FUNDAMENTAL

RESEARCH
Effectiveness of Denture Cleansers on Removal
of Adherent Candida albicans Cells from
Denture Base Acrylics of Various Roughness
Konstantinos Chatzivasileiou, DDS, MSc
Eleni Kotsiomiti, DDS, PhD
Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences,
Aristotle University of Thessaloniki, Thessalokini, Greece.

Timoleon-Achilleas Vyzantiadis, MD, PhD

First Department of Microbiology, Medical School, Faculty of Health Sciences,
Aristotle University of Thessaloniki, Thessaloniki, Greece.

Purpose: To experimentally examine the effectiveness of a small sample of commercial denture cleansers
in removing Candida albicans cells from denture surfaces. Materials and Methods: A total of 216
specimens from three brands of denture base resins (72 for each acrylic resin) were divided into three
groups of 24 specimens that each received a different surface treatment (Ra1, Ra2, and Ra3). The specimens
were contaminated by the Candida albicans strain ATCC 90028, immersed for 15 minutes in one of two
experimental denture cleanser solutions or in tap water, and placed in Petri dishes with culture medium.
Results: Candida albicans colonies were measured after 24-hour incubation at 37°C. There was a statistically
significant difference in the cleansing result depending on the denture cleanser used. Conclusion: The use
of commercial denture cleansers may under certain conditions be effective in the removal of Candida
albicans from denture bases. Int J Prosthodont 2019;32:196–197. doi: 10.11607/ijp.6041

R
emovable prostheses function in an environment colonized by numerous mi-
croorganisms able to attach to hard, nonshedding surfaces, which can lead to
plaque formation and retention.1,2 Plaque retention is associated with various
diseases. Denture-related stomatitis is the most easily recognized of these diseases
and involves Candida species in about 90% of cases.3
The purpose of this study was to experimentally examine the effectiveness of a small
sample of commercial denture cleansers in removing Candida albicans (C albicans)
cells from acrylic resin denture base surfaces.

MATERIALS AND METHODS

Correspondence to:
Dr Konstantinos Chatzivasileiou
19is Maiou 69
Drama, 66132, Greece
Fax: +302521030587
Email: khatziv@gmail.com
Submitted July 3, 2018;
accepted July 26, 2018.
©2019 by Quintessence
Publishing Co Inc.
A total of 216 specimens from three brands of denture base resins (Paladon 65
[Heraeus], ProBase Hot [Ivoclar Vivadent], and Lucitone 199 [Dentsply]), 72 specimens
for each resin, were divided into three groups of 24 specimens that each received a
different surface treatment (surface roughness [Ra] groups; Ra1: laboratory polishing;
Ra2: tungsten carbide bur; or Ra3: silicone polishers) and were sterilized by exposure
to ultraviolet (UV) light.
The specimens were contaminated by adding 20 μL of 0.5 McFarland C albicans
suspension (ATCC 90028) to 20 mL of Sabouraud dextrose broth + chloramphenicol
0.05% for 24 hours at 37°C.
The specimens in each of the three groups (Ra1, Ra2, Ra3) were divided into four
subgroups (A, B, C, D) of six specimens each. Each specimen in subgroup A was
placed in a Petri dish containing culture medium (Sabouraud dextrose agar + chlor-
amphenicol 0.05%) for 10 minutes and then discarded. For subgroups B, C, and D,
each specimen was placed in a sterile container with one of the following liquids:
250 mL of warm tap water (35°C) (subgroup B); 250 mL of warm tap water (35°C)
and a Corega denture cleansing tablet (GlaxoSmithKline) (subgroup C); and 250 mL

196 The International Journal of Prosthodontics

© 2019 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY.
NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.
 Chatzivasileiou et al

of warm tap water (35°C) and a Protefix denture cleansing Table 1   Effect of Denture Cleanser on
tablet (Queisser Pharma) (subgroup D). Each specimen was Candida albicans Adherence in Relation to
kept immersed for 15 minutes and was then placed in a Polishing Method and Acrylic Resin Brand
Petri dish, as in subgroup A. Acrylic brand Polishing method P
Paladon 65 Laboratory .000
Plates were incubated at 37°C for 24 hours, after which Bur .000
C albicans colonies were measured in colony-forming units EVE .000
(CFUs). Data were statistically analyzed using analysis of ProBase HOT Laboratory .000
variance (ANOVA). Effects were considered significant at Bur .000
EVE .000
P < .05. Lucitone 199 Laboratory .000
Bur .000
RESULTS EVE .000
Only statistically significant differences (P < .05) are shown.

The C albicans CFU counter after 24-hour incubation was

high (> 105) regardless of the Ra or brand of acrylic resin. Table 2   Effect of Denture Brand on
There was a statistically significant three-way interaction Candida albicans Adherence in Relation to
between denture material, surface roughness, and denture Polishing Method and Denture Cleanser
cleanser (P < .05). Tables 1 through 3 show the effects of Polishing method Denture cleanser P
the different factors on C albicans adherence. Laboratory Protefix .024
H20 .000
Corega denture cleanser removed all adherent C albicans Bur H20 .000
cells (0 CFUs counted) in all cases. CFU counts after immer- EVE Protefix .014
sion in Corega were significantly less than those after im- H20 .001
mersion in Protefix or tap water (P < .05 in all cases). Only statistically significant differences (P < .05) are shown.
CFUs measured after immersion in Protefix were signifi-
cantly less than in subgroup A in all cases (P < .05) and af-
ter immersion in tap water (subgroup B) in all cases except Table 3   Effect of Surface Roughness on
Candida albicans Adherence in Relation to
for Probase denture acrylic finished with carbide bur. Acrylic Brand and Denture Cleanser
No statistically significant difference was recorded be- Acrylic brand Denture cleanser P
tween the CFUs in subgroups A and B. ProBase HOT Protefix .001
H20 .000
DISCUSSION Paladon 65 H20 .000
Lucitone 199 H20 .000
The results of this study indicate that C albicans easily adheres Only statistically significant differences (P < .05) are shown.

to denture base surfaces and does so in very large numbers,

irrespective of the resin brand used or surface finishing.
Ra did not seem to have a prominent effect on C albicans
adhesion. Previous research4 has shown that both labo-
ratory polishing of denture base resin and EVE chairside
polishing (groups Ra1 and Ra3, respectively) resulted in Ra
below the threshold value of 0.2 μm5 and can thus be con-
sidered equally effective. Surfaces treated with tungsten
bur (group Ra2) exhibited an Ra value as high as 0.48 μm.4
This corresponds to a surface topography that does not of-
fer protection to C albicans cells from shear forces.
Since initial C albicans adhesion cannot be prevented, it
is imperative that dentures are cleansed of attached micro-
organisms by the denture wearer. Older patients, especially
those suffering from some sort of motor skills impairment,
might not be able to effectively clean a denture surface by
brushing. Using a denture cleanser is a much easier way of
achieving a favorable result.
CONCLUSIONS
Given this preliminary study’s methodologic limitations, its
results cannot be perfectly matched to clinical conditions
(for instance, dentures rarely have flat surfaces). It does
however appear that the use of commercial denture
cleansers may under certain conditions be particularly
effective in the removal of C albicans from denture
surfaces.
ACKNOWLEDGMENTS
The authors report no conflicts of interest.
REFERENCES
  1. Verran J. Malodour in denture wearers: An ill-defined problem.
Oral Dis 2005;11(suppl 1):s24–s28.
  2. Bollen CM, Lambrechts P, Quirynen M. Comparison of surface
roughness of oral hard materials to the threshold surface roughness
for bacterial plaque retention: A review of the literature. Dent Mater
1997;13:258–269.
  3. Denture-related stomatitis. In: Scully C (ed). Oral and Maxillofacial
Medicine: The Basis of Diagnosis and Treatment, ed 2. Edinburgh:
Churchill Livingstone, 2008:201–203.
  4. Chatzivasileiou K, Emmanouil I, Kotsiomiti E, Pissiotis A. Polishing of
denture base acrylic resin with chairside polishing kits: An SEM and
surface roughness study. Int J Prosthodont 2013;26:79–81.
  5. Quirynen M, Bollen CM, Papaioannou W, Van Eldere J, van
Steenberghe D. The influence of titanium abutment surface rough-
ness on plaque accumulation and gingivitis: Short-term observations.
Int J Oral Maxillofac Implants 1996;11:169–178.

Volume 32, Number 2, 2019 197

© 2019 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY.
NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.