Anti-biofilm effectiveness of protocols for cleaning complete dentures in hospitalized patients: a randomized controlled trial

Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.

Reabilitação oral com próteses parciais removíveis após restabelecimento de dimensão vertical de oclusão e tratamento multidisciplinar: relato de caso / Oral rehabilitation with removable partial dentures after restoration of the vertical dimension of occlusion and multidisciplinary treatment: case report

As próteses parciais removíveis (PPRs) são uma alternativa de tratamento viável na prática clínica para reabilitar arcos parcialmente desdentados. Entretanto, o planejamento dessas próteses e preparo bucal prévio são frequentemente negligenciados. O presente artigo tem como objetivo relatar o caso clínico de uma reabilitação oral com PPRs superior e inferior após abordagem multidisciplinar, de modo a enfatizar as fases de um planejamento criterioso e de preparo prévio dos dentes pilares, visando o sucesso e a longevidade da reabilitação. Paciente do sexo masculino de 57 anos de idade compareceu à clínica da Faculdade de Odontologia de Bauru, Universidade de São Paulo, queixando-se da estética de seu sorriso e de algumas ausências dentárias. O indivíduo utilizava uma PPR provisória inferior insatisfatória e apresentava perda de dimensão vertical de oclusão (DVO). Após o exame clínico, radiográfico e estudo do caso em articulador semi-ajustável, realizou-se o planejamento com abordagens restauradoras, endodônticas, periodontais e protéticas. Após tratamento periodontal, foi realizada endodontia dos elementos 12, 15 e 47, confecção de núcleos e coroas nos dentes 12 e 15, restauração a nível gengival para apoio residual no dente 47, restaurações nos dentes 11, 13, 22, 24 e 44 e, por fim, a confecção das PPRs superior e inferior. A abordagem multidisciplinar utilizada neste caso clínico viabilizou o restabelecimento da DVO e possibilitou o sucesso da reabilitação protética(AU)

Removable partial dentures (RPDs) are a viable treatment alternative in clinical practice to rehabilitate partially edentulous arches. However, the planning of these dentures and prior oral preparation are often neglected. This article aims to report the clinical case of an oral rehabilitation with upper and lower RPDs after a multidisciplinary approach, to emphasize the phases of careful planning and prior preparation of the abutment teeth, aiming at the success and longevity of the rehabilitation. A 57-year-old male patient came to the clinic of the Bauru School of Dentistry, University of São Paulo, complaining about the esthetics of his smile and some missing teeth. The subject was using an unsatisfactory lower provisional prosthesis and had a loss of vertical dimension of occlusion (OVD). After the clinical and radiographic examination and the case study in a semi-adjustable articulator, planning was carried out with restorative, endodontic, periodontal and prosthetic approaches. After periodontal treatment, endodontics were performed on elements 12, 15 and 47, creation of cores and crowns on teeth 12 and 15, restoration at the gingival level for residual support on tooth 47, restorations on teeth 11, 13, 22, 24 and 44 and, finally, the making of the upper and lower PPRs. The multidisciplinary approach used in this clinical case enabled the restoration of the OVD and enabled the success of the oral rehabilitation(AU)

Impact of COVID-19 on gender gap in dental publications: a retrospective cohort with three Brazilian journals

Abstract This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors' highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson's Chi-square tests, and Fisher's Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

Influência da férula na resistência à fratura de restaurações com utilização ou não de retentores intrarradiculares em dentes tratados endodonticamente: uma revisão da literatura / Influence of the ferrule on the fracture resistance of restorations with or without the use of intraradicular posts in endodontically treated teeth: a literature review

Objetivo: realizar uma revisão de literatura narrativa sobre a importância e a influência do efeito férula na resistência à fratura de restaurações em dentes tratados endodonticamente com utilização ou não de retentores intrarradiculares. Metodologia: Foram utilizados os seguintes descritores indexados no DeCS (Descritores em Ciências da Saúde): "Férula", Prótese Dentária", "Falha da Restauração Dentária", "Técnica de Retentor Intrarradicular" e "Pinos de Retenção Dentária" para busca nas bases de dados PubMed, Embase, Lilacs, Web of Science, Scopus e Cochrane Library. Resultados: Os dados da maioria dos estudos in vitro ou in vivo incluídos nesta revisão sugerem o uso da férula para aumento da resistência à fratura e longevidade dos dentes tratados endodonticamente. Tem sido recomendada a confecção de uma férula com altura uniforme de 2 mm e espessura superior a 1,5 mm. Conclusão: O uso de retentores radiculares foi indicado pela maioria dos trabalhos, sendo geralmente recomendados os pinos de fibra de vidro ao invés de núcleos metálicos fundidos para minimizar os riscos de fratura radicular em razão do módulo de elasticidade semelhante à dentina, além de possibilidade de retratamentos em casos de falhas adesivas. Apesar disso, ainda são necessários estudos clínicos com acompanhamento a longo prazo para avaliar a longevidade das restaurações de dentes tratados endodonticamente utilizando pinos de fibra de vidro sem ou com a presença de férula em diferentes espessuras e alturas.

Objective: This study aimed to conduct a narrative literature review on the importance and influence of the ferrule effect on the fracture resistance of restorations in endodon-tically treated teeth with or without the use of intraradicular posts. Methodology: The following descriptors indexed in the DeCS (Health Sciences Descriptors) were used: "Ferrule", Dental Prosthesis", "Dental Restoration Failure", "Post and Core Technique", and "Dental Posts", to search on the databases of PubMed, Embase, Lilacs, Web of Science, Scopus, and Cochrane Library data. Results: Data from most of the in vitro or in vivo studies included in this review suggest the use of the ferrule to increase fracture resistance and longevity of endodontically treated teeth. It has been recommended to make a ferrule with a uniform height of 2 mm and a thickness greater than 1.5 mm. Conclusion: The use of intraradicular posts was indicated by most studies, and fiberglass posts are generally recommended instead of cast metal cores to minimize the risk of root fracture due to the modulus of elasticity similar to dentin, in addition to the possibility of retreatments in ad-hesive failure cases. Despite this, clinical studies with a long-term follow-up are essential to evaluating the longevity of restorations of endodontically treated teeth using fiberglass posts without or with the presence of ferrule in different thicknesses and heights.

Disposable Fox Ruler: a proposal to avoid cross-contamination / Régua de Fox descartável: uma proposta para evitar a contaminação cruzada

ABSTRACT Numerous pathogens, including SARS-CoV-2, can remain viable on surfaces over days, which favors cross-contamination. Preventive measures are essential to prevent infections and control the spread of COVID-19. Fox ruler is an essential device in the clinical planning of complete dentures and the contact with the patient's oral fluids during handling is unavoidable. Despite its importance, the conventional polycarbonate Fox ruler is easily damaged in the sterilization process. Therefore, the purpose of this article is to propose the use of a disposable Fox ruler. The confection is carried out in a simple way with wooden toothpicks joined by cyanoacrylate glue, following the same shape as the conventional one, but with the additional advantage of being made in an individual size according to the upper edge. The proposed disposable Fox ruler makes it possible to obtain the parallelism of the upper wax roller with the bipupillary line and with the Camper plane. Therefore, the disposable device described in this article was able to perform the same functions as the conventional one, in a practical way, without risks of cross contamination and with low cost.

RESUMO Vários patógenos, incluindo SARS-CoV-2, são capazes de permanecer viáveis em superfícies durante dias, o que favorece a contaminação cruzada. Medidas preventivas são essenciais para prevenir infecções e controlar a propagação da COVID- 19. A régua de Fox é um dispositivo essencial no planejamento clínico de próteses totais e é inevitável o contato com os fluidos orais do paciente, durante seu manejo. Apesar de sua importância, a régua de Fox convencional de policarbonato é facilmente danificada com o processo de esterilização. Portanto, o objetivo deste artigo é propor a utilização de uma régua Fox descartável. A confecção é feita de forma simples com palitos de madeira unidos por cola de cianoacrilato, seguindo o mesmo formato do convencional, mas com a vantagem adicional de ser produzida em tamanho individualizado de acordo com o rebordo superior. A régua Fox descartável proposta permite obter o paralelismo do rolete de cera superior com a linha bipupilar e com o plano de Camper. Portanto, o dispositivo descartável descrito neste artigo foi capaz de desempenhar as mesmas funções do convencional, de forma prática, sem riscos de contaminação cruzada e com baixo custo.

Beneficial effects of three natural products for the treatment of denture stomatitis: a randomized clinical trial / Efeitos benéficos de três produtos naturais para o tratamento da estomatite protética: um ensaio clínico randomizado

Aim: To evaluate the effect of three natural antifungal agents combined with routine denture care on the treatment of DS, using a quantitative mycological culture analysis. Methods: Thirty denture wearers with denture stomatitis DS were treated using five substances: sterile distilled water (G1), nystatin oral suspension (G2), 20% alcoholic extract propolis (G3), Punica granatumLinné gel (G4), and Uncaria tomentosa gel (G5). The substances were used 3 times a day for 14 days. Quantitative mycological culture analysis of samples collected from the palatal mucosa was performed at three stages: before treatment (T0), after 14 days of treatment (T1), and 30 days after treatment completion (T2). Data were evaluated using Kruskal-Wallis and Friedman tests (p < 0.05). Results: Palatal mucosa intragroup analysis showed a significant reduction of Candida CFU/mL values for all groups at T1 compared to T0 (p < 0.05). However, they did not present statistical differences when comparing T1 and T2 (p > 0.05). The intergroup analysis demonstrated that there are no statistical differences, regardless of the evaluation time (p > 0.05). Conclusion:The natural products tested showed a satisfactory result on DS treatment, which proved to be equivalent to conventional topical therapy with nystatin and to treatment using only regular oral hygiene procedures.

Objetivo: Avaliar o efeito de três antifúngicos naturais combinados com o cuidado rotineiro com próteses dentárias no tratamento da EP, por meio de uma análise quantitativa de cultura micológica. Métodos: Trinta usuários de próteses dentárias com EP foram tratados com cinco substâncias: água destilada estéril (G1), suspensão oral de nistatina (G2), extrato alcoólico de própolis 20% (G3), gel Punica granatum L. (G4) e gel Uncaria tomentosa (G5). As substâncias foram utilizadas 3 vezes ao dia durante 14 dias. A análise micológica quantitativa das amostras coletadas da mucosa palatina foi realizada em três etapas: antes do tratamento (T0), após 14 dias do tratamento (T1) e 30 dias após o término do tratamento (T2). Os dados foram avaliados pelos testes de Kruskal-Wallis e Friedman (p < 0,05). Resultados: A análise intragrupo da mucosa palatina mostrou uma redução significativa dos valores de Candida UFC/mL para todos os grupos em T1 em comparação com T0 (p < 0,05). No entanto, não apresentaram diferenças estatísticas na comparação de T1 e T2 (p > 0,05). A análise intergrupos demonstrou que não há diferenças estatísticas, independentemente do tempo de avaliação (p > 0,05). Conclusão: Os produtos naturais testados apresentaram resultado satisfatório no tratamento da EP, sendo equivalente à terapia tópica convencional com nistatina e ao tratamento apenas com procedimentos rotineiros de higiene bucal.

A novel acrylic resin palatal device contaminated with Candida albicans biofilm for denture stomatitis induction in Wistar rats

Abstract Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. Objective This study describes a protocol to obtain and to contaminate a palatal device with Candida albicans biofilm that could be used for an animal model of denture stomatitis. Methodology Acrylic resin devices (N=41) were obtained from impressions of the palates of Wistar rats with individual trays and polyether. The efficacy of microwave irradiation (MW), ultraviolet light (UV), or ultrasonic bath (US) was assessed by colony viability and spectrophotometric analyses (n=5) in order to select the most appropriate method for sterilizing the devices. Then, different devices (n=5) were contaminated with C. albicans and evaluated by CFU/mL determination, scanning electron microscopy, and laser confocal microscopy. Device stabilization was assessed with either autopolymerizing acrylic resins or a self-adhesive resin cement (n=2). The spectrophotometric data were analyzed by one-way ANOVA followed by the Tukey's HSD post-hoc test (α=0.05). Results MW was the only method capable of sterilizing the devices, and the contamination protocol developed a mature and viable C. albicans biofilm (~1.2 x 106 CFU/mL). The self-adhesive resin cement was the best stabilization material. Conclusions This acrylic resin palatal device was designed to be similar to the clinical situation of contaminated prostheses, with easy manufacturing and handling, effective stabilization, and satisfactory contamination. Thus, the acrylic device can be a valuable tool in the development of denture stomatitis in rats.

Esquema oclusal em prótese total / Occlusal scheme in complete dentures

O objetivo foi revisar a literatura e discutir os conceitos oclusais em reabilitações orais com próteses totais, enfatizando as vantagens e as necessidades de cada esquema oclusal. Realizou-se uma busca nas bases de dados PubMed, SciELO, Google Scholar e em li-vros didáticos com as palavras-chave "Oclusão Dentária", "Oclusão Dentária Balanceada", "Orientação de Canino", "Planejamento de Dentadura", "Planejamento de Prótese Dentá-ria" e "Prótese Total" e com os operadores booleanos AND (E), OR (OU), NOT (MENOS). Dentro dos esquemas oclusais disponíveis para o planejamento protético, a oclusão balan-ceada bilateral (OBB) e a oclusão guiada pelo canino (OGC) foram as mais estudadas e discutidas na desoclusão de próteses totais. Os estudos indicam que o tipo de oclusão pode interferir na atividade muscular do sistema estomatognático, na eficiência mastigatória, na reabsorção óssea, na retenção e estabilidade das próteses removíveis e na satisfação do pa-ciente. Na literatura examinada, foi perceptível a recomendação da OGC como o esquema oclusal de preferência no planejamento das próteses totais, pois os resultados dos estudos indicam menor atividade muscular durante a mastigação, melhor retenção e estabilidade da prótese total. A OGC é o esquema oclusal mais simples e fácil de ser obtido comparada à OBB, beneficia a fonética, é esteticamente preferida pelos pacientes e, em termos de qua-lidade de vida, autopercepção da força mastigatória e oclusal, tem se mostrado satisfatória. Conclui-se que a OGC pode ser recomendada como um esquema oclusal favorável para as reabilitações orais com próteses totais.Descritores: Oclusão Dentária. Oclusão Dentária Balanceada. Orientação de canino. Pró-tese Total. Planejamento de Prótese Dentária.

The aim was to review the literature and discuss the occlusal concepts in oral rehabilitation with complete dentures, emphasizing the advantages and needs of each occlusal scheme. A search was carried out on the databases PubMed, SciELO, Google Scholar and in textbooks, using "Dental Occlusion"; "Dental Occlusion Balanced"; "Canino guidance"; "Denture complete"; and "Denture design" as keywords and the Boolean operators AND, OR, and NOT. Among the occlusal schemes available for prosthetic planning, the bilateral balanced occlusion (BBO) and the canine guided occlusion (CGO) were the most studied and discussed in the disocclusion of complete dentures. Studies indicate the type of occlusion can interfere with muscle activity of the stomatognathic system, masticatory efficiency, bone resorption, retention and stability of removable dentures, and patient satisfaction. In the literature examined, the recommendation of the CGO as the preferred occlusal scheme in the planning of complete dentures was noticeable. The results of the studies indicate less muscle activity during mastication, better retention, and stability of the total denture. It is simpler and easier to obtain this occlusal scheme than the BBO. CGO benefits phonetics; it is aesthetically preferred by patients; and, in terms of quality of life, self-perception of masticatory and occlusal strength, has shown to be satisfactory. We conclude that CGO can be recommended as a favorable occlusal scheme for oral rehabilitation with complete dentures.

Surface morphology and in vitro leachability of soft liners modified by the incorporation of antifungals for denture stomatitis treatment

Abstract Objective: To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm. Methodology:Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (µg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05). Results: Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001). Conclusions: The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.

Beneficial effects of ethyl-cyanoacrylate coating against candida albicans biofilm formation

Abstract The aim of this study was to verify whether modifications made in a hard chairside reline resin by an ethyl-cyanoacrylate adhesive, ECA (Super Bonder®, Loctite, Itapevi, SP, Brazil) would be able to inhibit or reduce Candida albicans biofilm formation on its surface, comparing to a commercial surface sealant (BisCover®, Bisco, Schaumburg, USA). Reline resin specimens were fabricated and randomly divided into 6 groups (n=8): CG (control group), no surface treatment; ECA1, ECA coating on the surface before sterilization; ECA2, ECA coating after sterilization; ECA3, ECA incorporated in the resin bulk; DPE1, BisCover® coating before sterilization; DPE2, BisCover® coating after sterilization. Specimens were inoculated with C. albicans SC5314 (1x107 cells/mL) and incubated for 24 h. Then, the biofilm were stained with LIVE/DEAD® BaclightTM L7007 Kit and analyzed by Confocal Laser Scanning Microscopy. The images were evaluated by bioImageL® v.2.0 software and total biovolume (µm3), viable cells (%), and covered area (%) were calculated. Data were statistically analyzed by Kruskal-Wallis and Dunn tests (p<0.05). Results showed that ECA-coated groups presented better results, reducing C. albicans biofilm formation. Acquired images revealed that these groups (ECA1 and ECA2) presented a reduced number of cells, mostly in yeast form (less pathogenic), while the other groups presented higher number of cells, mostly in hyphae form (more pathogenic). Based on these findings, a beneficial effect of Super Bonder® coating reline resins surface could be demonstrated, suggesting a promising way to prevent fungal biofilm formation on dentures.

Resumo O objetivo deste estudo foi verificar se as modificações feitas com o adesivo etil cianoacrilato, ECA (Super Bonder ®, Loctite, Itapevi, SP, Brasil) sobre as resinas acrílicas para reembasamento, poderiam inibir ou reduzir a formação de biofilmes de C.albicans sobre sua superfície quando comparado com um selante de superfície comercial (BisCover®, Bisco, Schaumburg, EUA). Amostras de resina acrílica para reembasamento foram fabricadas e divididas aleatoriamente em 6 grupos (n=8): CG (grupo controle), sem tratamento superficial; ECA1, revestimento de ECA na superfície antes da esterilização; ECA2, revestimento de ECA após esterilização; ECA3, ECA incorporado no volume da resina; DPE1, revestimento de BisCover® antes da esterilização; DPE2, revestimento de BisCover® após esterilização. Os espécimes foram inoculados com C. albicans SC5314 (1x107 células/mL) e incubados durante 24 h. Seguidamente, o biofilme foi corado com LIVE/DEAD® BaclightTM L7007 Kit e analisado no microscópio confocal de varredura a laser. As imagens foram avaliadas pelo software bioImageL® v.2.0, no qual foram calculados o biovolume total (μm3), as células viáveis (%) e a área coberta (%). Os dados foram analisados estatisticamente pelos testes de Kruskal-Wallis e Dunn (p<0,05). Os resultados mostraram que os grupos revestidos com ECA apresentaram os melhores resultados, reduzindo a formação do biofilme de C. albicans. As imagens adquiridas revelaram que esses grupos (ECA1 e ECA2) apresentaram um número reduzido de células, principalmente na forma de levedura (menos patogênico), enquanto os outros grupos apresentaram um maior número de células, principalmente na forma de hifas (mais patogênicas). Com base nessas descobertas, encontra-se um efeito benéfico na aplicação do adesivo ECA sobre as superfícies das resinas acrílicas para reembasamento, sugerindo assim uma nova alternativa de prevenir a formação de biofilme fúngico em próteses dentárias.

Considerações sobre os tipos de próteses parciais removíveis e seu impacto na qualidade de vida / Considerations on types of removable partial dentures and their impact on oral health

O objetivo deste estudo foi discutir, por meio de uma revisão de literatura, as indicações, contraindicações, vantagens, desvantagens das alternativas reabilitadoras mais comuns utilizando PPRs e o impacto desses tratamentos na qualidade de vida relacionada à saúde bucal dos pacientes. Foi realizada uma pesquisa ampla na literatura, com a utilização dos termos "Prótese Parcial Removível", "Qualidade de Vida", "Saúde bucal"; "Satisfação do Paciente", no período entre 1990 e 2018, no Medline, Google Scholar, internet e livros didáticos. Foi demonstrado que a reabilitação com PPRs associadas a implantes resultou em melhor qualidade de vida associada à saúde bucal dos usuários, seguida por PPRs retidas por encaixe e PPRs convencionais. Entretanto, o profissional deve considerar as condições sistêmicas, bucais e econômicas de cada paciente, tendo o conhecimento biomecânico bem como a ciência dos benefícios e das desvantagens de cada tipo de tratamento para estabelecer um correto diagnóstico do caso e, assim, indicar o melhor tipo de PPR. Dessa forma, é possível oferecer o melhor tratamento para cada paciente parcialmente edêntulo, devolvendo estética e função de maneira satisfatória de modo a resultar em maior nível de satisfação e qualidade de vida(AU)

The purpose of this study was to discuss, through a review of the literature, indications, contraindications, advantages, disadvantages of the most common rehabilitation alternatives using RPDs and the impact of these treatments on patients' oral health quality of life. A broad research was conducted in the literature, using the terms "Partial Removable Prosthesis", "Quality of Life", "Oral Health"; "Patient Satisfaction" in the period between 1990 and 2018, in Medline, Google Scholar, internet and textbooks. It was demonstrated that rehabilitation with RPDs associated with implants resulted in a better oral health quality of life of users, followed by RPDs with attachments and conventional RPDs. However, the professional should consider the systemic, oral and economic conditions of each patient, based on the biomechanical knowledge, as well as the science of the benefits and disadvantages of each type of treatment to establish a correct diagnosis of the case, and thus, indicate the best type of RPD. In this way, it is possible to offer the best treatment for each partially edentulous patient, returning aesthetics and function in a satisfactory manner in order to result in a higher level of satisfaction and quality of life(AU)

Porosity, water sorption and solubility of denture base acrylic resins polymerized conventionally or in microwave

Abstract The proper selection of polymerization cycle is important to prevent overheating of the monomer that could cause degradation, porosity and, consequently, deleterious effects on the denture base properties. Objective This study evaluated the porosity, water sorption and solubility of acrylic resins (Vipi Cril-VC and Vipi Wave-VW) after conventional or microwave polymerization cycles. Material and Methods Specimens (n = 10) were made and cured: 1-WB = 65°C during 90 min + boiling during 90 min (VC cycle - control group); 2-M25 = 10 min at 270 W + 5 min at 0 W + 10 min at 360 W (VW cycle); 3-M3 = 3 min at 550 W; and 4-M5 = 5 min at 650 W. Afterward, they were polished and dried in a dessicator until a constant mass was reached. Specimens were then immersed in distilled water at 37°C and weighed regularly until a constant mass was achieved. For porosity, an additional weight was made with the specimen immediately immersed in distilled water. For water sorption and solubility, the specimens were dried again until equilibrium was reached. Data were submitted to 2 way-ANOVA and Tukey HSD (α=0.05). Results Porosity mean values below 1.52% with no significant difference among groups for both materials were observed. Resins showed water sorption and solubility values without a significant difference. However, there was a significant difference among groups for these both properties (P<0.013). The highest sorption (2.43%) and solubility (0.13%) values were obtained for WB and M3, respectively. Conclusions The conventional acrylic resin could be polymerized in a microwave since both the materials showed similar performance in the evaluated properties. Shorter microwave cycles could be used for both the materials without any detectable increase in volume porosity.

Efeito do desafio ácido nas propriedades superficiais das camadas externa e interna de dentes acrílicos reforçados / Effect of acid challenge on the surface properties of external and internal layers of cross-linked acrylic teeth

Introdução: Os dentes acrílicos artificiais devem apresentar característica de resistência aos ácidos, a fim de assegurar a manutenção de suas propriedades, ao longo de sua vida útil. Entretanto, não há estudos disponíveis na literatura pertinente sobre as propriedades superficiais de dureza e rugosidade das diferentes camadas de resina acrílica que compõem os dentes artificiais submetidos a ensaios de erosão simulada. Objetivo: Avaliar a dureza e rugosidade superficiais das camadas externa e interna de dentes artificiais acrílicos reforçados submetidos a desafio ácido. Metodologia: Molares (SR Postaris e Trilux) seccionados transversalmente foram avaliados inicialmente quanto à dureza Vickers e rugosidade. Esses ensaios foram repetidos após metade das amostras de cada tipo de dente (n=10) ser imersa em água destilada (controle) e outra metade em vinagre durante 15 min/dia por 28 dias. Os resultados foram analisados por ANOVA 2-critérios e teste de Tukey (α=0,05). Resultado: A dureza inicial da camada externa dos dois diferentes tipos de dente não sofreu alteração significativa pelo desafio ácido (p>0,05) e a imersão em vinagre não causou efeito deletério à dureza inicial da camada interna dos dois tipos de dentes avaliados (p>0,05). Após 28 dias, a rugosidade inicial de ambos os tipos de dentes estudados, para as duas camadas, não foi alterada com água ou vinagre (p>0,05). Conclusão: Os dentes acrílicos reforçados foram resistentes ao desafio ácido uma vez que suas camadas interna e externa não apresentaram alteração significativa de dureza e rugosidade superficiais.

Introduction: Artificial acrylic teeth must be resistant to acids for ensure the maintenance of their properties throughout their useful life. However, there are no studies available in the literature about the surface properties of hardness and roughness of the different layers of acrylic resin that make up the artificial teeth submitted to simulated erosion tests. Objective: To evaluate the surface hardness and roughness of external and internal layers of artificial cross-linked acrylic teeth submitted to acid challenge. Methodology: First molars (SR Postaris and Trilux) transversely sectioned had its Vickers hardness and roughness initially evaluated. These tests were repeated after half of the tooth samples (n=10) be immersed into distilled water (control) and half in vinegar during 15 min/day for 28 days. Data were analyzed using 2-way ANOVA and Tukey's test (α=0.05). Result: The initial external layers hardness of both was not significantly altered by acid challenge (p> 0.05) and the immersion in vinegar caused no deleterious effect on the initial internal layers hardness of the two tested teeth (p>0.05). After 28 days, the initial roughness of both teeth evaluated for the two layers was not affected by water or vinegar (p>0.05). Conclusion: The reinforced acrylic teeth were resistant to acid challenge since its internal and external layers showed no significant change in hardness and surface roughness.

Surface Properties of Temporary Soft Liners Modified by Minimum Inhibitory Concentrations of Antifungals

Abstract Evaluating the addition of minimum inhibitory concentrations (MICs) of antifungals for Candida albicans biofilm on the hardness and roughness of temporary denture soft liners. Specimens (n=8; 36×7×6 mm) of tissue conditioner (Softone) and resilient liner (Trusoft) were produced either without (control) or with incorporation of drugs at MICs: nystatin (0.032 g/mL), chlorhexidine diacetate (0.064 g/mL), ketoconazole (0.128 g/mL), miconazole (0.256 g/mL) and itraconazole (0.256 g/mL). Specimens were stored in distilled water at 37 °C for 24 h, 7 days and 14 days prior to the hardness/roughness measurements. Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). The addition of the antifungals into both materials demonstrated no evident hardness change or decrease of this property compared with the control, except for miconazole in Softone, which increased the hardness after 14 days (p=0.003). The addition of nystatin into both materials, chlorhexidine in Trusoft and ketoconazole in Softone resulted in no significant changes of roughness compared with the control, after 7 days and 14 days (p>0.05). In these periods, itraconazole increased the roughness of both materials (p<0.001). The addition of all antifungals, except for the miconazole in Softone, resulted in no deleterious effects on the materials’ hardness over the evaluation time. The MICs of nystatin in both temporary soft lining materials, ketoconazole in Softone and chlorhexidine in Trusoft resulted in no deleterious effects for roughness up to 14 days.

Resumo Avaliar a adição de antifúngicos nas mínimas concentrações inibitórias (MCIs) para o biofilme de Candida albicans sobre a dureza e rugosidade da reembasadores resilientes temporários. Foram confeccionados corpos de prova (n=8; 36×7×6 mm) a partir de um condicionador de tecido (Softone) e um reembasador resiliente (Trusoft), sem (controle) ou com a incorporação de fármacos nas MCIs: nistatina (0,032 g/mL), diacetato de clorexidina (0,064 g/mL), cetoconazol (0,128 g/mL), miconazol (0,256 g/mL) e itraconazol (0,256 g/mL). Os corpos de prova foram armazenados em água destilada a 37 °C durante 24 h, 7 dias e 14 dias antes das mensurações de dureza e rugosidade. Os dados foram analisados por ANOVA 3-fatores e teste de Tukey HSD (α=0,05). A adição dos antifúngicos em ambos os materiais não demonstrou nenhuma alteração evidente na dureza ou diminuiu esta propriedade em comparação com o controle, exceto para o miconazol no Softone que aumentou a dureza após 14 dias (p=0,003). A adição de nistatina aos dois materiais, clorexidina no Trusoft e cetoconazol no Softone não resultou em alterações significativas de rugosidade em comparação com o controle após 7 e 14 dias (p>0,05). Nestes períodos, o itraconazol aumentou a rugosidade de ambos os materiais (p<0,001). A adição de todos os antifúngicos, exceto para o miconazol no Softone, não resultou em efeitos deletérios sobre a dureza dos materiais ao longo do tempo de avaliação. As MCIs de nistatina em ambos os materiais reembasadores resilientes temporários, cetoconazol no Softone e clorexidina no Trusoft não produziram efeitos deletérios para a rugosidade em até 14 dias.

Porosity of temporary denture soft liners containing antifungal agents

ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.