Long term antifungal efficacy of silver‑zinc zeolite nanoparticles incorporated in two soft denture liners ‑ An in vitro assessment

Abstract

Background: There is generally a lack of compliance in patients who report with oral candidiasis,
as they are advised to temporarily stop wearing the prosthesis and are prescribed topical antifungals
which are generally unpleasant to taste and follow a rigorous schedule. Furthermore, with the
alarming evidence of drug resistance, there is a need for an enhanced drug and drug delivery
system. The aim of the study was to determine the dose‑dependent antifungal efficacy of silver‑zinc
zeolite nanoparticles (SZZ‑NPs) when incorporated in two brands of soft denture liners against
Candida albicans.
Materials and Methods: A total of 72 samples were made to determine the in vitro antifungal
efficacy of SZZ‑NPs and fluconazole by measuring the mean inhibition diameter (MID). Two
concentrations of SZZ‑NPs were compared (0.5%, 2% w/w) with fluconazole 5%w/w which is
routinely prescribed. The antifungals were incorporated in two types of commercially available
soft denture liners (Visco gel, GC soft denture liner). The MIDs were measured at day 1, day 7, day
15, and day 30. The values obtained (P < 0.001) were analyzed with one‑way ANOVA, Tukey’s post
hoc, and independent t‑test.
Results: A statistically significant difference (P < 0.001) was noted among all the antifungal agents
at all the time intervals tested. The anti‑fungal efficacy of SSZ‑NPs 2% w/w incorporated in GC soft
denture liner was significantly superior (P < 0.001) to all groups tested and it retained its antifungal
efficacy even on day 30 (MID: 18.33 ± 2.44).
Conclusion: SZZ‑NPs 0.5%w/w, 2%w/w, and fluconazole 5%w/w can be incorporated with soft
denture liners against C. albicans. Fluconazole 5%w/w is the recommended choice for short‑term
antifungal efficacy, while SZZ‑NPs 2%w/w is recommended when long‑term antifungal efficacy is
needed. GC soft denture liner was the recommended choice.
Key Words: Candida albicans, drug delivery systems, drug resistance, nanoparticles, zeolites