Authors : Khaleel; Kiran Kumar H. S.; Sanjayagbouda B. Patil; A. H. Shoeab Khan; Nivedha S.; K. Aishwarya; Seema C. S.; Pragati N. Kande

Volume/Issue : Volume 10 - 2025, Issue 11 - November

Google Scholar : https://tinyurl.com/3x5fy3e8

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DOI : https://doi.org/10.38124/ijisrt/25nov477

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Abstract : Background and Objectives: Denture stomatitis caused by Candida albicans is a common clinical concern associated with soft denture liners. Conventional antifungal agents such as fluconazole are effective but may lead to resistance or side effects with prolonged use. This study aimed to evaluate and compare the antifungal efficacy of Moringa oleifera leaf powder, stem bark powder, and fluconazole when incorporated into a soft liner material.  Materials and Method: A total of 40 samples (10 mm x10mm x 2 mm) were fabricated using a soft liner material. These were divided into four groups (n=10 each) as follows: Group A (control – soft liner without additives), Groups B (Moringa leaf powder at 5%w/w), Groups C (Moringa stem bark powder 5% w/w), and Groups D (fluconazole 2% w/w). The antifungal activity of each group was tested using the colony forming unit method against Candida albicans. The number of colony forming unit were measured and statistically analyzed using one-way ANOVA followed by post hoc tests.  Results: All experimental groups exhibited varying degrees of antifungal activity compared to the control group. The group with 5% Moringa leaf powder showed the highest antifungal activity compared with 5% w/w Moringa stem bark among the herbal groups. Fluconazole at 2% exhibited the maximum antifungal effect overall. Moringa stem bark groups demonstrated moderate antifungal activity against Candida albicans.

Keywords : Moringa Oleifera; Soft Denture Liner; Antifungal Activity; Candida Albicans; Leaf Powder; Stem Bark Powder; Herbal Antifungal Agent; Denture Stomatitis.

References :

1. Kubo CS, Amaral FR and de Campos EA. Relining of removable dentures: a literature review. RSBO 2014; 11(2):192-8.
2. Bartee BK. Extraction site reconstruction for alveolar ridge preservation. Part 2: membrane-assisted surgical technique. J Oral Implantol 2001; 27:194-197.
3. Glossary of Prosthodontic Terms, edition nine. J Prosthet Dent 2017, e1-105.
4. Braden M, Wright PS and Parker S. Soft lining materials: A review. Eur J Prosthodont Restor Dent 1995; 3:163-174.
5. E l Hadary A and Drummond J L. Comparative study of water sorption, solubility, and tensile bond strength of two soft lining materials. J Prosthet Dent 2000; 83:356-361.
6. Kawano F, Dootz ER and Koran A. 3rd, Craig RG. Comparison of bond strength of six soft denture liners to denture base resin. J Prosthet Dent 1992; 68:368-371.
7. Kawano F, Kon M, Koran A and Matsumoto N. Shock-absorbing behavior of four processed soft denture liners. J Prosthet Dent 1994; 72:599-605.
8. Kulak-Ozkan Y, Kazazoglu E and Arikan A: Oral hygiene habits, denture cleanliness, presence of yeasts and stomatitis in elderly people. J Oral Rehabil 2002; 29:300-304.
9. Nam KY: In vitro antimicrobial effect of the tissue conditioner containing silver nanoparticles. J Adv Prosthodont 2011; 3:20-24.
10. Tari BF, Nalbant D, Al FD and Kustimur S. Surface roughness and adherence of Candida albicans on soft lining materials as influenced by accelerated aging. J Contemp Dent Pract 2007; 8:18-25.
11. Webb BC, Thomas CJ, Willcox MD, Harty DW and Knox KW. Candida-associated    denture stomatitis. Aetiology and management: a review. Part 2. Oral diseases caused by Candida species. Aust Dent J 1998; 43:160–166.
12. Marta Radnai, Rob Whiley, Tim Friel and Paul S Wright. Effect of antifungal gels incorporated into a tissue conditioning material on the growth of Candida albicans: J Gerontol 2010; 27:292-296
13. Stuhlinger ME and Basson NJ. Effect of an antifungal denture liner on the saliva yeast count in patients with denture stomatitis: A pilot study. J Oral Rehabi 2008; 35: 664-669
14. Waters MG, Williams DW, Jagger RG and Lewis MA. Adherence of Candida albicans to experimental denture soft lining materials. J Prosthet Dent 1997; 77:306-312.
15. Douglas W.H and Walker D.M. Nystatin in denture liners – an alternative treatment of denture stomatitis. Br Dent J 1973; 135:55–59.
16. Quinn DM. The effectiveness, in vitro, of miconazole and ketoconazole combined with tissue conditioners in inhibiting the growth of Candida albicans. J Oral Rehabil 1985; 12: 177–182.
17. Shafiq NE and Mahdee AF. Moringa oleifera use in maintaining oral health and its potential use in regenerative dentistry. Sci World J 2023; 1:887-889.
18. Pareek A, Pant M, Gupta MM, Kashania P, Ratan Y, Jain V et al. Moringa oleifera: an updated comprehensive review of its pharmacological activities, ethnomedicinal, phytopharmaceutical formulation, clinical, phytochemical, and toxicological aspects.  Int J Mol Sci 2023; 24(3):209-212
19. Nweke F. Antifungal activity of petroluem ether extracts of Moringa oleifera leaves and stem bark against some plant pathogenic fungi. J Nat Sci 2015; 5(8):1-5.
20. Budtz - Jorgensen E, Stenderup A and Grabowski M. An epidemiologic study of yeasts in elderly denture wearers. CDOE 1975; 3:115-119.
21. Davenport JC. The oral distribution of Candida in denture stomatitis. Br Dent J 1970; 129(4):151-614.
22. Allison RT and Douglas WH. Micro-colonization of the denture-fitting surface by Candida albicans. J Dent 1973; 1(5):198–201.
23. Samaranayake LP, McCourtie J and MacFarlane TW. Factors affecting the in-vitro adherence of Candida albicans to acrylic surfaces. Arch Oral Biol1980; 25(8-9):611-615.
24. Wright PS, Clark P and Hardie JM. The prevalence and significance of yeasts in persons wearing complete dentures with soft-lining materials. J Dent Res 1985; 64(2):122-125.
25. Rogers TE, Walker GC and Ryder NS. Antifungal activity of fluconazole (UK 49,858) against Candida albicans in vitro and in experimental systemic infections in rats. AAC 1986; 29(4):513-517.
26. Okita N, Orstavik D, Orstavik J and Ostby K. In vivo and in vitro studies on soft denture materials: microbial adhesion and tests for antibacterial activity. Dent Mater J 1991; 7(3): 155–160.
27. Segal E, Kremer I and Dayan D. Inhibition of adherence of Candida albicans to acrylic by a chitin derivative. Eur J Epidemiol 1992; 8:350-355.
28. Chow CK, Matear DW and Lawrence HP. Efficacy of antifungal agents in tissue conditioners in treating candidiasis. Gerodontology 1999; 16(2):110-118.
29. Dinckal Yanikoglun and Yesil Duymusz. Comparative study of water sorption and solubility of soft lining materials in different solutions. Dent Mater J 2004; 23(2): 233-239.
30. Dorocka-Bobkowska B and Konopka K. Susceptibility of candida isolates from denture-related stomatitis to antifungal agents in vitro. Int J Prosthodont 2007; 1: 20-25.
31. Rahman MS, Aziz MA and Islam MS. Antibacterial and antifungal activity of Moringa oleifera stem bark extracts. J Med Plants Res 2008; 2(9):250-255.
32. Falah-Tafti A, Jafari AA, Lotfi-Kamran MH, Fallahzadeh H and Hayan RS. A Comparison of the efficacy of nystatin and fluconazole incorporated into tissue conditioner on the in vitro attachment and colonization of Candida albicans. J Dent Res 2010; 7(1):18-22.
33. Chopde N, Pharande A, Khade MN, Khadtare YR, Shah SS and Apratim A. In vitro antifungal activity of two tissue conditioners combined with nystatin, miconazole and fluconazole against Candida albicans. J Contemp Dent Pract 2012; 13(5):695-698.
34. Rocha MF, Alencar LP, Brilhante RS, Sales JD, Ponte YB, Rodrigues PH et al. Moringa oleifera inhibits growth of Candida spp. and Hortaea werneckii isolated from Macrobrachium amazonicum prawn farming with a wide margin of safety. Cienc Rural 2014; 44(12):197-203.
35. Chladek G, Żmudzki J and Kasperski J. Long-term soft denture lining materials. Materials. 2014; 7(8):16-42.
36. Patel P, Patel N, Patel D, Desai S and Meshram D. (2014). Phytochemical Analysis and Antifungal Activity of Moringa oleifera. Int J Pharm Pharm Sci 2014; 6(5):144–147.
37. Nweke F. Antifungal activity of petroluem ether extracts of Moringa oleifera leaves and stem bark against some plant pathogenic fungi. J Nat Sci Res. 2015; 5(8):1-5.
38. Khan MA, Vuddaraju R, Manne P and Ravoori S. Effectiveness of plant extracts and denture cleansers on Candida albicans adhered to soft denture liner – An in vitro study. J Clin Diagn Res 2016; 10(12):65–68.
39. Isitua CC, Ibeh IN and Olayinka JN. In vitro antifungal activity of Moringa oleifera Lam. leaf on some selected clinical fungal strains. Indian J Appl Res 2016; 6(8):548–552.
40. Krishnamurthy S and Hallikerimath RB. An in-vitro evaluation of retention, colonization and penetration of commonly used denture lining materials by candida albicans JCDR 2016; 10(10):84-86.
41. Bueno MG, Sousa EJB, Hotta J, Alves ALPF, Urban VM and Neppelenbroek KH. Surface properties of temporary soft liners modified by minimum inhibitory concentrations of antifungals. Braz Dent J 2017; 28(4):415–421.
42. Rawat P, Agarwal S and Tripathi S. Effect of addition of antifungal agents on physical and biological properties of a tissue conditioner: an in-vitro study. Adv Pharm Bull 2017; 7(3):485–490.
43. Khadka S, Sherchand JB, Pokhrel BM, Parajuli K, Mishra SK, Sharma S, et al. Isolation, speciation and antifungal susceptibility testing of Candida isolates from various clinical specimens at a tertiary care hospital, Nepal. BMC Res Notes 2017; 10:218-220.
44. Gauch L, Pedrosa SS, Silveira-Gomes F and Marques-da-Silva SH. Isolation of Candida spp. from denture-related stomatitis in Pará, Brazil. Braz J Microbiol 2018; 49(4):801–805.
45. Chincholikar S, Bhat V, Shetty V, Shenoy KK and Shetty S. Comparative evaluation of two antifungal agents incorporated in auto polymerising denture base resin, heat polymerising denture base resin and permanent silicone soft liner—An in vitro study. J Clin Diagn Res 2019; 13(1):49–54.
46. Ahmadu T, Ahmad K, Ismail SI, Rashed O, Asib N and Omar D. Antifungal efficacy of Moringa oleifera leaf and seed extracts against Botrytis cinerea causing gray mold disease of tomato (Solanum lycopersicum L.). Braz J Biol 2021; 81(4):1007–1022.
47. Rehman K, Khan S, Mehmood Z, Shahid M and Ahmed M. Evaluation of antibacterial and antifungal activities of Moringa oleifera L. against pathogenic bacterial and fungal strains. J Med Plants Res 2020; 14(5):221–227.
48. Ningsih AW, Nugraha R and Fatmawati S. Antimicrobial activity of Moringa oleifera leaf decoction and ethanol extract against Candida albicans and Staphylococcus aureus. J Trop Plant Physiol. 2021; 13(2):99–110.
49. Santos L, da Silva BM, de Oliveira R, dos Santos J, Santos CM and de Oliveira AC. Anti-Candida activity of the water-soluble lectin from Moringa oleifera seeds. Int J Biol Macromol 2021; 177:105–112.
50. Mondal A, Roy P, Pal S and  Das S. Insecticidal and fungicidal performance of biofabricated silver and gold nanoparticles using different parts of Moringa oleifera. J Environ Chem Eng 2022; 10(4):107-435.
51. Mahmoud S, El-Masry TA, Hassan AA and El-Sayed RH. Assessment of antifungal activity of three essential oils and nystatin against Candida albicans strains: An in vitro study. J Mycol Med. 2022; 32(3):101-305.
52. Al-Khalasi S, Al-Farsi M, Al-Harthy K and  Al-Mahruqi S. Comparative in vitro evaluation of antifungal efficacy of Moringa peregrina leaf, seed, and root extracts against Candida albicans with amphotericin B. J Mycol Med 2023;33(1):101-459.
53. Gani B, Ahmad S, Kumar V and Singh R. Evaluation of fungistatic effect of Moringa oleifera leaf ethanolic extract on metabolic changes in Candida albicans associated with growth and biofilm formation. J Mycol Med 2023; 33(2):101-482.
54. Sulistyani H, Rahman M, Wulandari D and Putri AP. In vitro evaluation of Moringa oleifera leaf extract on inhibition of Candida albicans biofilm formation. J Ethnopharmacol. 2024; 305:357-388.
55. Newton AV. Denture sore mouth- a possible etiology. Br Dent J 1962; 112: 357- 360.
56. Budtz-Jorgensen and Bertram E. Denture stomatitis, the etiology in relation to trauma and infection. Act Odontol Scand 1970; 28: 71.
57. Samaranayake L P. “Oral mycoses in HIV infection. OSOMOP 1992; 73(2):171-180.
58. Wright PS, Clark P and Hardie JM. The prevalence and significance of yeast in persons wearing complete dentures with soft-lining materials. J Dent Res 1985; 64:122-125.
59. Gruber R G, Lucatorto F M and Molnar D J. Fungus growth on tissue conditioners and soft denture liners, J Am Dent Assoc 1966; 73: 641- 643.