Introduction: Despite the rising concern with fungal resistance, a myriad of molecules has yet to be explored. Geraniol, linalool, and citronellal are monoterpenes with the same molecular formula (C10H18O), however, neither the effect of these compounds on inflammatory axis induced by Candida spp. nor the antibiofilm Structure-Activity Relationship (SAR) have been well-investigated. Herein we analyzed geraniol, linalool and citronellal antifungal activity, cytotoxicity, and distinctive antibiofilm SAR, also the influence of geraniol on Candida spp induced dysregulated inflammatory axis, and in vivo toxicity. Methods: Minimal inhibitory (MIC) and fungicidal (MFC) concentrations against Candida spp were defined, followed by antibiofilm activity (CFU-colony forming unit/mL/g of dry weight). Cytotoxic activity was assessed using human monocytes (THP-1) and oral squamous cell (TR146). Geraniol was selected for further analysis based on antifungal, antibiofilm and cytotoxic results. Geraniol was tested using a dual-chamber co-culture model with TR146 cells infected with C. albicans, and THP-1 cells, used to mimic oral epithelium upon fungal infection. Expression of Candida enzymes (phospholipase-PLB and aspartyl proteases-SAP) and host inflammatory cytokines (interleukins: IL-1β, IL-6, IL-17, IL-18, IL-10, and Tumor necrosis factor-TNF) were analyzed. Lastly, geraniol in vivo toxicity was assessed using Galleria mellonella. Results: MIC values obtained were 1.25-5 mM/mL for geraniol, 25-100 mM/mL for linalool, and 100-200 mM/mL for citronellal. Geraniol 5 and 50 mM/mL reduced yeast viability during biofilm analysis, only 500 mM/mL of linalool was effective against a 72 h biofilm and no biofilm activity was seen for citronellal. LD50 for TR146 and THP-1 were, respectively: geraniol 5.883 and 8.027 mM/mL; linalool 1.432 and 1.709 mM/mL; and citronellal 0.3006 and 0.1825 mM/mL. Geraniol was able to downregulate expression of fungal enzymes and host pro-inflammatory cytokines IL-1β, IL-6, and IL-18. Finally, safety in vivo parameters were observed up to 20 mM/Kg. Discussion: Despite chemical similarities, geraniol presented better antifungal, antibiofilm activity, and lower cytotoxicity when compared to the other monoterpenes. It also showed low in vivo toxicity and capacity to downregulate the expression of fungal enzymes and host pro-inflammatory cytokines. Thus, it can be highlighted as a viable option for oral candidiasis treatment.

OBJECTIVE: To evaluate the efficacy of recombinant psoriasin as a novel treatment for oral candidiasis by eliminating Candida albicans growth on polymethyl methacrylate denture base.
METHODS: Recombinant psoriasin protein was expressed and purified from E. coli, and Candida growth was monitored in vitro with varying concentrations of psoriasin. Subsequently, denture-base polymethyl methacrylate was immersed in psoriasin\'s solution or voriconazole, and fungal growth on the acrylic base and in the medium was examined by scanning electron microscopy and optical density, respectively. Cellular viability of HeLa and human gingival fibroblast cells treated with psoriasin was measured by methylene blue assay.
RESULTS: The findings reveal an effective antifungal activity of psoriasin, completely inhibiting Candida albicans growth in RPMI at a protein concentration above 400 nM. Immersing the polymethyl methacrylate with 50 μM psoriasin completely eradicates fungal growth. Psoriasin has low cytotoxicity in HeLa cells at a concentration higher than 12 μM and no toxic effect on human gingival fibroblasts.
CONCLUSIONS: This study marks psoriasin as an effective alternative to conventional antifungal treatments for denture stomatitis and a safe alternative to chemical antifungals in dental medicine and beyond.

BACKGROUND: Conventionally fabricated denture base resins have been used for over 150 years. Newer denture base resins can provide a superior fit and may be customized to the patient\'s characteristics, but the literature on their cleansibility remains limited. The oral cavity can be a hub for thousands of microflora. The maintenance of complete dentures by edentulous patients depends not only on the maintenance of the patient but also on the material used, biofilm adherence, and polishability.
METHODS: Cuboid specimens of 10 × 5 × 2 mm were designed using the Meshmixer version 3.5 software (Meshmixer, Australia). The standard tessellation (STL) file was imported and sent for printing (NextDent, Netherlands) (Group 1), milling in polymethyl methacrylate (PMMA) (Ivotion, Ivoclar, Schaan, Liechtenstein) (Group 2), and wax milling (Upcera, China), followed by flasking, counter flasking, and packing using heat-cured acrylic resin (DPI, India) (Group 3). The obtained specimens were polished using pumice and sterilized using a UV sterilization unit. The specimens were then immersed in a suspension of candida broth. After three days of biofilm formation, a colony count was performed and noted as colony-forming units per milliliter (CFU/mL). Specimens were treated using Secure denture cleansing tablets (Ghent, New York), table salt (iodized table salt, Tata, India), Clinsodent (ICPA, Mumbai, India), and Polident denture cleansing powder (Polident, Ontario, Canada). A colony count was done after treatment, and the data were tabulated. Statistical analysis was done using SPSS software to compare the efficiency of denture cleansers in all three groups, and statistical significance was set at 0.05. The Kolmogorov-Smirnov test was done to confirm the normality of the data, followed by a one-way analysis of variance (ANOVA) test to compare the efficiency of denture cleansers on the removal of candida colonies.
RESULTS: Milled denture base resins showed a significantly lower colony count when compared to printed and conventionally fabricated denture base resins. The denture cleansers showed high efficacy in all groups, with the most significant being Secure, which showed a mean difference ranging from 8.114 to 9.887 CFU/mL, followed by Clinsodent, showing a mean of 6.699-9.863 CFU/mL, followed closely by Polident, showing 4.964-7.114 CFU/mL, followed by table salt, being 5.254-8.920 CFU/mL. The 95% confidence interval confirmed statistical significance.
CONCLUSIONS: The highest candida colony count was demonstrated by the conventional, followed by rapid prototyping, and was least with milled denture base resins. Following treatment with denture cleansers, Secure demonstrated almost complete eradication of colonies, making it the most effective option. Salt exhibited the lowest efficiency, followed closely by Polident and Clinsodent, and the most effective was Secure denture cleanser.

BACKGROUND: The aim of this study was to summarize existing data and perform technological prospecting on the effect of incorporating antifungal agents into denture base materials in inhibiting Candida spp., as well as to explore the antimicrobial properties of these materials.
METHODS: A comprehensive electronic search was carried out in six major bibliographic databases (PubMed, Scopus, Embase, Cochrane Library, Web of Science and Lilacs) until February 2024. In addition, international patent databases were also examined. The search process, study and patent selection, data extraction and risk of bias assessment were carried out independently by researchers. The collected data underwent qualitative analysis.
RESULTS: A total of 10 718 articles were identified in the searched databases, of which 40 documents were included for qualitative data analysis (articles: 31; patents: 9). The majority of the studies focused on investigating tissue conditioners (n = 14) and acrylic resins (n = 14). The primary antifungal agents studied were nystatin (n = 15) and fluconazole (n = 13). The most commonly utilized microbiological evaluation methodology was the agar diffusion test (n = 16), followed by the microdilution (n = 7) and biofilm formation assays (n = 7). All of the studies investigated the inhibitory effect of these materials against Candida species.
CONCLUSIONS: The incorporation of antifungal agents into denture base materials has been extensively studied and has shown a significant inhibitory response against Candida spp. across various methodological assays.

In dentistry, denture stomatitis (DS), a frequent inflammatory illness of the oral mucosa mostly related to denture wearing, is a major concern. DS is a common oral mycotic infection for those who wear partial or total dentures. The most often found species of Candida that may be isolated from both healthy and diseased oral tissues is Candida albicans. DS is associated with uneven denture surfaces, inadequate oral hygiene, or ill-fitting dentures. The diagnosis and management of DS in a 72-year-old male patient is presented in this case study. The patient complained about burning in his palate and having difficulty chewing. Upon clinical examination, erythema and inflammation were seen in the palate region. The history and clinical findings were consistent with DS. The patient was told to completely stop using dentures. Interventions were included in the treatment plan, such as diode laser therapy, topical ozonated oil application, and teaching about denture hygiene. The third day\'s follow-up visit revealed a progressive healing of the lesions and symptom relief. The lesion fully resolved on the sixth day. This case emphasizes the value of all-encompassing management techniques in treating DS successfully. It also highlights the significance of patient education, good oral hygiene, and focused therapy in producing favorable results.

To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction.
A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models.
Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284).
This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults.
Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.

Denture stomatitis (DS) is a very common disease in wearers of removable complete and partial dentures with a worldwide prevalence in the range of 20-67%. Both industrially developed and impoverished nations are affected by the illness. DS is often associated with ill-fitting dentures or a fungal infection with Candida spp. Candida is normally found in the oral cavity microbiota, but it can be harmful to the health of elderly people with underlying diseases. Therefore, the purpose of the present study is to offer the most recent information about the epidemiology, etiology, and global distribution of Candida species associated with DS through a systematic review. Several databases, including Medline, Web of Science, and Scopus, were used to conduct an extensive search of the literature published in the previous 20 years. The selection of studies was performed by two authors. The extracted data were as follows: author, year of publication, country, sample, frequency of DS, method of diagnosing stomatitis, species of Candida, risk factors, and etiology of the disease. The JBI Critical appraisal tools were used to assess the quality of the studies. Eventually, twenty-eight studies were included in the systematic review. Twenty-one studies investigated DS, while seven studies examined Candida colonization in patients using removable dentures. The results show that the main causes of DS include the type of dentures, continuous wearing of dentures, and the formation of a Candida biofilm, which is facilitated by poor dental hygiene. Additionally, previous studies have pinpointed the significance of the salivary flow, saliva composition, and salivary pH. The findings of the current review indicate that it is crucial to monitor denture wearers for the appearance of DS, especially the patients whose immunity has been impaired due to a systemic condition. Finally, frequent follow-ups should include a clinical examination and microbial swabs of the palatal mucosa and the mucosal surface of the denture.

OBJECTIVE: This study investigated the effectiveness of a drug-modified tissue conditioner in an animal model of denture stomatitis.
RESULTS: Wistar rats wore a Candida albicans-contaminated palatal device for 4 days. Next, nystatin (Nys) or chlorhexidine (Chx) were added to a tissue conditioner in their raw or β-cyclodextrin-complexed (βCD) forms at their minimum inhibitory concentrations. As controls, one group was not subjected to any procedure (NC), one group used sterile devices, one group had denture stomatitis but was not treated (DS), and another had the devices relined with the tissue conditioner without the addition of any drug (Soft). After 4 days of treatment, treatment effectiveness was assessed visually, histologically, and through CFU count, and myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) assays. Rats from the Soft, Nys, Nys:βCD, and Chx groups presented a significant decrease in the microbial load compared with the untreated group. Treatment groups showed lower MPO and NAG activity compared to the non-treated group.
CONCLUSIONS: The addition of antifungals to a soft tissue conditioner can be a promising approach for denture stomatitis treatment.

UNASSIGNED: To study the efficacy of PADTM Plus-based photoactivated disinfection (PAD) for treating denture stomatitis (DS) in diabetic rats by establishing a diabetic rat DS model.
UNASSIGNED: The diabetic rat DS model was developed by randomly selecting 2-month-old male Sprague-Dawley rats and dividing them into four groups. The palate and denture surfaces of rats in the PAD groups were incubated with 1 mg/mL toluidine blue O for 1 min each, followed by a 1-min exposure to 750-mW light-emitting diode light. The PAD-1 group received one radiation treatment, and the PAD-2 group received three radiation treatments over 5 days with a 1-day interval. The nystatin (NYS) group received treatment for 5 days with a suspension of NYS of 100,000 IU. The infection group did not receive any treatment. In each group, assessments included an inflammation score of the palate, tests for fungal load, histological evaluation, and immunohistochemical detection of interleukin-17 (IL-17) and tumor necrosis factor (TNF-α) conducted 1 and 7 days following the conclusion of treatment.
UNASSIGNED: One day after treatment, the fungal load on the palate and dentures, as well as the mean optical density values of IL-17 and TNF-α, were found to be greater in the infection group than in the other three treatment groups (P < 0.05). On the 7th day after treatment, these values were significantly higher in the infection group than in the PAD-2 and NYS groups (P < 0.05). Importantly, there were no differences between the infection and PAD-1 groups nor between the PAD-2 and NYS groups (P > 0.05).
UNASSIGNED: PAD effectively reduced the fungal load and the expressions of IL-17 and TNF-α in the palate and denture of diabetic DS rats. The efficacy of multiple-light treatments was superior to that of single-light treatments and similar to that of NYS.

The present study aimed to evaluate the effect of denture wearing on the occurrence of fungal isolates in the oral cavity before and after complete denture insertion. Fifty completely edentulous patients were selected. Swab samples were collected intraorally before the fabrication of complete dentures from the palatal mucosal surface and after complete denture fabrication (1 and 7 days after denture insertion). Further, these samples were inoculated and incubated. Results showed that in 48 patients, no isolate of fungus before denture insertion was found. In two subjects, results were false positive (contamination from the environment), and in six patients, there was an increase in growth, but not much significant increase of growth was seen (mild growth of fungus only after denture insertion). One of the major findings of this study was that the overall occurrence of fungal isolates (before and after denture insertion) in the oral cavity was not significant.