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.

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin

In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. Objective: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). Material and Methods: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 degrees C for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 degrees C for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (alpha=0.05) and the failure modes were visually classified. Results: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. Conclusions: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Influence of Microwave Disinfection on the Dimensional Stability of Denture Reline Polymers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin

In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. Objective: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). Material and Methods: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 degrees C for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 degrees C for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (alpha=0.05) and the failure modes were visually classified. Results: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. Conclusions: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Avaliação in vitro da incorporação de clorexidina nas propriedades físico-químicas de resinas macias

A incorporação do diacetato de clorexidina em resinas macias para reembasamento de próteses pode se tornar uma boa alternativa na terapia com antimicrobianos usados para candidíase oral, uma vez que é independente da cooperação do paciente. Este trabalho teve como objetivo analisar a hipótese que a incorporação de diacetato de clorexidina em resinas macias não alteraria as suas propriedades físico-químicas. Foram analisadas duas resinas macias, uma à base de polimetilmetacrilato (PMMA) e outra à base de polietilmetacrilato (PEMA), com a incorporação de 0,5%, 1,0% e 2,0% de diacetato de clorexidina, além do grupo controle sem diacetato de clorexidina. Os espécimes foram armazenadas em água destilada a 37 durante 2hrs, 48 hrs, 7, 14, 21 e 28 dias e analisados quanto a cristalinidade do polímero através da difração de Raios X, a dureza mensurada com durômetro na escala shore A, o grau de conversão dos monômeros pela Espectroscopia de Infravermelho Transformada de Fourier (FTIR), a lixiviação de monômeros residuais e a liberação da clorexidina por Cromatografia Líquida de Alta Performace (HPLC). Os resultados mostraram que quanto à cristalinidade dos polímeros nas resinas macias à base de PMMA e de PEMA não alteraram após a incorporação de clorexidina, o que está relacionado à dureza Shore A, que aumentou ao longo do tempo, mas sem alteração significativa para nenhuma das concentrações de diacetato de clorexidina testadas. Já quanto ao grau de conversão, após a incorporação de clorexidina, a resina macia à base de PMMA não apresentou diferença estatisticamente significativa (р>0,05), porém a resina macia à base de PEMA apresentou diminuição significativa do grau de conversão (p<0,05), o que refletiu no aumento significativo da lixiviação de monômeros residuais nas concentrações 0,5% e 1,0% de clorexidina (p<0,05), principalmente nas primeiras 48 horas nessa resina. A resina macia à base de PMMA não apresentou alterações do padrão de lixiviação desses monômeros (р>0,05) e para ambas as resinas a cinética de liberação de clorexidina foi relacionada à lixiviação de monômeros residuais, que para a resina macia à base de PEMA foi maior significativamente nas primeiras 48 horas (p<0,05) e para a resina macia à base de PMMA não teve alteração estatisticamente significativa (р>0,05) se mantendo até o último dia de análise. Desse modo, conclui-se que a incorporação do diacetato de clorexidina não afetou a cristalinidade dos polímeros, inalterando a dureza nas duas resinas, porém o grau de conversão sofreu diminuição após a incorporação de diacetato de clorexidina na resina macia à base de PEMA, o que levou ao aumento da lixiviação de monômeros residuais e curta liberação de clorexidina; enquanto que a resina macia à base de PMMA, devido a não alteração significativa do seu grau de conversão, ocorreu menor lixiviação de monômeros residuais e liberação prolongada de clorexidina.

Photoelastic analysis to compare implant-retained and conventional obturator dentures

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Molhabilidade de material reembasador: efeito dos agentes químicos de limpeza

Risk of mechanical injuries contraindicate brushing and elect chemical agents as appropriate for daily cleaning of dentures relined with resilient materials. It was evaluated the effect of denture cleansers on the wettability of denture relining material (Dentusoft, Dental Medrano). We used 20 discs of acrylic resin thermoactivated VipiCril ® with 30mm diameter and 4mm thick, covered by 2mm Dentusoft ®. Divided into 4grupos were stored in artificial saliva at 37 +1 º C for 30 days, immersed daily for 15minutes in distilled water (GI), Corega ® Tabs (GII), a solution of sodium bicarbonate (GIII) or solution of sodium hypochlorite (GIV) after which, on the soft liner were poured 2 ml of type IV gypsum (Durone IV, Dentsply). Reached the final setting of the gypsum specimens were sectioned vertically and medially, settled water with sandpaper No. 400 and mounted on suitable device for reading (in the right and left) of the contact angle Carl Zeiss microscope (precision, 001). The results were submitted to analysis, showed non-normal distribution, opting for non-parametric test. Kruskal Wallis test performed at 5% significance, there was statistical difference between the groups with lower average contact angle for GII. It was concluded that the chemical cleaning Corega Tabs ® allowed a better adaptation of relining the gypsum studied.

Effect of relining, water storage and cyclic loading on the flexural strength of a denture base acrylic resin

Objectives: This study investigated the effect of relining, water storage and cyclic loading on the ultimate flexural strength (FSU) and on the flexural strength at the proportional limit (FSPl) of a denture base acrylic resin (Lucitone 550-L).Methods: Rectangular bars of L were made (64 mm x 10 mm x 2 mm) and relined (1.3 mm) with four relining resins (Kooliner-K, Ufi Gel Hard-UGH, Tokuso Rebase Fast-TR and New Truliner-NT). In addition, specimens relined with L and intact L specimens were made (64 mm x 10 mm x 3.3 mm). A three-point flexural test was applied on the specimens (n = 10) after (1) polymerization; (2) water storage (30 days); (3) cyclic loading (10,000 cycles at 5 Hz) and (4) water storage (30 days) + cyclic loading. Data (MPa) were analyzed with three-way ANOVA and Tukey's HSD tests (alpha = 0.05). To test for a possible correlation between FSU and FSPl, a linear regression coefficient 'r' was calculated.Results: After water storage, L-UGH and L-TR demonstrated an increased FSU (41.4950.64 MPa and 49.95-57.36 MPa, respectively) (P < 0.05). Only L-TR demonstrated an increased FSPl (20.58-24.21 MPa) after water storage (P < 0.05). L-L had the highest FSU (between 78.57 and 85.09 MPa) and FSPl (between 31.30 and 34.17 MPa) (P < 0.05). The cyclic loading decreased the FSU and FSPl of all materials (P < 0.05). Regression analysis showed a strong linear correlation between the two variables (r = 0.941).Conclusions: Water storage improved the FSU of L-UGH and L-TR and the FSPl of L-TR. L-L produced the highest FSU and FSPl. The FSU and FSPl of all materials were detrimentally influenced by cyclic loading.

Resistance to impact of cross-linked denture base biopolymer materials: Effect of relining, glass flakes reinforcement and cyclic loading

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Photoelastic Analysis of Implant-Retained and Conventional Obturator Prostheses With Different Attachment Systems and Soft Relining

Complete and partial loss of maxillary bone may jeopardize oral physiology and generate complications as oral-sinus-nasal communication. Palatal obturator prostheses are a treatment alternative for rehabilitation of these patients. The aim of this study was to assess stress distribution, through photoelasticity, on palatal obturator prostheses associated with different attachment systems (o'ring, bar clip, and o'ring/bar clip) of implants and submitted to relining. Two photoelastic models were fabricated according to an experimental maxillary model with oral-sinus-nasal communication. One model did not present implants, whereas the other included 2 implants with 13.0 mm in length in the left ridge. Four colorless maxillary obturator prostheses were fabricated and relined with soft silicone. One of these prostheses presented no attachment system, whereas the remaining prostheses included attachment systems adapted to the implants. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope during loading with 100 N at 10 mm/s. The results were based on observation during the experiment and photographic records of stress on the photoelastic model. The bar clip system exhibited the highest stress concentration followed by o'ring/bar clip and o'ring systems. The attachment systems presented different stress distribution with greater concentration surrounding the implants and homogenous stress distribution on the photoelastic model without implants. The highest concentration of fringes occurred, in ascending order, with o'ring, o'ring/bar clip, and bar clip systems.

Influence of thermal and mechanical stresses on the strength of intact and relined denture bases

Statement of problem. Denture bases may become increasingly weaker as a result of thermal stress and flexural cyclic loading. Information regarding this potential problem and its relationship to the denture base reline is limited.Purpose. This study evaluated the influence of thermal and mechanical stresses on the strength of intact and relined denture bases.Material and methods. Twenty-eight microwave-polymerized (Acron MC) intact denture bases were prepared in the shape of a 3-mm-thick maxillary denture. Additionally, fifty-six 2-mm-thick denture bases were relined with 1 mm of autopolymerizing resin (Tokuyama Rebase Fast II or New Truliner) (n = 28). Intact and relined specimens were divided into 4 groups (n = 7) as follows: without stress (control); a mechanical stress at 0.8 Hz for 10,000 cycles; 5000 thermal cycles between 5 degrees C and 55 degrees C; or a combination thermo-mechanical stress. The specimens were vertically loaded in compression with a rounded rod at 5 mm/min until failure, using a universal testing machine. Data on maximum fracture load (N), deflection at fracture (%), and fracture energy (N-mm) were analyzed by 2-way analysis of variance and Student-Newman-Keuls tests (alpha = .05).Results. The strength of the denture bases relined with New Truliner was not significantly affected by any of the experimental conditions, but comparing the control groups, New Truliner exhibited the lowest maximum fracture load values. The maximum fracture load of intact denture bases (P = .002) and those relined with Tokuyama Rebase Fast II (P = .01) showed a significant decrease after thermal stress. Additionally, cyclic loading significantly decreased the maximum fracture load (P < .001), deflection at fracture (P = .025), and fracture energy (P < .001) of intact denture bases and those relined with Tokuyama Rebase (P values of .002, .039, and .001, respectively).Conclusion. Thermal and mechanical stresses exert deleterious effects on the strength of intact and/or relined denture bases, which vary according to the relining material used.

Bonding strength between a hard chairside reline resin and a denture base material as influenced by surface treatment

Direct relining of dentures made with hard chairside reline resins is faster than laboratory-processed reline systems and the patient is not without the prosthesis for the time necessary to perform the laboratory procedures. However, a weak bond between the autopolymerizing acrylic reline resins and the denture base material has been observed. This study evaluated the effect of six different surface treatments on the bond strength between a hard chairside reline acrylic resin and ia heat-cured acrylic resin. Specimens of the heat-cured acrylic resin were divided into seven groups. one of these groups remained intact. In the other groups, a 10-mm square section was removed from the centre of each specimen. The bonding surfaces were then treated with (i) methyl methacrylate monomer, (ii) isobutyl methacrylate monomer, (iii) chloroform, (iv) acetone, (v) experimental adhesive and (vi) no surface treatment-control group. Kooliner acrylic resin was packed,into the square sections and polymerized. The bonding strength was evaluated by a three-point loading test. The results were submitted to one-way analysis of variance (ANOVA) followed by a Tukey multiple range test at a 5% level of significance. No significant difference was found between the surface treatment with Lucitone 550 monomer or chloroform, but both were stronger than the majority of the other groups. The bond strength provided by all the surface treatments was lower than that of the intact heat-cured resin.

Effect of water storage on the shear strength and fatigue limit of the reline resin bond to denture base resins

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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 degrees 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.

Effect of reline material and denture base surface treatment on the impact strength of a denture base acrylic resin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)