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.     

Evaluation of the occlusion vertical dimension of complete dentures after microwave disinfection

doi: 10.1111/j.1741‐2358.2011.00567.x Evaluation of the occlusion vertical dimension of complete dentures after microwave disinfection Objectives: An increase in occlusal vertical dimension (OVD) after microwave disinfection may result in the need for adjustments in the complete dentures. This in vitro study evaluated the increase in OVD of maxillary complete dentures submitted to microwave disinfection protocols. Material and methods: Thirty sets of complete dentures were evaluated as follows: Group 1–15 sets had the maxillary complete dentures submitted to microwave disinfection (650 W/3 min), once a week, for 4 weeks. Group 2–15 sets had the maxillary complete dentures submitted to microwave disinfection (650 W/3 min), three times a week, for 4 weeks. The vertical dimension was measured with a micrometre (in mm) before disinfection protocols (baseline readings) and after each week of disinfection. Data were analysed using Wilcoxon and Friedman tests (α = 0.05). Results: For Group 1, no significant difference was found between the increases in OVD and zero, and no significant difference was found between the weeks. For Group 2, the increases in OVD were significantly greater than zero, and the Friedman test showed that weeks 3 and 4 had significantly greater changes than week 1 and that week 4 had significantly greater change than week 2. Conclusion: Microwave disinfection only promoted significant increase in OVD in Group 2, in which the values increased progressively.     

Evaluation of experimental cleanser solution of Ricinus communis: effect on soft denture liner properties

doi: 10.1111/j.1741‐2358.2010.00438.x Evaluation of experimental cleanser solution of Ricinus communis: effect on soft denture liner properties Objective: This study evaluated colour stability, hardness and roughness of soft denture liners after immersion in various cleansers. Materials and methods: Thirty specimens (14 mm × 4 mm) of Elite Soft Relining (ES) and Mucopren Soft (MS) were randomly immersed in distilled water at 37°C, sodium hypochlorite 1%, and an experimental Ricinus communis solution (RC) for 7, 15 and 183 continuous days. Results: anova (p < 0.05) and Tukey’s test indicated that after T7 (μ =8.79 ± 7.36); T15 (μ = 4.23 ± 2.62) and T183 (μ = 8.78 ± 3.16), MS presented a higher increase in hardness than ES. After T7, MS underwent an increase in roughness (μ = 0.09 ± 0.80); ES underwent a decrease (μ = ?0.08 ± 0.16). RC caused the smallest variation in roughness. After T15, both materials presented an increase in roughness. After T183, ES (μ = ?0.30 ± 0.48) presented a higher roughness variation than MS (μ = ?0.07 ± 0.32). Hypochlorite caused an increase in roughness (μ = 0.02 ± 0.19). Conclusion: After all periods ES presented higher colour alteration than MS; highest colour alteration was caused by hypochlorite. Both materials were more stable after immersion in RC.     

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.     

Surface roughness of denture base and reline materials after disinfection by immersion in chlorhexidine or microwave irradiation

doi: 10.1111/j.1741‐2358.2011.00484.x
Surface roughness of denture base and reline materials after disinfection by immersion in chlorhexidine or microwave irradiation Background: This study evaluated the effect of disinfection by immersion and microwave irradiation on the roughness of one denture base resin (Lucitone‐L) and five relining materials, three hard (Tokuyama Rebase II‐TR, New Truliner‐NT, Ufigel Hard‐UH) and two resilient (Trusoft‐T, Sofreliner‐S). Methods: Fifty specimens were made and divided into groups: CL2 specimens were brushed with 4% chlorhexidine (1 min), immersed in the same solution (10 min) and immersed in water (3 min); MW2 specimens were immersed in water and microwave irradiated (650W; 6 min); CL2 and MW2 specimens were disinfected twice; CL7 and MW7 specimens were submitted to seven cycles using chlorhexidine or microwave irradiation, respectively; W specimens were not disinfected and remained in water (37°C; 7 days). Results: Results were statistically analysed (p = 0.05) and revealed that, at baseline, the highest mean value was observed for T (p < 0.001). Material NT showed increase in roughness after the first (p = 0.003), second (p = 0.001), seventh (p = 0.000) cycles of microwave disinfection and after 7 days of immersion in water (p = 0.033). Conclusions: Resilient liner S presented significant increase in roughness after the second cycle of disinfection with chlorhexidine (p = 0.003). Material T exhibited significantly decreased roughness in group W (p = 0.010), while microwaving produced severe alterations on its surface.     

The influence of double flask investing on tooth displacement in dentures processed by microwave irradiation

doi: 10.1111/j.1741‐2358.2011.00587.x The influence of double flask investing on tooth displacement in dentures processed by microwave irradiation Objective: This study evaluated the influence of the bimaxillary flask (BMF) and two different investing materials on first molar inclination in dentures processed by microwave irradiation. Background: The BMF may minimise tooth displacement, saving time and improving occlusion. Methods and materials: Forty pairs of dentures were randomised into four groups: stone wall in monomaxillary flask; silicone wall in BMF; stone wall in BMF; acrylic resin retentions and silicone in BMF. Dentures were processed by microwave irradiation. Two referential points were established on tooth surface. A microscope and a digital pachymeter were used to measure the distance between these points, and the angles α (right maxillary molar), β (left maxillary molar), α′ (right mandibular molar) and β′ (left mandibular molar) were calculated by the law of cosines. Data were submitted to Kruskal–Wallis (5% significance). Results: No difference was observed among the groups (p > 0.05). In the intra‐group analysis, α was significantly different for groups I, II and III; α′, for groups II and IV; β, for all groups; β′, for groups III and IV. Conclusion: First molar inclination was similar for monomaxillary and BMFs. The use of stone or silicone as investing materials presented the same effect on tooth inclination.     

Examination of denture-cleaning methods based on the quantity of microorganisms adhering to a denture

doi: 10.1111/j.1741‐2358.2011.00461.x Examination of denture‐cleaning methods based on the quantity of microorganisms adhering to a denture Objectives: To investigate effective denture‐cleaning methods, we examined the relationships between the quantity of microorganisms adhering to dentures and the use of a denture brush and the frequency of use of a denture cleanser. Subjects and Methods: Denture plaque was collected from the mucosal surface of the examined dentures, which were 142 and 80 upper and lower complete dentures, respectively, worn by 96 outpatients (mean age: 71.9 years) of a university hospital and 41 nursing home residents (mean age: 84.8 years). The collected microorganisms were counted in terms of isolated representative colonies that were cultured and identified using standard methods. The use of a denture brush, the frequency of use, and the type and soaking time of denture cleansers as denture‐cleaning methods were surveyed. Results: The quantity of microorganisms was significantly lower in dentures of denture brush users than in those of non‐users in the outpatients (p < 0.01, Mann–Whitney U test). The quantity of microorganisms was significantly lower in the dentures of outpatients who used a denture cleanser daily or 3–4 times a week than in those who used one once or less per month and in the dentures of nursing home residents who used one daily than in those who used one at other frequencies (p < 0.05, Kruskal–Wallis test, followed by Dunn’s Multiple Comparison test). Conclusion: Within the limitations of this study, it was concluded that the use of a denture brush and daily use of denture cleanser should be recommended to complete dentures wearers as denture‐cleaning methods that effectively reduce the quantity of microorganisms adhering to dentures.     

Denture disinfection by microwave energy: influence of Candida albicans biofilm

doi: 10.1111/j.1741‐2358.2010.00439.x Denture disinfection by microwave energy: influence of Candida albicans biofilm Objective: This study evaluated the influence of the area of Candida albicans biofilm on denture disinfection by microwave energy. Materials and methods: Candida albicans biofilm was allowed to form for 72 h on resin discs, and three small coverage or seven large coverage discs were placed onto the palatal surface of sterile maxillary dentures. Each denture was immersed in 200 ml distilled water and individually irradiated at a power of 450, 630 or 900 W for different time intervals (1, 2 or 3 min) (n = 6). The effectiveness of disinfection was evaluated by counting the residual cells. The data were analysed by anova and Tukey’s HSD test (α = 0.05). Pearson’s correlation test was performed to determine the correlation between effectiveness of sterilisation and temperature. Results: Dentures with a larger area of biofilm demanded a longer irradiation exposure to achieve disinfection (p < 0.001), irrespective of power setting, and in this time no yeast growth was detected. Dentures with small areas of biofilm were disinfected after 1 min at 900 W and 2 min at 450 or 630 W. A positive correlation was found between water temperature and effectiveness of disinfection (r = 0.6170; p < 0.001). Conclusion: The C. albicans biofilm area influenced disinfection by microwave energy; therefore dentures with larger biofilm areas required longer irradiation exposure to be disinfected.     

Effect of a denture cleanser on the concentration of volatile sulphur compounds and denture biofilm in institutionalised elderly

doi:10.1111/j.1741‐2358.2009.00341.x
Effect of a denture cleanser on the concentration of volatile sulphur compounds and denture biofilm in institutionalised elderly Objective: To determine the effectiveness of a denture cleanser in reducing the concentration of volatile sulphur compounds (VSC) and its antimicrobial action. Background: Micro‐organisms from the denture biofilm can cause local and systemic disease and halitosis. Denture cleansers are important adjuncts in oral care, but there is limited investigation on their effect in malodour compounds. Material and methods: Nineteen institutionalised elderly who wore at least an upper denture were selected; their VSC concentrations were measured and the denture biofilm was collected. In phase 1, the subjects wore their old denture and data were collected before (B₀) and after 7(A₁), 14(A₂), 28(A₃) days of continuous daily use of the denture cleanser. In phase 2, new dentures were inserted and measurements were made at 30(A_1.1), 60(A_2.2), 90(A_3.3) days of treatment. Results: The VSC concentration increased from B₀ to A₁ (p < 0.05)_, but no differences were found for the others intervals of times. Total micro‐organism data did not show a statistical difference between times in Phase I, but in Phase II, there was a statistical difference (p < 0.05) and a progressive re‐colonisation was observed. Conclusion: Within the limits of this study, it was concluded that the denture cleanser had no antimicrobial effect and VSC levels were not reduced.     

Evaluation of stain removal and inhibition properties of eight denture cleansers: an in vitro study

Gerodontology 2012; doi: 10.1111/j.1741‐2358.2011.00522.x
Evaluation of stain removal and inhibition properties of eight denture cleansers: an in vitro study Objectives: To determine the ability of eight denture cleansers to remove and inhibit tea‐stain build‐up on acrylic resin. Materials and methods: In the stain removal study, Perspex^® (cast heat polymerised resin) specimens previously soaked in saliva were stained using multiple exposures of chlorhexidine and tea solutions. Specimens were exposed for 1 min to one of the eight denture cleansers for five cycles, washed and dried and their optical density read on a uv/vis spectrophotometer at 295 nm. In the stain inhibition study, clear specimens were exposed to saliva followed by cleansers then tea solution, for five cycles. The build‐up of stain at each cycle was measured, and differences in optical densities from baseline were calculated. Results: All denture cleansers were significantly more effective than water in removing stain (p < 0.05). There were significant differences in cleaning ability between cleansers (p < 0.001), Dentural^® and Kleenite^® were particularly effective. The stain inhibition experiment showed that most cleansers were significantly more effective than water in inhibiting stain (p < 0.05). There were significant differences in inhibition ability between cleansers (p < 0.01). Kleenite^® and Equate were particularly effective. Conclusions: All denture cleansers had a capacity to remove stain and most had an inhibitory effect on staining. Kleenite^® was particularly effective in controlling stain formation.     

Clinical and microbiological efficacy of three different treatment methods in the management of denture stomatitis

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00354.x
Clinical and microbiological efficacy of three different treatment methods in the management of denture stomatitis Objective: This study evaluated. the effect of mouthrinses and tissue conditioner on the clinical findings and microbial flora of 60 patients with Newton’s type II denture stomatitis (N2DS) Background: Denture stomatitis is a common problem in complete denture wearers. Materials and methods: Sixty patients with N2DS were included in this study and divided into three groups. Two groups of patients were instructed to rinse their mouth with the designated mouthrinses DioxiDent and Corsodyl twice daily for 1 min and to soak their dentures overnight in these solutions for 15 days. For the third group, tissue conditioner was placed in each of 20 patients’ existing maxillary dentures. Patients were evaluated both clinically and microbiologically at baseline and after 15 days. Palatal swabs and smears were taken from each patient before and after treatment and these samples were examined mycologically. The difference between Candida colonisation before and after treatment and the differences between pre‐treatment and post‐treatment clinical findings were assessed. Results: DioxiDent and Corsodyl showed an improvement in palatal inflammation and a decrease in Candida colonisation compared to Visco‐gel. Conclusions: The effectiveness of topical chlorine dioxide and chlorhexidine gluconate in the management of N2DS was demonstrated.     

Effect of repeated microwave disinfections on bonding of different commercial teeth to resin denture base

doi: 10.1111/j.1741‐2358.2011.00516.x Effect of repeated microwave disinfections on bonding of different commercial teeth to resin denture base Objective: To verify the influence of repeated microwave disinfections on the shear bond strength of two commercial types of teeth to acrylic resin, when the ridge lap surfaces were unmodified, bur abraded, bur grooved or etched by monomer. Material and methods: Eighty specimens (n = 10) were adhered to the tooth ridge lap surface, polymerised in a water bath at 74°C for 9 h. Microwaved specimens were individually immersed in 150 ml of water and submitted to five simulated disinfections in a microwave oven calibrated at 650 W for 3 min. Control specimens were not microwave treated. Shear bond strength tests were performed in an Instron machine with a cross‐speed of 1 mm/min. The fracture load values were transformed into shear bond strength as a function of the bonding area (0.28 cm²). Data were submitted to anova and Tukey’s test (α = 0.05). Fractured areas were classified as adhesive, cohesive (resin or tooth) or mixed failures. Results: Repeated microwave disinfections increased the shear strength of the tooth/resin bond. Mechanical retention in microwaved and non‐microwaved procedures improved the shear bond strength. Conclusions: The different commercial types of teeth influenced shear bond strength values, with Biotone teeth showing the lower values.     

Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols

doi: 10.1111/j.1741‐2358.2011.00485.x
Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols Objective: The aim of this study was to investigate Candida albicans biofilm formation on denture liners and to analyse the efficacy of cleaning protocols. Material and methods: Specimens were prepared from four silicone‐based soft denture liners. After artificial ageing and surface free energy determination, specimens were incubated with saliva (2 h) and Candida albicans ATCC 10231 for either short‐ (2.5 h) or long‐term (24 h) biofilm formation. Adherent cells were determined either after incubation of specimens with Candida albicans or after treatment with different denture cleaning protocols. Statistical analysis was performed using one‐way anova and the Games–Howell test (α = 0.05). Results: For both short‐ and long‐term biofilm formation, similar amounts of Candida albicans cells were found on the surface of the different liners (p = 0.295 and 0.178, respectively). For both short‐ and long‐term biofilm formation, the highest cleaning efficacy was observed for sodium hypochlorite (NaOCl; p < 0.01). The efficacy of the chemical denture cleaner in removing long‐term Candida albicans biofilms was significantly lower than the efficacy of removal by brushing (p < 0.001). Conclusion: Different silicone‐based soft denture liners yield similar Candida albicans biofilm formation on their surface. The highest efficacy for the removal of Candida albicans biofilms was identified for NaOCl. Chemical denture cleaners appear to have rather low efficacy to remove mature Candida albicans biofilms.     

Inhibition of biofilms associated with dentures and toothbrushes by tetrasodium EDTA

AIMS: We examined the efficacy of tetrasodium EDTA in eradicating biofilms derived from salivary inocula or pure cultures of Candida albicans on discs of polymethyl methacrylate (PMMA) denture base or on toothbrushes that had been used normally for 4-8 weeks. Its efficiency in virus neutralization was also determined. METHODS AND RESULTS: Overnight (16 h) treatment with 4% (w/v) tetrasodium EDTA solution reduced salivary and C. albicans biofilm viable counts by > or =99%. Biofilm removal was confirmed using confocal laser scanning microscopy. Presence/absence of sucrose during biofilm formation had no effect on killing efficacy. Prolonged treatment of PMMA with tetrasodium EDTA did not influence subsequent formation of C. albicans biofilms or affect surface roughness of the PMMA, but it reduced subsequent biofilm formation from a salivary inoculum. Infectivities of herpes simplex virus and polio virus suspensions were reduced by >99.99% by treatment for 1 and 2 h, respectively. CONCLUSIONS: Tetrasodium EDTA solution efficiently disinfected toothbrushes and PMMA discs, with the detachment of biofilms, and rapidly neutralized both nonenveloped and enveloped viruses. SIGNIFICANCE AND IMPACT OF THE STUDY: Dentures and toothbrushes become contaminated by bacterial biofilms and by viruses. There is a need for disinfection methods that are rapidly effective, cost-effective, nontoxic and easily implemented. These studies indicate that tetrasodium EDTA solution has disinfection applications in the oral care field.     

Effects of home and office care denture reliners on maxillary complete dentures

doi:10.1111/j.1741‐2358.2009.00308.x
Effects of home and office care denture reliners on maxillary complete dentures Objectives: The aim of this study was to evaluate the effects of office (OR) and home (HR) care temporary denture reliners on satisfaction and functional outcomes in maxillary complete denture wearers. Methods: Thirty‐four maxillary edentulous patients received application of either OR or HR to their maxillary complete dentures. Patient’s ratings on satisfaction and functional aspects were measured on a 100‐mm visual analogue scale at 4 days post‐application. Associations between baseline ratings and improvement were also assessed. Results: There were no significant differences between the two groups in satisfaction ratings or in the functional outcomes. The OR group showed a significant improvement in mastication and retention, whereas the HR group exhibited a significant improvement in general satisfaction and mastication. Improvement was negatively associated with baseline ratings of speech, ease of cleaning, stability and retention in the OR groups and across all variables, except ease of cleaning, in the HR group. Conclusion: When used correctly, home care denture therapy can be as effective as office applied temporary liner in improving satisfaction with problematic maxillary dentures.     

康乐霉素C产生菌的微波诱变

以物理因子微波对免疫抑制剂康乐霉不C的产生菌进行了菌种诱变,研究了微波处理的条件、照射的时间及剂量,获得康乐霉素C生产能力高于出发菌株180%的M-13-21。