Combined Effect of Zinc Oxide and Titanium Dioxide Nanoparticles on Color Stability and Antifungal Activity of Maxillofacial Silicone Elastomers: An In Vitro Study

Objective: Maxillofacial silicone elastomers represent a standard material in maxillofacial prosthetic applications due to their excellent biocompatibility and aesthetic properties. However, their long-term performance is limited by color degradation and susceptibility to fungal colonization. Incorporating nanoparticles into silicone matrices has emerged as a potential solution to enhance durability and hygiene. This study aimed to evaluate the effect of zinc oxide (ZnO) and titanium dioxide (TiO2) nanoparticles used individually and in combination to evaluate the color stability and antifungal activity of pigmented maxillofacial silicone elastomers. Material and Methods: Fifty specimens were fabricated for each test and divided into five groups: Group (A) control (pigmented silicone only, no nanoparticles), Group (B) ZnO (1.5 wt%), Group (C) TiO2 (2.5 wt%), and two combinations: Group(D1) (0.75 wt% ZnO + 1.25 wt% TiO2) and Group (D2)(0.5 wt% ZnO + 0.83 wt% TiO2) ratios. Color stability was assessed before and after 500 h of artificial aging using CIELAB-ΔE values and visual scoring. Antifungal activity was evaluated against Candida albicans using the disk diffusion method. Attenuated Total Reflectance with Fourier Transform Infrared Spectroscopy (ATR-FTIR), Scanning electron microscopy (SEM) along side with Energy-dispersive X-ray spectroscopy (EDS) were applied for Specimen characterization. Data were analyzed with one-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: The dual-nanoparticle group with 0.75% ZnO and 1.25% TiO2 demonstrated the best color stability (ΔE = 0.86 ± 0.50) and strongest antifungal activity (inhibition zone: 7.8 ± 3.8 mm) compared to the control (ΔE = 2.31 ± 0.62; no inhibition). Single-nanoparticle groups showed moderate improvements. A significant Association (r = 0.89, p < 0.01) was found between nanoparticle dispersion and material performance. Conclusions: Incorporating ZnO and TiO2 nanoparticles into maxillofacial silicone elastomers significantly enhances color stability and antifungal efficacy. The combined formulation showed a synergistic effect, offering promising potential for improving the longevity and hygiene of maxillofacial prostheses.