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Antimicrobial effects of nano titanium dioxide and disinfectants on maxillofacial silicones

  • Pinar Cevik
    Correspondence
    Corresponding author: Dr Pinar Cevik, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara 06510, TURKEY
    Affiliations
    Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey; and Research Scholar, Department of General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas
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  • Gulcin Akca
    Affiliations
    Professor, Department of Medical Microbiology, Faculty of Dentistry, Division of Basic Sciences, Gazi University, Ankara, Turkey
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  • Neset Volkan Asar
    Affiliations
    Professor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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  • Emine Avci
    Affiliations
    Epidemiologist, General Directorate of Public Health, Turkish Ministry of Health, Turkey
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  • Sudarat Kiat-amnuay
    Affiliations
    Professor and Section Head, Department of General Practice and Dental Public Health, Houston Center for Biomaterials and Biomimetics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
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  • Burak Yilmaz
    Affiliations
    Associate Professor, Department of Reconstructive Dentistry and Gerodontology, and Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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      Abstract

      Statement of problem

      Deficient hygiene of maxillofacial prostheses can be a source of infection, and various disinfectants, including nano-oxides, have been suggested for the disinfection of silicone prostheses. While maxillofacial silicones involving nano-oxides at different sizes and concentrations have been evaluated in terms of their mechanical and physical properties, reports are lacking on the antimicrobial effect of nano titanium dioxide (TiO2) incorporated into maxillofacial silicones contaminated by different biofilms.

      Purpose

      The purpose of this in vitro study was to evaluate the antimicrobial effects of 6 different disinfectants and nano TiO2 incorporation into maxillofacial silicone contaminated with Staphylococcus aureus, Escherichia coli, and Candida albicans biofilms.

      Material and methods

      A total of 258 silicone specimens (129 pure silicones and 129 nano TiO2-incorporated silicones) were fabricated. Specimens in each silicone group (with or without nano TiO2) were divided into 7 disinfectant groups (control, 0.2% chlorhexidine gluconate, 4% chlorhexidine gluconate, 1% sodium hypochlorite, neutral soap, 100% white vinegar, and effervescent) in each biofilm group. Contaminated specimens were disinfected, and the suspension of each specimen was incubated at 37 °C for 24 hours. Proliferated colonies were recorded in colony-forming units per mL (CFU/mL). The differences in microbial levels among specimens were evaluated to test the effect of the type of silicone and the disinfectant (α=.05).

      Results

      Significant difference was found among disinfectants regardless of the silicone type (P<.05). Nano TiO2 incorporation showed an antimicrobial effect on S aureus, E coli, and C albicans biofilms. Nano TiO2 incorporated silicone cleaned with 4% chlorhexidine gluconate had statistically less C albicans than pure silicone. Using white vinegar or 4% chlorhexidine gluconate led to no E coli on either silicone. Nano TiO2 incorporated silicone cleaned with effervescent had fewer S aureus or C albicans biofilms.

      Conclusions

      The tested disinfectants and nano TiO2 incorporation into silicone were effective against most of the microorganisms used in this study.
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