Evaluation of Antimicrobials Incorporated into Artificial Saliva: Analysis Against Candida albicans
Source abstract
Abstract
Saliva is essential for maintaining oral health, and conditions like hyposalivation increase the risk of diseases. To address this, artificial saliva (AS) formulations incorporated with antimicrobials have been proposed. This study aimed to evaluate the antimicrobial activity and determine the minimum inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) of AS formulations containing nystatin (Nys), chlorhexidine diacetate 98% (Chx), and silver nanoparticles (AgNp) against Candida albicans biofilm. The fungistatic and fungicidal properties of six groups (AS; AS + AgNp 2 mM; AS + AgNp 4 mM; AS + AgNp 6 mM; AS + Nys; AS + Chx) were assessed using the XTT colorimetric assay. Additionally, 35 denture base heat-polymerized acrylic resin specimens were prepared and treated with the antimicrobials, serving as substrates for C. albicans biofilm development over 3, 6, and 12 h. Biofilm growth was quantified by CFU/mL counting. All analyses were performed with a significance level of p < 0.05. Results demonstrated fungal load inhibition and a reduction in metabolic activity across all experimental groups (p < 0.05). Notably, AS + Nys, AS + Chx, and AS + AgNp 6 mM exhibited similar and significant inhibitory effects against C. albicans biofilm.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Oral microbiology and periodontitis research · Salivary Gland Disorders and Functions · Antifungal resistance and susceptibility
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Prosthodontics and Periodontics, Dental School of Bauru, University of São Paulo, Bauru 17000-000, SP, Brazil
Dental Materials Research Lab, Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
Department of Chemistry, Sao Paulo State University (UNESP), Bauru 17033-360, SP, Brazil
References (81)
Show source-provided references
1. Kawanishi, N., Hoshi, N., Adachi, T., Ichigaya, N., and Kimoto, K. (2021). Positive effects of saliva on oral candidiasis: Basic research on the analysis of salivary properties. J. Clin. Med., 10.10.3390/jcm10040812 ↗
2. Does Oral Dryness Influence Pressure Pain Sensitivity in the Oral Mucosa of Removable Denture Wearers?10.1007/s00784-019-03118-1 ↗
3. Diagnosis, prevention, and treatment of radiotherapy-induced xerostomia: A review
4. Jasmer, K.J., Gilman, K.E., Munoz Forti, K., Weisman, G.A., and Limesand, K.H. (2020). Radiation-induced salivary gland dysfunction: Mechanisms, therapeutics and future directions. J. Clin. Med., 9.10.3390/jcm9124095 ↗
5. Comparative evaluation of xerostomia among diabetic and nondiabetic subjects wearing complete denture10.4103/jpbs.JPBS_124_20 ↗
6. Could the Use of Saliva Substitutes Improve Food Oral Processing in Individuals with Xerostomia? A Systematic Review10.1111/jtxs.12591 ↗
7. Non-pharmacologic interventions for management of radiation-induced dry mouth: A systematic review10.1111/odi.14804 ↗
8. Influence of oral moisturizing jelly as a saliva substitute for the relief of xerostomia in elderly patients with hypertension and diabetes mellitus10.1016/j.gerinurse.2015.10.014 ↗
9. Development of Artificial Salivas10.1177/10454411930040030401 ↗
10. Maxillary reservoir denture to overcome radiation-induced xerostomia—Light at the end of the tunnel10.4103/jcrt.JCRT_851_18 ↗
11. Saliva Artificial: Um Estudo da Literatura Sobre uso em Pacientes Submetidos A Radioterapia
12. Xerostomia and Patients’ Satisfaction with Removable Denture Performance: Systematic Review
13. Perić, M., Miličić, B., Kuzmanović Pfićer, J., Živković, R., and Arsić Arsenijević, V. (2024). A systematic review of denture stomatitis: Predisposing factors, clinical features, etiology, and global Candida spp. distribution. J. Fungi, 10.10.3390/jof10050328 ↗
14. Determining growth inhibition of Candida albicans biofilm on denture materials after application of an organoselenium-containing dental sealant10.1016/j.prosdent.2021.04.015 ↗
15. Stability and Efficacy of Combined Nystatin and Chlorhexidine Against Suspensions and Biofilms of Candida albicans10.1016/j.archoralbio.2018.02.009 ↗
16. Mallineni, S.K., Sakhamuri, S., Kotha, S.L., AlAsmari, A.R.G.M., AlJefri, G.H., Almotawah, F.N., Mallineni, S., and Sajja, R. (2023). Silver nanoparticles in dental applications: A descriptive review. Bioengineering, 10.10.3390/bioengineering10030327 ↗
17. Nanometals in Dentistry: Applications and Toxicological Implications—A Systematic Review10.1007/s12011-019-01986-y ↗
18. Silver nanoparticles: Synthesis, characterisation and biomedical applications10.1515/biol-2020-0094 ↗
19. Silver nanoparticles in denture adhesive: An antimicrobial approach against Candida albicans10.1016/j.jdent.2023.104445 ↗
20. Venante, H.S., Chappuis-Chocano, A.P., Marcillo-Toala, O.O., da Silva, R.A., da Costa, R.M.B., Pordeus, M.D., Barraviera, B., Ferreira Junior, R.S., Lara, V.S., and Neppelenbroek, K.H. (2021). Fibrin Biopolymer Incorporated with Antimicrobial Agents: A Proposal for Coating Denture Bases. Materials, 14.10.3390/ma14071618 ↗
21. European Commite for Antimicrobial Susceptibility Testing of the European Society of Clinical (2000). Determination of minimum inhibitory concentrations (MICs) of antimicrobial agents by agar dilution. Clin. Microb. Infect., 6, 509–515.10.1046/j.1469-0691.2000.00142.x ↗
22. Comparação de métodos para avaliação da atividade antimicrobiana e determinação da concentração inibitória mínima (cim) de extratos vegetais aquosos e etanólicos10.1590/1808-1657001192012 ↗
23. Microscopical analysis of Candida albicans biofilms on heat-polymerised acrilic after clorhexidine gluconate and sodium hypochlorite treatments10.1111/j.1439-0507.2010.02005.x ↗
24. Biofilm formation on denture liners in a randomised controlled in situ trial10.1016/j.jdent.2013.02.012 ↗
25. A biological active artificial saliva formulation containing flower mucilage from ceylon spinach (Basella alba linn.)10.1016/j.sjbs.2020.01.007 ↗
26. Influence of artificial saliva in biofilm formation of Candida albicans in vitro10.1590/S1806-83242012000100005 ↗
27. Antifungical resistance of candida biofilms formed on denture acrilyc in vitro10.1177/00220345010800031101 ↗
28. A modified Newton classification for denture stomatitis10.1177/20501684221101095 ↗
29. Łysik, D., Niemirowicz-Laskowska, K., Bucki, R., Tokajuk, G., and Mystkowska, J. (2019). Artificial saliva: Challenges and future perspectives for the treatment of xerostomia. Int. J. Mol. Sci., 20.10.3390/ijms20133199 ↗
30. The smart drug delivery system and its clinical potential10.7150/thno.14858 ↗
31. Silver colloidal nanoparticles: Antifungal effect against adhered cells and biofilms of Candida albicans and Candida glabrata10.1080/08927014.2011.599101 ↗
32. Effect of silver nanoparticles on Candida albicans biofilms: An ultrastructural study10.1186/s12951-015-0147-8 ↗
33. A review of the antibacterial effects of silver nanomaterials and potential implications for human health and the environment10.1007/s11051-010-9900-y ↗
34. Mode of bactericidal action of silver zeolite and its comparison with that of silver nitrate10.1128/AEM.69.7.4278-4281.2003 ↗
35. Silver nanoparticles as antimicrobial agent: A case study on E. coli as a model for Gram-negative bacteria10.1016/j.jcis.2004.02.012 ↗
36. Niemirowicz-Laskowska, K., Mystkowska, J., Łysik, D., Chmielewska, S., Tokajuk, G., Misztalewska-Turkowicz, I., Wilczewska, A.Z., and Bucki, R. (2020). Antimicrobial and physicochemical properties of artificial saliva formulations supplemented with core-shell magnetic nanoparticles. Int. J. Mol. Sci., 21.10.3390/ijms21061979 ↗
37. Antimicrobial Magnetic Nanoparticles Based-Therapies for Controlling Infectious Diseases10.1016/j.ijpharm.2018.11.043 ↗
38. Effect of experimental and commercial artificial saliva formulations on the activity and viability of microcosm biofilm and on enamel demineralization for irradiated patients with head and neck cancer (HNC)10.1080/08927014.2022.2111258 ↗
39. Influence of irradiated dentin, biofilm and different artificial saliva formulations on root dentin demineralization10.1016/j.heliyon.2024.e36334 ↗
40. Green Synthesis of Silver Nanoparticles Utilizing Cannabis sativa L. Extract and Their Structura lCharacterization
41. Ag–Ag2O Nanocomposite Biosynthesis by Mixed Bacterial Cultivation: Structural and Antimicrobial Evaluation
42. Refining Shape and Size of Silver Nanoparticles Using Ion Irradiation for Enhanced and Homogeneous SERS Activity10.1186/s11671-024-03994-x ↗
43. Velgosova, O., Mačák, L., Lisnichuk, M., and Vojtko, M. (2022). Synthesis and Analysis of Polymorphic Silver Nanoparticles and Their Incorporation into the Polymer Matrix. Polymers, 14.10.3390/polym14132666 ↗
44. Antifungal activity of Punicalagin–nystatin combinations against Candida albicans10.1111/odi.13507 ↗
45. In vitro interactions of nystatin and micafungin combined with chlorhexidine against Candida albicans isolates
46. Use of nystatin and chlorhexidine in oral medicine: Properties, indications and pitfalls with focus on geriatric patients10.1111/ger.12278 ↗
47. Oral candidal infections and antimycotics10.1177/10454411000110020301 ↗
48. Comparative evaluation of surface porosities in conventional heat polymerized acrylic resin cured by water bath and microwave energy with microwavable acrylic resin cured by microwave energy10.4103/0976-237X.114844 ↗
49. Measurement of interfacial porosity at the acrylic resin/denture tooth interface10.1111/j.1532-849X.2009.00511.x ↗
50. Dry Mouth Dilemma: A Comprehensive Review of Xerostomia in Complete Denture Wearers
51. The effect of two artificial salivas on the adhesion of Candida albicans to heat-polymerized acrylic resin10.4047/jap.2015.7.2.93 ↗
52. Effect of a denture base acrylic resin containing silver nanoparticles on Candida albicans adhesion and biofilm formation10.1111/ger.12142 ↗
53. Inhibition of Candida albicans Biofilme Formation on Denture Material10.1016/j.tripleo.2009.01.021 ↗
54. Evaluation of the physical and antifungal effects of chlorhexidine diacetate incorporated into polymethyl methacrylate10.1590/1678-7757-2019-0039 ↗
55. Human submandibular-sublingual saliva promotes adhesion of Candida albicans to polymethylmethacrylate10.1128/iai.61.6.2644-2652.1993 ↗
56. Complete denture biofilm after brushing with specific denture paste, neutral soap and artificial saliva10.1590/0103-6440201301946 ↗
57. In vitro analyses of the effects of heparin and parabens on Candida albicans biofilms and planktonic cells10.1128/AAC.05061-11 ↗
58. Forgács, L., Kovács, R., Almási, É., Borman, A.M., Majoros, L., Somogyvári, F., and Kardos, G. (2022). In Vivo Efficacy of Amphotericin B Against Four Candida auris Clades. J. Fungi, 8.10.3390/jof8050499 ↗
59. Elgammal, Y., Abdelazeem, A., and Abdel-Hamid, A. (2025). HIV Protease Inhibitors Restore Amphotericin B Activity Against Candida. PLoS ONE, 20.10.1371/journal.pone.0324080 ↗
60. Enhanced Therapeutic Efficacy of Lipophilic Amphotericin B Against Candida albicans with Amphiphilic Poly(N-isopropylacrylamide) Nanogels10.1007/s13233-014-2162-2 ↗
61. Amphotericin B: Side Effects and Toxicity10.1016/j.riam.2009.06.003 ↗
62. Comparison of Caspofungin and Amphotericin B for Invasive Candidiasis10.1056/NEJMoa021585 ↗
63. Systematic review on the first line treatment of amphotericin B in critically ill adults with candidemia or invasive candidiasis10.1080/14787210.2018.1528872 ↗
64. Micafungin versus amphotericin B in treatment of invasive fungal infection in preterm neonates: A randomized control trial10.1186/s13052-025-01852-9 ↗
65. Rodrigues, C.F., Rodrigues, M.E., and Henriques, M. (2017). Liposomal and Deoxycholate Amphotericin B Formulations: Effectiveness against Biofilm Infections of Candida spp. Pathogens, 6.10.3390/pathogens6040062 ↗
66. A Randomized Trial Comparing Fluconazole with Amphotericin B for Candidemia in Patients Without Neutropenia10.1056/NEJM199411173312001 ↗
67. Rabbit Model of Candida albicans Biofilm Infection: Liposomal Amphotericin B Antifungal Lock Therapy10.1128/AAC.48.5.1727-1732.2004 ↗
68. Synergistic Effect of 1,3,4-Thiadiazole Derivatives with Amphotericin B in Antifungal Therapy10.1038/s41598-025-01075-2 ↗
69. Sixty Years of Amphotericin B: An Overview of the Main Antifungal Agent Used to Treat Invasive Fungal Infections10.1007/s40121-020-00382-7 ↗
70. Comparative Effectiveness of Amphotericin B, Azoles and Echinocandins in the Treatment of Candidemia and Invasive Candidiasis: A Systematic Review and Network Meta-Analysis10.1111/myc.13290 ↗
71. Hernando-Ortiz, A., Eraso, E., Jauregizar, N., de Groot, P.W.J., Quindós, G., and Mateo, E. (2024). Efficacy of the combination of amphotericin B and echinocandins against Candida auris in vitro and in the Caenorhabditis elegans host model. Microbiol. Spectr., 12.10.1128/spectrum.02086-23 ↗
72. Evaluation of Efficacy and Tolerance of Intravesical Amphotericin B Irrigation for the Management of Candiduria10.1016/j.therap.2025.02.010 ↗
73. Bench-to-Bedside Review: Candida Infections in the Intensive Care Unit10.1186/cc6212 ↗
74. Micafungin versus Liposomal Amphotericin B for Candidemia and Invasive Candidosis: A Phase III Randomised Double-Blind Trial10.1016/S0140-6736(07)60605-9 ↗
75. Efficacy of Oral Cochleate-Amphotericin B in a Mouse Model of Systemic Candidiasis10.1128/AAC.44.9.2356-2360.2000 ↗
76. Liposomal Amphotericin B: A Review of its Use in the Management of Fungal Infections
77. Amphiphilic Hyperbranched Polyglycerol Nanoarchitectures for Amphotericin B Delivery in Candida Infections10.1016/j.bioadv.2022.212996 ↗
78. Akinosoglou, K., Kourkoumpetis, T., Gkirkas, K., Kirgou, A., Tsiakos, G., and Lidar, M. (2024). Amphotericin B in the Era of New Antifungals: Where Will It Stand?. J. Fungi, 10.10.3390/jof10040278 ↗
79. Comparative Efficacy and Safety of Systemic Antifungal Agents for Candidemia: Network Meta-Analysis and Multicriteria Acceptability Analyses10.1016/j.ijantimicag.2022.106614 ↗
80. Caballero, U., Eraso, E., Quindós, G., and Jauregizar, N. (2021). In Vitro Interaction and Killing-Kinetics of Amphotericin B Combined with Anidulafungin or Caspofungin Against Candida auris. Pharmaceutics, 13.10.3390/pharmaceutics13091333 ↗
81. Isavuconazole and Liposomal Amphotericin B as Successful Combination Therapy of Refractory Invasive Candidiasis in a Liver Transplant Recipient: Case Report and Literature Review