Chemotherapeutic methods for denture care: analysis of a novel denture care product.
MSc(R) thesis, University of Glasgow.
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Oral colonisation by the opportunistic yeast species Candida albicans is the major cause of oropharyngeal candidosis (OPC) in a variety of individuals. A sub-set of OPC, denture induced stomatitis (DIS), is predominantly associated with the elderly population is considered to occur due to multiple factors, including improper denture hygiene. Biofilm forming ability of C. albicans strains is linked to high carriage and persistence rates following treatment among infected individuals.
These studies aimed to assess various denture decontamination options upon C. albicans biofilms grown on both polystyrene and acrylic resin surfaces. ‘Gold standard’ denture hygiene regimens proved to be partially effective in reducing C. albicans numbers therefore combination treatments with two commercial denture cleansers as well as dentifrice were investigated. Sequential treatment with Polident® (pH 8.6) yielded highest efficacy in biofilm inactivity with no re-growth present following incubation in growth medium. Interactions of known morphological modulators upon initial biofilm formation as well as mature biofilm viability were also assessed. Both EDTA; a cation chelator and farnesol; a molecule involved in quorum sensing in C. albicans spp. demonstrated anti-biofilm effects. Implications of fungicidal activity presented could impact upon novel anti-candidal formulations.
Finally, host immune responses related to C. albicans infection were investigated in vitro using OKF6 TERT2 oral epithelial cells. Release of the inflammatory marker; IL-8 demonstrated that the biofilm mode of candidal growth results in elevated levels of host inflammation. Treatment of biofilms with Polident® (pH 7.0) denture cleanser did not impact upon levels of host inflammation suggesting that biofilm components, independent of viability lead to elevated immune responses.
In conclusion, current methods for the treatment of C. albicans biofilm forming species are inadequate as the majority of commercially available ‘chemical cleaners’ merely inactivate the fungal biofilm without dispersing biofilm material. This has implications on subsequent yeast re-growth and prospective infection.
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