Development and Evaluation of Clove and Cinnamon Supercritical Fluid Extracts-Loaded Emulgel for Antifungal Activity in Denture Stomatitis

Abstract

Denture stomatitis (DS), usually caused by Candida infection, is one of the common denture-related complications in patients wearing dentures. Clove and cinnamon oils have been acknowledged for their anti-inflammatory, antimicrobial activity, and antifungal effects in the oral cavity. The aim of this study, therefore, was to prepare clove/cinnamon oils-loaded emulgel and to assess its efficacy in treating Candida albicans-associated denture stomatitis. Central composite design was adopted to formulate and optimize clove/cinnamon extracts-loaded emulgel. The formulated preparations were assessed for their physical appearance, particle size, viscosity, spreadability, and in-vitro drug release. In addition, in-vivo therapeutic experiments were conducted on 42 patients with denture stomatitis. The prepared emulgel formulations showed good physical characteristics with efficient drug release within 3 h. In addition, in-vivo antifungal studies revealed that the optimized formula significantly (p < 0.001) reduced Candida colony counts from the denture surface, compared to commercially available gel (240.38 ± 27.20 vs. 398.19 ± 66.73 CFU/mL, respectively). Furthermore, the optimized formula and succeeded in alleviating denture stomatitis-related inflammation with a better clinical cure rate compared to commercially available gel Collectively, herbal extracts-loaded emulgel might be considered an evolution of polyherbal formulations and might represent a promising alternative to the existing allopathic drugs for the treatment of denture stomatitis, with better taste acceptability and no side effects.

Gellan-Based Hydrogel as a Drug Delivery System for Caffeic Acid Phenethyl Ester in the Treatment of Oral Candida albicans Infections

“…Since denture stomatitis has high prevalence and recurrence [ 4 , 83 ], many other studies have evaluated drug delivery systems for prevention and treatment of this oral disease [ 79 , 84 , 85 ]. For this, Sultan et al [ 79 ] developed an animal model of denture stomatitis using 3D digital imaging and printing technology to fabricate intraoral devices.…”

Management of Chronic Atrophic Candidiasis (Denture Stomatitis)—A Narrative Review

“…Phytomedicine, which has existed since the dawn of human civilization, can be defined as herbal or natural products with therapeutic and medicinal values [ 74 ]. Natural products are said to be effective in treating DS because they have improved the clinical and microbiological aspects of the condition [ 45 ].…”

“…Previous studies have suggested that the incorporation of natural products into the acrylic resin denture base material might be effective in preventing Candida albicans adhesion. Compared to traditional antifungals, these products have a better taste, comparable efficacy, fewer side effects, and higher patient satisfaction [ 45 , 65 , 74 ]…”

Exploring the Potential of Extracts from Sloanea medusula and S. calva: Formulating Two Skincare Gels with Antioxidant, Sun Protective Factor, and Anti-Candida albicans Activities

“…Their use implies lower toxicity compared to oral or intravenous antifungals, excellent chemical stability, and enhanced penetration in infected areas, making them effective delivery agents for multiple compounds [ 55 ]. The benefits of plant-extract-based gels have been observed in emulgels loaded with clove/cinnamon oils, which are an alternative for treating C. albicans -associated denture stomatitis [ 56 ], and in hydrogels integrating lemongrass-loaded nanosponges showing an enhanced antifungal effect with reduced irritation [ 57 ].…”