Growth of Candida species on complete dentures: effect of microwave disinfection

Microwave disinfection of complete dentures has been recommended to treat denture stomatitis in non-immune compromised patients. Oral candidiasis is a frequent manifestation of HIV infection. The objective of this study is to evaluate the effectiveness of microwave irradiation on the disinfection of complete dentures inoculated with American Type Culture Collection (ATCC) and HIV isolates of five species of Candida. Fifty dentures were made, sterilised and inoculated with the tested microorganisms (C. albicans, C. dubliniensis, C. krusei, C. glabrata and C. tropicalis). After incubation (37 degrees C/48 h), dentures were microwaved (650 W/3 min). Non-irradiated dentures were used as positive controls. Replicate aliquots of suspensions were plated at dilutions 10(-1) to 10(-4) and incubated (37 degrees C/48 h). Colony counts (cfu ml(-1)) were quantified. Dentures were also incubated at 37 degrees C for 7 days. Data were analysed with 2-way anova and Tukey HSD tests (alpha = 0.05). Dentures contaminated with all Candida species showed sterilisation after microwave irradiation. All control dentures showed microbial growth on the plates. The cfu ml(-1) for C. glabrata was higher than those of C. albicans, C. dubliniensis and C. tropicalis whereas the cfu ml(-1) for C. krusei was lower. The cfu ml(-1) for clinical isolates was higher than those of ATCC yeast. Microwave irradiation for 3 min at 650 W resulted in sterilisation of all complete dentures.

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

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

Evaluation of the occlusion vertical dimension of complete dentures after microwave disinfection

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

Microwave Disinfection of Complete Dentures Contaminated In Vitro with Selected Bacteria

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

Effectiveness of microwave irradiation on the disinfection of complete dentures

Purpose: The purpose of this study was to evaluate the effectiveness of microwave irradiation on the disinfection of simulated complete dentures. Materials and Methods: Eighty dentures were fabricated in a standardized procedure and subjected to ethylene oxide sterilization. The dentures were individually inoculated (10 7 cfu/mL) with tryptic soy broth (TSB) media containing one of the tested microorganisms (Candida albicans, Streptoccus aureus, Bacillus subtilis, and Pseudomonas aeruginosa). After 48 hours of incubation at 37°C, 40 dentures were individually immersed in 200 mL of water and submitted to microwave irradiation at 650 W for 6 minutes. Forty nonirradiated dentures were used as positive controls. Replicate aliquots (25 μL) of suspensions were plated at dilutions of 10 -3 to 10 -6 on plates of selective media appropriate for each organism. All plates were incubated at 37°C for 48 hours. TSB beakers with the microwaved dentures were incubated at 37°C for 7 more days. After incubation, the number of colony-forming units was counted and the data were statistically analyzed by Kruskal-Wallis test (α = .05). Results: No evidence of growth was observed at 48 hours for S aureus, B subtilis, and C albicans. Dentures contaminated with P aeruginosa showed small growth on 2 plates. After 7 days incubation at 37°C, no growth was visible in the TSB beakers of S aureus and C albicans. Turbidity was observed in 3 broth beakers, 2 from P aeruginosa and 1 from B subtilis. Conclusion: Microwave irradiation for 6 minutes at 650 W produced sterilization of complete dentures contaminated with S aureus and C albicans and disinfection of those contaminated with P aeruginosa and B subtilis.

HARDNESS and SURFACE ROUGHNESS of RELINE and DENTURE BASE ACRYLIC RESINS AFTER REPEATED DISINFECTION PROCEDURES

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of microwave disinfection procedures on torsional bond strengths of two hard chairside denture reline materials

Purpose: This study evaluated the potential effects of denture base resin water storage time and an effective denture disinfection method (microwave irradiation at 650 W for 6 minutes) on the torsional bond strength between two hard chairside reline resins (GC Reline and New Truliner) and one heat-polymerizing denture base acrylic resin (Lucitone 199). Materials and Methods: Cylindrical (30 x 3.9 mm) denture base specimens (n = 160) were stored in water at 37°C (2 or 30 days) before bonding. A section (3.0 mm) was removed from the center of the specimens, surfaces prepared, and the reline materials packed into the space. After polymerization, specimens were divided into four groups (n = 10): Group 1 (G1) - tests performed after bonding; Group 2 (G2) - specimens immersed in water (200 ml) and irradiated twice (650 W for 6 minutes); Group 3 (G3) - specimens irradiated daily until seven cycles of disinfection; Group 4 (G4) - specimens immersed in water (37°C) for 7 days. Specimens were submitted to a torsional test (0.1 Nm/min), and the torsional strengths (MPa) and the mode of failure were recorded. Data from each reline material were analyzed by a two-way analysis of variance, followed by Neuman-Keuls test (p = 0.05). Results: For both Lucitone 199 water storage periods, before bonding to GC Reline resin, the mean torsional strengths of G2 (2 days - 138 MPa; 30 days - 132 MPa), G3 (2 days - 126 MPa; 30 days - 130 MPa), and G4 (2 days - 130 MPa; 30 days - 137 MPa) were significantly higher (p < 0.05) than G1 (2 days - 108 MPa; 30 days - 115 MPa). Similar results were found for Lucitone 199 specimens bonded to New Truliner resin, with G1 specimens (2 days - 73 MPa; 30 days - 71 MPa) exhibiting significantly lower mean torsional bond strength (p < 0.05) than G2 (2 day - 86 MPa; 30 days - 90 MPa), G3 (2 days - 82 MPa; 30 days - 82 MPa), and G4 specimens (2 days - 78 MPa; 30 days - 79 MPa). The adhesion of both materials was not affected by water storage time of Lucitone 199 (p > 0.05). GC reline showed a mixed mode of failure (adhesive/cohesive) and New Truliner failed adhesively. Conclusions: Up to seven microwave disinfection cycles did not decrease the torsional bond strengths between the hard reline resins, GC Reline and New Truliner to the denture base resin Lucitone 199. The effect of additional disinfection cycles on reline material may be clinically significant and requires further study. Copyright © 2006 by The American College of Prosthodontists.

Effect of disinfection treatments on the hardness of soft denture liner materials

Purpose: To evaluate the effects of disinfection treatments with chemical solutions (2% glutaraldehyde, 5% sodium hypochlorite, and 5% chlorhexidine) and microwave energy on the hardness of four long-term soft denture liners. Materials and Methods: Forty rectangular specimens of four soft lining materials (Molloplast-B, Ufi Gel P, Eversoft, and Mucopren soft) were made for each material. Ten samples of each material were immersed in different disinfectant solutions for 10 minutes or placed in a microwave oven for 3 minutes at 500 W. The hardness values were obtained with a Shore A durometer, before the first disinfection cycle (control), and also after two cycles of disinfection. Data were submitted to analysis of variance and Tukey's test (p < 0.01). Results: The highest value of hardness was obtained for Molloplast-B, independent of the disinfection technique. Mucopren soft demonstrated intermediate values and Ufi Gel P and Eversoft the lowest values of Shore A hardness. For Molloplast-B, the disinfection using glutaraldehyde demonstrated the highest value of hardness. The number of disinfections had no effect on the hardness values for all the materials studied and disinfection techniques. Conclusions: The application of two disinfection cycles did not change the Shore A hardness values for all the materials. The glutaraldehyde solution demonstrated the highest values of Shore A hardness for the Molloplast-B, Mucopren soft, and Ufi Gel P materials, while Eversoft did not present any differences in hardness when submitted to different disinfection treatments. Copyright © 2007 by The American College of Prosthodontists.

A randomized controlled trial evaluating the quality of life and the sense of coherence in seniors wearing complete conventional dentures or mandibular two-implant overdentures

La supériorité des prothèses mandibulaires retenues par deux implants (IODs) sur les prothèses conventionnelles (CDs) nécessitent d’être éclaircies notamment en rapport à leur influence sur la qualité de vie reliée à la santé bucco-dentaire (OHRQoL) ainsi que sur la stabilité de cet effet de traitement. De plus, l’influence des facteurs psychologiques, tel que le sens de cohérence (SOC), sur l’effet de traitement reste encore inconnue. Le but de cette étude est de déterminer l’amplitude de l’influence du port des IODs et des CDs sur l’OHRQoL et d’évaluer la stabilité de l’effet de traitement dans le temps, tout en prenant en considération le niveau du SOC. MÉTHODOLOGIE: Des participants édentés (n=172, âge moyen 71, SD = 4.5) ayant reçu des CDs ou des IODs ont été suivis sur une période de deux ans. L’OHRQoL a été évaluée à l’aide du questionnaire « Oral Health Impact Profile (OHIP -20) » et ce avant le traitement et à chacun des deux suivis. Le SOC a été évalué à l’aide du questionnaire « The Orientation to Life (SOC -13) » à chacun des deux suivis. Des analyses statistiques ont été effectuées pour évaluer les différences intra et entre groupes (analyses statistiques descriptives, bivariées et multivariées). RÉSULTATS: Une amélioration statistiquement significative de l’OHRQoL entre les statuts avant et après traitement a été notée dans les deux groupes (Wilks’s Lambda = 0.473, F (1,151) = 157.31, p < 0.0001). L’amplitude de l’effet du traitement IOD est 1.5 fois plus grande que celle du traitement CD. Ces résultats ont été stables pendant les deux années d’étude et ils n’ont pas été influencés par le SOC. CONCLUSION: Le traitement IOD amène une meilleure OHRQoL à long terme en comparaison avec le traitement CD et ce sans influence du niveau du SOC. Ces résultats sont cliniquement significatifs et confirment la supériorité des IODs sur les CDs.

Phase-I clinical trial on the effect of palatal brushing on denture stomatitis

Introduction: La stomatite prothétique est une condition inflammatoire chronique de la muqueuse buccale recouverte par une prothèse. Cette maladie est considérée comme la lésion buccale la plus fréquente chez les porteurs de prothèses amovibles. Des études récentes sur l'étiologie de la stomatite prothétique suggèrent que des traitements basés sur la réduction de l'inflammation seraient efficaces dans le traitement de cette maladie. Objectifs: Évaluer l'efficacité du brossage du palais dans le traitement de la stomatite prothétique. Méthodes: Quarante-huit participants (âge moyen : 66,0 ± 11,2 ans) avec un diagnostic de stomatite prothétique, ont été sélectionnés à partir d’un examen préalable de 143 individus, afin de participer à cet essai clinique de phase I à deux centres, réalisé selon un devis de type pré-test/post-test à un seul groupe. L'intervention a consisté en un brossage du palais avec une brosse manuelle après chaque repas et avant le coucher. Des examens cliniques et microbiologiques ont été effectués avant le traitement, et à 1 mois et 3 mois de suivi. Des données supplémentaires ont été obtenues par l'utilisation d'un questionnaire validé. Les résultats primaires et secondaires étaient, respectivement, la rémission de stomatite prothétique et la diminution du nombre de colonies de Candida. Des tests statistiques descriptifs et non paramétriques ont été menés pour analyser les données. Résultats: À 3 mois de suivi, 10,4 % des participants ont été guéris et 70,8 % ont eu une amélioration clinique de la stomatite prothétique grâce au brossage du palais. Une réduction statistiquement significative de la surface et de l’intensité de l’inflammation après 3 mois de brossage du palais a été démontrée (p < 0,0001). L’ampleur de l’effet a varié d’un effet modéré à important (0,34 à 0,54) selon la classification utilisée pour le diagnostique de la stomatite prothétique. De plus, le nombre de colonies de Candida, recueillies par sonication des prothèses et par échantillonnage du palais, a diminué de manière statistiquement significative après 3 mois de brossage (p ≤ 0,05). Conclusion: Les résultats de cette étude suggèrent que le brossage du palais est efficace comme traitement de la stomatite prothétique.

Reliability of a method for evaluating porosity in denture base resins

Background: The method of porosity analysis by water absorption has been carried out by the storage of the specimens in pure water, but it does not exclude the potential plasticising effect of the water generating unreal values of porosity. Objective: The present study evaluated the reliability of this method of porosity analysis in polymethylmethacrylate denture base resins by the determination of the most satisfactory solution for storage (S), where the plasticising effect was excluded. Materials and methods: Two specimen shapes (rectangular and maxillary denture base) and two denture base resins, water bath-polymerised (Classico) and microwave-polymerised (Acron MC) were used. Saturated anhydrous calcium chloride solutions (25%, 50%, 75%) and distilled water were used for specimen storage. Sorption isotherms were used to determine S. Porosity factor (PF) and diffusion coefficient (D) were calculated within S and for the groups stored in distilled water. anova and Tukey tests were performed to identify significant differences in PF results and Kruskal-Wallis test and Dunn multiple comparison post hoc test, for D results (alpha = 0.05). Results: For Acron MC denture base shape, FP results were 0.24% (S 50%) and 1.37% (distilled water); for rectangular shape FP was 0.35% (S 75%) and 0.19% (distilled water). For Classico denture base shape, FP results were 0.54% (S 75%) and 1.21% (distilled water); for rectangular shape FP was 0.7% (S 50%) and 1.32% (distilled water). FP results were similar in S and distilled water only for Acron MC rectangular shape (p > 0.05). D results in distilled water were statistically higher than S for all groups. Conclusions: The results of the study suggest that an adequate solution for storing specimens must be used to measure porosity by water absorption, based on excluding the plasticising effect.

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-J circle divide rgensen 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-J circle divide rgensen 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 kappa. 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 (kappa = 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-J circle divide rgensen Index. This should be the method of choice for clinical studies when more sophisticated approaches are not possible.

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

Insertion and follow-up of complete dentures: a literature reviewObjective: 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.

A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review

Background:It has been stated that mandibular overdentures are more satisfactory than conventional dentures, but problems relating to the use of retrospective ratings, lack of control group and sequential provision of treatment may compromise the findings.Objective:To establish a comparison between treatment with conventional complete dentures and implant-retained overdentures in elderly patients by conducting a literature review.Materials and methods:A search of English language peer-review literature was completed using Medline up to 2008 focusing on evidence-based research. Randomised clinical trials (RCTs) and longitudinal prospective studies were favoured in the review, using a general hierarchical classification. Articles that did not focus exclusively on the comparison of patient satisfaction between complete dentures and overdentures were excluded from further evaluation. The last search was conducted in February 2008. Key terms included quality of life, patient satisfaction, edentulism, complete denture and overdenture.Results:Among the 90 articles found in the initial search, 27 met the inclusion criteria. This included 18 RCTs and eight prospective and one cohort study. Most of the articles stated superiority of the mandibular implant-retained overdenture therapy over the conventional complete denture regarding patient satisfaction and quality of life.Conclusion:Even with implant treatment presenting higher patient satisfaction and improvement of quality of life, it was not possible to establish a direct comparison between the studies due to differences in adopted methodologies.

Silver Distribution and Release from an Antimicrobial Denture Base Resin Containing Silver Colloidal Nanoparticles

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)