MONIKA L FERREIRA
ANDRESSA S BARBOZA
RAFAEL G LUND
GEELSU HWANG
| MONIKA L FERREIRA | ANDRESSA S BARBOZA | RAFAEL G LUND | GEELSU HWANG |
Monika L Ferreira1, Andressa S Barboza2, Rafael G Lund2, Geelsu Hwang1
1Department of Preventive and Restorative Sciences, University of Pennsylvania, School of Dental Medicine ; 2Department of Restorative Dentistry, Universidade Federal de Pelotas, Brazil
Introduction
Denture stomatitis (DS) is characterized by an inflammation of the oral mucosa mainly caused by a fungal infection. Among them, Candida spp., a fungus commonly found in the oral microbiota, largely contributes to colonizing and forming biofilm on prosthetic surfaces. Due to the intimate contact of the prosthesis surface with the oral mucosa, biofilm formation on denture surfaces often result in DS (75%). Furthermore, recent studies revealed that cross-kingdom interactions between Candida and bacteria often prosper in denture biofilms. While broad-spectrum antimicrobial agents have been developed to address this, these exhibit limitations such as short period of drug retention and side effects. Additionally, the efficacy of local therapies such as cleasing solutions combined with strict hygiene protocols that heavily relies on patient complinance is limited, particularly for elderly users. Thus, more effective alternative therapies are required. With the aid of the advancement of additive manufacturing and digital workflow, a new functional denture could be easily developed and tested in vitro. In this study, we formulated and characterized a novel 3D printed denture resin with antifungal properties, and evaluated antibiofilm activity against bacterial-fungal cross-kingdom biofilm.
Methods
Disc-shaped samples were printed with denture resin containing traditional antifungal agents with two concentrations (2mg/ml and 10mg/ml): nystatin (NYS2 and NYS10) and fluconazole (FLU2 and FLU10); resin with no antifungal agent was prepared as a control (Cont). All groups were subjected to surface roughness measurement, hydrophobicity analysis (water contact angle), and antibiofilm test using a mixed-species model (Candida albicans and Streptococcus mutans).
Results
In the surface studies, no statistical differences were found in roughness measurements among groups, however FLU2 and NYS2 were significantly more hydrophobic than Cont. Meanwhile, in the biofilm experiment, FLU10 presented a significantly reduced biomass, compared to all other groups (p<.05). C. albicans CFU/ml data presented a log reduction in FLU10 compared to Cont (p < .05), while no differences in CFU/ml were found for S. mutans.
Conclusion
The incorporation of antifungal agents into the resin showed a potent antibiofilm activity against cross-kingdom biofilms containing C. albicans and S. mutans, which is a strong virulent model for the investigation of oral infectious diseases.