Andrew R. Dentino

Effect of phosphate group addition on the properties of denture base resins.

STATEMENT OF PROBLEM Acrylic resins are prone to microbial adherence, especially by Candida albicans. Surface-charged resins alter the ionic interaction between the denture resin and Candida hyphae, and these resins are being developed as a means to reduce microbial colonization on the denture surface. PURPOSE The purpose of this study was to investigate the physical and mechanical properties of phosphate-containing polymethyl methacrylate resins for their suitability as a denture material. MATERIAL AND METHODS Using PMMA with cross-linker (Lucitone 199) as a control, 4 experimental groups containing various levels of phosphate with and without cross-linker were generated. The properties examined were impact strength, fracture toughness, wettability (contact angle), and resin bonding ability to denture teeth. Impact strength was tested in the Izod configuration (n=16), and fracture toughness (n=13) was measured using the single-edge notched bend test. Wettability was determined by calculating the contact angle of water on the material surface (n=12), while ISO 1567 was used for bonding ability (n=12). The data were analyzed by 1- and 2-way ANOVA (alpha=.05). RESULTS A trend of increased hydrophilicity, as indicated by lower contact angle, was observed with increased concentrations of phosphate. With regard to the other properties, no significant differences were found when compared with the control acrylic resin. CONCLUSIONS No adverse physical effect due to the addition of a phosphate-containing monomer was found in the acrylic denture resins. Additional mechanical and physical properties, biocompatibility, and clinical efficacy studies are needed to confirm the in vivo anti-Candida activity of these novel resins.

Denture polymers with antimicrobial properties: a review of the development and current status of anionic poly(methyl methacrylate) polymers

The denture base polymer poly(methyl methacrylate) (PMMA) is highly susceptible for microbial colonization resulting in denture-associated infections. Over the years research has focused on ways to modify the PMMA properties via surface and chemical modification. These studies led to the development of new denture polymers that include anionic PMMA polymers. The new anionic polymers presented the possibility of compromising the physical and mechanical properties required for denture fabrication. These obstacles were overcome by generating anionic PMMA polymers with physical and mechanical properties suitable for denture fabrication. A large body of literature is available on the anionic PMMA polymers, their antimicrobial properties and their potential for the commercial and clinical application as dental biomaterials. This article describes a review and evaluation of the anionic PMMA polymers for their suitability to serve as denture base polymers, their antimicrobial properties, their efficacy to prevent denture-induced infection and their safety in the oral environment.

Treatment of Gingival Recession

Gingival recession is an intriguing and complex phenomenon. Recession frequently disturbs patients because of sensitivity and esthetics. Many surgical techniques have been introduced to treat gingival recession, including those involving autogenous tissue grafting, various flap designs, orthodontics, and guided tissue regeneration. This article describes different clinical approaches to treat gingival recession with emphasis on techniques that show promising results and root coverage.

New phosphated poly(methyl methacrylate) polymers for the prevention of denture-induced microbial infection: an in vitro study

Purpose Poly(methyl methacrylate) (PMMA) has been widely used as a denture-base acrylic resin due to its excellent physical and mechanical properties. However, the material is highly prone to microbial fouling that often leads to Candida-associated denture stomatitis. Incorporation of phosphate groups into PMMA could facilitate adsorption of salivary antimicrobials and inhibit microbial adherence on the polymer surface. An in vitro study evaluated PMMA polymers containing varying amounts of phosphate group for their efficacy to inhibit Candida albicans adhesion, adsorb salivary histatin 5, and exhibit candidacidal activity. Methods Six PMMA polymers containing 0%, 5%, 15%, 10%, 20%, and 25% of phosphate group were synthesized by bead (suspension) polymerization technique using mixtures of methyl methacrylate and methallyl phosphate as monomers. The efficacy of the polymers to inhibit the adherence of C. albicans was examined by using human saliva-coated polymer beads and radio-labeled C. albicans cells, as compared with that of PMMA. The potency of the phosphated PMMA polymers to adsorb histatin 5 was determined by measuring the radioactivity of the adsorbed labeled-peptide on the polymer surface. The candidacidal activity of the histatin 5-adsorbed polymers was assessed by using the fluorescence technique. The percent release of the fluorescent probe calcein from the C. albicans membrane caused by the disruption of the cell membrane was determined. The data were analyzed statistically by one-way ANOVA followed by Scheffé’s test (α = 0.05 and n = 6). Results The presence of ≥15% phosphate content in PMMA significantly reduced the saliva-mediated adhesion of C. albicans. Phosphated PMMA polymers showed significantly enhanced adsorption of histatin 5 in a phosphate density-dependent manner. The candidacidal activity of the histatin 5-bound polymers increased significantly with the increase in the phosphate content of the polymer. Conclusion Phosphated PMMA polymers have the potential to serve as novel denture-base resins, which may reduce C. albicans colonization and prevent denture stomatitis.

Novel molecules for intra-oral delivery of antimicrobials to prevent and treat oral infectious diseases

New molecules were designed for efficient intra-oral delivery of antimicrobials to prevent and treat oral infection. The salivary statherin fragment, which has high affinity for the tooth enamel, was used as a carrier peptide. This was linked through the side chain of the N-terminal residue to the C-terminus of a defensin-like 12-residue peptide to generate two bifunctional hybrid molecules, one with an ester linkage and the other with an anhydride bond between the carrier and the antimicrobial components. They were examined for their affinity to a HAP (hydroxyapatite) surface. The extent of the antimicrobial release in human whole saliva was determined using 13C-NMR spectroscopy. The candidacidal activity of the molecules was determined as a function of the antimicrobial release from the carrier peptide in human saliva. The hybrid-adsorbed HAP surface was examined against Candida albicans and Aggregatibacter actinomycetemcomitans using the fluorescence technique. The bifunctional molecules were tested on human erythrocytes, GECs (gingival epithelial cells) and GFCs (gingival fibroblast cells) for cytotoxicity. They were found to possess high affinity for the HAP mineral. In human whole saliva, a sustained antimicrobial release over a period of more than 40-60 h, and candidacidal activity consistent with the extent of hybrid dissociation were observed. Moreover, the bifunctional peptide-bound HAP surface was found to exhibit antimicrobial activity when suspended in clarified human saliva. The hybrid peptides did not show any toxic influence on human erythrocytes, GECs and GFCs. These novel hybrids could be safely used to deliver therapeutic agents intra-orally for the treatment and prevention of oral infectious diseases.

MiniReviewCurrent status of defensins and their role in innate and adaptive immunity

Naturally occurring antimicrobial cationic polypeptides play a major role in innate and adaptive immunity. These polypeptides are found to be either linear and unstructured or structured through disulfide bonds. Among the structured antimicrobial polypeptides, defensins comprise a family of cysteine-rich cationic polypeptides that contribute significantly to host defense against the invasion of microorganisms in animals, humans, insects and plants. Their wide-spread occurrence in various tissues of these diverse organisms, and their importance in innate and adaptive immunity have led to their identification, isolation and characterization. A large volume of literature is available on defensins’ occurrence, structural characterization, gene expression and regulation under normal and pathological conditions. Much has also been published regarding their antimicrobial, antiviral and chemoattractive properties, and their molecular and cellular interactions. In this review, we describe the current status of our knowledge of defensins with respect to their molecular, cellular and structural biology, their role in host defense, future research paradigms and the possibility of their utilization as a new class of non-toxic antimicrobial agents and immuno-modulators.

Surface modification of dental implants

Abstract Dental implant surface advancement techniques have been developing rapidly to facilitate osseointegration and bone formation on the implant surface and to enhance the predictability of accelerated implant therapy. Surface modifications have been proven effective on capitalizing the features of titanium that make it the material of choice in dental implantology. Some of these features include wettability, surface area, and osteogenic potential. The following chapter is a brief review of commercial methods of surface modification processing and demonstrates the advantages and disadvantages of each, noting potential for improvement when applicable. Prospective studies in surface modification of implants attempt to address problems in conventional implant treatment, from promoting soft-tissue adherence and antimicrobial properties to induction of osteogenic processes. Overall, prospective trends indicate a shift in the focus to increase the success rate in compromised patients, such as those suffering from osteoporosis, as well as improving soft-tissue integration onto the implant surface to reduce the risk of development of periimplant disease. Surface roughness continues to be optimized, with prospects of configuration at a nanoscale.