Isolation of Candida dubliniensis from denture wearers

Candida albicans is considered the most important Candida species able to cause oral infections in denture wearers. In recent years, Candida dubliniensis has emerged as a pathogenic yeast in humans. The close phenotypic similarities of C. albicans and C. dubliniensis have led to the misidentification of these species. In this work, our aim was to verify through PCR the presence of C. dubliniensis in palate and maxillary denture samples from 112 denture wearers presenting with or without denture-related stomatitis (DRS). C. dubliniensis was isolated at low rates from both palate (5.3% and 10.7%) and maxillary denture (5.3% and 8.9%) samples from wearers regardless of the presence of the disease. However, when C. dubliniensis was detected in individuals with DRS, it was always associated with C. albicans. In addition, our results showed that C. albicans was the most commonly identified candidal species in maxillary denture and hard palate samples from DRS patients (78.5% and 89.2%, respectively) as well as from controls (31.2% and 28.5%, respectively). In conclusion, C. dubliniensis was detected in the oral environment of denture wearers. The association of C. dubliniensis with C. albicans occurred in approximately 10% of the DRS cases.

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals. Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants. Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations. Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Effects of Mandibular Fixed Implant-Supported Prostheses on Masticatory and Swallowing Functions in Completely Edentulous Elderly Individuals

To evaluate the effect of oral rehabilitation with immediately loaded fixed implant-supported mandibular prostheses on chewing and swallowing in elderly individuals. Materials and Methods: Fifteen completely edentulous patients aged more than 60 years (10 women and five men), wearing removable dentures in both arches, had a mandibular denture replaced by an implant-supported prosthesis. All individuals were evaluated before surgery and again 3, 6, and 18 months later with regard to mastication and swallowing conditions. Examinations entailed an interview, evaluation of tactile sensitivity of the face, and observation of food intake, masticatory type, formations of bolus, and pain during mastication. The swallowing evaluation comprised observation of clinical signs related to the oral and pharyngeal stages of swallowing, as well as the presence of oral residue. The findings of different evaluations before and 3, 6, and 18 months after the surgical-prosthetic procedure were statistically compared by analysis of variance for repeated measurements at a significance level of 5%. Results: The questionnaire revealed a reduction in complaints of masticatory and swallowing disturbances, a decreased need for liquid ingestion, and reduced choking and coughing. Clinical evaluations showed improved oral function and bolus propulsion for both solid and paste-consistency foods; pain during mastication was also resolved. Conclusion: Treatment with mandibular implant-supported dentures had positive effects on the clinical aspects of mastication and swallowing in elderly individuals. INT J ORAL MAXILLOFAC IMPLANTS 2009; 24:110-117

HYPERZINCEMIA FROM INGESTION OF DENTURE ADHESIVES

The purpose of this article is to review the recent literature that documents the serious adverse systemic effects of prolonged, excessive zinc ingestion from the overuse of denture adhesives. This condition causes elevation of serum zinc levels that result in depression of serum copper. The low serum copper levels cause bone marrow depression and widespread sensory and motor neuropathies. Epidemiologic studies revealed the source of excessive zinc intake to be from overuse of denture adhesives. Denture patients must be advised of the risks of prolonged overuse of denture adhesives. (J Prosthet Dent 2010;103:380-383)

Reliability and Failure Modes of Implant-Supported Y-TZP and MCR Three-Unit Bridges

Purpose: Chipping within veneering porcelain has resulted in high clinical failure rates for implant-supported zirconia (yttria-tetragonal zirconia polycrystals [Y-TZP]) bridges. This study evaluated the reliability and failure modes of mouth-motion step-stress fatigued implant-supported Y-TZP versus palladium-silver alloy (PdAg) three-unit bridges. Materials and Methods: Implant-abutment replicas were embedded in polymethylmethacrylate resin. Y-TZP and PdAg frameworks, of similar design (n = 21 each), were fabricated, veneered, cemented (n = 3 each), and Hertzian contact-tested to obtain ultimate failure load. In each framework group, 18 specimens were distributed across three step-stress profiles and mouth-motion cyclically loaded according to the profile on the lingual slope of the buccal cusp of the pontic. Results: PdAg failures included competing flexural cracking at abutment and/or connector area and chipping, whereas Y-TZP presented predominantly cohesive failure within veneering porcelain. Including all failure modes, the reliability (two-sided at 90% confidence intervals) for a ""mission"" of 50,000 and 100,000 cycles at 300 N load was determined (Alta Pro, Reliasoft, Tucson, AZ, USA). No difference in reliability was observed between groups for a mission of 50,000. Reliability remained unchanged for a mission of 100,000 for PdAg, but significantly decreased for Y-TZP. Conclusions: Higher reliability was found for PdAg for a mission of 100,000 cycles at 300 N. Failure modes differed between materials.

On the direct product of two weak uniquely completable partial latin squares

In this note we show by counter-example that the direct product of two weak uniquely completable partial latin squares is not necessarily a uniquely completable partial latin square. This counter-example rejects a conjecture by Gower (see [3]) on the direct product of two uniquely completable partial latin squares.

Photoelastic Stress Analysis of Different Designs of Cement-Retained Fixed Partial Dentures on Morse Taper Oral Implants

There is no consensus in literature regarding the best plan for prosthetic rehabilitation with partial multiple adjacent implants to minimize stress generated in the bone-implant interface. The aim of this study was to evaluate the biomechanical behavior of cemented fixed partial dentures, splinted and nonsplinted, on Morse taper implants and with different types of coating material (ceramic and resin), using photoelastic stress analysis. A photoelastic model of an interposed edentulous space, missing a second premolar and a first molar, and rehabilitated with 4 different types of cemented crowns and supported by 2 adjacent implants was used. Groups were as follows: UC, splinted ceramic crowns; IC, nonsplinted ceramic crowns; UR, splinted resin crowns; and IR, nonsplinted resin crowns. Different vertical static loading conditions were performed: balanced occlusal load, 10 kgf; simultaneous punctiform load on the implanted premolar and molar, 10 kgf; and alternate punctiform load on the implanted premolar and molar, 5 kgf. Changes in stress distribution were analyzed in a polariscope, and digital photographs were taken of each condition to allow comparison of stress pattern distribution around the implants. Cementation of the fixed partial dentures generated stresses between implants. Splinted restorations distributed the stresses more evenly between the implants than nonsplinted when force was applied. Ceramic restorations presented better distribution of stresses than resin restorations. Based on the results obtained, it was concluded that splinted ceramic restorations promote better stress distribution around osseointegrated implants when compared with nonsplinted crowns; metal-ceramic restorations present less stress concentration and magnitude than metal-plastic restorations.

Domestic use of a disclosing solution for denture hygiene: a randomised trial

Objectives: The purpose of this study was to investigate the effect of the domestic use of a disclosing agent for denture hygiene. Materials and methods: Completely edentulous participants wearing maxillary dentures were randomly assigned to one of the three intervention groups: (1) Follow-up only (control; n = 12); (2) Oral and denture hygiene instructions (n = 10); (3) Instructions associated with the home use of a disclosing agent (1% neutral red; n = 10). Biofilm coverage area (%) over internal and external surfaces of the maxillary denture was assessed at baseline and after 14 and 90 days. Data were evaluated by generalised estimating equations based on score tests (alpha = 0.05). Results: The participants presented low changes for areas of biofilm coverage (14 days (%): internal: GI = 1.4 +/- 0.9; GII = 1.5 +/- 1.3; GIII = -0.4 +/- 0.9; external: GI = 1.4 +/- 1.5; GII = 1.5 +/- 1.4; GIII = -0.4 +/- 0.9; 90 days (%): internal: GI = 2.0 +/- 0.9; GII = 2.2 +/- 1.4; GIII = 0.3 +/- 1.0; external: GI = 2.1 +/- 1.4; GII = 2.2 +/- 1.5; GIII = 0.3 +/- 0.9). Changes were similar for the three groups (p = 0.293) and were not influenced by the test time (p = 0.218). Conclusion: It can be concluded that the home use of a disclosing agent for denture hygiene does not improve the removal of the biofilm, particularly for patients with adequate oral hygiene habits.

Testing the retention of attachments for implant overdentures - validation of an original force measurement system

P>The aim of this study was to validate an original portable device to measure attachment retention of implant overdentures both in the lab and in clinical settings. The device was built with a digital force measurement gauge (Imada) secured to a vertical wheel stand associated with a customized support to hold and position the denture in adjustable angulations. Sixteen matrix and patrix cylindrical stud attachments (Locator (R)) were randomly assigned as in vitro test specimens. Attachment abutments were secured in an implant analogue hung to the digital force gauge or to the load cell of a traction machine used as the gold standard (Instron Universal Testing Machine). Matrices were secured in a denture duplicate attached to the customized support, permitting reproducibility of their position on both pulling devices. Attachment retention in the axial direction was evaluated by measuring maximum dislodging force or peak load during five consecutive linear dislodgments of each attachment on both devices. After a wear simulation, retention was measured again at several time periods. The peak load measurements with the customized Imada device were similar to those obtained with the gold standard Instron machine. These findings suggest that the proposed portable device can provide accurate information on the retentive properties of attachment systems for removable dental prostheses.

Effects of Ethanol on the Surface and Bulk Properties of a Microwave-Processed PMMA Denture Base Resin

Purpose: This study evaluated the effect of different concentrations of ethanol on hardness, roughness, flexural strength, and color stability of a denture base material using a microwave-processed acrylic resin as a model system. Materials and Methods: Sixty circular (14 x 4 mm) and 60 rectangular microwave-polymerized acrylic resin specimens (65 x 10 x 3 mm(3)) were employed in this study. The sample was divided into six groups according to the ethanol concentrations used in the immersion solution, as follows: 0% (water), 4.5%, 10%, 19%, 42%, and 100%. The specimens remained immersed for 30 days at 37 degrees C. The hardness test was performed by a hardness tester equipped with a Vickers diamond penetrator, and a surface roughness tester was used to measure the surface roughness of the specimens. Flexural strength testing was carried out on a universal testing machine. Color alterations (Delta E) were measured by a portable spectrophotometer after 12 and 30 days. Variables were analyzed by ANOVA/Tukey`s test (alpha = 0.05). Results: For the range of ethanol-water solutions for immersion (water only, 4.5%, 10%, 19.5%, 42%, and 100%), the following results were obtained for hardness (13.9 +/- 2.0, 12.1 +/- 0.7, 12.9 +/- 0.9, 11.2 +/- 1.5, 5.7 +/- 0.3, 2.7 +/- 0.5 VHN), roughness (0.13 +/- 0.01, 0.15 +/- 0.07, 0.13 +/- 0.05, 0.13 +/- 0.02, 0.23 +/- 0.05, 0.41 +/- 0.19 mu m), flexural strength (90 +/- 12, 103 +/- 18, 107 +/- 16, 90 +/- 25, 86 +/- 22, 8 +/- 2 MPa), and color (0.8 +/- 0.6, 0.8 +/- 0.3, 0.7 +/- 0.4, 0.9 +/- 0.3, 1.3 +/- 0.3, 3.9 +/- 1.5 Delta E) after 30 days. Conclusions: The findings of this study showed that the ethanol concentrations of tested drinks affect the physical properties of the investigated acrylic resin. An obvious plasticizing effect was found, which could lead to a lower in vivo durability associated with alcohol consumption.

Effects of the domestic use of a disclosing solution on the denture biofilm: a preliminary study

To investigate the effect of the home use of a disclosing agent on the microbial composition of denture biofilm, by means of a cross-over randomized clinical trial. Two interventions were tested during 7 days each: (i) oral and denture hygiene instructions and (ii) instructions associated with the home use of a disclosing agent (1% neutral red). Eleven participants with visible biofilm deposits over their maxillary complete dentures were randomly assigned to one of the two sequences of interventions: (i) I followed by II, and (ii) II followed by I. A washout period of 7 days was established. After each intervention, samples of denture biofilm were evaluated by DNA checkerboard hybridization for the detection of Candida spp. and 17 bacterial species. Counts were low for all the tested species, and no significant difference was found between the tested interventions ( Wilcoxon test, P > 0.05). The home use of a disclosing agent does not remarkably change the composition of denture biofilm.

The Effect of Polymerization Cycles on Color Stability of Microwave-Processed Denture Base Resin

Purpose: This study evaluated the effect of different microwave polymerization cycles on the color changes of a microwave-processed denture base resin after accelerated aging and immersion in beverages. Materials and Methods: Specimens of light pink acrylic resin were divided into three groups according to polymerization cycle: (A) 500 W for 3 minutes, (B) 90 W for 13 minutes + 500 W for 90 seconds, and (C) 320 W for 3 minutes + 0 W for 4 minutes + 720 W for 3 minutes. Control groups were a heat-processed acrylic resin (T) and a chemically activated denture repair resin (Q). Eight specimens per group were aged in an artificial aging chamber and evaluated at 20, 192, and 384 hours. Another series of 40 specimens per group were immersed in water, coffee, tea, cola, or red wine and evaluated at 1, 12, and 36 days. Color was measured by a spectrophotometer before and after aging or immersion. Color changes (Delta E) were analyzed by ANOVA/Bonferroni t-test (alpha = 0.05). Results: Mean Delta E (+/- SD) after 384 hours of accelerated aging were (A) 2.51 +/- 0.50; (B) 3.16 +/- 1.09; (C) 2.89 +/- 1.06; (T) 2.64 +/- 0.34; and (Q) 9.03 +/- 0.40. Group Q had a significantly higher Delta E than the other groups. Color changes of immersed specimens were significantly influenced by solutions and time, but the five groups showed similar values. Mean Delta E at 36 days were (water) 1.4 +/- 0.8; (coffee) 1.3 +/- 0.6; (tea) 1.7 +/- 0.5; (cola) 1.4 +/- 0.7; and (red wine) 10.2 +/- 2.7. Results were similar among the five test groups. Conclusions: Color changes of the microwave-polymerized denture base resin tested were not affected by different polymerization cycles after accelerated aging or immersion in beverages. These changes were similar to the conventional heat-polymerized acrylic resin test, but lower than the repair resin after accelerated aging.

Evaluation of the Bond Strength of Denture Base Resins to Acrylic Resin Teeth: Effect of Thermocycling

Purpose: The purpose of this study was to evaluate the thermocycling effects and shear bond strength of acrylic resin teeth to denture base resins. Materials and Methods: Three acrylic teeth (Biotone, Trilux, Ivoclar) were chosen for bonding to four denture base resins: microwave-polymerized (Acron MC), heat-polymerized (Lucitone 550 and QC-20), and light-polymerized (Versyo. bond). Twenty specimens were produced for each denture base/acrylic tooth combination and were divided into two groups (n = 10): without thermocycling (control groups) and thermocycled groups submitted to 5000 cycles between 4 and 60 degrees C. Shear strength tests (MPa) were performed with a universal testing machine at a crosshead speed of 1 mm/min. Statistical analysis of the results was carried out with three-way ANOVA and Bonferroni`s multiple comparisons post hoc analysis for test groups (alpha = 0.05). Results: The shear bond strengths of Lucitone/Biotone, Lucitone/Trilux, and Versyo/Ivoclar specimens were significantly decreased by thermocycling, compared with the corresponding control groups (p < 0.05). The means of Acron/Ivoclar and Lucitone/Ivoclar specimens increased after thermocycling (p < 0.05). The highest mean shear bond strength value was observed with Lucitone/Biotone in the control group (14.54 MPa) and the lowest with QC-20/Trilux in the thermocycled group (3.69 MPa). Conclusion: Some acrylic tooth/denture base resin combinations can be more affected by thermocycling; effects vary based upon the materials used.

Effect of methyl methacrylate monomer on bond strength of denture base resin to acrylic teeth

Bond failures at the acrylic teeth and denture base resin interface are still a common clinical problem in prosthodontics. The effect of methyl methacrylate (MMA) monomer on the bond strength of three types of denture base resins (Acron MC, Lucitone 550 and QC-20) to two types of acrylic teeth (Biotone and Trilux) was evaluated. Twenty specimens were produced for each denture base resin/acrylic tooth combination and were randomly divided into control (acrylic teeth received no surface treatment) and experimental groups (MMA was applied to the surface of the acrylic teeth for 180 s) and were submitted to shear tests (1 mm/mm). Data (MPa) were analyzed using three-way ANOVA/Student`s test (alpha = 0.05). MMA increased the bond strength of Lucitone denture base resins and decreased the bond strength of QC-20. No difference was detected for the bond strength of Acron MC base resin after treatment with MMA. (C) 2008 Elsevier Ltd. All rights reserved.