Current perspectives and the future of Candida albicans-associated denture stomatitis treatment

Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been suggested for the prevention and treatment of DS. Among the different approaches that have been implemented to inhibit and control DS there are the topical application of antifungal agents, the surface modification of the denture base and the incorporation of antimicrobial agents into the denture base material. Antifungal agents can effectively control DS, but the recurrence of the disease is common. Accordingly, it has been suggested that coating the surface of the acrylic denture base may result in a decreased fungal adhesion. In recent years, nanotechnology has dominated the research, and several nanoparticles have demonstrated antifungal effects. Therefore, the aim of this article was to review the antifungal effects of the different methods that have been suggested for the prevention and/or control of DS as well as the antimicrobial activity of denture base acrylic resin additives, including nanoparticles. Studies reporting the incorporation of antifungal/antimicrobial agents into the polymethyl methacrylate (PMMA) denture base were included in this review. The PubMed, Web of Science, Google Scholar, and Scopus databases were searched for the articles published between January 2000 and December 2018 using the following key words: dental prosthesis, denture stomatitis, candidiasis, antifungal agents, biofilm formation, polymethyl methacrylate, and PMMA. The antimicrobial material incorporated into the resin may have a superior effect in preventing DS over simply coating the surface of the denture base. However, some antimicrobial fillers can have adverse effects on the physical and mechanical properties of the denture base resin.