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Inhibitory effect of zirconium oxide nanoparticles on Candida albicans adhesion to repaired polymethyl methacrylate denture bases and interim removable prostheses: a new approach for denture stomatitis prevention

Authors Gad MM, Al-Thobity AM, Shahin SY, Alsaqer BT, Ali AA

Received 3 June 2017

Accepted for publication 28 June 2017

Published 28 July 2017 Volume 2017:12 Pages 5409—5419

DOI https://doi.org/10.2147/IJN.S142857

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Thomas Webster


Mohammed M Gad,1 Ahmad M Al-Thobity,1 Suliman Y Shahin,2 Badar T Alsaqer,3 Aiman A Ali4,5

1Department of Substitutive Dental Sciences, 2Department of Preventive Dental Sciences, College of Dentistry, 3Department of Microbiology, College of Medicine, 4Department of Biomedical Dental Sciences, College of Dentistry, University of Dammam, Dammam, Saudi Arabia; 5Oral Pathology and Medicine, College of Dentistry, University of Toronto, Toronto, ON, Canada

Background: Despite drawbacks, cold-cured acrylic resin is still the most common material used in denture repair. Zirconia nanoparticles were among the reinforcements added to increase the strength of the resin. The effect on Candida due to the addition of zirconia nanoparticles to the resin has not been investigated.
Purpose: The aim of this study was to evaluate the effect of zirconia nanoparticles added to cold-cured acrylic resin on Candida albicans adhesion.
Materials and methods: A total of 120 acrylic resin specimens with dimensions measuring 22×10×2.5 mm3 were prepared and divided into two equal groups. One group (repair) comprised heat-polymerized specimens that were sectioned at the center and prepared to create a 2 mm repair area that was repaired with cold-cured resin reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. The second group contained intact cold-cured acrylic resin specimens reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. Specimens were incubated at 37°C in artificial saliva containing C. albicans, and the effect of zirconia nanoparticles on C. albicans was assessed using two methods: 1) a slide count method and 2) a direct culture test. Variations in the number of living Candida were observed in relation to the different concentrations of zirconia nanoparticles. Analysis of variance (ANOVA) and post hoc Tukey’s tests were performed for data analysis. If the P-value was ≤0.05, then the difference was considered as statistically significant.
Results: It was found that C. albicans adhesion to repaired specimens was significantly decreased by the addition of zirconia nanoparticles (P<0.00001) in comparison with the control group. Intact cold-cured groups and groups repaired with cold-cured resin reinforced with 7.5% wt zirconia nanoparticles showed the lowest Candida count. Tukey’s test showed a significant difference between the repaired group and the intact cold-cured group, while the later demonstrated a lower Candida count.
Conclusion: The addition of zirconia nanoparticles to cold-cured acrylic resin is an effective method for reducing Candida adhesion to repaired polymethyl methacrylate (PMMA) denture bases and cold-cured removable prosthesis.
Clinical significance: Based on the results of the current study, zirconia nanoparticles have an antifungal effect, which could be incorporated in the repair material for repairing denture bases and in PMMA removable prostheses as a possible approach for denture stomatitis prevention.

Keywords: Candida albicans, denture base repair, PMMA, interim prosthesis, reinforcement, zirconium oxide nanoparticles

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