Joint sounds in complete denture wearers. Literature review.

Long-term denture wearers can present with prosthesis instability, reduced occlusal vertical dimension and incorrect positioning of the jaw. This can lead to muscular changes and joint vibration. This study presents the main considerations related to joint vibrations in partially or totally edentulous patients. Occlusal treatment improves the disc-condyle relationship in the mandibular fossa. Furthermore, a detailed clinical exam and anamnesis must be performed to identify the dysfunction and its etiology, so that appropriate treatment can be provided.

Effect of storage in artificial saliva and thermal cycling on Knoop hardness of resin denture teeth

Purpose: This study aimed to evaluate the effect of different storage periods in artificial saliva and thermal cycling on Knoop hardness of 8 commercial brands of resin denture teeth. Methods: Eigth different brands of resin denture teeth were evaluated (Artplus group, Biolux group, Biotone IPN group, Myerson group, SR Orthosit group, Trilux group, Trubyte Biotone group, and Vipi Dent Plus group). Twenty-four teeth of each brand had their occlusal surfaces ground flat and were embedded in autopolymerized acrylic resin. After polishing, the teeth were submitted to different conditions: (1) immersion in distilled water at 37 ± 2 °C for 48 ± 2. h (control); (2) storage in artificial saliva at 37 ± 2 °C for 15, 30 and 60 days, and (3) thermal cycling between 5 and 55 °C with 30-s dwell times for 5000 cycles. Knoop hardness test was performed after each condition. Data were analyzed with two-way ANOVA and Tukey's test (α= .05). Results: In general, SR Orthosit group presented the highest statistically significant Knoop hardness value while Myerson group exhibited the smallest statistically significant mean (P< .05) in the control period, after thermal cycling, and after all storage periods. The Knoop hardness means obtained before thermal cycling procedure (20.34 ± 4.45 KHN) were statistically higher than those reached after thermal cycling (19.77 ± 4.13 KHN). All brands of resin denture teeth were significantly softened after storage period in artificial saliva. Conclusion: Storage in saliva and thermal cycling significantly reduced the Knoop hardness of the resin denture teeth. SR Orthosit denture teeth showed the highest Knoop hardness values regardless the condition tested. © 2010 Japan Prosthodontic Society.

Influence of ridge type on mandibular distal extension removable partial denture.

The aim of this study was to use photoelastic models to analyze the distribution of stress caused by the incidence of loads on a mandibular distal extension removable partial denture, both on the abutment teeth and on differently shaped residual ridges: distal ascending, descending-ascending, horizontal and distal descending. The best type of retainer and location of the rest on the last abutment tooth were determined for the different types of ridge. Four models were made from photoelastic resin (PL-1 for the teeth and PL-2 for the alveolar ridge), one for each kind of ridge. For each model, 4 removable partial dentures (RPD) were made (16 RPD altogether): T-bar retainer and distal rest, T-bar retainer and mesial rest, circumferential retainer and distal rest, and circumferential retainer and mesial rest. The models were placed on a circular polariscope and a 100 N axial load (point load) was applied to premolars and molars of the RPD. The formation of photoelastic bands was photographed for qualitative analysis. Results showed that the horizontal ridge had better distribution of stress, while the distal descending ridge had greater concentration of stress. The circumferential retainer had greater areas of stress for all types of ridges except the horizontal ridge, where there was no influence related to retainer type. The distribution of stress was similar among the different types of ridges when the rest was mesial or distal to the last abutment tooth, except for the distal descending ridge, where there was greater concentration of stress when the rest was located distally to the last abutment tooth. Thus, it may be concluded that (1) the situation was least favorable for the distal descending ridge and most favorable for the horizontal ridge, (2) the T-bar retainer had more favorable stress distribution, except when the ridge was horizontal, in which case there was no influence in relation to the type of retainer, (3) the location of the rest showed similar behavior in all except the distal descending ridge.

Impact strength of denture base and reline acrylic resins subjected to long-term water immersion

Water may influence the mechanical properties of the acrylic resins. Thus, the effect of water storage on the impact strength (IS) of one denture base (Lucitone 550 - L) and four reline resins (Tokuyama Rebase II - T; UfiGel Hard - U; Kooliner - K; New Truliner - NT) was evaluated. Bars of L were made (60 x 6 x 2 mm) and relined (2 mm) with T, U, K, NT and L. Intact specimens of each material (60 x 6 x 4 mm) were also fabricated for comparative purposes. Specimens were submitted to Charpy impact tests without water storage (control) and after immersion in water for 7, 90 and 180 days. Data (kJ/m 2) analyzed by two-way ANOVA and Tukey's test (p=0.05) revealed that after 90 days, U exhibited an increase in the IS (0.93) compared to 7 days (0.58). K (1.48) and L/K (7.21) exhibited a decrease at the 7-day period (1.01 and 3.23, respectively). NT (0.60) showed an increase in the IS after 180 days (1.52), whereas L/ NT (7.70) showed a decrease (3.17). Water immersion improved the IS of U and NT, and decreased the IS of K, L/K, and L/NT. Water may affect differently the IS of acrylic resins and, consequently, the resistance to fracture of relined denture bases.

Color stability of resins and nylon as denture base material in beverages

Purpose: Staining of prosthodontic materials may result in patient dissatisfaction and additional expense for replacement. This study aimed to determine the color stability of two heat-cured denture base acrylic (Lucitone 550, Vipi Cril) and one nylon denture base resin (Transflex) after immersion in beverages. Materials and Methods: Forty disks of each resin (20.0-mm diameter, 3.0-mm thick) were prepared and stored in distilled water for 24 hours at 37°C. During that time (T 0), the color of all specimens was spectrophotometrically measured. Each specimen was immersed in coffee, cola, red wine, and distilled water as a means of control. After 15-day (T 1) and 30-day (T 2) periods of immersion, the color of the specimens was measured again. The CIE (Commission Internationale de L' Eclairage) L*a*b* system was used to determine mean ΔE (color changes) values for each material and compared statistically with two-way ANOVA and Bonferroni intervals at 0.95. Results: In ΔET 0T 1 and ΔET 0T 2 the most severe staining was apparent with red wine (p < 0.001), followed by coffee (p < 0.01), when compared to the specimens stored in distilled water. Transflex also showed significant color change after immersion in cola (p < 0.01). In ΔET 1T 2 only red wine promoted significant staining of all resins (p < 0.0001). Conclusion: Chromatic changes were exhibited by specimens immersed in red wine, followed by coffee. For Transflex, cola also promoted color changes. The values of color changes converted to National Bureau of Standard units showed them to be perceivable to the human eye. © 2011 by the American College of Prosthodontists.

Effect of thermal cycling and disinfection on colour stability of denture base acrylic resin

Objectives: The purpose of this study was to investigate the effect of thermal cycling and disinfection on the colour change of denture base acrylic resin. Materials and Methods: Four different brands of acrylic resins were evaluated (Onda Cryl, QC 20, Classico and Lucitone). All brands were divided into four groups (n=7) determined according to the disinfection procedure (microwave, Efferdent, 4% chlorhexidine or 1% hypochlorite). The treatments were conducted three times a week for 60days. All specimens were thermal cycled between 5 and 55°C with 30-s dwell times for 1000 cycles before and after disinfection. The specimens' colour was measured with a spectrophotometer using the CIE L*a*b* system. The evaluations were conducted at baseline (B), after first thermal cycling (T 1), after disinfection (D) and after second thermal cycling (T 2). Colour differences (ΔE) were calculated between T 1 and B (T 1B), D and B (DB), and T 2 and B (T 2B) time-points. Results: The samples submitted to disinfection by microwave and Efferdent exhibited the highest values of colour change. There were significant differences on colour change between the time-points, except for the Lucitone acrylic resin. Conclusions: The thermal cycling and disinfection procedures significantly affected the colour stability of the samples. However, all values obtained for the acrylic resins are within acceptable clinical parameters. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

Association of fixed partial denture and gingival prosthesis as alternative approach to recover esthetics and function in anterior maxillary region

Tooth replacement in the maxillary anterior region is especially difficult when the loss includes significant amounts of the residual ridge and the soft tissue. Several techniques are available, such as dental implants or fixed partial denture, and bone and gingival grafts or gingival prostheses, respectively. This article showed a clinical case of an elderly who was treated with a collarless metal-ceramic fixed partial denture and acrylic removable gingival prosthesis to recover the esthetics in the maxillary anterior region. The association of a metal-ceramic fixed denture and gingival prosthesis was an excellent alternative in cases when surgical procedures are contraindicated. © 2012 Japan Prosthodontic Society.

Oral health of the elderly with Alzheimer's disease

Objective: The objective of this study was to describe the oral health of elderly people diagnosed with Alzheimer's disease (AD). Study Design: Thirty elderly subjects with AD (mild, moderate, and severe) and 30 without AD (controls) were included in the study. Volunteer-reported oral health data were collected using the General Oral Health Assessment Index (GOHAI). Demographic and oral characteristics were assessed, including the number of natural teeth; number of decayed, missing, and filled teeth (DMTF); oral health index (OHI); removable prosthesis conditions; and oral pathologies. Results: GOHAI values were similar for both groups. Compared with the controls, the subjects with AD had a higher age, DMTF, OHI, and number of oral pathologies and a lower educational level and number of natural teeth. Conclusions: Elderly subjects with AD had poorer oral health than those without the disease. Despite the positive self-perception of their oral health, the oral health of subjects with AD tended to decline as their disease progressed. © 2012 Elsevier Inc.

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 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.

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.

Epidemiological and oral manifestations of HIV-positive patients in a specialized service in Brazil

The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.