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.     

Effervescent tablets and ultrasonic devices against Candida and mutans streptococci in denture biofilm

doi: 10.1111/j.1741‐2358.2010.00378.x Effervescent tablets and ultrasonic devices against Candida and mutans streptococci in denture biofilm Objective: To evaluate the antimicrobial action of effervescent tablets and ultrasound on Candida spp. and mutans streptococci from denture biofilm. Background: It is not uncommon for edentulous patients to be elderly and find it difficult to brush their dentures. Hence, auxiliary methods are required for cleansing dentures as well as treating oral infections. Materials and methods: Seventy‐seven complete denture wearers were randomly assigned into four groups: (A) Brushing with water (control); (B) Effervescent tablets; (C) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (D) Effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush and water, three times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. The samples were collected by brushing the dentures with saline and the detached microbial cells were quantified by plating. Counts [log (CFU+1) ml^?1] of total aerobes, Candida spp. and mutans streptococci were compared by one‐way anova or Kruskal–Wallis test (α = 0.05). Results: No significant difference was found among the methods from C. albicans (p = 0.76), C. tropicalis (p = 0.94) and C. glabrata (p = 0.80). Lower counts were found for methods B and D when compared with the other methods against mutans streptococci (p < 0.001). Method B showed lower total aerobic counts than A, whereas C and D showed intermediate results (p = 0.011). Conclusion: The effervescent tablets significantly reduced mutans streptococci and total aerobes from denture biofilm. However, they was not as effective against C. albicans. Ultrasonic cleansing presented a discrete antimicrobial effect and was less effective than the tablets for complete denture disinfection.     

Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva

doi: 10.1111/j.1741‐2358.2010.00390.x
Correlation between factors associated with the removable partial dentures use and Candida spp. in saliva Objectives: To correlate the presence and number of Candida spp. in the saliva of wearers of removable partial dentures retained with precision attachments with the proportion of metal/acrylic resin present in the dentures. Methods: Saliva samples from 40 removable partial denture wearers (test) and one paired sample of individuals, non‐wearers of any type of removable denture (control) were collected, seeded, and the colony forming units of Candida counted and identified. The metal/acrylic resin proportion of each denture was quantified, using silicone plates pressed over each denture. Results: Candida spp. was found in the saliva of 80% of the individuals in the test group and 65% of the control, with C. albicans being the most prevalent species. The test group presented with the highest number of colony forming units of Candida per ml of saliva, and there was weak correlation between this number and the metal and resin area of the denture (Pearson’s coefficient of correlation). Greater prevalence and a higher number of colony forming units of Candida per ml of saliva occurred in removable partial denture wearers (p = 0.04) with a weak positive correlation between the metal and resin area and the number of colony forming units of Candida per ml of saliva. However, this correlation was more significant for the area of resin.     

Comparative analysis of biofilm levels in complete upper and lower dentures after brushing associated with specific denture paste and neutral soap

Objectives: The objective of this study was to compare and correlate biofilm levels in complete upper and lower prosthesis after brushing, associated with specific paste and soap, by means of computerised methodology. Materials and methods: Forty‐five complete denture wearers were selected and instructed to brush their prostheses (Soft Oral B 40) three times a day for 3 weeks with water (Control), specific paste for complete dentures (Corega Brite) (Experiment 1) and neutral soap (Experiment 2). The study was based on a cross‐over model and a wash‐out period was not included. For biofilm quantification, the internal surfaces were dyed (neutral red 1%), photographed (Canon EOS Digital) and the disclosed biofilm was measured with the Image Tool 2.0 software. The products were assessed by means of a questionnaire regarding their hygiene properties and acceptance. Results: The variance analysis indicated that the lower prostheses exhibited a mean biofilm percentage, significantly higher than the upper prostheses and that brushing with paste (Experiment 1) was more effective than soap (Experiment 2) and, in turn, this was more effective than water (Control). There was a high biofilm correlation (Pearson correlation) between both prostheses. Both products were well accepted by the patients, but the most favoured one was the paste. Conclusions: This was effective in controlling the biofilm and can be used preventatively in the maintenance of oral health by wearers of complete dentures. This is important where the lower prosthesis can harbour microorganisms which may act as a reservoir for other areas of the mouth and thus enhance the importance of proper hygiene.     

Age-related satisfaction with complete dentures,desire for improvement and attitudes to implant treatment

In the edentulous lower jaw implant stabilised dentures have proved clinically so successful that the indication for this treatment is now being discussed more often with geriatric patients. The aim of this study of edentate subjects was to determine the age-relation of the demand for denture improvement, the risks and feasibility of implant treatment. Sixty four complete denture wearers aged from 42 to 84 years took part in the study. A questionnaire was used to determine the subjective demand for denture improvement. For 33 subjects implants seemed possible. For these patients fear and scepticism concerning implant treatment were specified and quantified. Impaired general health was the most frequent absolute contra-indication for implants; the local oral prerequisites tended to be slightly less favourable in elderly. Older patients were more satisfied with poorly fitting dentures and were less prepared to take trouble to achieve denture improvement. Although scepticism concerning implant treatment was not age-related, patients who were keen for an improvement of their dentures were significantly younger and less sceptical about implants.     

Survival analysis of mandibular complete dentures with acrylic‐based resilient liners

doi: 10.1111/j.1741‐2358.2012.00658.x Survival analysis of mandibular complete dentures with acrylic‐based resilient liners Objective: The purpose of this long‐term randomised controlled trial was to compare the longevity of dentures constructed using a conventional acrylic resin (CAR) to that of dentures constructed using an acrylic‐based resilient liner (ARL). Materials and methods: The follow‐up study was essentially carried out by annual telephone calls to each of the 67 participants. The Kaplan–Meier method and life‐table analysis were used for univariate analyses. The Cox proportional‐hazards test was used as a final model for statistically adjusting predictor variables such as sex, clinician type, mandibular denture type and age at denture delivery. Results: The denture type was likely to affect the survival time of the dentures, while the sex and clinician type were not. The group using acrylic‐based resilient denture liners had twice the risk of having shorter denture‐survival times than those using conventional acrylic resin dentures. Younger participants were likely to have a reduced risk of having shorter denture‐survival times than older participants. Conclusion: We conclude that mandibular complete dentures constructed using ARL are twice as likely as dentures constructed using CAR to have shorter denture survival times, mainly because of material deterioration.     

Effect of double flasking and investing methods on artificial teeth movement in complete dentures processing

doi: 10.1111/j.1741‐2358.2011.00494.x
Effect of double flasking and investing methods on artificial teeth movement in complete dentures processing Purpose: The aim of this study was to evaluate linear dimensional alterations of artificial teeth for complete dentures when using different investment and flasking techniques. Background: Dimensional changes in the vertical dimension may occur owing to changes in artificial teeth positioning caused by different investing and flasking techniques. Materials and methods: Thirty pairs of the complete dentures were manufactured and randomly divided into three groups (n = 10): (1) invested with type III stone in monomaxillary PVC flask; (2) invested with type III stone in bimaxillary PVC flask; and (3) invested with laboratory silicone in bimaxillary PVC flask. Dentures were polymerised by microwave, and 12 linear distances were measured before and after denture processing. Data were analysed by one‐way anova , considering manufacturing technique as the study factor. Tukey’s HSD was used as post hocanova (p = 0.05). Results: Most of the linear distances were comparable for all groups. All transversal maxillary and mandibular distances were higher for group 1 compared with groups 2 and 3 (p < 0.05), except the distance 3–6 for mandibular arch, in which no difference was found between groups (p < 0.05). Both maxillary diagonal distances were higher in group 1 (p < 0.05), and no differences were found among all groups for mandibular measurements. Conclusions: Double flasking technique independent on the investment material is shown to be the most effective method to reduce changes in artificial teeth positioning.     

Insertion and follow‐up of complete dentures: a literature review

Gerodontology 2010; 00; doi: 10.1111/j.1741‐2358.2010.00368.x Insertion and follow‐up of complete dentures: a literature review Objective: The aim of this study was to present the importance of clinical procedures related to insertion and follow‐up of complete dentures in elderly patients. Materials and Methods: The success of rehabilitation with complete dentures results from the accuracy of clinical and laboratorial procedures that makes the denture insertion an important step of treatment. Conclusion: The follow‐up and professional maintenance of function and hygiene facilitates long‐term efficiency.     

In vitro evaluation of adherence of Candida albicans,Candida glabrata,and Streptococcus mutans to an acrylic resin modified by experimental coatings

This study evaluated the effect of experimental coatings, containing zwitterion or hydrophilic monomers, on the adherence of Candida albicans, Candida glabrata, and Streptococcus mutans to an acrylic resin. Acrylic samples (smooth or rough surfaces) were left untreated (control) or coated with one of the following experimental coatings: 3-hydroxypropylmethacrylate (HP) or sulfobetaine methacrylate (S), at concentrations of 25, 30, or 35%. Half of the specimens were coated with saliva. The adhesion test was performed by incubating specimens in C. albicans, C. glabrata, and S. mutans suspensions at 37°C for 90?min. The number of adhered microorganisms was determined by metabolic activity (XTT) and by cell viability (CFU). All coated specimens exhibited lower absorbance and CFU values compared to control specimens. Saliva and roughness did not promote microorganism adherence. An XPS analysis confirmed the modification in the chemical composition of the coatings in the experimental samples. These experimental coatings significantly reduced the adherence of C. albicans, C. glabrata and S. mutans to acrylic resin.     

Evaluation of three indices for biofilm accumulation on complete dentures

doi:10.1111/j.1741‐2358.2009.00285.x
Evaluation of three indices for biofilm accumulation on complete dentures Objectives: The objective of this study was to evaluate the accuracy and reproducibility of three complete denture biofilm indices (Prosthesis Hygiene Index; Jeganathan et al. Index; Budtz‐Jørgensen Index) by means of a computerised comparison method. Background: Clinical studies into denture hygiene have employed a large number of biofilm indices among their outcome variables. However, the knowledge about the validity of these indices is still scarce. Materials and methods: Sixty‐two complete denture wearers were selected. The internal surfaces of the upper complete dentures were stained (5% erythrosine) and photographed. The slides were projected on paper, and the biofilm indices were applied over the photos by means of a scoring method. For the computerised method, the areas (total and biofilm‐covered) were measured by dedicated software (Image Tool). In addition, to compare the results of the computerised method and Prosthetic Hygiene Index, a new scoring scale (including four and five graded) was introduced. For the Jeganathan et al. and Budtz‐Jørgensen indices, the original scales were used. Values for each index were compared with the computerised method by the Friedman test. Their reproducibility was measured by means of weighed κ. Significance for both tests was set at 0.05. Results: The indices tested provided similar mean measures but they tended to overestimate biofilm coverage when compared with the computerised method (p < 0.001). Agreement between the Prosthesis Hygiene Index and the computerised method was not significant, regardless of the scale used. Jeghanathan et al. Index showed weak agreement, and consistent results were found for Budtz‐Jorgensen Index (κ = 0.19 and 0.39 respectively). Conclusion: Assessment of accuracy for the biofilm indices showed instrument bias that was similar among the tested methods. Weak inter‐instrument reproducibility was found for the indices, except for the Budtz‐Jørgensen Index. This should be the method of choice for clinical studies when more sophisticated approaches are not possible.     

Activity of sodium trimetaphosphate,associated or not with fluoride,on dual-species biofilms

Abstract

A response surface methodology was used to build a model to predict reductions in uropathogenic Escherichia coli biofilms in response to three compounds: cranberry extract [CB] at 3.0–9.0%, and caprylic acid [CAR] and thymol [TM] at 0.01%–0.05%. The predictive model for microbial reduction had a high regression coefficient (R²?=?0.9988), and the accuracy of the model was verified (R²?=?0.9527). Values of CAR, TM, and the quadratic term CAR² were the most significant (P?10 reduction) determined by ridge analysis were 8.3% CB +0.04% CAR +0.04% TM at 37?°C for 1?min. The model could be used to predict the most cost-efficient amounts of antimicrobial agents for anti-urinary tract infection products such as catheter lock solution and antimicrobial coatings for catheters.     

Influence of different metal flask systems on tooth displacement in complete upper dentures

doi: 10.1111/j.1741‐2358.2010.00392.x Influence of different metal flask systems on tooth displacement in complete upper dentures Objective: To verify the occurrence of tooth displacement in dentures processed by moist hot‐polymerisation using traditional and experimental metal flask systems. Materials and methods: Waxed complete dentures were randomly assigned to three groups (n = 10), including traditional (TF) and experimental flasks (DF and HHF). Metal pins were placed at the incisal edge of maxillary central incisors (I), buccal cusp of first premolars (P) and mesiobuccal cusp of second molars (M). Transversal (I–I, P–P and M–M) and anteroposterior (LI–LM and RI–RM) distances were measured before and after denture processing using an optical microscope. The dentures were processed by hot water curing cycle (9 h/74°C). Collected data were analysed by anova , Paired Student’s t‐test and Holm–Sidak method (p < 0.05). Results: All measured distances demonstrated contraction after polymerisation, except for LI–LM in TF and RI–RM in DF and HHF. Statistically significant differences were found between the distances P–P for DF and HHF, and M–M for all groups. Comparison among flask systems revealed statistically significant difference in the P–P distance for the TF and HHF. Conclusion: Different flask systems did not cause variation in tooth displacement during denture processing, with the exception of P–P distances for the TF and HHF. There is no evidence that different metal flask systems would promote tooth displacement of clinical significance.     

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.     

Biofilm formation by Candida albicans and Streptococcus mutans in the presence of farnesol: a quantitative evaluation

The aim of this study was to evaluate the effect of the QS molecule farnesol on single and mixed species biofilms formed by Candida albicans and Streptococcus mutans. The anti-biofilm effect of farnesol was assessed through total biomass quantification, counting of colony forming units (CFUs) and evaluation of metabolic activity. Biofilms were also analyzed by scanning electron microscopy (SEM). It was observed that farnesol reduced the formation of single and mixed biofilms, with significant reductions of 37% to 90% and 64% to 96%, respectively, for total biomass and metabolic activity. Regarding cell viability, farnesol treatment promoted significant log reductions in the number of CFUs, ie 1.3–4.2 log₁₀ and 0.67–5.32 log₁₀, respectively, for single and mixed species biofilms. SEM images confirmed these results, showing decreases in the number of cells in all biofilms. In conclusion, these findings highlight the role of farnesol as an alternative agent with the potential to reduce the formation of pathogenic biofilms.     

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.     

纳米-TiO2对变异链球菌和白色假丝酵母菌抗菌机制的研究

目的 采用原子力显微镜对应用抗菌剂纳米Ag-Ti02作用后的口腔两种常见致病菌的分子形貌进行观测,为研究其抑菌机制提供有力的直观影像科学依据和可靠、直观的实验方法.方法 选择两种菌种:白色假丝酵母菌、变形链球菌,采用液体稀释法将纳米Ag-TiO2与两种菌相互作用,分别使用光学显微镜、原子力显微镜观察两种菌的细胞微观形态变化.结果 抗菌剂与两种菌作用后,细菌形态均有不同程度的改变,甚至是死亡.结论 原子力显微镜能直观地显示白色假丝酵母菌,变形链球菌的分子结构,通过本实验在研究纳米Ag-TiO2抗菌剂对白色假丝酵母菌,变形链球菌的抑菌机理形态学改变方面做了进一步的完善.     

Distribution of biofilm on internal and external surfaces of upper complete dentures: the effect of hygiene instruction

Objectives: The purpose of this study was to evaluate biofilm distribution over internal and external surfaces of upper complete dentures. It was also aimed at assessing the effect of oral hygiene instructions before and after home use of a disclosing solution. Materials and methods: The sample consisted of 29 complete denture wearers whose upper prostheses were evaluated. Surface biofilm was disclosed by means of a 1% neutral red solution and quantified with regard to internal and external surfaces. Oral hygiene information was provided on an individual basis. During the second stage, an amount of disclosing solution was given for domestic use. Results: Internal and external surfaces presented a similar amount of biofilm, which was concentrated over the area of the posterior teeth area, palatal rugae and the internal vestibular incline of the distobuccal flange. This pattern was maintained during the study. However, overall amounts were reduced following denture hygiene information. The use of disclosing solution by subjects at home resulted in a further reduction. Conclusions: It was concluded that biofilm deposits were similar over assessed surfaces, regardless of the type of procedure but irregular areas presented greater amounts. Oral health instruction was effective in reducing the biofilm, in particular when associated with home use of a disclosing agent.     

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.     

The prevalence of opportunistic pathogens associated with intraoral implants

Aims: The aim of this study was to determine the prevalence and proportions of opportunistic pathogens harboured on orthodontic retainers. Methods and Results: First, Staphylococcus spp. and Candida spp. were isolated from the retainer’s inner surface and from other mucosal surfaces of the subject’s mouth by routine bacterial culture. The prevalence and proportions of these micro‐organisms on retainers was compared in different areas of the mouth within a group of retainer wearers, and mucosal carriage was compared to a group of nonretainer wearers. Staphylococcus spp. were isolated from 50% of the retainers and comprised on average 8·4% of the viable microbiota. Candida spp. comprised 0·13% of the viable microbiota and were recovered from 66·7% of the retainers. Neither genus was isolated from nonretainer wearers. Second, the two most commonly worn retainers manufactured from different materials were sampled; again Staphylococcus spp. and Candida spp. were recovered; however, no statistical differences were observed between the devices. Conclusions: Opportunistic, nonoral, pathogenic micro‐organisms were recovered from orthodontic retainers. Significance and Impact of the Study: It is possible that an orthodontic retainer could be a reservoir for opportunistic pathogens and act as a source of cross‐, self‐ and re‐infection.