Maxillary complete denture movement during chewing in mandibular removable partial denture wearers

Objectives: To evaluate the pattern of maxillary complete denture movement during chewing for free‐end removable partial dentures (RPD) wearers, compared to maxillary and mandibular complete denture wearers. Materials and methods: Eighteen edentulous participants (group I) and 10 volunteers with bilateral posterior edentulous mandibles (group II) comprised the sample. Measures of mean denture movement and its variability were obtained by a kinesiographic instrument K6‐I Diagnostic System, during the mastication of bread and a polysulphide block. Data were analysed using two‐way anova (α = 0.05). Results: Upper movement during chewing was significantly lower for group II, regardless of the test food. The test food did not influence the vertical or lateral position of the denture bases, but more anterior dislocation was found when polysulphide blocks were chewed. Group II presented lower intra‐individual variability for the vertical axis. Vertical displacement was also more precise with bread as a test food. Conclusion: It can be concluded that mandibular free‐end RPD wearers show smaller and more precise movements than mandibular complete denture wearers.     

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.     

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.     

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 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.     

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.     

In vitro and clinical evaluation of specific dentifrices for complete denture hygiene

Objectives: To study the physical properties of two experimental dentifrices for complete denture hygiene, their effect on denture biofilm removal and antimicrobial properties by means of a clinical trial. Materials and methods: The experimental dentifrices comprised two compositions. One was based on the addition of 1% chloramine T (D1) and the other on the presence of 0.01% fluorosurfactant (D2). Measurements of density, pH, consistency, rheological features and abrasiveness were conducted. Sixty complete denture wearers were randomly assigned to three groups and were instructed to brush their dentures with a specific toothbrush: (1) Water (control); (2) D1; or (3) D2. Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface. Microbiological assessment was conducted to quantify Candida sp. and mutans streptococci. Data were evaluated by one‐way anova and Tukey HSD, or Kruskal–Wallis (α = 0.05). Results: Both dentifrices decreased biofilm coverage when compared with the control group. D1 was the most efficacious treatment to reduce mutans streptococci, whereas D2 showed an intermediate outcome (anova , p < 0.040). No treatment influenced Candida albicans or non‐albicans species (Kruskal–Wallis, p = 0.163 and 0.746, respectively). Conclusion: It can be concluded that brushing complete dentures with the experimental dentifrices tested could be effective for the removal of denture biofilm.     

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.     

Complete denture wearing and fractures among edentulous patients treated in university clinics

doi: 10.1111/j.1741‐2358.2011.00551.x
Complete denture wearing and fractures among edentulous patients treated in university clinics Objective: The prevalence of wearing and fracture of complete dentures was evaluated among edentulous patients treated in two dental schools in Brazil. Background: Acceptance and wearing of complete dentures are related to adaptive behaviour of edentulous patients. However, one reason that could interfere with the wearing dentures is their potential to fracture, which is still a common complication in denture rehabilitation practice. Material and methods: Two hundred and twenty‐four edentulous patients rehabilitated with complete dentures from 2000 to 2005 in Araçatuba and Araraquara Dental School, University of State of São Paulo, were assessed in 2006 and 2007 to answer a questionnaire about wearing and fracture of their dentures. Statistical analysis were performed using Epi Info software and chi‐squared test to compare maxillary and mandibular data (α = 0.05). Results: Almost 26% of the patients did not wear their dentures, and among the remainder, the majority wore the maxillary denture. About 30% of the dentures were fractured, with higher prevalence in the maxillary arch (p = 0.003). Conclusions: Discontinuation of wearing dentures was quite high, especially considering the treatment which was carried out in university clinics. Prevalence of fractures was also high, greater for the maxillary denture, and was one of the main reasons for non‐wearing of complete dentures.     

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.     

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.     

Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00351.x
Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers Objective: To determine the frequency of the oral lesions related to gender, age, the length of time of denture usage, education level and economic status. Methods: The 153 patients with old complete dentures (CD) were asked to participate in the investigation. The subjects (76 male and 77 female) were 37–85 years of age with a mean age of 61.8 ± 9.8 years. Education, economic status and age factors were estimated in subgroups. The data obtained were evaluated by one‐way anova , Mann–Whitney U‐test, Kruskal–Wallis test, Student’s t‐test and chi‐squared test. The level of statistical significance was set at p < 0.05. Results: The patients who had denture stomatitis and traumatic ulcers were statistically significantly older than the ones who did not have these lesions (p < 0.05). Based on the length of denture usage, patients who had a flabby ridge, fibrous inflammatory hyperplasia, traumatic ulcers (p < 0.01) and denture stomatitis (p < 0.05) were using their dentures statistically significantly longer than the ones who had healthy tissues. Conclusions: The CD wearers should be advised to visit their dentist regularly to prevent oral mucosal lesions due to the changing supporting tissues during the length of denture usage and to improve their quality of life.     

Relining of prosthesis with auto‐polymerizing hard denture reline resins: effect of post‐polymerization treatment on flexural strength

Background: It has been suggested that microwave irradiation and prosthesis immersion in hot water after its polymerization may improve mechanical and viscoelastic properties of acrylic resins. Purpose: This study was proposed to verify the influence of microwave post‐polymerization (PP) treatment over the flexural strength of thermo‐polymerizing acrylic resin specimens (QC‐20) relined or not with two different composition hard chairside auto‐polymerizing reliners [Kooliner (K) and New Truliner (NT)]. Materials and Methods: For this study, 50 specimens of 64 × 10 × 3.3 mm were polymerized and distributed into five groups. G1 (control) specimens without relining and PP; G2 specimens relined with K, without PP; G3 specimens relined with NT, without PP; G4 specimens relined with K, with PP (microwave irradiation with 650 W for 5 min); G5 specimens relined with NT, with PP. Tests were performed on a universal testing machine Instron 4411 with compression speed of 5 mm/min. Results: Specimens of K without PP did not show statistically different results (p < 0.05) when compared with control. However, when submitted to PP these specimens showed a significant increase in flexural strength. Specimens of NT showed the lowest flexural strength of all groups, with or without PP when compared with control and K groups. Conclusion: Microwave PP (650 W for 5 min) proved to be an effective method of improving the flexural strength of K relined prosthesis. However, it did not seem to affect NT specimens.     

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.     

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.