The effects of silane-SiO2 nanocomposite films on Candida albicans adhesion and the surface and physical properties of acrylic resin denture base material.

STATEMENT OF PROBLEM: Polysiloxane has been used as a coupling material in restorative dental materials for several decades. However, few studies are available on the application of polysiloxane in other dental prosthesis functions. PURPOSE: The purpose of this study was to investigate the effects of silane-SiO2 nanocomposite films on Candida albicans adhesion and the surface and physical properties of acrylic resin denture base materials. MATERIAL AND METHODS: Specimens were separated into 2 groups, uncoated and coated. They were coated with a film by using the dip-coating method. Specimens were incubated with Candida albicans 10(7) cells/mL for 1 hour, and the adherent cells were counted under an optical microscope. The following surface properties were measured: surface chemical composition with Fourier-transform infrared spectrometry, surface roughness with a surface profiler, surface energy with the sessile drop method, and surface hardness with a microhardness tester. The physical properties, including water sorption, water solubility, ultimate flexural strength, and flexural modulus, were evaluated according to International Organization for Standardization 20795-1 requirements. The adhesion of Candida albicans and the surface properties of the specimens were investigated after cleaning with effervescent tablets and brushing. An MTT assay was used to evaluate the coated specimens. The results were statistically analyzed with the Mann-Whitney U test (α=.05). RESULTS: A significant reduction in Candida albicans adhesion (P=.002) was observed before cleaning. In addition, the surface energy was comparable (P=.100), the surface hardness increased significantly (P=.008), and the surface roughness remained unchanged (P=.310). After cleaning with effervescent tablets, a significant decrease in Candida albicans adhesion (P=.002) and in surface roughness (P=.008) was observed; however, similar surface energies were measured (P=.100). After cleaning with a toothbrush, the adhesion of Candida albicans was significantly higher on the coated specimen than on the uncoated specimen (P=.004). The surface roughness values were significantly different (P=.008), and the surface energies could not be determined. The coated specimen had a silicon-oxygen-silicon peak instead of an ester bond in the polymethyl methacrylate structure. The coating film reduced the water sorption (P=.008) and water solubility (P=.032), and increased the ultimate flexural strength (P=.008) and flexural modulus (P=.032) of the specimen. The coated specimen also had satisfactory toxicity results. CONCLUSIONS: Reduced Candida albicans adhesion was observed on the coated specimens. The polymeric film did not change the surface roughness of the acrylic resin specimen; however, it did slightly reduce the surface energy. The physical properties of the acrylic resin did not decrease after it was coated with the film.

Oral Microbiome in Orthodontic Acrylic Retainer.

The oral microbiome can be shifted if the patients wear the acrylic retainers for a lengthy period. It is essential to understand the components of the plaque in order to forestall the development of dental caries and gingivitis. The aim of this study is to report the bacterial communities that adhere to the acrylic retainers by full-length nanopore 16S sequencing. Six healthy participants were allocated into 2 groups (chemical tablet and brushing groups). Plaque samples were collected from the acrylic retainer surfaces before and after cleaning. The bacterial communities were reported using full-length nanopore 16S sequencing. The results showed that 7 distinct phyla were identified by sequencing. The most prevalent of these was the Firmicutes. We found a total of 72 genera. The most common microorganism across all samples was Streptococcus, followed by Neisseria, Rothia, and Gemella. The beta diversity showed a significant difference between before and after cleaning (p < 0.05). This study revealed the novel finding that a combination of chemical and mechanical cleaning methods was the most effective method of eliminating retainer biofilms. Moreover, retainer cleaning tablets did not alter the homeostatic balance of the bacterial communities adhering to the acrylic retainers.

Comparison of Various Antimicrobial Agents for Thermoplastic Polymeric Retainers.

The thermoplastic retainers indicated a rising incidence of cariogenic bacteria such as Streptococcus mutans. A report suggested the case of a patient with severe gingival inflammation and dental caries as a result of inadequate appliance cleaning. This study aims to compare the various antimicrobial agents for thermoplastic polymeric retainers. A minimum bactericidal concentration (MBC) of acetic acid was determined. Streptococcus mutans biofilm was formed on punched 4-mm copolyester (Essix ACE®) and polyurethane (Vivera®) retainers after they were submerged in 0.12% chlorhexidine (CHX group), acetic acid (AA group), Polident Denture Cleanser® (PD group), and Polident Pro Guard & Retainer® (PR group). A crystal violet (CV) test was performed. The biofilm imaging was assessed by confocal laser scanning microscopy (CLSM). The results showed that all chemical disinfectants exhibited statistically significant differences (p < 0.05) compared to the positive control. This novel finding elucidated that 0.625% acetic acid is effective for antimicrobial in both copolyester and polyurethane retainers. However, only the CHX, PD, and PR groups could reduce biofilm mass. In addition, the CV assay cannot provide information about the actual number of living and dead bacteria. Furthermore, the LIVE/DEAD BacLight assay was able to show the bacterial viability.

Effect of an essential oil-containing mouth rinse on VSC-producing bacteria on the tongue.

The objective of the present study was to investigate the inhibitory effect of a commercially available essential oil-containing mouth rinse 12 hours after a single rinse and two weeks of twice daily rinsing, on volatile sulphur compounds (VSC) producing bacteria on the tongue. The study was a randomized, double-blind, controlled crossover design. Thirty-six healthy subjects, aged 20-48 years, volunteered to participate in the study. Subjects were randomly assigned to rinse twice daily with either an essential oil-containing mouth rinse (Cool Mint Listerine Antiseptic) or a negative control rinse. Bacteria samples were taken from the dorsum of the tongue at baseline, after the first rinse and two weeks later. They were plated on OOPS medium to enumerate the VSC-producing bacteria. Intergroup comparisons of log10 transformed colony-forming units of the samples were made using analysis of covariance. Each comparison was performed at a 5% significance level. The mean VSC-producing bacteria in subjects using the essential oil mouth rinse were significantly lower than those using the control rinse twice daily. In healthy subjects, rinsing with an essential oil-containing mouth rinse can have a significant effect on VSC-producing bacteria on the tongue and may be useful for controlling intrinsic oral malodor over prolonged periods.

Remineralization of enamel subsurface lesions by xylitol chewing gum containing funoran and calcium hydrogenphosphate.

The aim of the present study was to determine the remineralization effects of xylitol chewing gum containing funoran and calcium hydrogenphosphate on enamel subsurface lesions in humans. The study was a double-blind, randomized, cross-over design, with 4 types of gum: (1) xylitol gum, (2) xylitol gum containing funoran and calcium hydrogenphosphate, (3) sugar gum, and (4) gum base as a control. Seven subjects were instructed to wear removable lingual appliances, with half-slab insets of human enamel containing demineralized subsurface lesions. They were told to chew gum for 20 minutes 4 times per day for 7 days. Upon completion of each treatment the enamel half-slabs were paired with their respective demineralized control half-slabs, embedded, sectioned, and subjected to microradiography and densitometric image analysis, for measurement of the level of remineralization. The mean area of remineralization (deltaZd-deltaZr) and mean percent remineralization (%R) in those chewing xylitol gum containing funoran and calcium hydrogenphosphate were significantly higher than the corresponding values for xylitol gum, sugar gum and gum base. Chewing xylitol gum containing funoran and calcium hydrogenphosphate has a significant effect on the remineralization of initial caries-like lesions of the teeth.

Salivary secretory IgA, pH, flow rates, mutans streptococci and Candida in children with rampant caries.

The aim of this study was to determine the levels of secretory IgA (SIgA), pH, flow rates, mutans streptococci (MS) and Candida in saliva of children with rampant caries compared to those caries-free. Thirty children (age 62-123 months) were enrolled and divided into two groups: Group I, children with rampant caries, Group II, caries-free children. The average salivary flow rate was measured from the volume yielded within 5 minutes and the pH was determined using a pH-electrode. Measurement of SIgA was performed using an immunoassay kit. The levels of MS and Candida were determined by culture on Mitis-Salivarius Bacitracin agar and Sabouraud dextrose agar. It was found that children with rampant caries presented with significantly higher levels of salivary SIgA, MS and Candida. However, the mean values for salivary flow rates and pH were similar between the groups. The results reveal that children with rampant caries had significantly higher levels of SIgA, MS and Candida in their oral cavities. This finding tends to support the hypothesis that higher levels of salivary SIgA may reflect a past exposure of the host to cariogenic microorganisms.

Plaque pH response to snack foods in children with different levels of mutans streptococci.

This study aimed to investigate the effects of some snack foods on plaque pH in children with different levels of mutans streptococci (MS). Six children, aged 9-12 years, with low (<10(4)) and 6 children, aged 10-12 years, with high (>106) numbers of MS/ml saliva participated in the study. Dental plaque pH changes, after the consumption of milk chocolate, sweet biscuit, instant noodle, sticky rice with banana and a 10% sucrose positive control were measured using pH-electrode. The measurements of plaque pH were made on forty-eight-hour accumulated plaque, at baseline to determine the resting pH of the fasted plaque and at time intervals of 2, 5, 10, 20 and 30 minutes after food consumption. The plaque pH curves, delta pH values and area under curve for pH 6.0 for each test food were determined. Plaque acidogenicity was more pronounced for the high-MS group at almost all test periods compared to the low-MS group with all test foods. The test foods were ranked according to maximum pH drop in about the same order in both groups as follows: 10% sucrose > milk chocolate > sweet biscuit > sticky rice with banana > instant noodle. The plaque pH also stayed below pH 6.00 for a longer period in the high-MS group with sweet biscuit, milk chocolate, and sticky rice with banana. Findings suggest that pH responses were more acidic in high-MS group than low-MS group.

Exploring the salivary microbiome of children stratified by the oral hygiene index.

Poor oral hygiene often leads to chronic diseases such as periodontitis and dental caries resulting in substantial economic costs and diminished quality of life in not only adults but also in children. In this study, the salivary microbiome was characterized in a group of children stratified by the Simplified Oral Hygiene Index (OHI-S). Illumina MiSeq high-throughput sequencing based on the 16S rRNA was utilized to analyze 90 salivary samples (24 Good, 31 Moderate and 35 Poor oral hygiene) from a cohort of Thai children. A total of 38,521 OTUs (Operational Taxonomic Units) with a 97% similarity were characterized in all of the salivary samples. Twenty taxonomic groups (Seventeen genera, two families and one class; Streptococcus, Veillonella, Gemellaceae, Prevotella, Rothia, Porphyromonas, Granulicatella, Actinomyces, TM-7-3, Leptotrichia, Haemophilus, Selenomonas, Neisseria, Megasphaera, Capnocytophaga, Oribacterium, Abiotrophia, Lachnospiraceae, Peptostreptococcus, and Atopobium) were found in all subjects and constituted 94.5-96.5% of the microbiome. Of these twenty genera, the proportion of Streptococcus decreased while Veillonella increased with poor oral hygiene status (P < 0.05). Furthermore, an unassigned species of Veillonella, Veillonella dispar and Veillonella parvula tended to be elevated in the Poor oral hygiene group. This is the first study demonstrating an important association between increase of Veillonella and poor oral hygiene status in children. However, further studies are required to identify the majority of Veillonella at species level in salivary microbiome of the Poor oral hygiene group.

Effects of sonicated Prevotella intermedia, Fusobacterium nucleatum and Lactobacillus casei extracts on interleukin-8 production by human dental pulp cells.

The objective of this study was to determine the effects of Prevotella intermedia, Fusobacterium nucleatum and Lactobacillus casei on the production of IL-8 by human dental pulp cells. Human dental pulp cells from teeth of young patients (aged 18-25 years) were cultured and tested with sonicated P. intermedia ATCC 25611, F. nucleatum ATCC 25586 and L. casei ATCC 4646 extracts. IL-8 secreted into the culture supernatants were measured at 6, 12 and 24 hours using a quantitative sandwich enzyme immunoassay technique. Cell viability was evaluated using trypan blue exclusion technique. IL-8 production by human dental pulp cells increased significantly at 12 and 24 hours after exposure to P. intermedia and F. nucleatum, whereas L. casei extract exhibited low IL-8 production. The sonicated bacterial extracts did not significantly affect viability or total number of dental pulp cells.

A modified dip-slide test for microbiological risk in caries assessment.

This study was undertaken to evaluate the validity of a new modified dip-slide test kit for the estimation of salivary mutans streptococci, lactobacilli and Candida levels by comparison with the results obtained from conventional agar plate counts. Five milliliters of paraffin-stimulated saliva sample was collected from 118 6-12-year old children attending 4 primary schools in Thailand. Saliva was poured over a 3-compartment slide containing Mitis-Salivarius Bacitracin agar, Rogosa agar and Sabouraud dextrose agar. A slide was incubated in a 5% CO2 incubator for 48 hours. The results of the modified test kit were compared with those from the conventional saliva sampling with dilution method. The salivary mutans streptococci, lactobacilli and Candida counts obtained from the conventional methods were significantly correlated (p < 0.0001) with the modified dip-slide estimates of these organisms. (Kendall Tau = 0.71, 0.58 and 0.76, respectively). The correlation between a modified dip-slide test kit and the conventional method indicates that this new test kit is suitable for the screening of salivary mutans streptococci, lactobacilli and Candida levels in patients. The test is simple and would be useful for the early selection of patients for dental examination. In addition, it would be a valuable educational aid for the motivation and dietary counseling among children.

Antimicrobial activity of Cratoxylum formosum on Streptococcus mutans.

The gum of Cratoxylum formosum, commonly known as mempat, is a natural agent that has been used extensively for caries prevention by hill tribe people residing in Thailand. The objective of this study was to investigate the antimicrobial activity of Cratoxylum formosum gum on Streptococcus mutans (S. mutans) in vitro. The gum extracted from stem bark of Cratoxylum formosum was investigated for antimicrobial activity against different strains of S. mutans, including S. mutans KPSK2 and 2 clinical isolates. Inhibition of growth was primarily tested by agar diffusion method. A two-fold broth dilution method was then used to determine the minimum inhibitory concentration (MIC) of the extract. The extract of Cratoxylum formosum was effective against S. mutans with the inhibition zones ranging from 9.5 to 11.5 mm and MIC values between 48 microg/ml and 97 microg/ml. The gum of Cratoxylum formosum has high antimicrobial activity against S. mutans and may become a promising herbal varnish against caries.

Identification of Veillonella Species in the Tongue Biofilm by Using a Novel One-Step Polymerase Chain Reaction Method.

Six Veillonella species have been frequently isolated from human oral cavities including infectious sites. Recently, it was reported that diet, smoking, and possibly socioeconomic status can influence the bacterial profile in oral cavities. In addition, oral hygiene habits may also influence oral microbiota in terms of both numbers and diversity of microorganisms. In this study, the identification of Veillonella species in tongue biofilms of Thai children, divided into three groups dependent on their status of oral hygiene. For this, we used a novel one-step PCR method with species-specific primer sets based on sequences of the rpoB gene. As shown in the results, the number of isolates of Veillonella species was 101 strains from only 10 of 89 subjects. However, the total number of bacteria was high for all subjects. Since it was reported in previous studies that Veillonella species were easy to isolate in human tongue biofilms at high numbers, the results obtained in this study may suggest country- or age-specific differences. Moreover, Veillonella species were detected predominantly in subjects who had poor oral hygiene compared to those with good or moderate oral hygiene. From these results, there is a possibility that Veillonella species may be an index of oral hygiene status. Furthermore, V. rogosae was a predominant species in tongue biofilms of Thai children, whereas V. parvula and V. denticariosi were not isolated at all. These characteristics of the distribution and frequency of Veillonella species are similar to those reported in previous studies. Although further studies are needed in other countries, in this study, a successful novel one-step PCR method was established to detect Veillonella species in human oral cavities easily and effectively. Furthermore, this is the first report investigating the distribution and frequency of Veillonella species in tongue biofilms of Thai children.

Lead in saliva and its relationship to blood in the residents of Klity Village in Thailand.

Lead concentrations in whole blood and saliva were examined in 16 females and 13 males living in Klity village, a highly contaminated area from lead mining, Thailand. The geometric mean for the lead content in the blood was 24.03 microg/dl (range 11.80-46.60 microg/dl) while the lead content in the saliva was 5.69 microg/dl (range 1.82-25.28 microg/dl). No significant differences were found between the concentrations of lead in blood and saliva in relation to the age of the subject. Males were found to have higher blood lead levels than females. The coefficient of correlation gamma between salivary and blood lead levels was -0.025. Our data suggests that saliva is not suitable material for biological monitoring with respect to lead exposure.

Induction of type I collagen and osteocalcin in human dental pulp cells by retinoic acid.

Retinoic acid has been known to play a key role in the regulation of bone cell differentiation and function. The effects of retinoic acid on human dental pulp cells, which contain several characteristics similar to those of bone cells, has yet to be elucidated extensively. The effects of retinoic acid on human dental pulp cells in terms of type I collagen and osteocalcin induction were investigated in vitro. Dental pulp cells obtained from the teeth of young patients (age between 18-22 years) were cultured and subsequently treated with various concentrations of retinoic acid (0, 10(-7), 10(-6), 10(-5) M) in serum-free DMEM. At different time intervals (8, 12 and 24 hours), the levels of type I collagen and osteocalcin secreted were determined using Type I Procollagen C-Peptide and Gla-type Osteocalcin EIA kits, respectively. Induction effects were evaluated using analysis of variance and the Duncan's multiple rank test. Retinoic acid at concentrations of 10(-5), 10(-6), 10(-7) M was able to induce type I collagen and osteocalcin production in human dental pulp cells within 12 hours of exposure. Dose-dependent induction was observed only after 24 hours. A two-fold increase in osteocalcin level was detected after exposed to 10(-5) M retinoic acid within 24 hours. Our data suggest that retinoic acid at concentrations of 10(-5), 10(-6), 10(-7) M has the ability to induce type I collagen and osteocalcin secretions in human dental pulp cells in vitro.

Salivary mutans streptococci and lactobacilli after self arresting caries treatment.

Previous studies have shown that Self Arresting Caries Treatment (SACT) may be a useful technique to arrest active caries in Thai preschool children in remote areas. The objective of this study was to examine the effect of SACT on the levels of salivary mutans streptococci and lactobacilli in Thai children. Eighty-two subjects aged 4-6 years from primary school in a remote area of Thailand were recruited for this study. Each subject has at least two pairs of interproximal carious cavities between the first and second deciduous molars, and no history of severe pain. The subjects were divided into the control and SACT groups. The SACT technique was performed by removing food remnants and the surrounding overhang enamel of the carious cavity walls to enlarge the space between the carious cavities. The levels of mutans streptococci and lactobacilli in paraffin-stimulated whole saliva were determined at baseline, 2 and 4 months after treatment compared to those of the control group by the spatula method. The bacterial growth score was divided into three categories: 1 = 0-20 CFU, 2 = 21-100 CFU, and 3 > or = 100 CFU. At baseline, no differences in the mutans streptococci and lactobacilli scores were found between the SACT and control groups (p>0.05). Lower salivary lactobacilli levels were found in the SACT group on follow-up at 2 and 4 months (p<0.05), whereas the mutans streptococci level remained unchanged during these time periods. Our data confirms that the SACT technique can promote a self cleansing condition for interproximal lesions and can reduce the retentive sites in the oral cavity due to a reduction in salivary lactobacilli.

Evaluation of host ß-globin gene fragment lengths in peri-implant crevicular fluid during the wound healing process: a pilot study.

PURPOSE: To evaluate the host ß-globin gene fragment lengths in the cell-free peri-implant crevicular fluid (PICF) during the wound healing process. MATERIALS AND METHODS: Nineteen patients (25 implants) were recruited into this study. As part of the control group, gingival crevicular fluids (GCF) from healthy teeth were collected before implant placement. PICF specimens from each implant were collected during weeks 2 to 12 after implant placement. All GCF and PICF specimens were centrifuged to collect the supernatant as cell-free DNA. Five primer pairs specific to the ß-globin gene for amplifying 110-base pair (bp), 325-bp, 408-bp, 536-bp, and 2-kilo-base pair (kb) amplicons were used to evaluate DNA fragment lengths with conventional polymerase chain reaction (PCR). The longest PCR amplicon of each specimen was recorded. RESULTS: The number of 536-bp amplicons (10 of 25 implant specimens) and 2-kb amplicons (8 of 25 implant specimens) in week 2 was higher than at the other visits. In the study, the mucositis group showed the highest number of 536-bp amplicons (22 of 34 implant specimens) and 2-kb amplicons (12 of 34 implant specimens), whereas the healthy implant group showed a low number of 536-bp amplicons (3 of 66 implant specimens), and the cell-free PICF specimens had no 2-kb amplicons. Furthermore, 325-bp and 110-bp amplicons were similar in number in the control teeth and healthy implants. CONCLUSION: There was a difference in the number of the longest amplicons of cell-free PICF specimens between the mucositis and healthy implant groups. This pilot study suggests that the PCR amplicon lengths of ß-globin gene fragments in cell-free PICF specimens might be used as a biomarker to monitor soft tissue inflammation around implants.

Effect of fluoride on human dental pulp cells in vitro.

Human dental pulp cells were cultured in fluoride containing medium of various concentrations (0, 1, 2, 5, 10, 20, 25, 30, 40, 50, 60 and 80 ppm) in order to study the biological effect on the cells' proliferation and alkaline phosphatase (ALP) activities. It was found that fluoride at 5 ppm concentration significantly stimulated cell proliferation and ALP activity between 24 and 48 hours after exposure whereas at higher concentrations (40 - 80 ppm), fluoride significantly inhibited cell growth and ALP activity after 48 hours (Student's t test). The maximum effect was around 80 ppm. These observations suggest that fluoride, if used at a low concentration, may be a useful therapeutic agent for the treatment of pulpal disease by means of stimulating the proliferation and differentiation of dental pulp cells. At higher concentrations, it will have negative effects on this kind of cell.

The effect of xylitol chewing gum on mutans streptococci in saliva and dental plaque.

Dental caries are one of the most common infectious diseases occurred in Thai children. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. The aim of the present investigation was to evaluate the effect of xylitol chewing gum on mutans streptococci (MS) in saliva and dental plaque. Ninety-one children, aged 10-12 years, with more than 1 x 10(5) MS per milliliter of saliva were included in this study. They were divided into three groups balanced according to their MS counts at baseline: one control group (no supervised gum use), and two xylitol groups (supervised 55% and 100% xylitol gum use). Whole saliva and pooled plaque samples were obtained after 90 school days. When comparing the MS counts between the groups, those chewing 100% and 55% xylitol gum showed significant reductions (p < 0.025), but a dose response effect was not demonstrated. Chewing 100% xylitol gum caused significant reductions on salivary MS scores (p < 0.025) which was little different from the 55% xylitol group. The results suggest that the use of xylitol chewing gum can reduce the levels of MS in plaque and saliva.

In vitro effects of Salvia officinalis L. essential oil on Candida albicans.

OBJECTIVE: To determine the anticandidal activities of Salvia officinalis L. (S. officinalis) essential oil against Candida albicans (C. albicans) and the inhibitory effects on the adhesion of C. albicans to polymethyl methacrylate (PMMA) resin surface. METHODS: Disc diffusion method was first used to test the anticandidal activities of the S. officinalis L. essential oil against the reference strain (ATCC 90028) and 2 clinical strains of C. albicans. Then the minimal inhibitory concentration (MIC) and minimal lethal concentration (MLC) were determined by modified membrane method. The adhesion of C. albicans to PMMA resin surface was assessed after immersion with S. officinalis L. essential oil at various concentrations of 1×MIC, 0.5×MIC and 0.25×MIC at room temperature for 30 min. One-way ANOVA was used to compare the Candida cell adhesion with the pretreatment agents and Tukey's test was used for multiple comparisons. RESULTS: S. officinalis L. essential oil exhibited anticandidal activity against all strains of C. albicans with inhibition zone ranging from 40.5 mm to 19.5 mm. The MIC and MLC of the oil were determined as 2.780 g/L against all test strains. According to the effects on C. albicans adhesion to PMMA resin surface, it was found that immersion in the essential oil at concentrations of 1×MIC (2.780 g/L), 0.5×MIC (1.390 g/L) and 0.25×MIC (0.695 g/L) for 30 min significantly reduced the adhesion of all 3 test strains to PMMA resin surface in a dose dependent manner (P<0.05). CONCLUSIONS: S. officinalis L. essential oil exhibited anticandidal activities against C. albicans and had inhibitory effects on the adhesion of the cells to PMMA resin surface. With further testing and development, S. officinalis essential oil may be used as an antifungal denture cleanser to prevent candidal adhesion and thus reduce the risk of candida-associated denture stomatitis.

Effect of Phyllanthus emblica Linn. on candida adhesion to oral epithelium and denture acrylic.

OBJECTIVE: To investigate the effect of Phyllanthus emblica (P. emblica) Linn. ethanolic extract on the adhesion of Candida albicans (C. albicans) to human buccal epithelial cells (BECs) and denture acrylic surfaces. METHODS: Human BECs and transparent acrylic strips were pretreated with ethanolic extract solution of P. emblica fruits at concentration ranged from 18.7 to 300 mg/mL. After washing BECs and the strips were inoculated with three strains of C. albicans (ATCC 10281 and two clinical isolates) (10(7) cells/mL). Normal saline solution (NSS) and 0.2% chlorhexidine gluconate were used as negative and positive controls, respectively. BECs were harvested on 12 µm-polycarbonate filters (Millipore, USA). The membrane filters and the strips were stained with Gram stain. Adherent yeast cells on 100 randomly selected epithelial cells and 20 randomly selected fields on each strip were counted under microscope. The statistical significance was calculated by Kruskal-Wallis and Tukey tests at a significant level of P< 0.05. RESULTS: Significant lower numbers of all strains of yeasts adhering to BECs and acrylic strips were observed after exposure to 75-300 mg/mL of plant extract compared with NSS. CONCLUSIONS: The present study demonstrates that P. emblica ethanolic extract interferes with the adhesion of C. albicans to BECs and denture acrylic surfaces in vitro.