A Comparison of the eFficacy of Nystatin and Fluconazole Incorporated into Tissue Conditioner on the In Vitro Attachment and Colonization of Candida Albicans

BACKGROUND Denture stomatitis is a common oral lesion following the use of ill-fitting dentures. A layer of tissue conditioner is usually used to improve adaptation of the denture. These liners can support the in vivo adhesion and colonization of the oral Candida. The aim of this study was to evaluate the efficacy of the two common antifungal agents mixed with tissue conditioner against Candida albicans. METHODS Tissue conditioner disks (Acrosoft) with 5mm diameter and 1mm thickness containing different concentrations of nystatin and fluconazole (1%, 3%, 5%, 10% wt/wt) as well as disks with no antifungal agents (8 disks for each group) were prepared for experimental biofilm formation by inoculation with Candida albicans cell suspensions. The specimens were incubated in cell culture microtiter plate wells containing Sabouraud's broth in a rotator shaker at 30°C for 48 hours. Then, the specimens were rinsed and sonicated in sterile water to remove surface organisms. The attached yeasts were enumerated by inoculation of the yeast suspension on Sabouraud's agar. The data was compared using Kruskal-Wallis and Dunn's tests using prism software. P value less than 0.05 was considered significant. RESULTS The 1% to 10% mixture of nystatin and tissue conditioner completely inhibited the attachment and colonization of Candida albicans, although for fluconazole only a 10% concentration caused complete inhibition. Nystatin showed a potentially higher effect in inhibition of candida attachment and colonization (P = 0.0001) compared to that of fluconazole and a statistically significant difference was seen between 5% and 1% fluconazole (P = 0.0001). CONCLUSION Tissue conditioner with 1% to 10% nystatin or 10% fluconazole can completely inhibit the adhesion and colonization of Candida albicans.