A review on poly (methyl methacrylate) denture base materials with antimicrobial properties

Denture stomatitis (DS) is one of the most common infectious diseases affecting edentulous patients, due to the colonization of candida albicans on the fitting surface dentures. Despite its multifactorial aetiology, most of the attempts at addressing this problem have been dedicated to the development of dentures or associated materials with antimicrobial activity. This review aims to provide an overview of the published literature on the development of denture base materials with antimicrobial activity and their properties. The published literature indicates that antimicrobial activity to the denture base materials was induced either by physically blending or chemically copolymerizing the antimicrobial agents into the polymeric matrix. A variety of materials such as chlorhexidine, silver and silver- based compounds, titanium dioxide nanoparticles (TiO₂NP), and quaternary ammonium salts (QAS), etc., have been physically blended with the denture base materials. Antimicrobial monomers such as methacryloyloxy dodecylpyridinium bromide (MDPB), methacryloyloxy undecylpyridinium bromide (MUPB), quaternary ammonium (QA), dimethylaminododecyl methacrylate (DMADDM), 2-tert-butylaminoethyl methacrylate (TBAEMA), methacryloxylethylcetyl dimethyl ammonium chloride (DMAE-CB), acrylamide monomer (AAm), 2-methacryloxylethyl dodecyl methyl ammonium bromide (MAE-DB), 2-methacryloxylethyl hexadecyl methyl ammonium bromide (MAE-HB), 2- dimethyl-2-dodecyl-1-methacryloxyethyl ammonium iodine (DDMAI) and 2-Dimethyl-2-hexadecyl-1-methacryloxyethyl ammonium iodine (DHMAI), etc. have been copolymerized with methyl methacrylate to impart antimicrobial activity. These attempts have shown promising antimicrobial activity against C. albicans. However, significant differences in their antimicrobial activity as well as in their properties were noted. Incorporation of antimicrobial monomers to PMMA denture base resin decreased the biofilm formation with a consequent reduction in the acid production and metabolic activity of microbes. Such modifications showed promise as possible alternatives against Candida associated denture stomatitis.