Evaluation and Comparison of Ketoconazole and Alkaline Glutaraldehyde Effects on Candida albicans Adherence to Three Denture Base Materials: An In Vitro Study

This study aimed to evaluate and compare the effects of two antimicrobial agents, ketoconazole and alkaline glutaraldehyde, on Candida albicans (C. albicans) adherence to three denture base materials: conventional heat-cured polymethyl methacrylate (PMMA), flexible denture base material, and injectable denture base material. The objectives of this study were to assess the efficacy of ketoconazole in reducing C. albicans adherence, evaluate the effectiveness of alkaline glutaraldehyde in preventing microbial attachment, and compare the performance of both agents across the tested materials to identify optimal strategies for controlling fungal infections. This in vitro study was conducted at the Sibar Institute of Dental Sciences, Guntur, India, between June 2023 and June 2024. Sixty uniform wax patterns (20 × 2 mm) were fabricated and divided into three groups (n = 20 each): Group 1 (conventional heat-cured PMMA, Dental Products of India (DPI®), Mumbai, India), Group 2 (flexible denture base material, Proflex®, Prevest DenPro, Jammu, India), and Group 3 (injectable denture base material, SR Ivocap® High Impact, Ivoclar Vivadent, Schaan, Liechtenstein). Each group was subdivided into subgroups A (ketoconazole, Nizral® 2%, Johnson & Johnson, New Brunswick, NJ, USA) and B (alkaline glutaraldehyde, Hospal®-G Plus, Septodont, Saint-Maur-des-Fossés, France). The samples were inoculated with C. albicans (ATCC 14053), treated with disinfectants for 10 minutes, and incubated on Sabouraud dextrose agar at 37°C for 24 and 48 hours. Colony-forming units (CFU/mL) were counted, and data were analyzed using independent t-tests, one-way analysis of variance (ANOVA), and repeated-measures ANOVA (p < 0.05). Pretreatment results indicated no significant intergroup differences (p > 0.05) in CFU/mL. At 24 hours, alkaline glutaraldehyde significantly reduced C. albicans counts compared with ketoconazole (p = 0.001), particularly in the injectable group. By 48 hours, both agents achieved significant reductions (p = 0.001), with alkaline glutaraldehyde maintaining superior efficacy, especially for injectable materials. Both ketoconazole and alkaline glutaraldehyde effectively reduced C. albicans adherence, but alkaline glutaraldehyde demonstrated a faster and more potent antimicrobial action, particularly on injectable denture materials, making it suitable for rapid disinfection. Ketoconazole showed gradual and sustained efficacy, which is ideal for long-term fungal control.