Date of Award

Spring 2010

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Dentistry

First Advisor

Andrew Dentino

Second Advisor

Ziebert Gerald

Third Advisor

Arthur Hefti, April Harkins

Abstract

Denture-induced stomatitis is prevalent among prosthesis users, particularly the elderly and institutionalized where it has been estimated to be present in over 60-65% of denture wearers. Treatment of this clinical condition is problematic due to incomplete disinfection of the acrylic surface and rapid microbial re-colonization. Moreover, ingestion or aspiration of pathogens in denture plaque exposes the elderly and immunocompromised to unexpected infections.

Acrylic polymers have generally been used to replace missing teeth and periodontal tissues in edentulous or partially dentate patients. Currently, edentulous adults in the US population are common, with complete edentulism greater than 41% among Americans aged 65 and older. Poly (methyl methacrylate) [PMMA] is the most commonly used denture base material, and satisfies most esthetic, physical and mechanical criteria for an intra-oral prosthesis. However, the absence of ionic charge may inhibit the selective adsorption of salivary antimicrobials which could provide a more protective pellicle coat.

Salivary antimicrobials such as defensins and histatins are cationic peptides, which are strongly adsorbed onto the tooth surface by electrostatic interaction. Absence of an ionic surface on PMMA not only minimizes the adsorption of defense molecules on denture surfaces, attractive London-van der Waals forces actually facilitate adherence of Candida albicans and other microorganisms. This is a prerequisite for denture biofilm formation and subsequent denture stomatitis.

The goal of this research project is to assess the ability of phosphated polymers to inhibit C. albicans adhesion and biofilm formation, in the hope of preventing denture-induced stomatitis. The novel denture-base polymers incorporate a charge through bead suspension polymerization with poly (methyl methacrylate) [PMMA] and a phosphate containing monomer. Other groups have also been looking to alter denture base surfaces using other techniques.

The possible effects of this project include a new generation of denture-base polymers with great potential for clinical and commercial application in a large population of denture and oral prosthesis users.