Incorporation of Fluconazole and Ocimum Sanctum Oil in Soft Denture Liners to Treat Biofilms of Candida albicans Associated with Denture Stomatitis

Aamir Zahid Godil, Diksha Bhagat, Parijat Das, Ashi Ilyas Kazi, Ramandeep Dugal, Surekha Satpute

Abstract


Purpose: To investigate the In Vitro activity of incorporated antifungal agents like Fluconazole and Ocimum sanctum oil (Tulsi) in the denture soft liners to reduce the risks associated with the biofilms of Candida albicans.

Materials and Methods: In the current study, the minimum inhibitory concentration (MIC) of two antifungal agents namely Fluconazole and O. sanctum (Tulsi oil) against C. albicans (ATCC 10231) was evaluated to examine their effect in reducing the count of candida and its biofilms. Analysis of physical properties such as surface roughness and hardness of soft denture liners (test and control) were also performed. The effect of both antifungal agents was also observed on cell morphology of candida cells using scanning electron microscopy (SEM).

Results: Studies confirmed MIC value for fluconazole and O. sanctum oil as 600 and 400 µg/ml respectively. Surface hardness and roughness of soft denture material (test) remained unaltered. Finally, SEM studies also proved the effectiveness of incorporated antifungal agents on the cell morphology of C. albicans at their respective MIC values.

Conclusions: This approach allows the prolonged drug release in the oral cavity which simultaneously treats the injured denture bearing tissues and also the infection, biofilms of candida without compromising on their physical properties. These studies are significant and have tremendous medicinal and therapeutic relevance.


Keywords


Antifungal agents; biofilms; scanning electron microscope; soft liners; hardness; surface roughness; minimal inhibitory concentration; denture stomatitis

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References


Chincholikar S, Sridevi J, Kalavathy N, Singh S, Kapoor A, Saumya S. Comparative evaluation of two antifungal agents incorporated in auto polymerising denture base resin, heat polymerising denture base resin and permanent silicone soft liner-An in vitro study. J Clin Diag Res 2019;13.

DOI : 10.7860/JCDR/2019/37889.12520

Neppelenbroek KH, Lima JF, Hotta J, Galitesi LL, Almeida AL, Urban VM. Effect of incorporation of antifungal agents on the ultimate tensile strength of temporary soft denture liners. J Prosthodont 2018;27:177-181.

DOI: 10.1111/jopr.12660

Tumbarello M, Posteraro B, Trecarichi EM, Fiori B, Rossi M, Porta R, de Gaetano Donati K, La Sorda M, Spanu T, Fadda G, Cauda R. Biofilm production by Candida species and inadequate antifungal therapy as predictors of mortality for patients with candidemia. J Clin Microbiol 2007;45:1843-1850.

DOI: 10.1128/JCM.00131-07

Martins N, Ferreira ICFR, Barros L, Silva S, Henriques M. Candidiasis: Predisposing factors, prevention, diagnosis and alternative treatment. Mycopathologia 2014;177:223-240.

DOI: 10.1007/s11046-014-9749-1

Iqbal Z, Zafar MS. Role of antifungal medicaments added to tissue conditioners: a systematic review. J Prosthodont Res 2016;60:231-239.

DOI: 10.1016/j.jpor.2016.03.006

Radford D, Challacombe SJ, Walter JD. Denture plaque and adherence of Candida albicans to denture-base materials in vivo and in vitro. Crit Rev Oral Biol Med 1999;10:99-116.

DOI: 10.1177/10454411990100010501

Kumar N, Kumari A, Priyadarshi V, Kumar A, Prasad RS, Kumar B. A comparative efficacy of Nystatin and Fluconazole incorporated into tissue conditioner as drug delivery method for Denture stomatitis. J Adv Med Dent Scie Res 2020;8(1):159-62.

DOI: 10.4103/ccd.ccd_542_17

Maluf CV, Peroni LV, Menezes LR, Coutinho W, Lourenço EJ, Telles DD. Evaluation of the physical and antifungal effects of chlorhexidine diacetate incorporated into polymethyl methacrylate. J Appl Oral Sci 2020;28.

DOI: 10.1590/1678-7757-2019-0039

Jung J, Bae Y, Cho YK, Ren X, Sun Y. Structural insights into conformation of amphiphilic quaternary ammonium chitosans to control fungicidal and anti-biofilm functions. Carbohydr polym 2020;228:115391.

DOI: 10.1016/j.carbpol.2019.115391

Habibzadeh S, Omidvaran A, Eskandarion S, Shamshiri AR. Effect of incorporation of silver nanoparticles on the tensile bond strength of a long term soft denture liner. Eur J Dent 2020;14(2):268.

DOI: 10.1055/s-0040-1709923

Dudley MN. Clinical pharmacology of fluconazole. Pharmacotherapy: J Human Pharmacology and Drug Therapy 1990;10:141-145

https://doi.org/10.1002/j.1875-9114.1990.tb02599.x

Masotti E, Poma N, Guazzelli E, Fiaschi I, Glisenti A, Vivaldi F, Bonini A, Francesco FD, Tavanti A, Galli G, Martinelli E. Fluorinated vs. zwitterionic-polymer grafted surfaces for adhesion prevention of the fungal pathogen Candida albicans. Polymers 2020;12(2):398.

DOI: 10.3390/polym12020398

Srivatstava A, Ginjupalli K, Perampalli NU, Bhat N, Ballal M, Evaluation of the properties of a tissue conditioner containing origanum oil as an antifungal additive. J Prosthet Dent 2013;110:313-319.

DOI: 10.1016/S0022-3913(13)60381-9

Sharma S, Hegde V. Comparative evaluation of antifungal activity of melaleuca oil and fluconazole when incorporated in tissue conditioner: an in vitro study. J Prosthodont 2014;23:367-373.

DOI: 10.1111/jopr.12117

Muttagi S, Subramanya JK. Effect of incorporating seed oils on the antifungal property, surface roughness, wettability, weight change, and glucose sorption of a soft liner. J Prosthet Dent 2017;117:178-185.

DOI: 10.1016/j.prosdent.2016.05.010

Sushma R, Sathe TT, Farias A, Sanyal PK, Kiran S. Nature cures- An alternative herbal formulation as a denture cleanser. Ann Afr Med 2017;16:6¬12.

DOI: 10.4103/aam.aam_43_16

Gupta D, Bhaskar DJ, Gupta RK, Karim B, Jain A, Singh R, Karim WA. randomized controlled clinical trial of Ocimum sanctum and chlorhexidine mouthwash on dental plaque and gingival inflammation. J Ayurveda Integr Med 2014;5:109-116.

DOI: 10.4103/0975-9476.131727

Shokeen P, Bala M, Singh M, Tandon V. In vitro activity of eugenol, an active component from Ocimum sanctum, against multiresistant and susceptible strains of Neisseria gonorrhoeae. Int J Antimicrob Agents 2008;32:174-179.

DOI: 10.1016/j.ijantimicag.2008.03.018

Schneid TR. An in vitro analysis of a sustained release system for the treatment of denture stomatitis. Special Care in Dentistry 1992;12(6):245-50.

DOI: 10.1111/j.1754-4505.1992.tb00458.x

Jadhav V, Shetty MM, Kalavathy N, Kumar R. Effect of 3 types of antifungal agents on hardness of 2 different commercially available tissue conditioners: An in vitro study. SRM J Res in Dental Sci 2013;1;4(4):150.

DOI: 10.4103/0976-433X.125590

Urban VM, Lima TF, Bueno MG, Giannini M, Arioli Filho JN, de Almeida AL, Neppelenbroek KH. Effect of the addition of antimicrobial agents on Shore A hardness and roughness of soft lining materials. J Prosthodont 2015;24(3):207-214.

DOI: 10.1111/jopr.12205

Urban VM, De Souza RF, Galvao Arrais CA, Borsato KT, Vaz LG. Effect of the association of nystatin with a tissue conditioner on its ultimate tensile strength. J Prosthodont 2006;15:295-299.

DOI: 10.1111/j.1532-849X.2006.00130.x

Urban VM, Seó RS, Giannini M, Arrais CA. Superficial distribution and identification of antifungal/antimicrobial agents on a modified tissue conditioner by SEM‐EDS microanalysis: a preliminary study. J Prosthodont: Implant, Esthet Reconst Dent 2009;18(7):603-610.

DOI: 10.1111/j.1532-849X.2009.00479.x

Bueno MG, Sousa EJ, Hotta J, Porto VC, Urban VM, Neppelenbroek KH. Surface properties of temporary soft liners modified by minimum inhibitory concentrations of antifungals. Brazilian Dental J 2017;28:158-164.

DOI: 10.1590/0103-6440201701266

Koch C, Bürgers R, Hahnel S. Candida albicans adherence and proliferation on the surface of denture base materials. Gerodontology 2013;30:309-313.

DOI: 10.1111/ger.12056

Budtz-Jorgensen E, Stenderup A, Grabowski M. An epidemiologic study of yeasts in elderly denture wearers. Community Dent Oral Epidemiol 1975;3:115-119.

DOI: 10.1111/j.1600-0528.1975.tb00291.x

Koopmans A, Kippuw N, Graaff J. Bacterial involvement in denture-induced stomatitis. J Dent Res 1988;67:1246-1250.

DOI: 10.1177/00220345880670091901

Bates AM, Garaicoa JL, Fischer CL, Brogden KA. Diminished antimicrobial peptide and antifungal antibiotic activities against Candida albicans in denture adhesive. Antibiot 2017;6:6.

DOI: 10.3390/antibiotics6010006

Webb BC, Thomas CJ, Willcox MD, Harty DW, Knox KW. Candida‐associated denture stomatitis. Aetiology and management: a review. Part 3. Treatment of oral candidosis. Australian dental journal. 1998;43:244-249.

DOI: 10.1111/j.1834-7819.1998.tb00152.x

Douglas CJ, Walker DM. Nystatin in denture liners- an alternative treatment of denture stomatitis. Brit Dent J 1973;135:55-58.

DOI: 10.1038/sj.bdj.4803045

de Moraes AP, Barwaldt CK, Nunes TZ, Sarkis-Onofre R, Ogliari FA, Boscato N, Pereira-Cenci T. Effect of triazine derivative added to denture materials on a microcosm biofilm model. J Biomed Mater Res B Appl Biomater 2012;100:1328-1333.

DOI: 10.1002/jbm.b.32699

Banting DW, Hill SA. Microwave disinfection of dentures for the treatment of oral candidiasis. Special Care in Dentist 2001;21:4-8.

DOI: 10.1111/j.1754-4505.2001.tb00216.x

Ellepola AN, Samaranayake LP. Adhesion of oral Candida albicans isolates to denture acrylic following limited exposure to antifungal agents. Arch Oral Biol 1998;43:999-1007.

DOI: 10.1016/s0003-9969(98)00075-2

Balakumar S, Rajan S, Thirunalasundari T, Jeeva S. Antifungal activity of Ocimum sanctum Linn. (Lamiaceae) on clinically isolated dermatophytic fungi. Asian Pacific J Tropical Med 2011;4:654-657.

DOI: 10.1016/s1995-7645(11)60166-1

Pereira-Cenci T, Del Bel Cury AA, Crielaard W, Ten Cate JM. Development of Candida-associated denture stomatitis: new insights. J Appl Oral Science 2008;6:86-94.

DOI: 10.1590/S1678-77572008000200002

Kang SH, Lee HJ, Hong SH, Kim KH, Kwon TY. Influence of surface characteristics on the adhesion of Candida albicans to various denture lining materials. Acta Odontologica Scandinavica. 2013;1;71(1):241-248.

DOI: 10.3109/00016357.2012.671360

Craig RG. Prosthetics applications of polymers. 10th ed. St. Louis: Mosby 1997;551.

Gonzalez JB. Use of tissue conditioners and resilient liners. Dent Clin North Am 1977;21:249-259.

Yilmaz H, Aydin C, Turhan Bal B, Ocak F. Effects of different disinfectants on physical properties of four temporary soft denture-liner materials. Quintessence Int 2004;35:826-834.

Sonja De Nollin, Borgersand M, VanBelle H. The effects of miconazole on the ultastructure of Candida albicans. Roc Roy Soc Med 1977;Supplement 4.




DOI: https://doi.org/10.5195/d3000.2021.120



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