PolyEther Ether Ketone (PEEK) Containing the Antifungal Agent Nonanoic Acid as a Denture Base Material to Manage Candida albicans

Abstract

Statement of problem: Removable dentures are associated with denture stomatitis, caused by Candida albicans which has become increasingly resistant to common antifungal drugs. Purpose: The purpose of this study was to evaluate efficacy of different concentrations of nonanoic acid (C9 10%;1%;0.1%) loaded PEEK discs on inhibiting growth of C. albicans. Materials and methods: PEEK discs (1 mm diameter/2 mm thickness/N = 45) were fabricated; depending on group (n = 9/group) discs were loaded with either C9 (10%;1%;0.1%) or caspofungin (positive control) or no antifungal (negative control). The discs were cultured with C. albicans suspension and subjected to XTT (2,3-bis2-Methoxy-4-nitro-5-sulfophenyl-2H-tetrazolium-5-carboxyanilide) assay. Differences in mean optical density (OD) value between groups was compared using one-way ANOVA, at 95% level of statistical significance (p<0.05). One disc per group was subjected to scanning electron microscopy (SEM) for C. albicans adhesion on PEEK discs. Results: Mean OD values were significantly different between all groups (p<0.001), wherein lower OD value indicated greater inhibition of C. albicans growth. Caspofungin group had lowest mean OD (0.43±0.03), followed by 10%-C9 (0.84±0.03), 1%-C9 (1.24±0.04), 0.1%-C9 (1.52±0.04) and negative control (1.91±0.05). SEM analysis revealed pronounced quantity of C. albicans in negative control, however quantity decreased in the C9 groups as the concertation increased. Conclusion: Different concentrations of nonanoic acid (C9) loaded on PEEK discs significantly inhibited growth of C. albicans in culture, as evidenced by lower OD values after XTT essay. A dose response effect was observed with higher concentration of nonanoic acid resulting in significantly higher inhibition of C. albicans.