Candida Biofilms on Oral Biomaterials

Abstract

Biological as well as inert surfaces of the oral cavity are exposed to an abundant microflora that is able to initiate the formation of biofilms. Yeasts are frequently involved, such as Candida (especially albicans), a low-level commensal of oral, gastrointestinal, and genitourinary mucosae in humans. In vivo and in vitro studies have shown Candida incorporation into biofilms covering different biomaterials used in the oral cavity for the manufacturing of dentures, orthodontic appliances, etc. Yeast (Candida genus) biofilms can then induce device-related infections mainly in the elderly and in medically-compromised patients with subsequent morbidity and occasional mortality, all bearing high social and financial costs. Generally, scientific literature does not integrate all aspects of material/tissue interfaces: mechanisms of Candida biofilm development and biomaterial maintenance, the welfare of patients, and prevention of candidosis. In vitro investigations were mainly undertaken with mono-species biofilms whereas Candida incorporation into biofilms on oral surfaces tends to correspond with an increase in the yeast/bacteria ratio. This illustrates the need for interdisciplinary insight. This chapter will review 1) the literature data concerning material surfaces in support of Candida biofilms in the oral environment, 2) the in vitro approaches to understanding the mechanisms of Candida biofilm formation on materials, 3) the interfaced manipulations in order to prevent Candida biofilm onset, and 4) the precautions when testing new devices in vivo in the oral cavity.