In vitro cytotoxicity and clinical efficacy of an eco-friendly denture adhesive / Juzailah Roffie

A new denture adhesive known as Eco-Friendly Denture Adhesive (EFDA) has been developed by Universiti Sains Malaysia and claimed to have superior properties than a commercial adhesive. The ingredients in this new product have a mixture of synthetic and natural polymer with more that 50 percent of the ingredients were natural origin. Natural polymer derived from starches has been incorporated as fillers in this product. To evaluate the cytotoxicity and efficacy of EFDA, an in vitro study and a randomized, crossover, and double-blind clinical trial was employed in this study. The in vitro cytotoxicity assessment using Alamar blue assay was executed to four EFDA prototypes with different starches namely native tapioca starch (NTS), modified tapioca starch (MTS), native corn starch (NCS), and modified corn starch (MCS). The output of the in vitro test showed that all adhesives were found to be non-toxic to the fibroblast cells and the mean of optical density was the highest among NTS. Therefore, denture adhesive filled with NTS was chosen in the clinical trial study to identify the efficacy of EFDA. 24 complete denture subjects with the mean (SD) age of 65.83 (6.332) years old were selected in the clinical trial. Polident® was chosen as the positive control for this study. The evaluation of the efficacy done by measuring the retentive strength (RS) and maximum occlusal bite force (MOBF) of the complete dentures. The measurements were made at several time interval with the subject fasting and drinking hot water. The results of the clinical study revealed that both denture adhesives produced a statistically significant (p = 0.001) improvement RS and MOBF of complete dentures after 2 hours of fasting and followed by a gradual decline of RS and MOBF when the subject consumed hot water. The RS and MOBF of complete dentures with EFDA were found to be higher than Polident® at most of the time interval, however, no significant difference was seen between both denture adhesives. During the clinical observation, 2 mild oral mucosa reaction were observed on 2 of EFDA subjects in which the adverse events were subside after denture adhesive removal. In conclusion, EFDA was non-toxic to gingival fibroblasts cell and the addition of the native starches in EFDA has improved the retention and bite force of complete dentures.