Investigation of adhesion status of Candida species to the surface of resin materials produced at different angles with additive manufacturing

BACKGROUND

The aim of this study was to evaluate the adhesion of Candida glabrata, Candida albicans, Candida krusei, Candida parapsilosis and Candida tropicalis yeasts to disk-shaped resin materials produced from resin which used in the production of surgical guide with 0, 45 and 90-degrees printing orientations by Liquid Crystal Display additive manufacturing technology.

METHODS

Disk-shaped specimens were printed with surgical guide resin using the Liquid Crystal Display production technique in 3 printing orientations (0, 45 and 90-degrees). Surface roughness and contact angle values were evaluated. Real-Time PCR analysis was performed to evaluate Candida adhesion (C. glabrata, C. albicans, C. krusei, C. parapsilosis and C. tropicalis) Field emission scanning electron microscope (FESEM) images of the materials were obtained.

RESULTS

Specimens oriented at 45-degrees demonstrated higher surface roughness (P < .05) and lower contact angle values than other groups. No significant difference was found in the adhesion of C. glabrata, C. albicans, and C. parapsilosis among specimens printed at 0, 45, and 90-degrees orientations (P > .05). A higher proportion of C. krusei and C. tropicalis was found in the specimens printed at orientation degrees of 45 = 90 < 0 with statistical significance. Analyzing the adhesion of all Candida species reveals no statistical disparity among the printing orientations.

CONCLUSIONS

The surface roughness, contact angle, and adhesion of certain Candida species are affected by printing orientations. Hence, careful consideration of the printing orientation is crucial for fabricating products with desirable properties. In 45-degree production, roughness increases due to the layered production forming steps, whereas in 0-degree production, certain Candida species exhibit high adhesion due to the formation of porous structures. Consequently, considering these factors, it is advisable to opt for production at 90-degrees, while also considering other anticipated characteristics.

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

OBJECTIVE

This study evaluated the surface roughness, wettability and adhesion of multispecies biofilms (Candida albicans, Staphylococcus aureus and Streptococcus mutans) on 3D-printed resins for complete denture bases and teeth compared to conventional resins (heat-polymerized acrylic resin; artificial pre-fabricated teeth).

METHODOLOGY

Circular specimens (n=39; 6.0 mm Ø × 2.0 mm) of each group were subjected to roughness (n=30), wettability (n=30) and biofilm adhesion (n=9) tests. Three roughness measurements were taken by laser confocal microscopy and a mean value was calculated. Wettability was evaluated by the contact angle of sessile drop method, considering the mean of the three evaluations per specimen. In parallel, microorganism adhesion to resin surfaces was evaluated using a multispecies biofilm model. Microbial load was evaluated by determining the number of Colony Forming Units (CFU/mL) and by scanning electron microscopy (SEM). Data were subjected to the Wald test in a generalized linear model with multiple comparisons and Bonferroni adjustment, as well as two-way ANOVA (α=5%).

RESULTS

The roughness of the conventional base resin (0.01±0.04) was lower than that of the conventional tooth (0.14±0.04) (p=0.023) and 3D-printed base (0.18±0.08) (p<0.001). For wettability, conventional resin (84.20±5.57) showed a higher contact angle than the 3D-printed resin (60.58±6.18) (p<0.001). Higher microbial loads of S. mutans (p=0.023) and S. aureus (p=0.010) were observed on the surface of the conventional resin (S. mutans: 5.48±1.55; S. aureus: 7.01±0.57) compared to the 3D-printed resin (S. mutans: 4.11±1.96; S. aureus: 6.42±0.78). The adhesion of C. albicans was not affected by surface characteristics. The conventional base resin showed less roughness than the conventional dental resin and the printed base resin.

CONCLUSION

The 3D-printed resins for base and tooth showed less hydrophobicity and less adhesion of S. mutans and S. aureus than conventional resins.

Impact of multiscale surface topography characteristics on Candida albicans biofilm formation: From cell repellence to fungicidal activity

While there has been significant research conducted on bacterial colonization on implant materials, with a focus on developing surface modifications to prevent the formation of bacterial biofilms, the study of Candida albicans biofilms on implantable materials is still in its infancy, despite its growing relevance in implant-associated infections. C. albicans fungal infections represent a significant clinical concern due to their severity and associated high fatality rate. Pathogenic yeasts account for an increasing proportion of implant-associated infections, since Candida spp. readily form biofilms on medical and dental device surfaces. In addition, these biofilms are highly antifungal-resistant, making it crucial to explore alternative solutions for the prevention of Candida implant-associated infections. One promising approach is to modify the surface properties of the implant, such as the wettability and topography of these substrata, to prevent the initial Candida attachment to the surface. This review summarizes recent research on the effects of surface wettability, roughness, and architecture on Candida spp. attachment to implantable materials. The nanofabrication of material surfaces are highlighted as a potential method for the prevention of Candida spp. attachment and biofilm formation on medical implant materials. Understanding the mechanisms by which Candida spp. attach to surfaces will allow such surfaces to be designed such that the incidence and severity of Candida infections in patients can be significantly reduced. Most importantly, this approach could also substantially reduce the need to use antifungals for the prevention and treatment of these infections, thereby playing a crucial role in minimizing the possibility contributing to instances of antimicrobial resistance. STATEMENT OF SIGNIFICANCE: In this review we provide a systematic analysis of the role that surface characteristics, such as wettability, roughness, topography and architecture, play on the extent of C. albicans cells attachment that will occur on biomaterial surfaces. We show that exploiting bioinspired surfaces could significantly contribute to the prevention of antimicrobial resistance to antifungal and chemical-based preventive measures. By reducing the attachment and growth of C. albicans cells using surface structure approaches, we can decrease the need for antifungals, which are conventionally used to treat such infections.

Adhesion of Candida Albicans to digital versus conventional acrylic resins: a systematic review and meta-analysis

BACKGROUND

The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins (both milled and 3D-printed) compared to the conventional heat-polymerized acrylic resins.

METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). A comprehensive search of online databases/search tools (Web of Science, Scopus, PubMed, Ovid, and Google Scholar) was conducted for all relevant studies published up until May 29, 2023. Only in-vitro studies comparing the adherence of Candida albicans to the digital and conventional acrylic resins were included. The quantitative analyses were performed using RevMan v5.3 software.

RESULTS

Fourteen studies were included, 11 of which were meta-analyzed based on Colony Forming Unit (CFU) and Optical Density (OD) outcome measures. The pooled data revealed significantly lower candida colonization on the milled digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (MD = - 0.36; 95%CI = - 0.69, - 0.03; P = 0.03 and MD = - 0.04; 95%CI = - 0.06, - 0.01; P = 0.0008; as measured by CFU and OD respectively). However, no differences were found in the adhesion of Candida albicans between the 3D-printed digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (CFU: P = 0.11, and OD: P = 0.20).

CONCLUSION

The available evidence suggests that candida is less likely to adhere to the milled digitally-fabricated acrylic resins compared to the conventional ones.

Evaluation of the Influence of Build Orientation on the Surface Roughness and Flexural Strength of 3D-Printed Denture Base Resin and Its Comparison with CAD-CAM Milled Denture Base Resin

OBJECTIVES

 The purpose of this study was to determine the surface roughness and flexural strength of a three-dimensional (3D)-printed denture base resin printed with two different build plate orientations and to compare them with a computer-aided design-computer-aided manufacture (CAD-CAM) milled denture base resin.

MATERIALS AND METHODS

 Sixty-six specimens (n = 22/group) were prepared by 3D printing and CAD-CAM technology. The group A and B specimens were 3D-printed bar-shaped denture base specimens printed at 120-degree and 135-degree build orientation, respectively, whereas group C specimens were milled using a CAD-CAM technology. The surface roughness was assessed using a noncontact profilometer with a 0.01 mm resolution and the flexural strength was determined using a three-point bend test. The maximum load in Newtons (N) at fracture, the flexural stress (MPa), and strain (mm/mm) was also measured.

STATISTICAL ANALYSIS

 Data were analyzed by a statistical software package. One-way analysis of variance test was applied to determine whether significant differences existed among the study groups, followed by Bonferroni post-hoc test to determine which resin group significantly differed from the others in terms of flexural strength and surface roughness (p ≤ 0.05).

RESULTS

 The flexural stress (MPa) of group C was 200% of group A and 166% of group B. The flexural modulus was 192% of group A and 161% of group B. In contrast, group A had the lowest mean value among the three groups for all the parameters. No significant difference was seen between group A and group B. The mean roughness values of the CAD-CAM denture base resin specimens (group C) were the least (127356 nm) among all the three groups. The mean surface roughness of the 3D-printed denture base specimens (group A) was 1,34,234 nm and that of group B was (1,45,931 nm); however, it was statistically nonsignificant (p > 0.05) CONCLUSIONS:  The CAD-CAM resin displayed superior surface and mechanical properties compared to the 3D-printed resin. The two different build plate angles did not have any significant effect on the surface roughness of the 3D-printed denture base resin.

Cryptocarya moschata extract decreases single and mixed biofilms on acrylic resins

OBJECTIVE

This study proposed to assess the effect of Cryptocarya moschata extract on single and mixed biofilms formed on denture base and reline acrylic resin.

MATERIALS AND METHODS

Single and mixed biofilms of Candida albicans and Streptococcus mutans were formed on the samples and treated with C. moschata extract; Nystatin solution at 100,000 IU/mL or Penicillin antibiotic solution at 100,000 IU/mL; or PBS solution. Antimicrobial activity was analyzed by counting colony-forming units, metabolism assay, assessment of protein components of the biofilm matrix, and of cell viability using confocal laser scanning microscopy (CLSM). Data were submitted to ANOVA and Tukey's post-test (α = 0.05).

RESULTS

Cryptocarya moschata extract reduced cell viability of C. albicans and S. mutans single and mixed biofilms formed on samples. For all types of biofilms in the C. moschata group, there was a log reduction of the biofilm, proven by the Alamar Blue assay. Analyzing the extracellular matrix protein components, groups treated with the extract exhibited a lower level of fluorescence compared to the PBS groups. Reduction in thickness biofilm and viable cells was perceptible in the C. moschata group when assessing through CLSM.

CONCLUSION

Cryptocarya moschata extract reduced the single and mixed biofilms of C. albicans and S. mutans on acrylic resins.

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.

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.

Biodegradation of Poly(ethylene terephthalate) by Bacillus safensis YX8

Due to the extensive utilization of poly (ethylene terephthalate) (PET), a significant amount of PET waste has been discharged into the environment, endangering both human health and the ecology. As an eco-friendly approach to PET waste treatment, biodegradation is dependent on efficient strains and enzymes. In this study, a screening method was first established using polycaprolactone (PCL) and PET nanoparticles as substrates. A PET-degrading strain YX8 was isolated from the surface of PET waste. Based on the phylogenetic analysis of 16S rRNA and gyrA genes, this strain was identified as Bacillus safensis. Strain YX8 demonstrated the capability to degrade PET nanoparticles, resulting in the production of terephthalic acid (TPA), mono (2-hydroxyethyl) terephthalic acid (MHET), and bis (2-hydroxyethyl) terephthalic acid (BHET). Erosion spots on the PET film were observed after incubation with strain YX8. Furthermore, the extracellular enzymes produced by strain YX8 exhibited the ability to form a clear zone on the PCL plate and to hydrolyze PET nanoparticles to generate TPA, MHET, and BHET. This work developed a method for the isolation of PET-degrading microorganisms and provides new strain resources for PET degradation and for the mining of functional enzymes.

Effect of different disinfection protocols on the surface properties of CAD-CAM denture base materials

STATEMENT OF PROBLEM

Which disinfection protocol provides optimal water contact angle and microhardness for computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) materials is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different disinfection protocols (1% sodium hypochlorite, denture cleanser gel, and effervescent tablet) on the water contact angle and microhardness of different CAD-CAM PMMA denture base materials by comparing them with a heat-polymerized PMMA.

MATERIAL AND METHODS

Disk-shaped specimens (Ø10×2 mm) were fabricated from 3 different CAD-CAM PMMAs-AvaDent (AV), Merz M-PM (M-PM), and Polident (Poli)-and a heat-polymerized PMMA (Vynacron) (CV) (n=21). Three disinfection protocols (1% sodium hypochlorite [HC], denture cleanser gel [GEL], an effervescent tablet [TAB]) were applied to simulate 180 days of cleansing. The water contact angle and microhardness of specimens were measured before and after disinfection and compared by using a 2-way ANOVA (α=.05).

RESULTS

For water contact angle, material (P=.010) and disinfection protocol (P=.002) had a significant effect. The material (P<.001), disinfection protocol (P=.001), and their interaction (P<.001) significantly affected the microhardness after disinfection. When the condition after disinfection was compared with that before disinfection, the water contact angle increased significantly in all material-disinfection protocol pairs (P≤.025), and microhardness increased significantly in all material-disinfection protocol pairs (P≤.040), except for GEL- (P=.689) or TAB-applied (P=.307) AV, HC-applied M-PM (P=.219), and TAB-applied Poli (P=.159).

CONCLUSIONS

The material and disinfection protocol affected the water contact angle of all tested PMMAs after disinfection, resulting in more hydrophobic surfaces for heat-polymerized or CAD-CAM PMMAs. The microhardness of heat-polymerized PMMA was less than that of all CAD-CAM PMMAs after disinfection, regardless of the protocol.

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

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

Different Polymers for the Base of Removable Dentures? Part I: A Narrative Review of Mechanical and Physical Properties

Even before considering their introduction into the mouth, the choice of materials for the optimization of the prosthesis depends on specific parameters such as their biocompatibility, solidity, resistance, and longevity. In the first part of this two-part review, we approach the various mechanical characteristics that affect this choice, which are closely related to the manufacturing process. Among the materials currently available, it is mainly polymers that are suitable for this use in this field. Historically, the most widely used polymer has been polymethyl methacrylate (PMMA), but more recently, polyamides (nylon) and polyether ether ketone (PEEK) have provided interesting advantages. The incorporation of certain molecules into these polymers will lead to modifications aimed at improving the mechanical properties of the prosthetic bases. In the second part of the review, the safety aspects of prostheses in the oral ecosystem (fragility of the undercuts of soft/hard tissues, neutral pH of saliva, and stability of the microbiota) are addressed. The microbial colonization of the prosthesis, in relation to the composition of the material used and its surface conditions (roughness, hydrophilicity), is of primary importance. Whatever the material and manufacturing process chosen, the coating or finishes dependent on the surface condition remain essential (polishing, non-stick coating) for limiting microbial colonization. The objective of this narrative review is to compile an inventory of the mechanical and physical properties as well as the clinical conditions likely to guide the choice between polymers for the base of removable prostheses.

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

OBJECTIVE

To evaluate the antimicrobial potential of silver nanoparticles (Ag NPs) synthesized using three different routes (ultraviolet light, Turkevich, and green chemistry method using Glycine max extract) associated with COREGA® denture powder adhesive.

METHODS

Heat-cured acrylic resin specimens were treated with different Ag NPs associated with the adhesive (AD + Ag UV, AD + Ag Turk, and AD + Ag Gm groups). As controls, the specimens were treated with a combination of adhesive and nystatin (AD + Nyst group), only adhesive (AD group), or submerged on the surface of the specimens (PBS group). After the treatments, biofilms of C. albicans developed for 3, 6, and 12 h on the specimen surfaces. The biofilm was quantified using colony-forming units per milliliter, colorimetric assay, and confocal laser scanning microscopy.

RESULTS

Regardless of the period, we observed an inhibition of fungal load and a reduction in metabolic activity and biofilm mass in the resin specimens treated with the combinations AD/Ag NPs, compared to AD and PBS. The antimicrobial action of the AD + Turk and AD + Ag Gm groups was similar than that for the AD + Nyst group in all periods and viability tests, except for the biofilm mass (12 h).

CONCLUSIONS

The COREGA® adhesive with Ag NPs, mainly those synthesized using the Turkevich and Glycine max methods, showed excellent antimicrobial activity against C. albicans biofilms, maintained for up to 12 h.

CLINICAL SIGNIFICANCE

The association of Ag NPs to the adhesive can add preventive or therapeutic effects against denture stomatitis, to this prosthetic material.

Microbial adhesion and viability on novel CAD/CAM framework materials for implant-supported hybrid prostheses

The aim of the study was to investigate the adhesion and viability of Streptococcus oralis and Candida albicans under in vitro conditions on CAD/CAM framework materials for implant-supported hybrid prostheses. Twenty-nine specimens were prepared from each of three different materials: ZR (zirconia), PEEK (polyether ether ketone) and CoCr₄ (CoCr₄ alloy). The experimental part included surface roughness (SR) and contact angle of water (CAW) measurements, followed by colony forming unit (CFU), cell viability assay and scanning electron microscopy (SEM) analyses of Strep. oralis and C. albicans biofilms on the materials' surfaces. Kruskal-Wallis and one-way analysis of variance (ANOVA) tests were used for differences between materials, and the correlation between measurements was estimated using Spearman's correlation coefficient. PEEK specimens revealed higher SR, CAW and CFU mean values, than ZR and CoCr₄ specimens. Strong positive correlation was found between SR and CFU and between CAW and CFU for both microbial species. Cell viability assay revealed similar values for both species across materials. Higher numbers of Strep. oralis and C. albicans on PEEK specimens confirm the impact of the higher surface roughness and contact angle values on the microbial adhesion and describes PEEK as less desirable than ZR and CoCr₄ from microbiological aspect.

Antibiofilm Activity of 3D-Printed Nanocomposite Resin: Impact of ZrO2 Nanoparticles

Poly(methyl methacrylate) (PMMA) is a commonly used material, as it is biocompatible and relatively cheap. However, its mechanical properties and weak antibiofilm activity are major concerns. With the development of new technology, 3D-printed resins are emerging as replacements for PMMA. Few studies have investigated the antibiofilm activity of 3D-printed resins. Therefore, this study aimed to investigate the antibiofilm activity and surface roughness of a 3D-printed denture base resin modified with different concentrations of zirconium dioxide nanoparticles (ZrO₂ NPs). A total of 60 resin disc specimens (15 × 2 mm) were fabricated and divided into six groups (n = 10). The groups comprised a heat-polymerized resin (PMMA) group, an unmodified 3D-printed resin (NextDent) group, and four 3D-printed resin groups that were modified with ZrO₂ NPs at various concentrations (0.5 wt%, 1 wt%, 3 wt%, and 5 wt%). All specimens were polished using a conventional method and then placed in a thermocycler machine for 5000 cycles. Surface roughness (Ra, µm) was measured using a non-contact profilometer. The adhesion of Candida albicans (C. albicans) was measured using a fungal adhesion assay that consisted of a colony forming unit assay and a cell proliferation assay. The data were analyzed using Shapiro-Wilk and Kruskal-Wallis tests. A Mann-Whitney U test was used for pairwise comparison, and p-values of less than 0.05 were considered statistically significant. The lowest Ra value (0.88 ± 0.087 µm) was recorded for the PMMA group. In comparison to the PMMA group, the 3% ZrO₂ NPs 3D-printed group showed a significant increase in Ra (p < 0.025). For the 3D-printed resins, significant differences were found between the groups with 0% vs. 3% ZrO₂ NPs and 3% vs. 5% ZrO₂ NPs (p < 0.025). The highest Ra value (0.96 ± 0.06 µm) was recorded for the 3% ZrO₂ NPs group, and the lowest Ra values (0.91 ± 0.03 µm) were recorded for the 0.5% and 5% ZrO₂ NPs groups. In terms of antifungal activity, the cell proliferation assay showed a significant decrease in the C. albicans count for the 0.5% ZrO₂ NPs group when compared with PMMA and all other groups of 3D-printed resins. The group with the lowest concentration of ZrO₂ NPs (0.5%) showed the lowest level of C. albicans adhesion of all the tested groups and showed the lowest Candida count (0.29 ± 0.03). The addition of ZrO₂ NPs in low concentrations did not affect the surface roughness of the 3D-printed resins. These 3D-printed resins with low concentrations of nanocomposites could be used as possible materials for the prevention and treatment of denture stomatitis, due to their antibiofilm activities.

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.

Do denture cleansers influence the surface roughness and adhesion and biofilm formation of Candida albicans on acrylic resin? Systematic review and meta-analysis

PURPOSE

To evaluate the influence of denture cleansers on the surface roughness, Candida albicans adhesion, and biofilm formation on denture base acrylic resins.

STUDY SELECTION

Electronic databases and gray literature were searched using an individual search strategy. In vitro studies that evaluated the effects of immersion in denture cleansers on the surface roughness (µm) and antimicrobial activity (CFU/mL) on samples of heat-polymerized denture base acrylic resins were included.

RESULTS

After screening, 17 studies were included, and a qualitative synthesis was performed. After assessing the risk of bias, only nine studies were included in the meta-analysis. The meta-analysis results showed that the evaluated solutions (0.5% sodium hypochlorite, 1% sodium hypochlorite, alkaline peroxide, and natural substances) did not influence the roughness of the acrylic resin. However, in the qualitative analysis, it was not possible to confirm an association between roughness and C. albicans adhesion and biofilm formation on the acrylic resin samples.

CONCLUSION

Denture cleansers did not affect the surface roughness of denture base acrylic resins.

Effects of repeated use of tungsten carbide burs on the surface roughness and contact angles of a CAD-CAM PMMA denture base resin

STATEMENT OF PROBLEM

The surface roughness (Ra) and wettability of complete denture base materials must meet certain clinical requirements. Although computer-aided design and computer-aided manufacturing (CAD-CAM) systems have recently become popular for the fabrication of complete dentures, the effects of the repeated usage of milling burs on the surface properties of CAD-CAM denture base acrylic resins have not yet been fully investigated.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of new and used burs on the Ra and contact angles (wettability) of a CAD-CAM polymethylmethacrylate (PMMA) denture base material.

MATERIAL AND METHODS

A total of 40 Ø2×10-mm disks were fabricated from 1 brand of CAD-CAM PMMA resin (Polident). Half of the specimens (group N) were milled with a new tungsten carbide bur set, while the other half (group U) was milled with a used tungsten carbide bur set. Moreover, half of the specimens (groups NT and UT) were subjected to thermocycling before Ra and contact angle testing. Ra was tested by using a profilometer, and the surfaces were also examined by scanning electron microscopy (SEM). The contact angle was measured by using the sessile drop method. Data were analyzed with the Kruskal-Wallis and Dunn Pairwise Comparison tests (α=.05).

RESULTS

The mean contact angle was highest for group U (80 degrees) and lowest for group UT (66 degrees) (P<.05). Ra values were highest for group N (1.3 μm) and lowest for group U (0.93 μm) (P<.05).

CONCLUSIONS

Specimens milled with new tungsten carbide burs had lower mean contact angles and higher Ra values than specimens milled with used burs. The contact angles of CAD-CAM PMMA resin specimens milled with used burs decreased significantly after thermocycling. Regardless of whether or not thermocycling was performed, contact angle values decreased as Ra values increased.

Is there an optimal method to detach Candida albicans biofilm from dental materials?

Introduction. Candida albicans can produce a complex, dynamic and resistant biofilm on the surface of dental materials, especially denture base acrylic resins and temporary soft liners. This biofilm is the main aetiological factor for denture stomatitis, an oral inflammatory condition characterized by chronic and diffuse erythema and oedema of the denture bearing mucosa.Gap Statement. There is no consensus in the literature regarding the best method to detach biofilms from dental materials. In order to assess the antifungal efficacy of new materials and treatments, the biofilm needs to be properly detached and quantified.Aim. This study compared different methods of detaching C. albicans biofilm from denture base acrylic resin (Vipi Cril) and temporary soft liner (Softone) specimens.Methodology. Specimens of each material were immersed in an inoculum of C. albicans SC5314 and remained for 90 min in orbital agitation at 75 r.p.m. and 37 °C. After the removal of non-adherent cells, the specimens were immersed in RPMI-1640 medium for 48 h. Biofilm formation was evaluated with confocal laser scanning microscopy (n=5). Then, other specimens (n=7) were fabricated, contaminated and immersed in 3 ml of sterile phosphate-buffered saline (PBS) and vortexed or sonicated for 1, 2, 5, or 10 min to detach the biofilm. The quantification of detached biofilm was performed by colony-forming unit (c.f.u.) ml^-1 count. Results were submitted to one-way analysis of variance (ANOVA)/Tukey HSD test (α=0.05).Results. A mature and viable biofilm was observed on the surfaces of both materials. For both materials, there was no significant difference (P>0.05) among detachment methods.Conclusion. Any of the tested methods could be used to detach C. albicans biofilm from hard and soft acrylic materials.

Antifungal Activity of Denture Base Resin Containing Nanozirconia: In Vitro Assessment of Candida albicans Biofilm

Objective

To evaluate the antimicrobial effects of different concentrations of zirconium dioxide nanoparticles (nano-ZrO₂) reinforcement of poly(methyl) methacrylate (PMMA) on surface roughness and C. albicans biofilm.

Methods

20 heat-polymerized acrylic resin discs were conventionally made and divided into 4 groups (n = 5) according to nano-ZrO₂ concentration: control (0% filler) and 3 experimental groups (2.5% (Z2.5), 5.0% (Z5.0), and 7.5% (Z7.5)). An optical profilometer was used for surface roughness evaluation, followed by Candida adherence assay. Specimens were sterilized, then immersed in cultured yeast (C. albicans), and incubated at 37°C for 48 hours. After that, discs were rinsed before extracting the clustered pellets of Candida. The attached C. albicans was counted using the direct method after spreading on agar media and incubating for 48 hours. Statistical analysis was performed using one-way ANOVA and Tukey's post hoc test at α = 0.05.

Results

Surface roughness was significantly increased with all modified groups compared with control (P < 0.01), which showed the lowest roughness value (0.027 ± 0.004 μm). There was no significant difference in the roughness value among reinforced groups (2.5, 5.0, and 7.5%) (P > 0.05), with Z7.5 showing the highest roughness value (0.042 ± 0.004 μm). Candida count was reduced as the nano-ZrO₂ increased but not significantly (P=0.15).

Conclusions

The addition of different concentrations of nano-ZrO₂ particles to PMMA increased the surface roughness compared with control; in contrast, insignificant reduction of C. albicans biofilm was detected.

Oral prosthetic microbiology: aspects related to the oral microbiome, surface properties, and strategies for controlling biofilms

The oral cavity is an environment that allows for the development of complex ecosystems; the placement of prosthetic devices as a consequence of partial or total tooth loss may alter the diversity of microbial communities. Biofilms on the surface of materials used in dental prostheses can promote important changes in the mechanic and aesthetic properties of the material itself and may cause local and systemic diseases for the prosthetic wearer. This review presents the main features of the oral microbiome associated with complete or partial dentures and dental implants. The main diseases associated with microbial colonization of prosthetic surfaces, factors that may affect biofilm formation on prosthetic materials, as well as novel alternative therapies aiming to reduce biofilm formation and/or to eradicate biofilms formed on these materials are also explored.

A modeling approach for quantitative assessment of interfacial interaction between two rough particles in colloidal systems

HYPOTHESIS AND BACKGROUND

The simulation of rough particle surface is important to understand and control the interface behavior of particles in colloidal systems. Literature analysis suggested a lack of information for an accurate model simulating the interfacial interaction between two rough particles. It is hypothesized that the total interfacial energy developed between two rough particles would depend on the surface morphologies of particles, and it could be predicted if a mathematical model to represent the interaction of two rough particles were created accurately.

EXPERIMENTS

In this study, mathematical models were developed to determine the interfacial energy created between two particles according to the XDLVO theory by considering the rippled particle theory and surface element integral (SEI) method. Three different scenarios of particle interactions were assumed in the simulation. The present study provides deep insights into particle interactions via considering aspect ratio, size, and surface roughness of two particles in colloidal systems.

FINDINGS

The assessment of the interfacial interaction revealed that an increase in the aspect ratio, surface roughness, and relative surface roughness of particles would weaken the total interaction energy generated between particles and promote particle aggregation. Increased interaction energy was predicted for the interaction of particles by increasing the particle size. The asperity ratio was more effective than the asperity number in controlling the interfacial energy between two particles. The results of this study could be used for foreseeing the interaction of rough particles, which has a significant application in particle coagulation or dispersion in colloidal systems.

Nanoscale Surface Roughness Influences Candida albicans Biofilm Formation

The microbial contamination of surfaces presents a significant challenge due to the adverse effects associated with biofilm formation, particularly on implantable devices. Here, the attachment and biofilm formation of the opportunistic human pathogen, Candida albicans ATCC 10231, were studied on surfaces with decreasing magnitudes of nanoscale roughness. The nanoscale surface roughness of nonpolished titanium, polished titanium, and glass was characterized according to average surface roughness, skewness, and kurtosis. Nonpolished titanium, polished titanium, and glass possessed average surface roughness (S_a) values of 350, 20, and 2.5 nm; skewness (S_skw) values of 1.0, 4.0, and 1.0; and (S_kur) values of 3.5, 16, and 4, respectively. These unique characteristics of the surface nanoarchitecture were found to play a key role in limiting C. albicans attachment and modulating the functional phenotypic changes associated with biofilm formation. Our results suggest that surfaces with a specific combination of surface topographical parameters could prevent the attachment and biofilm formation of C. albicans. After 7 days, the density of attached C. albicans cells was recorded to be 230, 70, and 220 cells mm^-2 on nonpolished titanium, polished titanium, and glass surfaces, respectively. Despite achieving a very low attachment density, C. albicanscells were only observed to produce hyphae associated with biofilm formation on nonpolished titanium surfaces, possessing the highest degree of surface roughness (S_a = 350 nm). This study provides a more comprehensive picture of the impact of surface architectures on C. albicans attachment, which is beneficial for the design of antifungal surfaces.

Magnetically driven active topography for long-term biofilm control

Microbial biofilm formation on indwelling medical devices causes persistent infections that cannot be cured with conventional antibiotics. To address this unmet challenge, we engineer tunable active surface topographies with micron-sized pillars that can beat at a programmable frequency and force level in an electromagnetic field. Compared to the flat and static controls, active topographies with the optimized design prevent biofilm formation and remove established biofilms of uropathogenic Escherichia coli (UPEC), Pseudomonas aeruginosa, and Staphylococcus aureus, with up to 3.7 logs of biomass reduction. In addition, the detached biofilm cells are found sensitized to bactericidal antibiotics to the level comparable to exponential-phase planktonic cells. Based on these findings, a prototype catheter is engineered and found to remain clean for at least 30 days under the flow of artificial urine medium, while the control catheters are blocked by UPEC biofilms within 5 days.

Efficacy of newly developed denture cleaning device on physical properties of denture material and Candida biofilm

Background/purpose

Electrolyzed water has antimicrobial activity against oral microbes. The purpose of this study was to investigate the effects of a denture cleaning device that uses electrolyzed water on Candida biofilm on denture base-material and the physical properties of the denture material.

Materials and methods

Denture base-resin disks were prepared with Polymethyl methacrylate. After the formation of Candida albicans biofilm on the resin disks, the antimicrobial activity of the denture cleaning device and the chemical cleanser against C. albicans biofilm was compared. The resin disks were also treated with the cleaning device and the chemical cleanser for 150 days, and the physical properties were analyzed by an atomic force microscope, Vickers hardness tester, and colorimeter.

Results

The denture cleaning device and the chemical cleanser reduced the levels of C. albicans biofilm on the denture resin. Upon immersing of the resin disks for 150 days, the electrolyzed water of the denture cleaning device did not significantly change the surface roughness of the specimens, but significantly reduced its Vickers hardness compared to the initial value. The color changes of the resin disk were 0.477 ± 0.076, 0.612 ± 0.095 and 0.562 ± 0.096 after treating with tap water, the chemical cleanser, and the denture cleaning device, respectively.

Conclusion

The denture cleaning device may be suitable for use by the elderly to clean dentures without side effects caused by the misuse of chemical cleanser.

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.

In Vitro Evaluation of Adhesion of Candida albicans on CAD/CAM PMMA-Based Polymers

PURPOSE

To compare the amount of adherent Candida albicans to different CAD/CAM poly(methyl methacrylate) (PMMA)-based polymers and conventional heat-polymerized PMMA after long-term thermal cycling.

MATERIALS AND METHODS

The specimens were subjected to 10,000 thermal cycles (5-55°C) and divided into two groups, uncoated and pellicle-coated. Surface roughness and contact angles of the specimens were measured. The surface morphology was observed with scanning electron microscopy (SEM). An adhesion test was performed by incubating the disk specimens in C. albicans suspensions at 37°C for 2 hours, and the adherent cells were counted under an optical microscope. The data were analyzed statistically using a variance analysis and Tukey HSD post hoc comparison test. The correlation between measurements was tested using a Pearson correlation analysis (α = 0.05).

RESULTS

CAD/CAM polymers generally showed statistically significant lowest Ra and contact angle values, whereas conventional PMMA showed the highest Ra and contact angle values in the uncoated group (p < 0.05). Pellicle coating essentially increased contact angle of all materials and reduced the differences in a number of Candida cells on the materials (p < 0.05). Candida adhesion was statistically significantly greatest on conventional PMMA when compared to CAD/CAM polymers. A strong positive correlation was found between the surface roughness of the specimens (p < 0.05) and the amount of adhered cells, whereas no correlation was found between hydrophobicity of the specimens and the amount of adhered cells (p > 0.05).

CONCLUSIONS

CAD/CAM PMMA-based polymers may be preferable to reduce Candida-associated denture stomatitis in long-term use.

Development of antibacterial denture cleaner for brushing containing tea tree and lemongrass essential oils

We evaluated effectiveness of tea tree oil (TO) and lemongrass oil (LO) for removal of Candida biofilm from denture base resin and their influence on that surface. Biofilm of C. albicans was formed on resins, and immersed in various concentrations of each oil and distilled water (DW). The biofilm removal effect was determined by incubating specimens in RPMI medium containing Alamar blue (AB) and measuring absorbance. Wear test was also conducted, and surface condition of resins was determined using laser scanning microscope and digital microscope. Specimens immersed in the TO and LO solutions tended to have a lower AB value at higher concentrations and longer soaking times. Use of these agents resulted in less surface roughness as compared to DW. Our results suggest that TO and LO were valid to remove biofilm attached to resin with lower levels of abrasion, and these are effective for use in denture cleaner.