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  • Promise of Combining Antifungal Agents in Denture Adhesives to Fight Candida Species Infections.

Promise of Combining Antifungal Agents in Denture Adhesives to Fight Candida Species Infections.

Journal of prosthodontics : official journal of the American College of Prosthodontists (2016-11-22)
Jorge L Garaicoa, Carol L Fischer, Amber M Bates, Julie Holloway, Gustavo Avila-Ortiz, Janet M Guthmiller, Georgia K Johnson, Clark Stanford, Kim A Brogden
ABSTRACT

Several complications may arise in patients wearing complete prosthetic appliances, including denture-associated infections and mucosal stomatitis due to Candida species. This study evaluated the activity of anti-Candida agents in denture adhesive and the cytotoxicities of these preparations for primary human gingival epithelial (GE) keratinocytes. The anti-Candida activities of antimicrobial peptides, antimicrobial lipids, and antifungal agents against C. albicans ATCC 64124 or HMV4C were assessed in microdilution assays containing water or 1% denture adhesive. The minimal inhibitory concentrations (MIC) and the minimal bactericidal concentrations (MBC) were determined. The cytotoxicities of denture adhesive compounded with these agents were assessed in 1.0 × 105 primary GE keratinocytes in LGM-3 media with resazurin. Lactoferricin B, SMAP28, sphingosine, dihydrosphingosine, and phytosphingosine in 1% denture adhesive lost antimicrobial activity for C. albicans (p < 0.05). Amphotericin B, chlorhexidine dihydrochloride, chlorhexidine gluconate, fluconazole, and nystatin in 1% denture adhesive or compounded directly into denture adhesive and then diluted to 1% adhesive, did not lose antimicrobial activity. Compounded formulations were not cytotoxic (LD50 > 100.0 μg/ml) against primary human GE keratinocytes. Antimicrobial peptides and antimicrobial lipids had diminished activities in 1% adhesive, suggesting that components in adhesives may inactivate local innate immune factors in the oral cavity, possibly predisposing denture wearers to Candida species infections. More importantly, antifungal agents retained their anti-C. albicans activities in denture adhesive, strongly suggesting that antifungal agents could be candidates for inclusion in adhesive formulations and used as prescribed topical treatments for individuals with denture stomatitis.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
(2S,3S,4R)-2-Amino-1,3,4-octadecanetriol, AldrichCPR
Sigma-Aldrich
D-erythro-Dihydrosphingosine, ≥98%