An In Vitro Analysis of the Antifungal Effect of Nystatin and Fluconazole Incorporated into Tissue Conditioner with and Without Using Varnish Containing Self-cured Resin and 1,1,1-Trichloroethane

Incorporating antifungal drugs into liners has been proposed to treat denture stomatitis. Varnish application on tissue conditioners can decrease the porosities and irregularities, biofilm, and pathogens adhesion. In this study, we evaluated the effect of varnish application on releasing the antifungal drugs incorporated into tissue conditioners.

Pure form of nystatin and fluconazole were mixed into tissue conditioner powder separately at 5% wt/wt concentration and prepared according to manufacturer’s instruction. Then, disk-shaped specimens (5 mm in diameter and 1 mm in thickness) were prepared at 30 nystatin and 30 fluconazole specimens. Varnish (containing 50 mL of 1,1,1-trichloroethane and 3 ml of self-cured resin) was applied on the surface of 15 disks of each drug and the other specimens were used as the control group (without varnish). Next, the disks were put in agar plates cultured with standard Candida albicans and incubated for 7 days. Mean inhibition diameter for each disk was measured with digital caliper at 24 hours, 3 days, and 7 days. Each step was performed in triplicate. Data was analyzed with one-way ANOVA and Friedman, Wilcoxon, and Mann-Whitney U tests.

The mean inhibition diameter (MID) at days 1, 3, and 7 in fluconazole without varnish group was 12.63, 3.90, and 3.67, respectively; in fluconazole with varnish was 3.00, 2.50, and 2.50, respectively; in nystatin without varnish was 5.78, 3.90, and 3.87, respectively; in nystatin with varnish group was 2.50, 0.00, and 0.00, respectively. fluconazole without varnish group exhibited significantly higher MID and nystatin with varnish group had lower MID.

In this experimental study, fluconazole was more effective than nystatin. In groups without varnish, antifungal effect continued up to day 7. Using varnish in tissue conditioner can decrease antifungal effect.