Abstract

Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. Objective To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions.Methodology Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test.Results NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal.Conclusions The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

Highlights

  • The complete denture is made with acrylic resin and widely used to replace all teeth, restoring function, aesthetics and comfort to the patient

  • RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata in a similar manner, but, for C. tropicalis, CT 0.5% was more effective (Figure 2)

  • NaOCl 0.25% was most effective than the other solutions in reduction of CFU count, cell metabolism, hyphae growth, living cells of all Candida species and biofilm removal

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Summary

Introduction

The complete denture is made with acrylic resin and widely used to replace all teeth, restoring function, aesthetics and comfort to the patient. Candida infections are predominantly caused by C. albicans, but the literature indicates an increasing role for nonalbicans Candida species (C. glabrata, C. tropicalis, C. parapsilosis or C. krusei) as infectious agents, which have different adaptive capacity, different susceptibility to antifungal agents and potential for adhesion on acrylic surfaces.. The relative value of cell surface hydrophobicity and the biofilm biomass of non-albicans Candida species is greater than C. albicans, considering that 92% of the non-albicans Candida species of oral isolates had the capacity to form biofilm against only 78% of C. albicans.. The relative value of cell surface hydrophobicity and the biofilm biomass of non-albicans Candida species is greater than C. albicans, considering that 92% of the non-albicans Candida species of oral isolates had the capacity to form biofilm against only 78% of C. albicans.8 This fact indicates the need for a comprehensive approach to non-albicans species in individuals wearing dentures There is a direct risk relationship between denture use, biofilm and the development of denture stomatitis (DS). Many individuals are unaware that they have DS, an infection that can aggravate systemic diseases, such as chronic obstructive pulmonary disease, bacterial endocarditis, aspiration pneumonia and gastro-intestinal infection, due the high Candida spp. count. Immune response is a determinant of infections caused by Candida spp., which can become even more serious with the exacerbation of the pathogenicity of these microorganisms and imbalance of the individual’s immune response. Candida infections are predominantly caused by C. albicans, but the literature indicates an increasing role for nonalbicans Candida species (C. glabrata, C. tropicalis, C. parapsilosis or C. krusei) as infectious agents, which have different adaptive capacity, different susceptibility to antifungal agents and potential for adhesion on acrylic surfaces. the relative value of cell surface hydrophobicity and the biofilm biomass of non-albicans Candida species is greater than C. albicans, considering that 92% of the non-albicans Candida species of oral isolates had the capacity to form biofilm against only 78% of C. albicans. This fact indicates the need for a comprehensive approach to non-albicans species in individuals wearing dentures

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