The antifungal activity and cytotoxicity of silver containing denture base material

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.

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.

The effects of nano-silver loaded zirconium phosphate on antibacterial properties, mechanical properties and biosafety of room temperature curing PMMA materials

Polymethyl methacrylate (PMMA) frequently features in dental restorative materials due to its favorable properties. However, its surface exhibits a propensity for bacterial colonization, and the material can fracture under masticatory pressure. This study incorporated commercially available RHA-1F-II nano-silver loaded zirconium phosphate (Ag-ZrP) into room-temperature cured PMMA at varying mass fractions. Various methods were employed to characterize Ag-ZrP. Subsequently, an examination of the effects of Ag-ZrP on the antimicrobial properties, biosafety, and mechanical properties of PMMA materials was conducted. The results indicated that the antibacterial rate against Streptococcus mutans was enhanced at Ag-ZrP additions of 0%wt, 0.5%wt, 1.0%wt, 1.5%wt, 2.0%wt, 2.5%wt, and 3.0%wt, achieving respective rates of 53.53%, 67.08%, 83.23%, 93.38%, 95.85%, and 98.00%. Similarly, the antibacterial rate against Escherichia coli registered at 31.62%, 50.14%, 64.00%, 75.09%, 86.30%, 92.98%. When Ag-ZrP was introduced at amounts ranging from 1.0% to 1.5%, PMMA materials exhibited peak mechanical properties. However, mechanical strength diminished beyond additions of 2.5%wt to 3.0%wt, relative to the 0%wt group, while PMMA demonstrated no notable cytotoxicity below a 3.0%wt dosage. Thus, it is inferred that optimal antimicrobial and mechanical properties of PMMA materials are achieved with nano-Ag-ZrP (RHA-1F-II) additions of 1.5%wt to 2.0%wt, without eliciting cytotoxicity.

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.

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.

Silver-loaded mesoporous silica nanoparticles enhanced the mechanical and antimicrobial properties of 3D printed denture base resin

The aim of this study is to develop a novel 3D printed denture base resin material modified with mesoporous silica nanocarrier loaded with silver (Ag/MSN) to enhance mechanical and antimicrobial properties. Acrylate resin-based was incorporated with various proportion of Ag/MSN (0.0-2.0 wt%). Specimens with different geometry were printed and characterized accordingly for the effect of modification on properties such as: mechanical and physical properties, chemical composition and degree of conversion, as well as biological response in term of biocompatibility and antimicrobial against oral fibroblast and candida biofilm (C. albicans), respectively. The consecutive addition of Ag/MSN improved significantly surface hardness and crack propagation resistance, while flexural strength remained similar to control; however, a negligible decrease was observed with higher concentrations ≥1 wt%. No significant difference was noticed with water sorption, while water solubility had a remarkable trend of reduction associated with filler content. The surface roughness significantly increased when concentration of Ag/MSN was ≥1.0 wt%. A significant reduction in C. albicans biofilm mass, as the inhibition proficiency was correlated with the proportion of the filler. With respect to the amount of Ag/MSN, the modification was compatible toward fibroblast cells. The sequential addition of Ag/MSN enhanced significantly the mechanical and antimicrobial properties of the 3D printed resin-based material without affecting adversely compatibility. The acrylic resin denture base material has susceptibility of microbial adhesion which limits its application. Silver loaded MSN showed a significant performance to enhance antimicrobial activity against C. albicans which is the main cause of denture stomatitis. The proposed invention is a promise technique for clinical application to provide an advanced prosthesis fabrication and serve as long-term drug delivery.

Synthesis of Functional Silver Nanoparticles and Microparticles with Modifiers and Evaluation of Their Antimicrobial, Anticancer, and Antioxidant Activity

An accumulating body of evidence reports the synthesis and biomedical applications of silver nanoparticles. However, the studies regarding the use of maleic acid and citric acid in the synthesis of nano-sized silver particles (AgNPs) and micro-sized silver particles (AgMPs) as well as their antibacterial, antifungal, and anticancer activities have not been reported. In the current study, we synthesized AgNPs and AgMPs using maleic acid and citric acid as capping agents and have characterized them by UV-Vis, energy-dispersive X-Ray spectroscopy (EDS), X-Ray diffraction (XRD), and scanning electron microscope (SEM) analysis. The capped silver particles were examined for their antimicrobial activity and cytotoxicity against bacteria, fungi, and brine shrimp. Additionally, the anticancer activity of these particles was tested against human breast and liver cancer cell lines. The free radical scavenging activity of capped silver particles was evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. SEM analysis revealed a round plate-like morphology of maleic acid capped particles with an average size of 39 ± 4 nm, whereas citric acid capped particles display flower-shaped morphology with rough surfaces and an average size of 250 ± 5 nm. The uncapped AgMPs were hexagonal with 500 ± 4 nm size. EDS and XRD analysis confirmed the presence of Ag and face-centered cubic crystalline nature, respectively. Functionally, capped silver particles exhibited antibacterial activity against Gram-positive (Staphylococcus aureus, Bacillus subtilis, and Micrococcus luteus) and Gram-negative bacteria (Salmonella setubal, Enterobacter aerogenes, and Agrobacterium tumefaciens). The bactericidal activity was more active against Gram-negative bacteria with minimum inhibitory concentration (MIC) as low as 5 ppm as compared to 25 ppm for Gram-positive. Similarly, the silver particles demonstrated antifungal activity by inhibiting the growth of five fungal strains (Mucor species, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, and Fusarium solani) up to 50% at the concentration of 500 ppm. Additionally, these particles showed substantial toxicity against brine shrimp and also significantly inhibited the proliferation of breast cancer (MCF7) and liver cancer (HePG2) cell lines (IC₅₀ 8.9-18.56 µM). Uncapped AgMPs were less effective, inhibiting only the proliferation of MCF7 cells with IC₅₀ 46.54 µM. Besides cytotoxicity, these particles acted as potential antioxidants, showing free radical scavenging up to 74.4% in a concentration-dependent manner. Taken together, our results showed that the modifiers affect the shape and size of silver particles and may, in part, contribute to the antimicrobial and antioxidant activity of silver particles. However, the contribution of maleic acid and citric acid in enhancing the antimicrobial, anticancer, and antioxidant potential independent of silver nano and microparticles needs to be studied further. In vivo experiments may determine the therapeutic effectiveness of silver particles capped with these modifiers.

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.

Effect of Antibacterial Silver-Releasing Filler on the Physicochemical Properties of Poly(Methyl Methacrylate) Denture Base Material

Colonization of polymeric dental prosthetic materials by yeast-like fungi and the association of these microorganisms with complications occurring during prosthetic treatment are important clinical problems. In previously presented research, submicron inorganic particles of silver sodium hydrogen zirconium phosphate (S-P) were introduced into poly(methyl methacrylate) (PMMA) denture base material which allowed for obtaining the antimicrobial effect during a 90 day experiment. The aim of the present study was to investigate the flexural strength, impact strength, hardness, wear resistance, sorption, and solubility during three months of storage in distilled water. With increasing S-P concentration after 2 days of conditioning in distilled water, reduced values of flexural strength (107-72 MPa), impact strength (18.4-5.5 MPa) as well as enhanced solubility (0.95-1.49 µg/mm3) were registered, but they were at acceptable levels, and the sorption was stable. Favorable changes included increased hardness (198-238 MPa), flexural modulus (2.9-3.3 GPa), and decreased volume loss during wear test (2.9-0.2 mm3). The percentage changes of the analyzed properties during the 90 days of storage in distilled water were similar for all materials.

Analysis of the oral microbiome on the surface of modified dental polymers

OBJECTIVES

This study characterized the microbial diversity of formed biofilm on the surface of acrylic resins modified with nanostructured silver vanadate decorated with silver nanoparticles (AgVO₃) after incubation in human saliva.

DESIGN

Resin specimens prepared with AgVO₃ at concentrations 0%, 1%, 2.5%, and 5% by either vacuum mixing or polymer solubilization were characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD). After 24 h and 7 days of saliva incubation, biofilm samples were collected from the surface of the specimens. The 16S rDNA genes were amplified, sequenced with the 454-Roche next-generation sequencing platform and analyzed to identify the Operational Taxonomic Units at the genus or higher level.

RESULTS

Significant differences in the dispersion pattern of the nanoparticles were observed among the two different methods of AgVO₃ incorporation. In the microbiological analysis, a total of 103 genera and 7 more inclusive taxa, representing the phyla Bacteroidetes, Firmicutes and Proteobacteria were identified colonizing resin surfaces. The incorporation method of the AgVO₃ had little to no significant effect on the microbiota of samples. Significant time and concentration-dependent responses to AgVO₃ caused changes in the taxonomic profile at the phylum and genus level.

CONCLUSIONS

The results show differences in relation to the microbial diversity of modified resins during the initial phase of biofilm maturation. The incorporation of AgVO₃ seems to significantly affect the colonizing microbiota.