Clinical evaluation of three denture cushion adhesives by complete denture wearers

doi: 10.1111/j.1741‐2358.2010.436.x Clinical evaluation of three denture cushion adhesives by complete denture wearers Objective: The aim of this study was the clinical evaluation of three denture cushion adhesives and whether the results were correlated to Kapur Index for denture‐supporting tissues. Background: Various types of denture adhesives are used among denture patients. However, information on the clinical behaviour of denture cushions is limited. Materials and methods: Thirty edentulous patients had their denture‐supporting tissues scored by Kapur Index and their old dentures replaced. They received three brands of denture cushion adhesives (Fittydent^®, Protefix^® and Seabond^®) and were instructed to use them in a sequence according to the group they were randomly assigned to. Each brand of adhesive was used for 48 h on the lower denture according to the manufacturer’s suggestions. After each brand was used, participants spent 24 h without applying any sort of adhesive. Finally, a questionnaire evaluating and comparing the performance of each brand was filled out. Results: Denture adhesives generally improved patient satisfaction and masticatory ability, especially in participants with poor Kapur Index and those who reported a poor retention of their old dentures. Conclusion: Fittydent^® was the most preferred adhesive, showing the best retention and the longest duration of its effect, but also reported as difficult to remove from the denture‐bearing area.     

Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands

doi: 10.1111/j.1741‐2358.2011.00566.x
Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands Objective: To explore whether there are differences in usage of and attitudes towards denture adhesives among patients in two countries. Background: There are no multi‐country surveys concerning usage of and attitudes towards denture adhesives from complete denture wearers. Materials and methods: The survey took place in Greece and the Netherlands with a sample of 284 and 165 consecutive complete denture wearers, respectively, by using a 9‐item prepared questionnaire. Statistical analysis relied on chi‐square test at α = 0.05. Results: In this survey, 26 and 20% of Greek and Dutch patients, respectively, had tried denture adhesive, but only 27% of them in Greece as well as in the Netherlands currently used it; 49% of the Greek and 45% of the Dutch participants rated the overall performance of adhesives as good. Between the two populations, no differences were identified in a majority of the research variables, except where 27% of Greeks answered that they did not know the existence of denture adhesives compared to none of the Dutch patients and when 90% of the Dutch contrary to 70% of Greeks reported that they did not need denture adhesives as they could manage their dentures well. Conclusion: The usage of and attitudes towards denture adhesives between the Greek and Dutch sample were similar with only two exceptions concerning the knowledge of existence and the need of using denture adhesives.     

Management of a post-radiotherapy xerostomic patient--a case report

doi: 10.1111/j.1741‐2358.2011.00519.x Management of a post‐radiotherapy xerostomic patient – a case report Objective: The objective of the study was to fabricate complete denture with palatal reservoir filled with artificial saliva for a post radiotherapy edentulous patient. Background: Xerostomia is a subjective complaint rather than a disease. It is caused by irradiation, medication, Sjogren's syndrome & neurological factors such as stress. Radiotherapeutic treatment of head and neck cancer patients often causes long term dysfunction involving their salivary function, swallowing capabilities & taste. All three of these domains are affected by radiation‐ induced damage to the salivary glands. This in turn results in poor retention of complete denture, frequent trauma to alveolar ridge & other oral infections. All these events drastically affects quality of life of ageing patients. Material and Method: A complete denture in heat cure acrylic resin was fabricated in which a palatal reservoir was made on the palatal side. Results: Problems arising due to xerostomia were reduced to a great extent. Conclusion: Prosthodontic management of Xerostomic patient include several techniques. This paper presents a case report of post radiotherapy edentulous patient in which complete denture with palatal reservoir filled with artificial saliva was fabricated.     

In vivo assessment of the effect of an adhesive for complete dentures on colonisation of Candida species

doi: 10.1111/j.1741‐2358.2009.00345.x
In vivo assessment of the effect of an adhesive for complete dentures on colonisation of Candida species Objective: Denture adhesives have long been recognised by denture wearers as a useful adjunct to denture retention and stability. The objective of the present study was to evaluate, in vivo, the effect of a denture adhesive on oral quantities of Candida species by determination of absolute counts of colony‐forming units (CFU) per ml of saliva of individuals who use this denture adhesive for a period of 14 days. Materials and methods: Twenty‐four individuals were randomised in two equal groups of 12 (test and control), with the individuals of the test group using the adhesive for 14 days. Samples of saliva were collected from all individuals on days 0 (initial), 7 and 14. Aliquots of saliva were diluted and plated in duplicate on Sabouraud dextrose agar with chloramphenicol and incubated for 37°C for 48 h, the CFU/ml were counted in the individuals of each group and the data of each group were compared at the different time periods and analysed statistically by the non‐parametric Mann‐Whitney U‐test (α ≤ 5%). Results: There were no statistically significant differences between the test and control groups during the test periods. Conclusion: Within of the limitations of this study, the data suggested that the denture adhesive tested did not significantly alter the oral microbiota during the 14‐day trial period.     

Effects of denture maintenance on satisfaction levels of Taiwanese elderly using removable partial dentures: a pilot study

doi: 10.1111/j.1741‐2358.2011.00500.x
Effects of denture maintenance on satisfaction levels of Taiwanese elderly using removable partial dentures: a pilot study Objective: The aim of this study was to evaluate the correlation between patient satisfaction with removable partial dentures and denture maintenance by patients, including regular application of denture adhesives and cleansers. Background: The success of removable partial dentures depends on patient satisfaction with dentures and their regular denture maintenance. Materials and methods: Demographic information, the Oral Impacts on Daily Performance (OIDP) indicator and details of denture maintenance (including the use of denture cleansers and adhesives) were collected from 193 (41.5% men and 58.5% women) participants by using questionnaires. A dentist performed oral examinations to evaluate denture function according to the OIDP items photographically and recorded the number of remaining teeth and Kennedy’s classification. Results: Most participants were satisfied with their removable partial dentures and tended to have higher satisfaction levels than the dentist’s estimation. Further, those using denture adhesives and cleansers had higher satisfaction levels than those not using such denture maintenance. Conclusions: Appropriate education regarding denture use is important because regular denture maintenance by patients affects their degree of satisfaction with dentures, as well as the dentist’s skill and the patient’s oral condition. Dentists could use this information to predict the potential success of dentures.     

Irritation and cytotoxic potential of denture adhesives

Objective: The present study aimed to examine the in vitro biocompatibility of denture adhesives. Background: Denture adhesives absorb water to become viscous and sticky, and by this process, other constituents like colouring, flavouring, wetting and preserving agents may be released. Some of these constituents may induce adverse reactions among users of denture adhesives. Materials and methods: Five commercially available denture adhesives; three different creams, a powder, and a cushion were included in the study. The irritation and cytotoxic potential was evaluated using the Hen's Egg Test Chorioallantoic Membrane (HET‐CAM) method and three cell culture methods; filter diffusion, dimethylthiazol diphenyltetrazolium bromide (MTT) assay and agar diffusion. Results: None of the tested denture adhesives showed a noteworthy acute irritation as evaluated by the HET‐CAM method. None of the tested denture adhesives induced cytotoxicity in the filter diffusion test. One of the denture adhesives induced a severe cytotoxic reaction in both the MTT and agar diffusion assays. These tests employ longer exposure times than in both the filter diffusion and the HET‐CAM test. Conclusion: Denture adhesives are commonly used throughout the day, and our results raise the concern that denture adhesives may contribute to mucosal inflammation in denture wearers.     

The effect of denture adhesives on Candida albicans growth in vitro

doi: 10.1111/j.1741‐2358.2011.00478.x
The effect of denture adhesives on Candida albicans growth in vitro Objective: Denture‐wearing favours the growth of Candida. In view of the fact that many denture wearers regularly use adhesives to enhance denture retention, stability and function, the aim of this work was to study the effect of denture adhesives on Candida albicans growth in vitro. Materials and methods: The denture adhesives tested were Corega^® cream, Kukident^® cream, Novafix^® cream, Polident^® cream, Protefix^® cream, Steradent^® cream, Aderyn^® powder, Corega^® ultra powder, Protefix^® powder and Corega^® strip. C. albicans growth curves were obtained in the presence or absence of a 1% solution of the denture adhesive diluted in Sabouraud broth. Macro‐ and microscopic morphological changes in C. albicans were analysed, as was microbial contamination of the denture adhesive. Results: Most of the denture adhesives studied induced morphological changes in C. albicans cells and colonies, but only two had any significant inhibitory effect on yeast growth. Kukident^® cream markedly inhibited C. albicans growth in a concentration‐dependent way, reducing the growth rate by 95%, whereas Corega^® cream also inhibited C. albicans growth but in a non‐concentration‐dependent way, reducing the growth rate by 37%. In addition, denture adhesives available as powders had detectable microbial contamination. Conclusion: Some commercially available denture adhesives showed microbial contamination and some had significant inhibitory effect on C. albicans growth.     

Treatment protocol for denture stomatitis,prior to anatomical molding

doi: 10.1111/j.1741‐2358.2012.00661.x Treatment protocol for denture stomatitis, prior to anatomical molding Background: Microorganisms of the genus Candida have been recovered from complete dentures made of acrylic resin, with high numbers of colony forming units and species diversity, which can act as infectious agents causing chronic atrophic candidiasis (denture stomatitis). Objective: The objective of this paper is present a treatment protocol for chronic atrophic candidiasis (denture stomatitis). Materials and Methods: The work describes three cases of totally edentulous patients presenting palate stomatitis who were submitted for treatment associating denture rebasing with chemically‐activated acrylic resin, night immersion in 2.5% sodium hypochlorite and use of topical antifungals for two weeks. Results: In all cases, remission of the inflammatory process occurred. Conclusion: The proposed treatment protocol proved to be to be effective.     

下颌种植覆盖义齿的生物力学研究进展

口腔生物力学是用生物力学的概念和方法,研究口腔医学中的有关基础性科学问题、解决口腔医学中的临床实际问题、发展口腔临床技术的一门学科。在口腔正畸学、修复学、种植学及口腔颌面外科学等领域存在着大量的生物力学问题,生物力学已成为口腔医学的基础科学之一。传统全口义齿修复常常会出现固位稳定差、咀嚼效率低、患者有疼痛感、适应时间长等情况,很大程度上不能满足患者的修复要求。种植覆盖义齿对于下颌牙槽嵴严重吸收的患者,效果尤为明显。种植覆盖义齿是义齿与种植体之间以不同的附着体作为连接,形成患者可以自行摘戴的种植体支持的覆盖义齿修复。下颌种植覆盖义齿因其能有效地提高下半口义齿的固位性和稳定性、显著提高了患者的咀嚼效率,目前已成为修复下颌牙槽骨严重吸收的无牙颌患者的有效修复方法。本文针对下颌种植覆盖义齿的生物力学研究进展作一综述。     

The prevalence of denture stomatitis and its predisposing conditions in an older Greek population

doi:10.1111/j.1741‐2358.2009.00359.x
The prevalence of denture stomatitis and its predisposing conditions in an older Greek population Background: Pathology related to complete denture‐wearing will remain an important issue because of an increase in the ageing population. Objective: To investigate the prevalence and the risk factors for denture‐related stomatitis in the edentulous maxilla of older patients with a maxillary complete denture. Material and methods: One hundred and six patients treated in the Department of Prosthodontics of the Athens Dental School were interviewed and clinically examined. The results were analysed using chi‐square tests and multiple logistic regression. Results: Denture stomatitis was recorded in 39.6% of the sample (pinpoint hyperaemia: 17%, diffuse erythema: 16%, papillary hyperplasia: 6.6%). Chi‐square tests recorded significant associations between denture stomatitis and the continuous use of dentures (particularly the diffuse erythema type), the increased duration of denture experience and the poor retention of the maxillary denture. Other significant associations were recorded between the increased age of the current denture and pinpoint hyperaemia, and the reduced frequency of denture cleaning and papillary hyperplasia. Multiple logistic analysis revealed that the most important risk factor for denture stomatitis was the continuous use of the denture. Conclusion: The prevalence of denture stomatitis was high in denture users. Although many predisposing conditions were recorded, the most important risk factor was the continuous use of the denture. Therefore, appropriate advice on denture maintenance should be provided.     

Effect of denture adhesive on the micro-organisms in vivo

doi: 10.1111/j.1741‐2358.2010.00381.x Effect of denture adhesive on the micro‐organisms in vivo Background: Denture adhesives increase the retention and stability of dentures in edentulous patients, especially in cases where salivary flow is impaired or in the management of traumatised oral mucosa. Objectives: The effect of a denture adhesive on the oral flora at different time intervals. Method: Thirty denture‐wearing patients were involved in this study. While half of the group received a denture adhesive, the other half did not. At baseline, 1 and 2 months after delivering the dentures, smear samples were obtained from the saliva, palate and the dentures. Candida albicans, Candida krusei, Candida glabrata, Candida spp., Staphylococcus aureus, Moraxella catarrhalis, α‐haemolytic streptococci, β‐haemolytic streptococci, Pneumococcus aureus, S. anginosus, S. intermedius, S. constellatus, S. sanguis, S. gordonii, S. mitis, S. mutans, S. salivarius, and yeasts were investigated. The data were statistically analysed using anova and repeated measures. Results: Most types of the micro‐organisms were not seen and could not be analysed statistically except α‐haemolytic streptococci and C. albicans. No statistically significant difference was found for α‐haemolytic streptococci and C. albicans in saliva, palate and the denture at all time intervals. Conclusions: Prolonged use of the denture adhesive tested up to 2 months did not yield to increase in micro‐organisms of the oral flora.     

Perceptions and preferences on denture marking in an Indian sample

doi: 10.1111/j.1741‐2358.2011.00499.x Perceptions and preferences on denture marking in an Indian sample Aim: Denture marking is useful in institutional settings and post‐mortem identification. Numerous markers have been developed, and their advantages and limitations assessed previously; however, patient perception to denture marking is paramount. We evaluated this in an Indian sample and also gauged their preference for different markers. Materials and methods: One‐hundred and one edentulous patients seeking prosthodontic treatment in our institution were shown four denture markers (stainless steel matrix band, paper strip with name inscribed on it, patient photograph and optically readable laminated bar code) and asked whether they wanted similar markers in their dentures; patients were also asked to rank the markers based on preference and indicate their satisfaction with it. Results: Approximately two‐thirds of patients (65/101) were uninterested in getting their dentures marked; among the 36 who agreed, 10 preferred the stainless steel band followed by photographs (9), paper strip (6) and bar code (2); nine gave multiple responses and were excluded from analyses. Sixteen patients expressed dissatisfaction with the photographic marker and bar code, while this number reduced for the stainless steel band (13) and paper strip (10). Conclusions: The results are in contrast to European studies wherein the majority of patients agreed to denture marking, indicating patient background (e.g. education level) may affect perception to denture marking; amongst those who agreed to marking, most preferred, or were satisfied with, the stainless steel and paper strip markers over photographic marker and a complex method such as bar‐coding, implying that simple methods harbouring basic patient information may suffice in the Indian context.     

Oral health related quality of life of edentulous patients after denture relining with a silicone-based soft liner

doi: 10.1111/j.1741‐2358.2011.00503.x Oral health related quality of life of edentulous patients after denture relining with a silicone‐based soft liner Background: Knowledge of benefits caused by a treatment on quality of life is very relevant. Despite the wide use and acceptance of soft denture liners, it is necessary to evaluate the patient’s response about the use of these materials with regard to improvement in oral health related quality of life (OHRQoL). Objectives: The aim of this study was to evaluate the influence of denture relining in the OHRQoL of edentulous patients. Materials and methods: Thirty‐two complete denture wearers had their lower dentures relined with a silicone‐based material (Mucopren soft, Kettenbach, Germany) according to chairside procedures. OHRQoL was assessed before and after 3 months of relining by means of OHIP‐EDENT, and the median scores were compared by Wilcoxon test (p ≤ 0.05). Results: After 3 months of relining, participants reported significant improvement of their OHRQoL (p ≤ 0.01). Conclusion: Denture relining with a soft liner may have a positive impact on the perceived oral health of edentulous patients.     

Antimicrobial activity of denture adhesive associated with Equisetum giganteum- and Punica granatum-enriched fractions against Candida albicans biofilms on acrylic resin surfaces

Candida biofilms adhere to the internal surface of removable dentures, which is an etiological factor in the pathogenesis of denture stomatitis (DS). Adhesive materials are used at the base of maxillary complete dentures to improve their retention and chewing qualities. This article reports the antimicrobial activity of the enriched fractions of Equisetum giganteum and Punica granatum incorporated into a denture adhesive against C. albicans biofilm. The biofilms were induced on the surface of heat-cured acrylic resin specimens that were previously treated with a mixture of adhesive/herb extracts. The antimicrobial activity was evaluated by CFU counts, XTT reduction, and SEM and CLSM analysis. Both herb extracts amplified the anti-biofilm action of the adhesive on the acrylic resin by up to 12 h. Therefore, when these extracts were combined with COREGA®, they played a collaborative and innovative role in biofilm control and can be considered alternatives for temporary use in the treatment and/or prevention of DS.     

Variables affecting denture satisfaction in Israeli elderly:a one year follow-up

The purpose of this study was to investigate patient satisfaction with complete dentures after one year of use and several potential mitigating factors in Israeli elderly. Eighty–four patients who were 54 years of age or older and who were rehabilitated with complete dentures were recalled for examination 12-15 months later; 84.5% (n=70) were interviewed and reexamined by calibrated examiners who judged all prostheses to be clinically acceptable. The mean age of participants was 71.90 years and two-thirds were females. Over 73 % reported that they wore their dentures “always.” Nearly 79% indicated that they were pleased with their denture appearance. Difficulties were reported by 28.2%, while 46.5% reported difficulties with chewing. Chewing problems were significantly related to swallowing problems (P<.001); food enjoyment “as much now as you did five years ago” (P<.001); difficulties speaking (P<.00105) and “having sores under your dentures” (P<.00101) which affected 28.2% of the survey group. Married elderly expressed higher satisfaction with denture comfort as compared to “single” patients, and patients suffering from any systemic chronic diseases were more dissatisfied with appearance. A summary satisfaction scale of 7 items was constructed (Cronbach alpha reliability 0.6834) and logistic regression performed to identify key model variables for overall satisfaction. Stat sign findings included: 1) immigration year; 2) neurological or psychological disorder; and 3) age. The model correctly classified 92.75%. Findings suggest that a variety of factors may influence denture satisfaction. Gathering detailed information by means of a questionnaire before new denture fabrication may be an important tool for the dentist in predicting and consequently enhancing patient satisfaction with complete dentures.     

Denture Wearers' Awareness of their Vertical Dimension

A method of analyzing facial proportions in evaluating occlusal vertical dimension was used in a test on 71 complete denture wearers aiming to find a way to rank denture wearers with different stages of reduced vertical dimension and development an instruction for patients' self judgment. By use of face drawings on a proforma the patients ranked themselves into one of four classes. The investigator also ranked the patients into these classes. There was a significant correlation (p<0.01) between the ranking by patient and investigator. The face proportions were also measured with an instrument. The distances nasion-rima oris and subnasale-gnathion were established. When ranking into classes, there was a significant (p<0.0001) correlation between the ranking by the investigator and the measurements. The results show that it may be possible to use information of facial proportions to give complete denture wearers a way of assessment of face height and thus a reason to consult a dentist in case of suspicion of reduced vertical dimension.     

Cytogenetical damage in exfoliated oral mucosa cells in elderly people suffering denture stomatitis

doi:10.1111/j.1741‐2358.2009.00315.x
Cytogenetical damage in exfoliated oral mucosa cells in elderly people suffering denture stomatitis Objectives: The aim of this study was to evaluate comparatively the DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated oral mucosa cells from chronic denture stomatitis patients and healthy controls. Background: Over the course of ageing, individuals may develop many diseases such as denture stomatitis. Material and methods: A total of 23 chronic denture stomatitis patients and 23 controls presenting good oral conditions were included in this study. Individuals had epithelial cells mechanically exfoliated, placed in fixative and placed on clean slides, which were checked for nuclear phenotypes. Results: The results indicated no statistically significant differences (p > 0.05) of micronucleated oral mucosa cells from chronic denture stomatitis patients when compared to healthy controls. Nevertheless, chronic denture stomatitis was able to increase other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis and karyolysis as depicted by significant differences (p < 0.05) between groups. No interaction was observed between smoking and chronic denture stomatitis. Conclusion: In summary, these data indicated that chronic denture stomatitis was able to induce cytotoxic effects as assessed by a micronucleus test.     

Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2010.00369.x Complete denture hygiene and nocturnal wearing habits among patients attending the Prosthodontic Department in a Dental University in Brazil Objective: The aim of this study was to evaluate the overnight wearing and cleaning habits of complete denture wearers. Background: Successful complete denture treatment can be achieved when the patients are motivated and aware of appropriate denture wear and hygiene. Materials and methods: A sample of 224 complete denture wearers (162 women) aged 37–89 years was studied. Inclusion criteria comprised edentulous subjects who had received their new complete dentures between 2000 and 2005 in the Dental Clinic of the Araçatuba and Araraquara Dental School, São Paulo State University. Ethical approval was sought and granted. Subjects were interviewed using questions related to overnight denture wearing and denture cleaning habits. Possible statistical relationships among some of items were analysed by the chi‐square test at 5% significance level. Results: Of the patients, 55.8% removed their dentures during the overnight period and 88% did this every day. Among them, 66.4% removed both dentures. Most of the patients used brushing with toothpaste (105 patients – 46.87%) as a cleaning method. More than a half of the subjects (63.4%) showed biofilm and calculus on their dentures. Conclusion: The patients need instructions and motivation concerning denture hygienic and denture removal overnight.     

Effects of a denture adhesive in edentulous patients after maxillectomy

doi: 10.1111/j.1741‐2358.2011.00538.x
Effects of a denture adhesive in edentulous patients after maxillectomy Objective: The objective of this study is to evaluate the usefulness of a denture adhesive in edentulous patients after maxillectomy. Background: Maxillectomy patients suffer from functional impairments. Denture adhesives (DAs) are the solution in such patients. However, little is known about DAs in maxillectomy patients. Materials and Methods: Eight edentulous patients who had undergone maxillectomy were included and divided into three groups. Group 1 (half ≤ remaining residual maxilla), Group 2 (quarter < remaining residual maxilla < half) and Group 3 (remaining residual maxilla ≤ quarter). They were evaluated by a speech intelligibility test and a mixing ability test, respectively. A cream‐type DA called New Poligrip^® (GlaxoSmithKline, Tokyo, Japan) was used. Results: Applying the DA, speech intelligibility showed a higher score than the data without DA. Conclusion: The effects of using a DA depend on the amount of the remaining residual maxilla. Our study showed that if the remaining residual maxilla is less than a quarter (Group 3), it is difficult to have confidence in the effectiveness of the DA to improve masticatory function. On the other hand, the use a DA showed improved speech intelligibility test values in all groups.     

Elderly complete denture wearers: a social approach to tooth loss

doi: 10.1111/j.1741‐2358.2011.00550.x Elderly complete denture wearers: a social approach to tooth loss Objectives: To correlate emotional reactions to tooth loss with denture satisfaction attributes in elderly complete denture wearers. Background: Total tooth loss is a serious life event, and poor oral health has an impact on daily life. Edentulism treated by rehabilitation with dentures can have a positive effect on patients’ self‐image and social behaviour. Methods: A group of 80 edentulous subjects undergoing routine prosthetic care in a Greek Department of Prosthetic Dentistry were interviewed using two structured questionnaires. The first questionnaire explored reactions to tooth loss, whereas the second measured their subjective experience of complete dentures. The responses to both questionnaires were compared using the statistical package spss v.17. Results: The results showed significant correlation between aspects of tooth loss experience and complete denture satisfaction. Despite the fact that a substantial proportion of patients were satisfied with their complete dentures, some patients experienced increased social and psychological problems related to their edentulousness and the wearing of complete dentures. The aesthetic and functional aspects of complete dentures affected both patients’ social behaviour and self‐confidence. Conclusions: Total tooth loss was not only reflected in patient’s social behaviour and self‐image, but it had a complex and multifaceted impact on satisfaction from complete dentures.