The irreplaceable role of teeth in daily functions like chewing and speech is well-known, but tooth decay and loss can become a reality as time takes its toll.
The loss of teeth can be due to damage to the hard tissues of the teeth, which is no longer possible to restore, severe damage to supporting tissues, systemic diseases, or trauma. To address this, many turn to dentures for restoration.
According to the 2018 Indonesia health survey, denture use is highest among those over 65, closely followed by the 35-44 age group. As denture usage continues to rise, there’s a growing need for enhanced denture care advancements.
Dr. Titik Ismiyati, a distinguished lecturer at the UGM Faculty of Dentistry, highlighted the importance of leveraging biodiversity, particularly chitosan, as a potential avenue for medical innovation during her inauguration as a professor of prosthodontics on Thursday (Jan. 4) at the UGM Senate Hall.
In her inaugural address titled “Chitosan as a Natural Material Rich in Uses in the Medical Field (A Study in the Field of Prosthodontics),” Professor Ismiyati elucidated that denture development aims to restore the oral cavity’s structure, disrupted by tooth loss.
It seeks to enhance chewing function, taste, aesthetics, and tissue health, prevent further oral structure damage due to tooth loss, and preserve the chewing system’s health and function.
“Patients who lose one or more teeth can receive partial removable dentures. If all teeth are lost, they will be replaced with complete dentures,” she stated.
An ideal denture base must meet specific criteria—it should not be irritating, possess adequate mechanical properties, be robust, elastic, impervious to oral fluids, insoluble, non-absorbent, and non-toxic.
“The selection of acrylic resin as a preferred material for denture bases requires in-depth study to meet the ideal requirements,” she expounded.
Chitosan, derived from chitin waste found in shrimp shells, crabs, and oysters, emerges as a natural polysaccharide with promising potential for denture construction.
Shrimp shell waste, comprising protein (25% – 44%), calcium carbonate (45%-50%), and chitin (15%-20%), can be a valuable resource. The chitin content in shrimp shell waste ranges from 20% to 50% by weight.
Professor Ismiyati shared that research on chitosan for denture base creation has been undertaken using flexible denture base material known as nylon thermoplastic. Widely employed in removable denture bases, nylon thermoplastic represents a material of choice, emerging as an alternative to traditional rigid dentures.
“Nylon thermoplastic offers superior flexibility to thermoplastic resin, providing heightened comfort. Furthermore, its design eliminates the need for metal clasps,” she said.
Dentures fashioned from chitosan boast heightened aesthetic appeal, with no visible wires adorning the teeth. However, the Achilles’ heel of nylon thermoplastic lies in its susceptibility to abrasion, a lack of scratch resistance, hygroscopicity, and porosity, rendering it susceptible to color changes through the absorption of stains and saliva-borne molecules.
“This vulnerability can trigger the formation of microbial colonies like Candida albicans on nylon thermoplastic dentures,” she added.
Denture cleaning becomes a crucial practice in inhibiting the growth of Candida albicans. Two commonly employed methods include mechanical and chemical means.
The mechanical approach entails brushing dentures with toothpaste, while the chemical method involves soaking dentures in alkaline peroxide cleaning solution, alkaline hypochlorite, acid, disinfectant, enzyme, and Chlorhexidine 2%.
However, both methods carry drawbacks, including alterations in color, scratches, and thinning of acrylic resin materials. Beyond routine cleaning, chitosan emerges as a potential solution for inhibiting the growth of Candida albicans.
Incorporating chitosan involves mixing high molecular weight nano-chitosan with nylon thermoplastic, showcasing its potential to impede the growth of Candida albicans.
The pursuit of denture advancements remains an ongoing endeavor for dental researchers. The landscape of materials and tools for denture creation remains dynamic, albeit with considerable costs.
Despite the urgency for expeditious and precise research innovation within the confines of conventional materials, the quest to uncover biocompatible, antifungal, and antibacterial materials with mechanical and physical robustness at an affordable cost persists.
“To date, these experiments continue to unfold within the Prosthodontics field at the UGM Faculty of Dentistry,” Professor Ismiyati concluded.
Author: Gusti Grehenson
Photographer: Donnie