Comparative Evaluation of Anti-bacterial, Anti-inflammatory Efficacy and Cytotoxicity of Triple Antibiotic Paste Modified Soft Liners with Conventional Soft Liners: An In-vitro Study

Abstract

Introduction: Soft-Liner is an acrylic temporary relining material for the temporary rebasing (relining) of acrylic dentures and tissue conditioning. The use of soft liner as a medium to deliver anti-bacterial and anti-inflammatory medications locally to the site enhances the healing of the soft tissues, further maintaining the mucosa healthy in the transitional healing period. Soft liners modified with Triple Antibiotic Paste (TAP) help in soft tissue healing and reduce post-surgical inflammation. Aim: To evaluate the anti-bacterial, anti-inflammatory efficacy, and cytotoxicity of TAP modified soft liners with conventional soft liners. Materials and Methods: The in-vitro study was conducted in the Gold Laboratory at Saveetha Dental College, Chennai, Tamil Nadu, India, in March 2023. A solution of TAP was prepared and mixed with Gas Chromatography (GC) soft liner material. The antibacterial efficacy against the strains of Staphylococcus aureus, Pseudomonas, and E. faecalis was assessed, and Mueller Hinton Agar was used to identify the zone of inhibition. The Kolmogorov-Smirnov test was conducted to assess the normality of the distribution, and non-parametric tests were performed for further analysis. A chi-square test was used to compare the cytotoxicity of TAP modified soft liners, which was assessed by a Lethality assay for brine shrimps over 24 hours. The Egg albumin denaturation assay was used to assess anti-inflammatory properties, with different concentrations of 10 μL, 20 μL, 30 μL, 40 μL, and 50 μL. Human Gingival Fibroblast (HGF) was used for the cell line study, and the isolation of HGF was performed by enzymatic digestion subjected to collagenase (900 u/mL) and dispase (400 u/mL) digestion at 37°C for one hour. Results: In comparing the modified TAP liners to commercially available liners on the basis of antibacterial efficacy, there was increased anti-bacterial efficacy in the TAP modified liners, which increased with increasing concentration, with the maximum being 40.25±14.87 mm for a 1:3 concentration against S. aureus and the least being 23±1.3 mm of unmodified soft liners against Pseudomonas and S. aureus. Different concentrations of 10 μL, 20 μL, 30 μL, 40 μL were used for the anti-inflammatory test, and as the concentration increased, anti-inflammatory activity also increased. The cytotoxicity of the material increased from 10% to 40% as the concentration of TAP rose from 5 μL to 80 μL. Conclusion: TAP shows a better response in managing postoperative inflammation and better soft tissue healing when incorporated into the soft liners. More precise studies are needed to understand the exact mechanism of TAP.

Keywords

• antibacterial activity
• dental materials
• nano-technology in dentistry