Changes in roughness of denture base and reline materials by chemical disinfection or microwave irradiation: Surface roughness of denture base and reline materials

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)

The occurrence of porosity in reline acrylic resins. Effect of microwave disinfection

Microwave energy has proved to be an effective method for disinfecting acrylic dentures. However, the effect of microwave heating on the porosity of autopolymerising denture reline resins has not been investigated.The purpose of the study was to determine the effect of microwave disinfection on the porosity of autopolymerised denture reline materials (Kooliner-K, New Truliner-NT, Tokuso Rebase Fast-TR and Ufi Gel Hard-UGH) and a conventional heat-polymerised denture base resin (Lucitone 550-L).Specimens (10 mm x 20 mm x 1 mm) were obtained from the impression surface of the palatal mucosa in a single person and divided into four groups (n = 5). The porosity was evaluated after polymerisation (C1), after two cycles of microwave disinfection (MW2), after seven cycles of microwave disinfection (MW7) and after 7 days storage in water at 37 degrees C (C2). Specimens from group MW7 were exposed to microwave disinfection daily being stored in water at 37 degrees C between exposures. All the replicas were sputter coated with gold and micrographs/digital images were taken of each replica using scanning electron microscopy at magnification x 100. The SEM micrographs were then examined using an image analyser to determine the number of pores. Comparison between materials and groups were made using Kruskal-Wallis tests.MW7 resulted in a significant increase in the number from the pores of material K, but decreased in number in reline material TR and UGH reline resin. The number of pores in materials NT and L remained unaffected following microwave disinfection.Differences in the porosity amongst the materials and for different experimental conditions were observed following microwave disinfection.

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.

Effectiveness of 2% peracetic acid for the disinfection of gutta-percha cones

The aim of this study was to evaluate the effectiveness of 2% peracetic acid for the disinfection of gutta-percha cones contaminated in vitro with Escherichia coli, Staphylococcus aureus, Streptococcus mutans, Candida albicans and Bacillus subtilus (in spore form). Two hundred and twenty-five gutta-percha cones were contaminated with standardized suspensions of each microorganism and incubated at 37 degrees C for 24 h. The cones were divided into 10 experimental groups (n = 15), according to the microorganism tested and disinfection testing times. The disinfection procedure consisted of immersing each cone in a plastic tube containing the substance. The specimens remained in contact with the substance for 1 or 2.5 minutes. Afterwards, each cone was transferred to a 10% sodium thiosulphate solution (Na2S2O3) to neutralize the disinfectant. Microbial biofilms adhering to the cones were dispersed by agitation. Aliquots of 0.1 ml of the suspensions obtained were plated on Sabouraud dextrose agar, or brain and heart infusion agar, and incubated at 37 degrees C for 24 h. The results were expressed in colony forming units (CFU/ml) and the data were submitted to the Wilcoxon Signed Rank Test (level of significance at 0.05). A significant reduction was observed, after 1 minute of exposure, in the test solution for C. albicans (p = 0.0190), S. aureus (p = 0.0001), S. mutans (p = 0.0001), B. subtilis (p = 0.0001), and E. coli (p = 0.0001). After 2.5 minutes of exposure, 100% of the microbial inocula were eliminated. It was concluded that the 2% peracetic acid solution was effective against the biofilms of the tested microorganisms on gutta-percha cones at 1 minute of exposure.

Histologic Characterization of Engineered Tissues in the Canal Space of Closed-apex Teeth with Apical Periodontitis

Introduction: The aim of this study was to investigate the capacity of endodontic regenerative procedures combining an induced blood clot, platelet-rich plasma (PRP), and bone marrow aspirate (BMA) to regenerate dental pulp in canine closed-apex necrotic teeth. Methods: Apical periodontitis was induced in 20 upper and lower premolars of 2 dogs. After biomechanical preparation, enlargement to a #60 file, and disinfection with a triantibiotic paste for 28 days, the roots were randomly assigned to 4 treatment groups: blood clot (BC), BC + PRP gel, BC + BMA gel, and BC + BMA/PRP gel. Negative controls were also included. After a 3-month follow-up period, the animals were killed. Results: Histologic analysis showed the presence of newly formed vital tissues (connective, cement-like, and bone-like tissue) in 23 of the 32 treated roots (71.87%). There was no statistically significant difference between the treatment groups. Conclusions: New vital tissues were formed and characterized as connective, cementum-like, or bone-like, but not as pulp-like tissue; PRP and/or BMA did not improve the tissue ingrowth. © 2013 American Association of Endodontists.

Tissue-engineering-based Strategies for Regenerative Endodontics

Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on their potential translation to clinical settings.

Endodontics pastes formulated with copaiba oil: action on oral microbiota and dentin bridge formation in dogs

This study analysed the effect of pastes formulated with calcium hydroxide P.A. and different vehicles (saline solution - paste A and Copaifera langsdorffii Desfon oil - paste B) on oral microorganisms and dentin bridge formation in dogs. The antimicrobial action of the pastes and their components was analysed by the minimum inhibitory concentration in agar gel technique. The components were diluted and tested on fifteen standard strains of microorganisms associated with endodontic diseases. The microorganisms were cultivated and after incubation data was analysed using One-Way ANOVA and Turkey's test (P≤0.05). Four superior incisors of ten animals were used to evaluate dentin bridge formation. Two incisors were capped with paste A (GA) and two with paste B (GB). After 90 days, the teeth were extracted for histological analysis and the degree of dentin bridge formation evaluated. Data was analysed by the Kruskal-Wallis test (P<0.05). The pastes and their components were classified in the following decreasing order of antimicrobial action: calcium hydroxide P.A., paste A, paste B and Copaifera langsdorffii Desfon oil. Calcium hydroxide P.A. showed significantly higher antimicrobial action than the pastes or their vehicles. No significant difference was observed between the two pastes in dentin bridge formation. Based on the microorganisms studied, it can be concluded that the pastes analysed showed similar antimicrobial potential but differed significantly from their individual components. No significant difference was observed in dentin bridge formation between the different pastes tested.

Clinical Influence of Different Intracanal Medications on Th1-type and Th2-type Cytokine Responses in Apical Periodontitis

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

Antimicrobial activity of two techniques for arm skin disinfection of blood donors in Brazil

Objective: Evaluation of the antimicrobial effect of skin disinfection techniques is essential to avoid the transmission of infectious agents during blood transfusion. The aim of this study was to examine the effectiveness of two methods of arm skin disinfection used in blood donors at a Hemotherapy Center in Brazil that represents an important centre for distributing haemocomponents to many cities in the country. Methods: Two skin disinfection techniques in 50 blood donors were evaluated. For the first arm, 10% povidone-iodine/two-stage technique was used. On the opposite arm, 0.5% chlorhexidine digluconate alcohol solution/one-stage technique was used. The swabs were seeded on three culture media: blood agar, mannitol salt agar and Mac Conkey agar. Automated bacterial classification based on biochemical tests/specific substrates was performed. Donor characteristics were collected using the computerised system of the Hemotherapy Center. Results: We found that microbial reduction was significantly higher for 10% povidone-iodine technique (98.57-98.87%) when compared with 0.5% chlorhexidine technique (94.38-95.06%). The species Leuconostoc mesenteroides and Staphylococcus hominis showed resistance to both disinfection techniques. We did not find statistically significant relationships between donor characteristics and microbial reduction. Conclusions: Arm skin disinfection with 10% povidone-iodine produced better antimicrobial activity. We must acknowledge that 10% povidone-iodine technique has the limitation of being a two-stage method. However, prevention of adverse events due to bacterial contamination and transfusion reactions should be prioritised. Production of hypoallergenic and stronger antiseptics that allowed a safe one-stage disinfection technique should be encouraged in health systems, not only in Brazil but also around the world.

The efficacy of chemical agents in cleaning and disinfection programs

Abstract Background Due to the growing number of outbreaks of infection in hospital nurseries, it becomes essential to set up a sanitation program that indicates that the appropriate chemical agent was chosen for application in the most effective way. Method For the purpose of evaluating the efficacy of a chemical agent, the minimum inhibitory concentration (MIC) was reached by the classic method of successive broth dilutions. The reference bacteria utilized were Bacillus subtilis var. globigii ATCC 9372, Bacillus stearothermophilus ATCC 7953, Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923. The strains of Enterobacter cloacae IAL 1976 (Adolfo Lutz Institute), Serratia marcescens IAL 1478 and Acinetobactev calcoaceticus IAL 124 (ATCC 19606), were isolated from material collected from babies involved in outbreaks of infection in hospital nurseries. Results The MIC intervals, which reduced bacteria populations over 08 log10, were: 59 to 156 mg/L of quaternarium ammonium compounds (QACs); 63 to 10000 mg/L of chlorhexidine digluconate; 1375 to 3250 mg/L of glutaraldehyde; 39 to 246 mg/L of formaldehyde; 43750 to 87500 mg/L of isopropanol or ethanol; 1250 to 6250 mg/L of iodine in polyvinyl-pyrolidone complexes, 150 to 4491 mg/L of chlorine-releasing-agents (CRAs); 469 to 2500 mg/L of hydrogen peroxide; and, 2310 to 18500 mg/L of peracetic acid. Conclusions Chlorhexidine showed non inhibitory activity over germinating spores. A. calcoaceticus, was observed to show resistance to the majority of the agents tested, followed by E. cloacae and S. marcescens.

Determination of decimal reduction time (D value) of chemical agents used in hospitals for disinfection purposes

Abstract Background Prior to the selection of disinfectants for low, intermediate and high (sterilizing) levels, the decimal reduction time, D-value, for the most common and persistent bacteria identified at a health care facility should be determined. Methods The D-value was determined by inoculating 100 mL of disinfecting solution with 1 mL of a bacterial suspension (104 – 105 CFU/mL for vegetative and spore forms). At regular intervals, 1 mL aliquots of this mixture were transferred to 8 mL of growth media containing a neutralizing agent, and incubated at optimal conditions for the microorganism. Results The highest D-values for various bacteria were determined for the following solutions: (i) 0.1% sodium dichloroisocyanurate (pH 7.0) – E. coli and A. calcoaceticus (D = 5.9 min); (ii) sodium hypochlorite (pH 7.0) at 0.025% for B. stearothermophilus (D = 24 min), E. coli and E. cloacae (D = 7.5 min); at 0.05% for B. stearothermophilus (D = 9.4 min) and E. coli (D = 6.1 min) and 0.1% for B. stearothermophilus (D = 3.5 min) and B. subtilis (D = 3.2 min); (iii) 2.0% glutaraldehyde (pH 7.4) – B. stearothermophilus, B. subtilis (D = 25 min) and E. coli (D = 7.1 min); (iv) 0.5% formaldehyde (pH 6.5) – B. subtilis (D = 11.8 min), B. stearothermophilus (D = 10.9 min) and A. calcoaceticus (D = 5.2 min); (v) 2.0% chlorhexidine (pH 6.2) – B. stearothermophilus (D = 9.1 min), and at 0.4% for E. cloacae (D = 8.3 min); (vi) 1.0% Minncare® (peracetic acid and hydrogen peroxide, pH 2.3) – B. stearothermophilus (D = 9.1 min) and E. coli (D = 6.7 min). Conclusions The suspension studies were an indication of the disinfectant efficacy on a surface. The data in this study reflect the formulations used and may vary from product to product. The expected effectiveness from the studied formulations showed that the tested agents can be recommended for surface disinfection as stated in present guidelines and emphasizes the importance and need to develop routine and novel programs to evaluate product utility.