proliferation of microorganisms with the use of turbidity after 24 and 48 hours of incubation at 37ºC.

Results. Complete inhibition of the proliferation of Candida albicans, Enterococcus faecalis and Pseudomonas aeruginosa was observed at 24- and 48-hour intervals at a concentration of 10%; such inhibition was observed at 20% concentration of nanoparticles with Streptococcus mutans. In addition, the most effective concentration of ZnO‒Ag nanoparticles at both 24- and 48-hour intervals was 5% with C. albicans and 2.5% with E. faecalis. In addition, the most effective concentration at 24- hour interval with S. mutans was 10% and with P. aeruginosa they were 5% at 24-hour and 2.5% at 48-hour intervals.

Conclusion. Incorporation of ZnO‒Ag nanoparticles into tissue conditioners resulted in the inhibition of bacterial proliferation

Effect of cigarette smoke on the surface roughness of two different denture base materials: An in vitro study

Aim

This study aimed to evaluate the effect of cigarette smoke on the surface roughness of two commercially available denture base materials.

Materials and Methods

A total numbers of 40 specimens were fabricated from two commercially available denture base materials: heat-cured polymethylmethacrylate and flexible denture base materials (20 for each). The specimens for each type were divided into four subgroups: subgroup I, heat-cured denture base material specimens (control group); subgroup II, flexible denture base material (control group); subgroup III, heat-cured denture base material specimen exposed to cigarette smoking group; and subgroup IV, flexible denture base material specimens exposed to cigarette smoking. The control groups were used for immersion in distilled water, and the smoke test groups were used for exposure to cigarette smoking. The smoke test group specimens were exposed to smoking in a custom-made smoking chamber using six cigarettes for each specimen. The surface roughness was measured using a profilometer, and the measurements were considered as the difference between the initial and final roughness measured before and after smoking. Paired t test and independent t-test were used to interpret differences in initial and final roughness values within and between groups respectively.

Results

Paired t-test showed a significant difference between initial surface roughness and final surface roughness within each subgroup.

Conclusion

The surface roughness of the specimens fabricated from the flexible denture base material was found to be more compared to heat-cured denture base specimens after exposure to cigarette smoke.

Nanoparticles and the control of oral biofilms

Nanoparticles, novel in size, shape, and surface chemistry when compared to more conventional materials, offer additional functional properties to a range of possible oral applications, from drug-delivery systems to dental implant coatings. Exploitation of the toxic properties of nanoparticles to bacteria, viruses, and fungi has increased markedly over recent years. Metal and metal oxide nanoparticles and their incorporation into other materials have been of particular interest. The potential of nanoparticles to control the formation of biofilms within the oral cavity, as a function of their antimicrobial, anti-adhesive, and delivery capabilities, is coming under close scrutiny. However, optimum formulation of materials at the nanoscale does require innovative physical and chemical approaches.

Incorporation of the microencapsulated antimicrobial agent phytoncide into denture base resin

BACKGROUND

This study aimed to fabricate a denture base resin (DBR) containing phytoncide microcapsules (PTMCs) and determine the mechanical properties of the resin and antifungal activity.

METHODS

Fifty-four heat-cured rectangular DBR specimens (64 × 10 × 3.3 ± 0.2 mm) containing nine concentrations of PTMC between 0 and 5% (wt/wt) were fabricated and subjected to a three-point bending test. A phytoncide release bioassay was developed using DBR containing 0% and 2.5% PTMCs (wt/wt) in a 24 well-plate assay with incubation of Porphyromonas gingivalis at 37 °C for 74 h. The antifungal activity of PTMCs against Candida albicans, in a pH 5.5 acidic environment was determined in a plate assay.

RESULTS

Flexural strength decreased with increasing PTMC concentration from 97.58 ± 4.79 MPa for the DBR alone to 53.66 ± 2.46 MPa for DBR containing 5.0% PTMC. No release of phytoncide from the PTMCs in the DBR was detected at pH 7.4. The PTMCs had a minimal inhibitory concentration of 2.6% (wt/vol) against C. albicans at pH 5.5.

CONCLUSIONS

PTMCs can be added to DBR 2.5% (wt/wt) without adversely affecting flexural strength. PTMCs released the antimicrobial agent at pH 5.5 at concentrations sufficient to inhibit the growth of the C. albicans.

Synergistic mechanism of Ag+-Zn2+ in anti-bacterial activity against Enterococcus faecalis and its application against dentin infection

Background

Ag⁺ and Zn²⁺ have already been used in combinations to obtain both enhanced antibacterial effect and low cytotoxicity. Despite this, it is still unclear how the Zn²⁺ co-works with Ag⁺ in the synergistic antibacterial activity. The main purposes of this study were to investigate the co-work pattern and optimum ratio between Ag⁺ and Zn²⁺ in their synergistic antibacterial activity against E. faecalis, the possible mechanisms behind this synergy and the primary application of optimum Ag⁺–Zn²⁺ co-work pattern against the E. faecalis biofilm on dentin. A serial of Ag⁺–Zn²⁺ atomic combination ratios were tested on both planktonic and biofilm-resident E. faecalis on dentin, their antibacterial efficiency was calculated and optimum ratio determined. And the cytotoxicity of various Ag⁺–Zn²⁺ atomic ratios was tested on MC3T3-E1 Cells. The role of Zn²⁺ in Ag⁺–Zn²⁺co-work was evaluated using a Zn²⁺ pretreatment study and membrane potential—permeability measurement.

Results

The results showed that the synergistically promoted antibacterial effect of Ag⁺–Zn²⁺ combinations was Zn²⁺ amount-dependent with the 1:9 and 1:12 Ag⁺–Zn²⁺ atomic ratios showing the most powerful ability against both planktonic and biofilm-resident E. faecalis. This co-work could likely be attributed to the depolarization of E. faecalis cell membrane by the addition of Zn²⁺. The cytotoxicity of the Ag⁺–Zn²⁺ atomic ratios of 1:9 and 1:12 was much lower than 2% chlorhexidine.

Conclusions

The Ag⁺–Zn²⁺ atomic ratios of 1:9 and 1:12 demonstrated similar strong ability against E. faecalis biofilm on dentin but much lower cytotoxicity than 2% chlorhexidine. New medications containing optimum Ag⁺–Zn²⁺ atomic ratios higher than 1:6, such as 1:9 or 1:12, could be developed against E. faecalis infection in root canals of teeth or any other parts of human body.

Metal ions from S-PRG filler have the potential to prevent periodontal disease

The surface pre-reacted glass ionomer (S-PRG) filler, a component of composite resin, is capable of releasing metal ions that possess antibacterial activity against caries and periodontal pathogens. Although S-PRG has been suggested to be involved in oral disease prevention, no reports have been published regarding its preventive effect on periodontal disease in vivo. The present study investigated whether the eluate from S-PRG (S-PRG eluate) has a suppressive effect on tissue destruction induced in a mouse model of ligature-induced periodontal disease. Twenty-seven C57BL/6 mice were divided into three groups of nine animals each, no ligature group (Lig(-)), ligature group (Lig(+)S-PRG(-)) and ligature with S-PRG eluate group (Lig(+)S-PRG(+)). Alveolar bone loss was evaluated using micro-computed tomography scanning. Histologic changes were detected by hematoxylin and eosin staining. The infiltration of inflammatory cells was assessed by Ly6G and F4/80 staining immunohistochemically. The distribution of metal ions was detected by time-of-flight secondary ion mass spectrometry. S-PRG eluate clearly inhibited alveolar bone loss and bone density. The histological analysis revealed that S-PRG eluate reduced destruction of the collagen bundle in the periodontal ligament and the infiltration of inflammatory cells. Immunohistochemical analysis showed that the S-PRG eluate significantly suppressed the number of infiltrating neutrophils and macrophages. Time-of-flight secondary ion mass spectrometry analysis revealed that more boron ions were present in the Lig(+)S-PRG(+) group than in the Lig(+)S-PRG(-) group. Our results suggest that the S-PRG eluate has a preventive effect against tissue destruction in periodontal disease through its anti-inflammatory effects in vivo.

PMMA denture base material enhancement: a review of fiber, filler, and nanofiller addition

This paper reviews acrylic denture base resin enhancement during the past few decades. Specific attention is given to the effect of fiber, filler, and nanofiller addition on poly(methyl methacrylate) (PMMA) properties. The review is based on scientific reviews, papers, and abstracts, as well as studies concerning the effect of additives, fibers, fillers, and reinforcement materials on PMMA, published between 1974 and 2016. Many studies have reported improvement of PMMA denture base material with the addition of fillers, fibers, nanofiller, and hybrid reinforcement. However, most of the studies were limited to in vitro investigations without bioactivity and clinical implications. Considering the findings of the review, there is no ideal denture base material, but the properties of PMMA could be improved with some modifications, especially with silanized nanoparticle addition and a hybrid reinforcement system.

Antifungal, optical, and mechanical properties of polymethylmethacrylate material incorporated with silanized zinc oxide nanoparticles

Background

Fungal infected denture, which is typically composed of polymethylmethacrylate (PMMA), is a common problem for a denture wearer, especially an elderly patient with limited manual dexterity. Therefore, increasing the antifungal effect of denture by incorporating surface modification nanoparticles into the PMMA, while retaining its mechanical properties, is of interest.

Aim of the study

This study aimed to evaluate antifungal, optical, and mechanical properties of heat-cured PMMA incorporated with different amounts of zinc oxide nanoparticles (ZnOnps) with or without methacryloxypropyltrimethoxysilane modification.

Materials and methods

Specimens made from heat-cured PMMA containing 1.25, 2.5, and 5% (w/w) nonsilanized (Nosi) or silanized (Si) ZnOnps were evaluated. Specimens without filler served as control. The fungal assay was performed placing a Candida albicans suspension on the PMMA surface for 2 h, then Sabouraud Dextrose Broth was added, and growth after 24 h was determined by counting colony forming units on agar plates. A spectrophotometer was used to measure the color in L* (brightness), a* (red-green), b* (yellow-blue) and opacity of the experimental groups. Flexural strength and flexural modulus were determined using a three-point bending test on universal testing machine after 37°C water storage for 48 h and 1 month.

Results

The antifungal, optical, and mechanical properties of the PMMA incorporated with ZnOnps changed depending on the amount. With the same amount of ZnOnps, the silanized groups demonstrated a greater reduction in C. albicans compared with the Nosi groups. The color difference (ΔE) and opacity of the Nosi groups were greater compared with the Si groups. The flexural strength of the Si groups, except for the 1.25% group, was significantly greater compared with the Nosi groups.

Conclusion

PMMA incorporated with Si ZnOnps, particularly with 2.5% Si ZnOnps, had a greater antifungal effect, less color differences, and opacity compared with Nosi ZnOnps, while retaining its mechanical properties.

Effect of comonomer of methacrylic acid on flexural strength and adhesion of Staphylococcus aureus to heat polymerized poly (methyl methacrylate) resin: An in vitro study

Aims and Objective:

The purpose of the present study was to evaluate and compare flexural strength and Staphylococcus aureus adhesion of heat-activated poly (methyl methacrylate [MMA]) resin modified with a comonomer of methacrylic acid (MAA) and MMA monomer.

Materials and Methods:

Comonomer preparation was done with the addition of varying concentration of MAA (0, 15, 20, and 25 wt %) to the MMA of conventional heat-activated denture base resin to prepare the specimens. Prepared specimens were stored in distilled water at 37°C for 1 day and 1 week before the evaluation of flexural strength and microbial adhesion. Flexural strength was measured using a universal testing machine at a crosshead speed for 2 mm/min (n = 10). Microbial adhesion (colony-forming unit [CFU]) was evaluated against S. aureus using a quadrant streaking method (n = 5). Data were subjected to one-way ANOVA, and the significant differences among the results were subjected to Tukey's HSD test. P < 0.05 was considered statistically significant.

Results:

Addition of MAA to the MMA monomer was found to significantly reduce the adhesion of S. aureus for all the groups. Reduction of CFU of S. aureus was found be more significant for Group 3 as compared to control, both at 1-day (P < 0.001) and 1-week (P < 0.002) storage in distilled water. However, no statistically significant changes in the flexural strength were observed with the addition of MAA at 1-day (P = 0.52) and 1-week (P = 0.88) time interval.

Conclusion:

Addition of MAA to conventional denture base resin reduced the microbial adhesion without significantly affecting the flexural strength.

Evaluation of Antibacterial Efficacy of MTA with and without Additives Like Silver Zeolite and Chlorhexidine

INTRODUCTION

Microorganisms, predominantly Enterococcus faecalis are found responsible in the progression of pulpal, periradicular diseases and in endodontic failures. Unsuccessful conventional treatment might necessitate the need for a surgical approach; where in retrograde restorative materials are used to seal the apex. Among the root end filling materials, Mineral Trioxide Aggregate (MTA) is considered biocompatible and is most commonly used in clinical applications but it has limited antibacterial activity. Metallic silver and chlorhexidine have been added into various dental materials to enhance the antibacterial activity.

AIM

This study aimed to compare the antibacterial effect of MTA, MTA mixed with silver zeolite and MTA mixed with chlorhexidine against Enterococcus faecalis.

MATERIALS AND METHODS

Test materials used in the study were divided into three groups namely Group 1- MTA, Group 2-MTA + Silver Zeolite, Group 3-MTA + Chlorhexidine. Direct contact test was done by placing a standardized suspension of Enterococcus faecalis on the test materials in a 96 well microtiter plate. The bacterial growth was measured spectrophotometrically using ELISA reader at intervals of one, three and seven days.

STATISTICAL ANALYSIS

Data was collected by recording the optical density and analyzed using two-way ANOVA and Tukey's multiple post hoc test followed by paired-t test.

RESULTS AND CONCLUSION

All test groups showed antibacterial activity against Enterococcus faecalis at day one, three and seven. MTA with silver zeolite showed the maximum antibacterial activity followed by MTA with 2% chlorhexidine. The least antibacterial effect was shown by MTA mixed with sterile water.

Role of antifungal medicaments added to tissue conditioners: A systematic review

PURPOSE

The aim of this review is to investigate the current state of knowledge on the incorporation of antifungal agents into the tissue conditioners for the treatment of denture induced stomatitis.

STUDY SELECTION

Studies reporting the incorporation of antifungal/antimicrobial agents in to tissue conditioners were included in the review. In order to search the studies on the topic "incorporation of antifungal agents in tissue conditioners for the treatment of denture induced stomatitis" ISI web of science, PubMed/MEDLINE, and Google-Scholar databases were searched from 1970 up to and including July 2015 using various keywords such as antifungal agents, tissue conditioners, Candida albicans, denture stomatitis, etc.

RESULTS

Various studies reported the efficacy and effectiveness of adding conventional organic antifungal medicines (nystatin, azole group derivatives and chlorhexidine, antimicrobials/antifungals other than organic (silver zeolite, silver nano-particles, photo-catalysts and metallic oxides) and natural and herbal antimicrobials (tea tree oil, lemongrass essential oil and origanum oil) into various tissue conditioners. The review literature reported that incorporation of antifungal agents into tissue conditioners is effective with minimal or no effects on physical and mechanical properties of tissue conditioners.

CONCLUSIONS

Incorporation of different antifungal medicaments to commercially available tissue conditioners can be recommended for the management of denture induced stomatitis.

Enhancing the antibacterial activity of the gold standard intracanal medicament with incorporation of silver zeolite: An in vitro study

Background:

Enterococcus faecalis is a persistent organism that plays a major role in the etiology of persistent periradicular lesions after root canal treatment has been associated with different forms of periradicular disease including primary endodontic infections and persistent infections. The present study compares the antibacterial activities of calcium hydroxide, calcium hydroxide mixed with silver zeolite, and calcium hydroxide mixed with 2% chlorhexidine against E. faecalis using direct contact test.

Materials and Methods:

The test materials of the in vitro experimental study were grouped as group 1—calcium hydroxide mixed with sterile water, group 2—2% silver zeolite added in calcium hydroxide mixed with sterile water, and group 3—calcium hydroxide mixed with 2% chlorhexidine. The bottom of microtiter plate were coated with freshly mixed tested material and a 10 μL of bacterial suspension was placed. After 1 h of incubation at 37°C, brain–heart infusion (BHI) broth (245 μL) was added and mixed for 2 min. These were designated as “subgroup 1” wells. A volume of 15 μL of broth then transferred from subgroup 1 wells to an adjacent set of four wells containing fresh BHI medium (215 μL); these wells were designated as “subgroup 2”’ wells. The optical density was measured by a spectrophotometer after the first day, third day, and seventh day. One-way analysis of variance (ANOVA) and Tukey tests were performed for the analysis.

Results:

Calcium hydroxide mixed with silver zeolite showed maximum antibacterial activity.

Conclusion:

Silver zeolite can be added in calcium hydroxide to enhance the latter's antibacterial activity against E. faecalis.

The effect of microwave processing and use of antimicrobial agent on porosity of conventional heat cured denture base resin: An in vitro study

Statement of Problem:

The occurrence porosity in polymethyl methacrylate, the most commonly used denture base material is a problem. The occurrence of oral candidiasis and other infections has also been reported in denture users.

Purpose:

The aim of this study was to evaluate the effect of addition of an antimicrobial agent, silver zeolite on the porosity of denture base resin, which will be an effective tool in the prevention of oral candidiasis among denture wearers. This study also aims to analyze the effect of polymerization technique on porosity in zeolite incorporated dentures to develop a denture base resin which will be easy to process with optimal mechanical and antimicrobial properties.

Materials and Methods:

Eighty rectangular resin specimens (65 mm × 40 mm × 5 mm) were divided into one control group (A) and three experimental groups (B – Microwave cured denture base resin specimens, C – Conventionally cured denture base resin incorporated with antibacterial zeolites, D – Microwave cured denture base resin incorporated with antibacterial zeolites) porosity was calculated by measurement of the specimen volume before and after its immersion in water. Data were analyzed using one-way analysis of variance.

Results:

The mean values of the percent mean porosity were: A = 0.9555%, B = 0.9590%, C = 0.9630%, D = 0.9695%. No significant differences were found in mean porosity among the groups evaluated.

Conclusion:

Within the limitations of this study, it could be concluded that the addition of zeolites did not result in significant porosity and that the use of microwave processing is a viable option for denture processing.

The effects of silver nanoparticles on antimicrobial activity of ProRoot mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM)

Background

Although, mineral trioxide aggregate (MTA) and new experimental cement (CEM) are good root filling cements, but had no or low antimicrobial activities. The aim of this study was to evaluate the effects of addition of silver nanoparticles (SNP) to these two cements on antimicrobial effects against five most dental infection related microorganisms.

Material and Methods

Two suspensions of 100 and 200 ppm of SNP were prepared and 180 μl of microbial suspension with 1.5 × 108 CFU/ml of each respected microorganisms were re-suspended in deionized water or each of SNP suspensions. After that, 60 μg of MTA and CEM were added to each tube. In one tube, the mixture of all above mentioned microorganisms were added as a source of microorganism. Colonies were counted after 0, 24, 48, 72 and 96 hours intervals of incubation at 35°C on blood agar for evaluation of antimicrobial efficacy.

Results

MTA and CEM had antibacterial activities on all microorganisms’ strains except for Enterococcus faecalis and mixture group. MTA had better antibacterial activity than CEM but the difference was not significant (p<0.05). The combination of SNP with two cements resulted in significantly higher antimicrobial activities (p<0.05). Also, there was no statistically significant difference between two SNP concentrations (p>0.05).

Conclusions

Mixture of MTA and CEM with different concentrations of SNP significantly increased the antibacterial activity.

Key words:Mineral trioxide aggregate, calcium-enriched mixture, silver nanoparticle, antimicrobial activity.

In vitro study of the antibacterial properties and impact strength of dental acrylic resins modified with a nanomaterial

STATEMENT OF PROBLEM

The accumulation of bacteria on the surface of dental prostheses can lead to systemic disease.

PURPOSE

The purpose of this in vitro study was to evaluate the growth of Staphylococcus aureus and Pseudomonas aeruginosa on the surface of autopolymerizing (AP) and heat-polymerizing (HP) acrylic resins incorporated with nanostructured silver vanadate (β-AgVO3) and its impact strength.

MATERIAL AND METHODS

For each resin, 216 circular specimens (9 × 2 mm) were prepared for microbiologic analysis and 60 rectangular specimens (65 × 10 × 3.3 mm) for mechanical analysis, according to the percentage of β-AgVO3: 0%, control group; 0.5%; 1%; 2.5%; 5%; and 10%. After a biofilm had formed, the metabolic activity of the bacteria was measured using the XTT reduction assay (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) (n=8), and the number of viable cells was determined by counting colony forming units per milliliter (CFU/mL) (n=8). Confocal laser scanning microscopy (CLSM) was used to complement the analyses (n=2). The mechanical behavior was evaluated by impact strength assays (n=10). Data were analyzed by 2-way ANOVA, followed by the Tukey honestly significant difference (HSD) post hoc test (α=.05).

RESULTS

The addition of 5% and 10% β-AgVO3 significantly decreased the metabolic activity of P. aeruginosa for both resins (P<.05). The HP resin promoted a greater reduction in metabolic activity than the AP resin (P<.05). No difference was found in the metabolic activity of S. aureus according to the XTT (P>.05). The number of CFU/mL for S. aureus and P. aeruginosa decreased significantly when 5% and 10% β-AgVO3 were added (P<.001). These concentrations significantly reduced the impact strength of the resins (P<.001) because the system was weakened by the presence of clusters of β-AgVO3.

CONCLUSION

The addition of β-AgVO3 can provide acrylic resins with antibacterial activity but reduces their impact strength. More efficient addition methods should be investigated.

Effect of Cigarette Smoke on Surface Roughness of Different Denture Base Materials

BACKGROUND

Surface roughness is an important property of denture bases since denture bases are in contact with oral tissues and a rough surface may affect tissues health due to microorganism accumulation. Therefore, the effect of cigarette smoke on the surface roughness of two commercially available denture base materials was evaluated to emphasize which type has superior properties for clinical use.

MATERIALS AND METHODS

A total numbers of 40 specimens were constructed from two commercially available denture base materials; heat-cured PMMA and visible light cured UDMA resins (20 for each). The specimens for each type were randomly divided into: Group I: Heat cured resin control group; Group II: Heat cured acrylic resin specimens exposed to cigarette smoking; Group III: Light cured resin control group; Group IV: Light cured resin specimens exposed to cigarette smoking. The control groups used for immersion in distilled water and the smoke test groups used for exposure to cigarette smoking. The smoke test groups specimens were exposed to smoking in a custom made smoking chamber by using 20 cigarettes for each specimen. The surface roughness was measured by using Pocket SurfPS1 profilometer and the measurements considered as the difference between the initial and final roughness measured before and after smoking.

RESULTS

The t-test for paired observation of test specimens after exposure to smoking was indicated significant change in surface roughness for Group II (p< 0.05) but has no significance with Group IV. Otherwise, there were no significant differences with control groups (Group I and III).

CONCLUSION

The surface roughness of the dentures constructed from heat cured acrylic resin had been increased after exposure to cigarette smoke but had no impact on the dentures constructed from visible light cured resin.

Development of a novel resin with antimicrobial properties for dental application

The adhesion of biofilm on dental prostheses is a prerequisite for the occurrence of oral diseases.

OBJECTIVE

To assess the antimicrobial activity and the mechanical properties of an acrylic resin embedded with nanostructured silver vanadate (β-AgVO3).

MATERIAL AND METHODS

The minimum inhibitory concentration (MIC) of β-AgVO3 was studied in relation to the species Staphylococcus aureus ATCC 25923, Streptococcus mutans ATCC 25175, Pseudomonas aeruginosa ATCC 27853, and Candida albicans ATCC 10231. The halo zone of inhibition method was performed in triplicate to determine the inhibitory effect of the modified self-curing acrylic resin Dencor Lay-Clássico. The surface hardness and compressive strength were examined. The specimens were prepared according to the percentage of β-AgVO3 (0%-control, 0.5%, 1%, 2.5%, 5%, and 10%), with a sample size of 9x2 mm for surface hardness and antimicrobial activity tests, and 8x4 mm for the compression test. The values of the microbiologic analysis were compared and evaluated using the Kruskal-Wallis test (α=0.05); the mechanical analysis used the Shapiro-Wilk's tests, Levene's test, ANOVA (one-way), and Tukey's test (α=0.05).

RESULTS

The addition of 10% β-AgVO3 promoted antimicrobial activity against all strains. The antimicrobial effect was observed at a minimum concentration of 1% for P. aeruginosa, 2.5% for S. aureus, 5% for C. albicans, and 10% for S. mutans. Surface hardness and compressive strength increased significantly with the addition of 0.5% β-AgVO3 (p<0.05). Higher rates of the nanomaterial did not alter the mechanical properties of the resin in comparison with the control group (p>0.05).

CONCLUSIONS

The incorporation of β-AgVO3 has the potential to promote antimicrobial activity in the acrylic resin. At reduced rates, it improves the mechanical properties, and, at higher rates, it does not promote changes in the control.

Effects of fluconazole, chlorhexidine gluconate, and silver-zinc zeolite on flexural strength of heat-cured polymethyl methacrylate resin

Aim:

We evaluated the effect of incorporating Fluconazole, Chlorhexidine Gluconate, and Silver-Zinc Zeolite as bioactive materials (10% of mass) on the flexural strength of commercially available heat-cured polymethyl methacrylate (PMMA; Travelon).

Materials and Methods:

The following four groups were compared; Group 1: Control group with pure PMMA, Group 2: Antibacterial drug group with chlorhexidine gluconate in powder form + PMMA, Group 3: Antifungal drug group with fluconazole in powder form + PMMA, Group 4: Antimicrobial agent group with silver zinc zeolite in powder form + PMMA. After processing, the specimens were subjected for flexural strength testing using three-point bending test in a universal testing machine.

Results:

A significant (P < 0.0001) decrease in flexural strength following incorporation of Fluconazole, Chlorhexidine Gluconate, and Silver-Zinc Zeolite to heat polymerized acrylic resin was observed when compared with the control group. The decrease in mean flexural strength was minimal in the fluconazole group.

Conclusion:

Although the addition of a bioactive material to PMMA acrylic is desirable, it is not practical as it reduces flexural strength of the acrylic base.