항진균제를 첨가한 수종의 점막 조정제가 candida albicans 성장 억제에 미치는 효과

Abstract

[한글]

의치 장착 후 나타날 수 있는 의치 구내염의 치료를 위하여 점막 조정제가 사용되고있으며 보다 치료 효과를 높이기 위하여 원인균으로 알려져 있는 Candida albicans(C. albicans)에 대한 증식 억제 목적으로 항진균제의 첨가가 시도되고 있다. 그러나 이러한 점막

조정제와 여기에 첨가되는 항진균제의 효과에 대한 광범위한 비교가 미흡한 실정이다.

본 연구에서는 현재 유통되고 있는 다수의 점막 조정제가 C. albicans 성장 억제에 미치는 효과를 상호 비교하고, 재료에 수종의 항진균제를 혼합하여 약제 첨가에 따른 영향을 평가하였으며 시간 경과에 따른 항균 효과의 변화를 관찰하였다. 점막 조정제로 Coe-comfort, Dura conditioner, Tempo, Visco-gel과, 임시 탄성 이장재로 Coe-soft를, 항균제로 amphotericin B, nystatin, chlorhexidine을 사용하였고, 한천 평판 배지 확산법을 이용하여 C. albicans에 대한 중식 억제대의 직경을 측정하였으며, 각 측정 24시간 전에 시편을 새로운 배지로 옮겨 배양하여 다음과 같은 결과를 얻었다.

1. Tempo는 1 일에서 억제대의 크기가 2.35 mm로서 가장 컸고 2 일, 4 일, 7 일에서도 가장 큰 항균 효과가 있었으며 (p < 0.05), Coe-comfort, Dura conditioner, Visco-gel, Coe-soft는 1 일에서 미미한 억제대를 형성하였고 2 일부터 억제대가 형성되지 않았다.

2. Nystatin을 첨가한 경우 1 일에서 9.60-12.04 mm의 억제대를 형성하여 가장 강한 억제효과를 보여주었다. 다음 amphotericin B, chlorhexidine 첨가군과 약제를 함유하지않은 순수 점막 조정제군의 순서대로 억제 효과가 적어졌으며 (p < 0.05) 모든 실험군에서

시간이 지나면서 억제대가 뚜렷하게 감소하였다.

3. Amphetericin B, nystatin, chlorhekidine을 첨가한 경우 Tempo는 1 일 에서 각각3.65, 12.04, 4.78 mm의 억제대를 형성하여 우수한 항균 효과를 보였으나, Dura conditioner는 2 일에서 각각 2.86, 5.33, 1.29 mm의 가장 큰 억제대를 형셩하였으며 4일, 7 일에서

는 Coe-comfort, Tempo, Coe-soft에 비하여 유의차 있는 (p < 0.05) 큰 효과를 지속적으로 나타냈다.

이상의 결과를 종합하여 Tempo를 제외한 대부분의 점막 조정제는 항진균 효과가 거의 없는 것으로 보이며, 억제대의 형성은 약제 amphotericin B, nystation,Chlorhexidine의 첨가에 의하여 좌우되었고 특히 nystatin 첨가가 가장 효과적이었다. 이런 점을 고려하여 의치 구내염 치료를 위한 점막 조정제 선택시 C, albicans에 대한 억제력 있는 재료의 선택과 아울러 효과적인 항진균제의 첨가가 도움이 될 것이라고 사료되는 바이다.

THE INHIBITING EFFECT OF TISSUE CONDITIONERS COMBINED WITH ANTIFUNGAL AGENTS ON THE

GROWTH OF CANDIDA ALBICANS

Dae- Soon Chang, D.D.S

Department of Dental Science, The Graduate School Yonsei University

(Directed by Assistant Prof. Keun-Woo Lee, D.D.S, M.S.D, Ph.D)

Tissue conditioners have been used for treatment of denture stomatitis caused by

wearing of dentures. Early studies pointed out Candida albicans (C. albicans) as

main etiologic factor, and antifugal agents were added for control of the species.

But there is a little information about broad comparison on the effect of tissue

conditioners and antifungal agents added. The purpose of the present study was to

compare the inhibiting effect of four tissue conditioners and one temporary soft

liner on tole growth of C. albicans for treatment of denture stomatitis using gel

diffusion method by measuring diameter of the zone of growth inhibition. Three

antifungal agents were added to each material for evaluation of the effect of added

agents. Finally, observation was made to evaluate the effect of the loss of

antifungal elements by aging of the specimen. The results of this study were

obtained as follows :

1. Tempo had remarkable antifungal effect showing the zone of growth inhibition

as2.35 mm at 1st day, and was most effective on 2nd, 4th and 7th day from

incubation(P < 0.05). But Coe-comfort, Dura conditioner, Visco-gel, Coe-soft had

little antifungal effect from the 1st day of incubation.

2. Nystatin was most effective showing 9.60-12.04 mm of zone of inhibition at

the1st day from incubation. The antifungal properties were reduced to amphotericin

B, chlorhexidine and materials without agent (p < 0.05), and the effect was

diminished by time.

3. As pretreatment with amphotericin B, nystatin, chlorhexidine, Tempo was very

effective at the 1st day from incubation showing zone of inhibition as 3.65, 12.04,

4.78mm with addition of each agent. Dura conditioner had strongest antifungal

effectat the next day as 2.86, 5.33, 1.29 mm of zone of inhibition, and yielding

results of Coe-comfort, Tempo, Coe-soft was shown at 4th and 7th day from

incubation(p < 0.05),

Taken all together, tissue conditioners have little antifungal effect except

Tempo. Formation of the zone of growth inhibition was due to agents amphotericin B,

nystatin, chlorhexidine and nystatin was most effective. Conclusively, it is

advisable to select material which is effective on the growth of C. albicans and

consider addition of antifungal agents for treatment of denture stomatitis.

[영문]

Tissue conditioners have been used for treatment of denture stomatitis caused by wearing of dentures. Early studies pointed out Candida albicans (C. albicans) as main etiologic factor, and antifugal agents were added for control of the species.

But there is a little information about broad comparison on the effect of tissue conditioners and antifungal agents added. The purpose of the present study was to compare the inhibiting effect of four tissue conditioners and one temporary soft liner on tole growth of C. albicans for treatment of denture stomatitis using gel diffusion method by measuring diameter of the zone of growth inhibition. Three antifungal agents were added to each material for evaluation of the effect of added agents. Finally, observation was made to evaluate the effect of the loss of

antifungal elements by aging of the specimen. The results of this study were obtained as follows :

1. Tempo had remarkable antifungal effect showing the zone of growth inhibition as2.35 mm at 1st day, and was most effective on 2nd, 4th and 7th day from incubation(P < 0.05). But Coe-comfort, Dura conditioner, Visco-gel, Coe-soft had little antifungal effect from the 1st day of incubation.

2. Nystatin was most effective showing 9.60-12.04 mm of zone of inhibition at the1st day from incubation. The antifungal properties were reduced to amphotericin B, chlorhexidine and materials without agent (p < 0.05), and the effect was

diminished by time.

3. As pretreatment with amphotericin B, nystatin, chlorhexidine, Tempo was very effective at the 1st day from incubation showing zone of inhibition as 3.65, 12.04, 4.78mm with addition of each agent. Dura conditioner had strongest antifungal

effectat the next day as 2.86, 5.33, 1.29 mm of zone of inhibition, and yielding results of Coe-comfort, Tempo, Coe-soft was shown at 4th and 7th day from incubation(p < 0.05),

Taken all together, tissue conditioners have little antifungal effect except Tempo. Formation of the zone of growth inhibition was due to agents amphotericin B, nystatin, chlorhexidine and nystatin was most effective. Conclusively, it is advisable to select material which is effective on the growth of C. albicans and consider addition of antifungal agents for treatment of denture stomatitis.