Evaluation of a Modified Polyether Ether Ketone (PEEK) with an Antifungal Agent as an Alternative Denture Base Material to Prevent Candida Colonisation

Abstract

Objectives: To investigate the processing of a novel modified PEEK denture material able to adsorb and retain anti-fungal agents that have the potential to inhibit the growth of Candida albicans, protecting patients from the risk of denture stomatitis. Method: 27 discs of PEEK were prepared. Samples were randomly allocated into three groups; A: acid-etched PEEK loaded with nonanoic acid(C9) (experimental group). B: acid-etched PEEK loaded with miconazole (control positive). C: acid-etched PEEK loaded with BPS (control negative). SEM images of PEEK surfaces were taken at the baseline to ensure the best acid etching protocol (5 mins vs 1 min). Discs were then acid etched, immersed in their allocated treatment solution for 24 hours, and then investigated using disc diffusion assay on candida albican (SC3118). As confirmatory testing, An additional disc diffusion assay on miconazole resistant strain (CAR17) was conducted for confirming the efficacy propose using six discs allocated between two groups (C9 and miconazole group) Results: At baseline, 5 minutes etching protocol demonstrated promising results regarding the porosity required to load PEEK with different anti-fungal agents. Disc diffusion test on SC3118 and CAR 17 candida strains showed the mean surface area of inhibition increased significantly in the nonanoic acid C9 group (p<0.0001, 0.009 respectively) compared to the miconazole group. Conclusion: A novel bioactive PEEK (AF-PEEK) demonstrated an ability to adsorb and release an anti-fungal agent owing to acid etching and immersion techniques; PEEK discs loaded with C9 showed greater inhibition zone in diffusion tests on two different C. albicans strains compared to PEEK discs loaded with comparable amounts of miconazole, which candida is increasingly developing resistance against, offering benefits in exploring a novel material that could be used as alternative denture base material to inhibit candida infection.