NEW YORK, U.S.: It is not uncommon for denture wearers to suffer fungal infections that cause inflammation, redness and swelling in the mouth. Seeking to avoid or better treat such denture-related stomatitis, researchers from the University at Buffalo have used 3-D printing to create dentures filled with microscopic capsules that periodically release amphotericin B, an antifungal medication. They found that the dentures reduced fungal growth.
“The major impact of this innovative 3-D printing system is its potential impact on saving cost and time,” said the study’s senior author, Dr. Praveen Arany, an assistant professor in the Department of Oral Biology in the university’s School of Dental Medicine.
Using PMMA for the denture material, the researchers sought to determine if the dentures could both maintain their strength and effectively release antifungal medication contained in biodegradable, permeable microspheres. The microspheres protect the drug from the heat of the printing process and allow the release of medication as they gradually break down. With a flexural strength testing machine, the scientists found that, while the flexural strength of the 3-D printed dentures was 35 percent less than that of a conventional laboratory-fabricated denture used as a control, the printed dentures never fractured.
To examine how well the dentures could release the antifungal medication, the dentures were tested with one, five and ten layers of material to learn if additional layers would allow the dentures to hold more medication. The researchers found that the dentures with five and ten layers were impermeable and thus not effective at dispensing the medication.
With the new approach, Arany believes the antifungal application could prove invaluable among those highly susceptible to infection, such as the elderly and hospitalized or disabled patients. Additionally, unlike current treatment options, such as antiseptic mouthwashes, baking soda and microwave disinfection, the new means of controlled drug release can help prevent infection while the dentures are in use.
Arany and his colleagues are now looking to further research how to reinforce the 3-D printed dentures with glass fibers and carbon nanotubes to achieve greater mechanical strength and to focus on denture relining.
The study, titled “Functionalized prosthetic interfaces using 3D printing: Generating infection-neutralizing prosthesis in dentistry,” was published in the June 2018 issue of Materials Today Communications.
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I question the prudence of ‘periodically release amphotericin B, an antifungal medication.’
While there may be a reduction in fungal growth, there will be an unavoidable imbalance of the oral microbiome, with that imbalance affecting the entire digestive system, of which the mouth is the beginning.
As always, investigating the root cause is the first appropriate step.
Fungal overgrowth indicates the denture material may be bio-incompatible for the patient.
While the overgrowth may be reduced by amphotericin B, we must take care to observe what else is reduced, increased or otherwise changed and/or destabilized.