Implant removal by means of an expansion of the alveolar bony crest: Report of a clinical technique

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

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. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Effectiveness of mechanical brushing with different denture cleansing agents in reducing in vitro Candida albicans biofilm viability

The adhesion of Candida albicans to surfaces is the prerequisite for occurrence of denture stomatitis, a common disease diagnosed among denture wearers. A routine of denture cleansing is essential to prevent biofilm formation and the onset of this infection. The aim of this study was to investigate the effectiveness of combining brushing and cleansing agents in killing C. albicans biofilm. Disks of acrylic resin were made, sterilized, and inoculated with C. albicans (107 cfu/mL). After incubation (37°C/48 h), specimens were randomly assigned to 10 experimental groups (n=9): 5 subjected to brushing with distilled water or cleansing agents - dentifrice slurry, 2% chlorhexidine gluconate (CHX), 1% sodium hypochlorite (NaOCl), and Polident fresh cleanse® (combined method) - and 4 exposed to the cleansing agents without brushing (immersion). Non-cleansed specimens were used as positive controls. The viability of cells was evaluated by XTT reduction method. Results were analyzed by Mann-Whitney and Kruskal-Wallis tests (α=0.05). The combined method was significantly more effective (p<0.0001) in reducing biofilm viability than the immersion. Brushing with CHX and NaOCl resulted in 100% removal of the biofilm. Immersion in the agents reduced significantly (p<0.0001) the biofilm viability, with CHX being the most effective (p<0.0001). The use of the combined method of brushing with cleansing agents is an effective method to reduce C. albicans biofilm, being CHX and NaOCl the most effective solutions.

Radiographic study of patients with ectodermal dysplasia and partial

Aim: To investigate the association between gender and type of cleft with hypodontia and to verify if the presence of the cleft interferes with hypodontia of one or more type of teeth in patients with ectodermal dysplasia attending the Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of Sγo Paulo (USP). Materials and Methods: Panoramic radiographs of 54 patients of both genders (29 males, 25 females), from the files of the oral radiology sector of HRCA/USP, presenting with ectodermal dysplasia and cleft lip and/or palate were evaluated by radiographic observation of hypodontia of one or more types of teeth. Statistical Analysis: We performed descriptive statistics and statistical analysis by Fisher test. Results: Hypodontia was observed in 50% of females and 50.88% of males; 50% for cleft palate and 50.59% for complete cleft lip and palate. Only 22.22% of patients with cleft palate and 6.67% with complete cleft lip and palate presented with hypodontia of one type of teeth, whereas 77.78% of cases with cleft palate and 93.33% with complete cleft lip and palate displayed hypodontia of more than one type of teeth. Conclusion: Based on the present methodology, there were no statistically significant differences in hypodontia of one or more types of teeth between genders or types of cleft.

Effect of disinfectant solutions on a denture base acrylic resin.

The aim of this study was to evaluate the hardness, roughness and mass loss of an acrylic denture base resin after in vitro exposure to four disinfectant solutions. Forty specimens (Clássico, Brazil) were prepared and randomly assigned to 4 groups n = 10) according to the disinfectant solution: G1: control, stored in distilled water at 37 degrees C; G2: 1% sodium hypochlorite; G3: 2% glutaraldehyde; G4: 4% chlorhexidine. G2 to G4 were immersed for 60 minutes in the disinfectant solution. Measurements were carried out both before and after immersion in the solution. The surface was analyzed with a surface roughness tester (Surfcorder SE 1700 KOZAKALAB), a microdurometer FM-700 (Future Tech) and a scanning electron microscope (DSM 962-ZEISS). Loss of mass was determined with a digital weighing scale. After disinfection procedures, values were analyzed statistically. The acrylic denture base resin may be vulnerable to surface changes after in vitro immersion in the disinfectant solutions studied.

Impact strength of denture base and reline acrylic resins: An in vitro study

This study evaluated the impact strength of a denture base resin (Lucitone 550-L) and four reline resins (Tokuyama Rebase II-T; Ufi Gel Hard-U; New Truliner-NT, and Kooliner-K), both intact and in a reline combination (L/L, L/T, L/U, L/NT, and L/K). For each group (n = 20), half of the specimens were thermocycled before testing. Charpy tests were performed, and the impact strengths were calculated. Data were analyzed by two-way analyses of variance and Tukey's test (p = 0.05). For the intact groups, mean impact strength values for L (1.65 and 1.50) were significantly higher than those of the reline resins (0.38-1.17). For the relined groups, the highest mean impact strength values were produced by L/T (5.76 and 5.12), L/NT (6.20 and 6.03), and L/K (5.60 and 5.31) and the lowest by L/U (0.76 and 0.78). There were no significant differences between L and L/L. Thermocycling reduced the impact strength of T (from 0.73 to 0.38) and L/L (from 1.82 to 1.56). © The Author(s) 2012.

Effect of experimental photopolymerized coatings on the hydrophobicity of a denture base acrylic resin and on Candida albicans adhesion

Objective: This study investigated the effect of experimental photopolymerized coatings, containing zwitterionic or hydrophilic monomers, on the hydrophobicity of a denture base acrylic resin and on Candida albicans adhesion. Methods: Acrylic specimens were prepared with rough and smooth surfaces and were either left untreated (control) or coated with one of the following experimental coatings: 2-hydroxyethyl methacrylate (HE); 3-hydroxypropyl methacrylate (HP); and 2-trimethylammonium ethyl methacrylate chloride (T); and sulfobetaine methacrylate (S). The concentrations of these constituent monomers were 25%, 30% or 35%. Half of the specimens in each group (control and experimentals) were coated with saliva and the other half remained uncoated. The surface free energy of all specimens was measured, regardless of the experimental condition. C. albicans adhesion was evaluated for all specimens, both saliva conditioned and unconditioned. The adhesion test was performed by incubating specimens in C. albicans suspensions (1 × 10 7 cell/mL) at 37 °C for 90 min. The number of adhered yeasts were evaluated by XTT (2,3-bis[2-methoxy-4-nitro-5-sulfophenyl]-5-[{phenylamino} carbonyl]-2H-tetrazolium-hydroxide) method. Results: For rough surfaces, coatings S (30 or 35%) and HP (30%) resulted in lower absorbance values compared to control. These coatings exhibited more hydrophilic surfaces than the control group. Roughness increased the adhesion only in the control group, and saliva did not influence the adhesion. The photoelectron spectroscopy analysis (XPS) confirmed the chemical changes of the experimental specimens, particularly for HP and S coatings. Conclusions: S and HP coatings reduced significantly the adhesion of C. albicans to the acrylic resin and could be considered as a potential preventive treatment for denture stomatitis. © 2012 Elsevier Ltd.

In vitro adhesion of Candida glabrata to denture base acrylic resin modified by glow-discharge plasma treatment

This study evaluated the potential of plasma treatments to modify the surface chemistry and hydrophobicity of a denture base acrylic resin to reduce the Candida glabrata adhesion. Specimens (n=54) with smooth surfaces were made and divided into three groups (n=18): control - non-treated; experimental groups - submitted to plasma treatment (Ar/50W; AAt/130W). The effects of these treatments on chemical composition and surface topography of the acrylic resin were evaluated. Surface free energy measurements (SFE) were performed after the treatments and after 48h of immersion in water. For each group, half (n=9) of the specimens were preconditionated with saliva before the adhesion assay. The number of adhered C. glabrata was evaluated by cell counting after crystal violet staining. The Ar/50W and AAt/130W treatments altered the chemistry composition, hydrophobicity and topography of acrylic surface. The Ar/50W group showed significantly lower C. glabrata adherence than the control group, in the absence of saliva. After preconditioning with saliva, C. glabrata adherence in experimental and control groups did not differ significantly. There were significant changes in the SFE after immersion in water. The results demonstrated that Ar/50W treated surfaces have potential for reducing C. glabrata adhesion to denture base resins and deserve further investigation, especially to tailor the parameters to prolong the increased wettability. © 2012 Blackwell Verlag GmbH.

Effect of thermal cycling and disinfection on microhardness of acrylic resin denture base

The purpose of this study was to investigate the effect of thermal cycling and disinfection on the microhardness of acrylic resins denture base. Four different brands of acrylic resins were evaluated: Onda Cryl, QC 20, Classico and Lucitone. Each brand of acrylic resin was divided into four groups (n = 7) according to the disinfection method (microwave, Efferdent, 4% chlorhexidine and 1% hypochlorite). Samples were disinfected during 60 days. Before and after disinfection, samples were thermal cycled between 5-55 °C with 30-s dwell times for 1000 cycles. The microhardness was measured using a microhardener, at baseline (B), after first thermal cycling (T1), after disinfection (D) and after second thermal cycling (T2). The microhardness values of all groups reduced over time. QC-20 acrylic resin exhibited the lowest microhardness values. At B and T1 periods, the acrylic resins exhibited statistically greater microhardness values when compared to D and T2 periods. It can be concluded that the microhardness values of the acrylic resins denture base were affected by the thermal cycling and disinfection procedures. However, all microhardness values obtained herein are within acceptable clinical limits for the acrylic resins. © 2013 Informa UK Ltd.

Effect of immersion cleansers on the bond strength between a denture base resin and acrylic resin teeth

The aim of the present study was to assess the shear bond strength between a heat-polymerized denture base resin and acrylic resin teeth after immersion in different denture cleansers by simulating a 180-day use. Two acrylic teeth (Biotone, Biotone IPN, Dentsply Ind. e Com., Rio de Janeiro, RJ, Brazil) were chosen for bonding to a heat-polymerized denture base resin (Lucitone 550- Dentsply Ind. e Com., Rio de Janeiro, RJ, Brazil). Eighty specimens were produced and divided into eight groups (n=10) according to their experimental condition (distilled water, 2% chlorhexidine digluconate, 1% sodium hypochlorite and Corega Tabs). Shear bond strength tests (MPa) were performed with a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed by two-way analysis of variance (ANOVA) and Student-Newman-Keuls' multiple comparisons post hoc analysis (α=.05). The shear bond strength results revealed statistically significant differences between the groups. For the Biotone IPN tooth, significantly lower shear bond strength values were found for the group immersed in sodium-perborate solution (4.48±2.18 MPa) than for the group immersed in distilled water (control group) (10.83±1.84 MPa). For Biotone, significantly higher bond strength values (10.04±3.28 MPa) were found for the group immersed in Corega Tabs than for the control group (5.45±2.93 MPa). The immersion in denture cleanser solutions was more detrimental to the conventional acrylic denture tooth (Biotone) than to the highly cross-linked denture tooth (Biotone IPN). However, this effect was not observed for the groups immersed in Corega Tabs solution, regardless of the type of denture tooth. © 2013 Elsevier Ltd.

Ricinus communis treatment of denture stomatitis in institutionalised elderly

This study compared the effectiveness of Ricinus communis (RC) with Nystatin (NYS) and Miconazole (MIC) in the treatment of institutionalised elderly with denture stomatitis (DS). They (n = 30) were randomly distributed into three groups: MIC, NYS or RC. Clinical and mycological evaluations were performed prior to the use of the antifungal (baseline) and repeated after 15 and 30 days of treatment. The sample was clinically examined for oral mucosal conditions. Standard photographs were taken of the palate, and the oral candidiasis was classified (Newton's criteria). Mycological investigation was performed by swabbing the palatal mucosa, and Candida spp. were quantified by counting the number of colony-forming units (cfu mL-1). The clinical and mycological data were analysed, respectively by Wilcoxon and Student's t-test (α = 0·05). Significant improvement in the clinical appearance of DS in the MIC and RC groups was observed between the 1st and 3rd collections (MIC - P = 0·018; RC - P = 0·011) as well as between the 2nd and 3rd collections (MIC - P = 0·018; RC - P = 0·011). Neither groups showed a statistically significant reduction in cfu mL-1 at any time. Although none of the treatments decreased the cfu mL-1, it was concluded that Ricinus communis can improve the clinical condition of denture stomatitis in institutionalised elderly patients, showing similar results to Miconazole. © 2013 Blackwell Publishing Ltd.

Effect of thermal cycling on denture base and autopolymerizing reline resins

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Chemical characterization and flexural strength of a denture base acrylic resin with monomer 2-tert-butylaminoethyl methacrylate

Purpose: The objectives of this study were to investigate the flexural strength (FS) and chemical interaction between 2-tert-butylaminoethyl methacrylate (TBAEMA) and a denture base acrylic resin. Materials and Methods: Specimens were divided into five groups according to the concentration of TBAEMA incorporated in acrylic resin Onda-Cryl (0%, 1%, 2%, 3%, 4%) and were submitted to Fourier transform infrared spectroscopy (FTIR), electron spectroscopy for chemical analysis (XPS-ESCA), and differential scanning calorimetry (DSC) analyses. FS of the specimens was tested, and results were analyzed by ANOVA/Tukey's test (α < 0.05). Results: Different nitrogen ratios were observed on specimens' surfaces: 0.36%, 0.54%, 0.35%, and 0.20% for groups 1%, 2%, 3%, and 4%, respectively. FTIR indicated copolymerization of acrylic resin and TBAEMA, and DSC results demonstrated a decrease in glass transition temperature (Tg). Significant differences were found for FS (p < 0.05). The mean values were 91.1 ± 5.5,A 77.0 ± 13.1,B 67.2 ± 12.5,B 64.4 ± 13.0,B and 67.2 ± 5.9B MPa for groups 0%, 1%, 2%, 3% and 4%, respectively (same superscript letters indicate no significant difference). Conclusions: The incorporation of TBAEMA in acrylic resin resulted in copolymerization and the presence of amine groups on specimens' surfaces, and in decreases of Tg and FS. © 2012 by the American College of Prosthodontists.

Susceptibility profile of a Brazilian yeast stock collection of Candida species isolated from subjects with Candida-associated denture stomatitis with or without diabetes

Objective: This study investigated the susceptibility of 198 clinical isolates of Candida species against caspofungin, amphotericin B, itraconazole, and fluconazole. Study Design: Suspensions of the microorganisms were spread on Roswell Park Memorial Institute (RPMI) agar plates. Etest strips were placed on the plates, and the minimal inhibitory concentration (MIC) was read after incubation (48 h at 37°C). Data were analyzed by a factorial analysis of variance and a 2 × 2 post hoc test (α = .05). Results: C glabrata showed the highest MIC values (P < .001) against caspofungin, itraconazole, and fluconazole. For amphotericin B, the MIC values of C tropicalis and C glabrata (P = .0521) were higher than those of C albicans (P < .001). Itraconazole was the least effective antifungal; 93.3% of the C glabrata isolates, 3.3% of the C albicans, and 1.3% of the C tropicalis were resistant. All microorganisms were susceptible to caspofungin and amphotericin B. Conclusions: Caspofungin and amphotericin B should be recommended as an effective alternative for the management of oral Candida infections when treatment with topical or other systemic drugs has definitely failed. © 2013 Elsevier Inc. All rights reserved.

Análise extensométrica de cargas estáticas axiais e não axiais em próteses implantossuportadas de três elementos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)