Managing oral candidiasis often poses a challenge for clinicians due to the rapid clearance of topical agents from the oral cavity. A recent study has characterized a novel mucoadhesive antifungal gel containing nystatin (NYS) or chlorhexidine (CHX) complexed with β-cyclodextrin (βCD). By using chitosan and hydroxyethylcellulose, researchers developed formulations that provide sustained drug release and improved tissue contact. This innovation addresses the common limitations of conventional topical treatments in dentistry.

Efficacy of Mucoadhesive Antifungal Gel in Oral Care

The study demonstrated that the mucoadhesive antifungal gel with βCD complexes significantly outperformed standard formulations. Specifically, the NYS:βCD and CHX:βCD groups showed superior mucoadhesiveness. Consequently, these gels maintained higher drug concentrations at the site of infection for longer durations. Furthermore, the microbiological analysis revealed that the complexed nystatin gel achieved a much lower minimum inhibitory concentration (MIC) against Candida albicans compared to pure nystatin. Therefore, this system provides potent antifungal action with reduced drug concentrations.

Beyond its antimicrobial properties, the gel also promotes tissue healing. Laboratory tests using an organotypic oral mucosa model showed high cytocompatibility. Moreover, the leachate from the NYS:βCD gel successfully stimulated collagen synthesis. This regenerative potential suggests that the gel does not just eliminate the infection but also aids in repairing the mucosal barrier. In contrast to traditional gels, these formulations exhibit predominantly elastic behavior, ensuring they remain stable under the dynamic conditions of the oral cavity.

Clinical Implications for Dentists

Clinicians in India frequently encounter denture stomatitis and other fungal infections. The use of inclusion complexes like β-cyclodextrin overcomes nystatin's low water solubility and bitter taste. Additionally, the sustained release mechanism likely improves patient compliance by reducing the frequency of application. Overall, this mucoadhesive antifungal gel represents a promising therapeutic alternative for managing resilient oral fungal infections while simultaneously supporting mucosal regeneration.

Frequently Asked Questions

How does β-cyclodextrin improve the antifungal gel?

β-cyclodextrin forms inclusion complexes that enhance the solubility and stability of drugs like nystatin. This allows for a more efficient drug delivery system with sustained release and better patient tolerance.

Can this gel help with tissue healing?

Yes, the study found that the mucoadhesive gel stimulates collagen synthesis in oral mucosa models. This suggests it may help regenerate damaged tissues while treating the underlying fungal infection.

Is the gel safe for long-term oral use?

The research indicated high cytocompatibility in oral mucosa models. However, clinicians should always monitor patients for any local irritation or adverse reactions during prolonged treatment.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or a professional relationship. Refer to the latest local and national guidelines for clinical practice.

References

Sugio CYC et al. Characterization, antifungal potential, cytocompatibility, and regenerative potential of mucoadhesive gel containing antifungal-β-cyclodextrin inclusion complexes. J Prosthodont. 2026 Apr 11. doi: 10.1111/jopr.70135. PMID: 41964385.

Urban AM et al. Characterization, antifungal evaluation against Candida spp. strains, and application of nystatin: β-cyclodextrin inclusion complexes. Curr Drug Deliv. 2022 Oct 17. doi: 10.2174/1567201820666221017103119. PMID: 36263476.

Soujanya KP et al. Formulation and Evaluation of Mucoadhesive Oral Gel for Treatment of Oral Candidiasis. Int J Pharm Res App. 2026 Feb; 11(1): 418-423. doi: 10.35629/4494-1101418423.