The effect of effervescent acanthus ilicifolius l. Extract on antifungal properties and flexural strength acrylic

Background: Acanthus ilicifolius L. has antifungal potential and makes it possible to be a candidate for denture cleanser . This study aims to evaluate the effect of effervescent Acanthus ilicifolius L. extract on antifungal properties and flexural strength acrylic after immersion for three duration times. Method: Extracts were made by maceration method with ethanol. For the antifungal test, effervescent Acanthus ilicifolius L extract was prepared by combining the Acanthus ilicifolius L extract 4% and sodium perborate with two ratios, 1:7 and 1:14. The microdilution method was carried out. Effervescent Acanthus ilicifolius L extract 4% with ratio 1:7 was prepared for the flexural strength test. The fifty-four heat-cured acrylic resin (20x10x2.5mm) were fabricated and divided into 3 groups. Group 1 was immersed in aquadest (control); Group 2 was immersed in sodium perborate; Group 3 was immersed in effervescent Acanthous ilicifolius L. extract. Each group was immersed for 15 min, 8, and 56 hours (n=6). The flexural strength test was performed using Universal Testing Machine. Result: Effervescent Acanthus ilicifolius L. extract exhibited antifungal activity which increased in an effervescent Acanthus ilicifolius L extract-dependent manner significantly (0.57 to 0.50 OD). There were no significant differences between sodium perborate, effervescent_AI1 (1:7) and effervescent_AI2 (1:14). The flexural strength was found to be within the range of 66.1 - 68.3 MPa. There were no significant differences between groups (p < 0.05). Conclusion: Effervescent Acanthus ilicifolius L extract with the ratios 1:7 had a good antifungal effect and appropriate flexural strength after immersion for 15 min, 8, and 56 hours .


INTRODUCTION
Denture care is one of the primary patient treatments that suffering from tooth loss. Most denture users are classified to (>65)-year-old ages above. Physiologically, the elderly patient's motor skills usually decrease, so that patient's ability to clean their dentures could be a troublesome activity for them. In addition, their denture could not also be optimally hygienic. It easily gets dirtier either, as the upper denture becomes rougher than caused by plaque. Candida albicans are also prone to sticking. Therefore, it is not too good aesthetically.
Furthermore, it could also create severe halitosis 1 .
Denture base cleaning can be done mechanically with a toothbrush or cleaned chemically by immersion to reduce Candida albicans colonization and prevent denture stomatitis 2,3 .
The effervescent tablet is the most appropriate option as a denture cleanser. The effervescent tablet is very appropriate for elder patients as their denture cleanser without using any motor skills, such as; brushing teeth. However, sodium perborate is also contained inside the Effervescent tablet which could give additional benefits. Those are the reaction ability to produce alkaline peroxide by water and the oxygen bubble production in order to cleanse biofilm and spots at dentures 4 . The effervescent tablet is also able to reach narrow areas that could not be gotten easily by toothbrushing, quickly dissolved in water, cleanse stains and calculus, not scratches the dentures, and anti-bacterial, anti-fungus 5 .
Candida albicans is a denture stomatitis fungus caused by 11%-67% prevalence. It is primarily found in complete dentures 6  Denture cleanser is a material that must meet non-toxic prerequisites, non-irritated material leftover, easily cleaned, stable storage, effective to dissolve organic and inorganic material at denture, and own fungicidal and bactericidal characteristics, and no physical and mechanical change to basic denture 10 . Dental acrylic resin heat cured is one of the primary materials that are frequently used as denture base material, despite its poor prone ability to absorb water and porosity causing an effect on denture physical and base material 11 . Some studies reported that the immersion time of the acrylic denture, the contact period between the acrylic denture and the denture cleanser may play an important role in the change in the physical and mechanical denture 12,13 . Porosity in dentures can be an ideal place for food and microorganisms in the mouth cavity including candida albicans 14 .It has been reported that a denture base material must have a good-mechanical characteristic such as adequate flexural strength.
Based on these, further research about 4% effervescent extract Acanthus ilicifolius as a denture cleanser candidate for antifungal activity testing and heat cured acrylic flexural strength is needed.

Materials and methodsEffervescent Acanthus ilicifolius extract preparation
The Acanthus ilicifolius L extract was made using the maceration technique with 96% ethanol.

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The effect of effervescent acanthus ilicifolius l. Extract on antifungal properties and flexural strength acrylic

Antifungal activity
The evaluation of antifungal activity confirmed that the effervescent Acanthus ilicifolius extract 4% showed statistically significant antifungal efficacy to reduce the growth of candida albicans.
There was no significant difference between 1:7 (wt%) and 1:14 (wt%), but this growth inhibitory Then, the ANOVA one-way differential test was done by post hoc LSD. There was significant difference between aquadest and all of the groups.

DISCUSSION
We developed the denture cleanser using biological source materials, but since it has been recommended that the application of effervescent provides many advantages for elderly people.
Those are cleanser to dentures without any motor skills ability or assistance, reach narrow areas that This study showed a lower density optical score (OD) from aquadest group compared to the sodium group, effervescent AI1 dan AI2. This also represented its lower turbidity level compared to another group. The turbidity also showed the total amount of bacteria growth to certain media. It is caused by pure and uncolored aquadest.
Therefore, it has smaller scores than other groups.
The aquadest is used as a negative control to extract inhibition towards Candida albicans growth, regardless of its inhibition areas 20 .  (Fig.2). Flexural strength is the load that occurs on the denture in the mouth during the masticatory process. The longevity of partial dentures depends on the flexural strength of acrylic resin after immersion in denture cleanser 25

ACKNOWLEDGMENT
Thanks to Hang Tuah University which has assisted in funding through internal research grants.

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The effect of effervescent acanthus ilicifolius l. Extract on antifungal properties and flexural strength acrylic