Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Action of disinfectant solutions on adaptive capacity and virulence factors of the Candida spp. biofilms formed on acrylic resin

Abstract Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. Objective To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions. Methodology Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test. Results NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal. Conclusions The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

Complete denture hygiene solutions: antibiofilm activity and effects on physical and mechanical properties of acrylic resin

Abstract Appropriated denture hygiene is a predictive factor for longevity of rehabilitation treatment and maintenance of the oral mucosal health. Although, disinfectant solutions are commonly used as denture cleansers, the impact of these solutions on acrylic resin-based dentures remain unclear. Objective To evaluate, in vitro, the antibiofilm activity of complete denture hygiene solutions and their effects on physical and mechanical properties of acrylic resin. Methodology For antibiofilm activity measurement acrylic resin specimens were contaminated with Candida albicans, Candida glabrata and Streptococcus mutans. After biofilm growth, the specimens were assigned to the hygiene solutions: Distilled water (Control); 0.2% Sodium hypochlorite (SH); Efferdent Power Clean Crystals (EPC) and 6.25% Ricinus communis (RC). The viability of microorganisms was evaluated by agar plate counts. In parallel, physical, and mechanical properties of the acrylic resin were evaluated after simulating a 5-year period of daily immersion in the previously mentioned solutions. The changes in surface roughness, color, microhardness, flexural strength, impact strength, sorption and solubility were evaluated. Data were compared by ANOVA followed by the Tukey test or Kruskal-Wallis followed by the Dunn test depending on the distribution (α=0.05). Results Regarding antibiofilm action, SH eliminated all microorganisms while EPC and RC exhibited moderate action against S. mutans (p=0.001) and C. glabrata (p<0.001), respectively. Relative to effects on the physical and mechanical properties of the acrylic resin, RC led to higher values of color change (p=0.030), hardness (p<0.001), surface roughness (p=0.006) and flexural strength (p<0.001). Moreover, RC induced the highest values of changes in solubility (p<0.001). EPC promoted greater changes in surface morphology, whereas immersion in SH retained the initial appearance of the acrylic resin surface. All hygiene solutions reduced the impact strength (p<0.05). Conclusion SH presented the most effective antibiofilm activity. In addition, changes on properties were observed after immersion in RC, which were considered within acceptable limits.

Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser

Abstract The development of opportunistic infections due to poor denture hygiene conditions justified the search for effective hygiene protocols for controlling denture biofilm. Objective This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction. Material and Methods It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire. Results S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient's satisfaction. Conclusions 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

Color stability and surface roughness of artificial teeth brushed with an experimental Ricinus communis toothpaste

To evaluate, in vitro, the effect of brushing with a Ricinus communis-based experimental toothpaste on color stability and surface roughness of artificial teeth. Methods: Ninety artificial teeth (maxillary central incisors) in different shades, light and dark (NatusDent Triple Pressing, Dentbras) were used. Initial color (Spectrophotometer Easyshade, VITA) and surface roughness (Rugosimeter Surfcorder SE 1700, Kosakalab) readouts were performed. After baseline measurements, samples were assigned to 10 groups (n=9) according to the artificial tooth shade and type of toothpaste used during the mechanical brushing test (Pepsodent, MAVTEC): Sorriso Dentes Brancos - SDB, Colgate Luminous White - CLW (Colgate-Palmolive), Close up White Now - CWN (Unilever), Trihydral - THL (Perland Pharmacos) and Ricinus communis - RCE (Experimental). After 29,200 cycles of brushing, corresponding to 2 years of brushing by a healthy individual, new color and roughness readouts of the specimens were performed. Data (before and after the tests) were statistically analyzed (2-way repeated measures ANOVA, Tukey, p<0.05). Results: RCE toothpaste produced the greatest color stability for dark tooth shade and the second best color stability for light tooth shade. For surface roughness alteration, there was no difference (p>0.05) for any tested toothpaste regardless of tooth shade. Conclusions: The experimental Ricinus communis toothpaste did not cause color and surface roughness alteration in the artificial teeth, and it may be considered a suitable option for denture cleaning...

Adverse Effects on PMMA Caused by Mechanical and Combined Methods of Denture Cleansing

This study evaluated the abrasiveness of mechanical and combined methods of denture hygiene, by the analysis of mass loss and surface roughness. Acrylic resin specimens (Plexiglass) were brushed by a tooth brushing machine (Mavtec) with a soft brush (Tek) and water (control) or four dentifrices (Sorriso, Colgate, Polident and Corega) (Experimental groups) for 50 min, representing one year of brushing (mechanical method). After brushing, the specimens were immersed in 0.5% sodium hypochlorite simulating a daily cleaning of 20 min for one year (combined method). Distilled water (23 ºC) was employed as control. The mass loss (g) was analyzed by an analytical balance and the surface roughness (μm) by a rugosimeter. Data were subjected to ANOVA and Bonferroni test (α=0.05). Polident dentifrice showed lowest values of mass loss for both methods (mechanical: -0.0072±0.0017, combined:-0.011±0.002) and the combined method resulted in greater mass loss than the mechanical, except for Corega. For the surface roughness, after the mechanical method, the lowest values were registered for water (-0.007±0.016) and Polident (0.402±0.378); for the combined method, water (-0.063±0.013) showed the lowest values; there was no statistically significant difference between methods. It was concluded that Polident was the less abrasive dentifrice and the association between chemical and mechanical methods increased the mass loss but did not change the surface roughness of specimens.

Este estudo avaliou a abrasividade causada pelos métodos mecânico e combinado de higiene de próteses totais, por meio da análise da perda de massa e rugosidade de superfície. Corpos de prova de resina acrílica (Plexiglass) foram escovados em máquina de escovação (Mavtec) com escova macia (Tek) e água ou dentifrícios (Sorriso, Colgate, Polident e Corega) (Grupos Experimentais) por 50 min, simulando 1 ano de escovação (método mecânico). Após a escovação, os corpos de prova foram imersos em hipoclorito de sódio a 0,5%, simulando imersões diárias de 20 min por 1 ano (método combinado). Água destilada (23 °C) foi empregada como controle. A perda de massa foi analisada por meio de balança analítica de precisão (g) e a rugosidade de superfície por rugosímetro (μm). Os dados foram submetidos à ANOVA e teste de Bonferroni (α=0,05). Em relação à perda de massa, os menores valores foram obtidos para o Polident em ambos os métodos (mecânico: -0,0072±0,0017; combinado: -0,011±0,002) e o método combinado resultou em maior perda de massa que o método mecânico, exceto para o Corega. Para a rugosidade de superfície, após aplicação do método mecânico, os valores mais baixos foram registrados para água (-0,007±0,016) e Polident (0,402±0,378); para o método combinado, os valores mais baixos foram obtidos para água (-0,063±0,013); não houve diferença estatística entre os métodos. Conclui-se que o Polident foi o dentifrício menos abrasivo e que a associação do método químico ao método mecânico aumentou a perda de massa, porém não alterou a rugosidade de superfície dos corpos de prova.

Trial of an Experimental Castor Oil Solution for Cleaning Dentures

Denture hygiene is essential because denture biofilm is involved in oral infections and systemic diseases. Although there are chemical agents available on the market, none of them have ideal properties and research on such products is still necessary. The aim of this study was to evaluate the efficacy of a castor bean (Ricinus communis)-based solution for removing denture biofilm, compared to two traditional products (sodium hypochlorite and alkaline peroxide). Fifty maxillary complete denture wearers were instructed to brush their dentures after meals and to immerse their dentures once a day in the following solutions: Saline (20 min; control), Polident alkaline peroxide (3 min), NaOCl (20 min) and 2% castor oil solution (20 min). Participants used each solution for a period of 7 consecutive days, according to a random sequence. After each period, the internal surfaces of maxillary complete dentures were stained with a disclosing solution (1% neutral red), photographed and the disclosed biofilm was quantified with the aid of specific software. The influence of treatments on results was verified by the Friedman test (α=0.05). Tested solutions presented significant difference (Fr=51.67; p<0.001). Saline and NaOCl were significantly different (median: 2.0% and 0.0%) whereas Polident and castor oil presented intermediate results (median: 1.0% and 1.5%, respectively). It can be concluded that the castor oil solution tested in this study was comparable to alkaline peroxide in terms of efficiency in denture biofilm removal.

A higiene de próteses totais é essencial, uma vez que o biofilme da prótese está envolvido com infecções orais e doenças sistêmicas. Apesar de existirem agentes químicos disponíveis no mercado, nenhum deles apresenta propriedades ideais e pesquisas com esses produtos ainda são necessárias. O objetivo neste estudo foi avaliar a eficácia de uma solução de mamona (Ricinus communis) para a remoção do biofilme de prótese total, comparada com dois produtos comerciais (NaOCl e peróxido alcalino). Cinqüenta usuários de próteses totais maxilares foram instruídos a escovar as próteses após as refeições e imergi-las uma vez por dia nas seguintes soluções: soro fisiológico (20 min), Peróxido alcalino Polident (3 min), NaOCl a 1% (20 min) e solução de mamona (20 min). Os participantes utilizaram cada solução por um período de sete dias consecutivos, de acordo com uma sequência aleatória. Após cada período, as superfícies internas das próteses totais superiores foram coradas com solução evidenciadora (vermelho neutro a 1%), fotografadas e o biofilme evidenciado foi quantificado com software. A influência dos tratamentos sobre os resultados foi verificada pelo teste de Friedman (α=0,05). Houve diferença significativa entre as soluções (Fr=51,67;p<0,001). O soro fisiológico e o NaOCl foram significativamente diferentes (mediana: 2,0% e 0,0%), enquanto o Polident e a solução de mamona apresentaram resultados intermediários (mediana: 1,0% e 1,5%, respectivamente). Concluiu-se que a solução de mamona avaliada é comparável ao peróxido alcalino, em termos de remoção do biofilme de prótese total.

Effectiveness of manual and electric brushes in the removal of biofilm from full dentures / Eficácia das escovas manual e elétrica na remoção do biofilme de próteses totais

Objective: To evaluate clinically the ability to remove biofilm from complete dentures. Methods: Thirty patients, users of full upper dentures, participated in a trial period of 21 days and were instructed to brush the dentures three times a day (after breakfast, lunch and dinner) with water, using a manual, special denture brush (Group I - Control) and electric brush (Group II - Experimental). At night, the patients were instructed to immerse their dentures in a container with filtered water. Before and after the use of these methods for 21 days, the internal surfaces of the complete upper dentures were stained (1% neutral red) and photographed. The areas (total of internal surface and the surface stained with biofilm) were quantified using software (Image Tool 2.02). The percentage of the biofilm was calculated as the ratio of the area of the biofilm multiplied by 100 to the total surface area of the internal base of the dentures. Results: The data for the two methods were compared using the Student?s t-test (?? = 0.05). There was a mean area of biofilm coverage (%, ± standard deviation) of 12.5 ± 12.8 and 16.9 ± 17.0 for the manual and electric toothbrushes, respectively. The differences were not significant (t = 0.799, P = 0.431). Conclusion: It was concluded that both brushes tested showed the same capacity for biofilm removal from complete dentures.

Objetivo: Avaliar clinicamente a capacidade de remoção do biofilme de prótese total de dois métodos mecânicos de higiene: escovação manual e elétrica. Métodos: Trinta pacientes, usuários de próteses totais superiores, participaram de um período experimental de 21 dias e foram orientados a escovar as próteses três vezes ao dia (após café da manhã, almoço e jantar) com água empregando escova manual específica para próteses totais (Grupo I - Controle) e elétrica (Grupo II - Experimental). Durante o período noturno o paciente foi orientado a imergir suas próteses em recipiente contendo água filtrada. Antes e após o uso dos métodos por 21 dias, as superfícies internas das próteses totais superiores foram evidenciadas (vermelho neutro 1%) e fotografadas. As áreas (total da superfície interna e corada com biofilme) foram quantificadas com um software (Image Tool 2.02). A porcentagem do biofilme foi calculada como a relação entre a área do biofilme multiplicado por 100 e a área da superfície total da base interna da prótese.Resultados: Os dados dos dois métodos foram comparados por meio do teste t de Student (?? = 0,05). Observou-se uma área média de cobertura por biofilme (%, ±desvio padrão) de 12,5±12,8 e 16,9±17,0 para a escova elétrica e a manual, respectivamente. As diferenças não foram significantes (t=0,799; p=0,431). Conclusão: Concluiu-se que ambas as escovas testadas apresentaram a mesma capacidade de remoção de biofilme das próteses totais.

Color Stability, Surface Roughness and Flexural Strength of an Acrylic Resin Submitted to Simulated Overnight Immersion in Denture Cleansers

This study evaluated color stability, surface roughness and flexural strength of acrylic resin specimens after immersion in alkaline peroxide and alkaline hypochlorite, simulating a period of one and a half year of use of overnight immersion. Sixty disc-shaped (16X4 mm) and 80 rectangular specimens (65X10X3.3 mm) were prepared from heat-polymerized acrylic resin (Lucitone 550) and distributed into 4 groups (n=20): C1: without immersion, C2: 8 h immersion in distilled water; AP: 8 h immersion in alkaline peroxide effervescent tablet; SH: 8 h immersion in 0.5% NaOCl solution. Properties were evaluated at baseline and after the immersion. Color data were also calculated according the National Bureau of Standards (NBS). Results were analyzed statistically by ANOVA and Tukey's HSD test (α=0.05). AP (2.34 ± 0.41) caused color alteration significantly higher than C2 (0.39 ± 0.30) and SH (1.73 ± 0.52). The mean ΔE values were classified as indicial for C2 (0.36 ± 0.29) and noticeable for AP (2.12 ± 0.39) and SH (1.59 ± 0.48). SH (0.0195 ± 0.0150) caused significantly higher ΔRa (p=0.000) than the C2 (0.0005 ± 0.0115) and PA (0.0005 ± 0.0157) groups. There was no statistically significant difference (p=0.063) among the solutions for flexural strength (C1: 105.43 ± 14.93, C2: 100.30 ± 12.43, PA: 97.61 ± 11.09, SH: 95.23 ± 10.18). In conclusion, overnight immersion in denture cleansing solutions simulating a year and a half of use did not alter the flexural strength of acrylic resin but caused noticeable color alterations, higher for alkaline peroxide. The 0.5% NaOCl solution caused increase in surface roughness.

Resumo O estudo avaliou a alteração de cor, rugosidade de superfície e força de flexão de espécimes de resina acrílica após imersão em peróxido alcalino e hipoclorito alcalino, simulando um ano e meio de uso seguindo a imersão noturna. Sessenta espécimes circulares (16 X 4 mm) e oitenta retangulares (65 X 10 X 3,3 mm) de resina acrílica termopolimerizável (Lucitone 550) foram distribuídos em 4 grupos (n=20): C1: sem imersão, C2: 8 h de imersão em água destilada; PA: 8 h de imersão em pastilhas efervescentes de peróxido alcalino; HS: 8 h de imersão em hipoclorito de sódio a 0,5%. As propriedades foram avaliadas antes e após as imersões. Os dados de alteração de cor também foram calculados de acordo com o National Bureau of Standards (NBS). Os dados foram analisados estatisticamente pelo teste ANOVA e Tukey HSD (α=0,05). O PA (2,34 ± 0,41) causou alteração de cor significativamente maior que C2 (0,39 ± 0,30) e SH (1,73 ± 0,2). A média ΔE foi classificada como indicial para C2 (0,36 ± 0,29) e perceptível para PA (2,12 ± 0,39) e HS (1,59 ± 0,48). HS (0,0195 ± 0,0150) causou significantemente maior ΔRa (p=0) do que os demais (C2: 0,0005 ± 0,0115 e PA: 0,0005 ± 0,0157). Não houve diferença estatisticamente significante (p=0,063) entre as soluções para a resistência à flexão (C1: 105,43 ± 14,93; C2: 100,30 ± 12,43, PA: 97,61 ± 11,09, HS: 95,23 ± 10,18). A imersão noturna em soluções higienizadores de próteses simulando um ano e meio de uso não alterou a resistência à flexão da resina acrílica, porém causou alterações perceptíveis de cor, sendo maiores com o peróxido alcalino. O hipoclorito de sódio a 0,5% ...

Complete denture biofilm after brushing with specific denture paste, neutral soap and artificial saliva

This study compared the levels of biofilm in maxillary and mandibular complete dentures and evaluated the number of colony-forming units (cfu) of yeasts, after using auxiliary brushing agents and artificial saliva. Twenty-three denture wearers with hyposalivation and xerostomia were instructed to brush the dentures 3 times a day during 3 weeks with the following products: Corega Brite denture dentifrice, neutral liquid soap, Corega Brite combined with Oral Balance (artificial saliva) or tap water. For biofilm quantification, the internal surfaces of the dentures were disclosed, photographed and measured using a software. For microbiological analysis, the biofilm was scrapped off, and the harvested material was diluted, sown in CHROMagar™ Candida and incubated at 37°C for 48 h. Data were analyzed statistically by two-way ANOVA and Tukey's test (α=0.05). Mandibular dentures presented a mean biofilm percentage (µ=26.90 ± 21.10) significantly greater than the maxillary ones (µ=18.0 ± 15.0) (p<0.05). Brushing using Corega Brite combined with Oral Balance (µ=15.87 ± 18.47) was more effective (p<0.05) than using the denture dentifrice (µ=19.47 ± 17.24), neutral soap (µ=23.90 ± 18.63) or tap water (control; µ=32.50 ± 20.68). For the microbiological analysis, the chi-square test did not indicate significant difference between the hygiene products for either type of denture. The more frequently isolated species of yeasts were C. albicans, C. tropicalis and C. glabrata. In conclusion, mandibular dentures had more biofilm formation than maxillary ones. Denture brushing with Corega Brite dentifrice combined with the use of Oral Balance was the most effective method for reduction of biofilm levels, but the use of products did not show difference in yeast cfu counts.

Este estudo comparou os níveis de biofilme em próteses totais maxilares e mandibulares, e analisou o número de unidades formadoras de colônias de leveduras, após o uso de agentes auxiliares da escovação e saliva artificial. Vinte e três usuários de próteses totais com hipossalivação e xerostomia foram orientados a escovar as dentaduras 3 vezes ao dia durante 3 semanas com os seguintes produtos: Corega Brite (dentifrício para prótese), sabonete líquido neutro, Corega Brite associado com o uso do Oral Balance (saliva artificial) ou água de torneira. Para a quantificação do biofilme, as superfícies internas das próteses totais foram evidenciadas, fotografadas e o biofilme quantificado com o auxílio de um software. Para a análise microbiológica, o biofilme foi removido por escovação, coletado, diluído, semeado em meio seletivo CHROMagar™ Candida e incubado a 37°C por 48 h. A análise de variância para dois fatores (p<0,05%) mostrou que as próteses mandibulares apresentaram uma média de porcentagem de biofilme (µ=26,90±21,10) maior que as maxilares (µ=18±15). O teste complementar de Tukey (0,46; p<5%) mostrou que a escovação com Corega Brite e Oral Balance (µ=15,87 ± 18,47) foi mais efetiva que o dentifrício (µ=19,47 ± 17,24), sabonete neutro (µ=23,90 ± 18,63), ou água de torneira (controle; µ=32,50 ± 20,68). Em relação á análise microbiológica, o teste de Qui-Quadrado não indicou diferença entre os produtos de higiene, para ambas as próteses. As espécies de leveduras mais comumente isoladas foram C. albicans, C. tropicalis e C. glabrata. Em conclusão, as próteses mandibulares apresentaram mais biofilme do que as maxilares. Além disso, a escovação das próteses com o Corega Brite associado ao uso do Oralbalance foi o método mais efetivo na redução dos níveis de biofilme, entretanto o uso dos produtos não demonstrou diferença no número de ufc de leveduras.

Abrasiveness of conventional and specific denture-cleansing dentifrices

This study analyzed the weight loss and surface roughness caused in Plexiglass specimens by conventional dentifrices (Sorriso, Colgate and Close Up) and specific dentifrices used for cleaning of dentures (Corega and Dentu Creme). Plexiglass specimens were divided into 6 groups (n=6) including: a control (distilled water - DW) and experimental groups. Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension and DW according to different brushing times (50, 100, 200 and 250 min -18,000, 36,000, 72,000 and 90,000 cycles, respectively, calculated to correspond to 1, 2, 4 and 5 years of regular brushing). The results of weight loss and surface roughness were analyzed by ANOVA and Tukey’s test at 5% significance level. In all tested times, the effect of DW was insignificant. Dentifrices differed significantly from DW in the initial period. Corega dentifrice caused greater mass loss in all studied times, followed by Close Up. Dentifrices resulted in a surface roughness similar to the DW at 50 min. In the other times, Sorriso, Colgate and Corega caused more surface roughness than DW. In conclusion, specific dentifrices caused larger mass loss and lower surface roughness as conventional dentifrice.

Este estudo analisou a perda de massa e rugosidade superficial causadas em corpos de prova de Plexiglass por dentifrícios convencionais (Sorriso, Colgate e Close Up) e específicos (Corega e Dentu Creme) para higienização de próteses totais. Os corpos de prova de Plexiglass foram distribuidos em 6 grupos (n=6), sendo um controle (água destilada - AD) e grupos experimentais. A escovação foi realizada em máquina de escovação com escovas macias e suspensões de dentifrícios ou AD, de acordo com os diferentes tempos de escovação (50, 100, 200 e 250 min -18.000, 36.000, 72.000 e 90.000 ciclos, respectivamente, calculados para corresponder a 1, 2, 4 e 5 anos de escovação regular). Os resultados de perda de massa e rugosidade superficial foram analisados por meio de ANOVA e teste de Tukey com 5% de significância. Em todos os tempos analisados, a AD teve efeito insignificante. Os dentifrícios diferiram significativamente da AD no período inicial. O dentifrício Corega causou maior perda de massa em todos os tempos estudados, seguido por Close Up. No tempo de 50 min, todos os dentifrícios causaram rugosidade superficial semelhante à AD. Nos outros tempos, Sorriso, Colgate e Corega causaram maior rugosidade superficial em relação à AD. Conclui-se que os dentifrícios específicos causaram maior perda de massa, porém menor rugosidade superficial que os dentifrícios convencionais.

The effectiveness of chemical denture cleansers and ultrasonic device in biofilm removal from complete dentures

Adequate denture hygiene can prevent and treat infection in edentulous patients. They are usually elderly and have difficulty for brushing their teeth. OBJECTIVE: This study evaluated the efficacy of complete denture biofilm removal using chemical (alkaline peroxide-effervescent tablets), mechanical (ultrasonic) and combined (association of the effervescent and ultrasonic) methods. MATERIAL AND METHODS: Eighty complete denture wearers participated in the experiment for 21 days. They were distributed into 4 groups (n=20): (1) Brushing with water (Control); (2) Effervescent tablets (Corega Tabs); (3) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (4) Association of effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush (Bitufo) and water, 3 times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. To quantify the biofilm, the internal surfaces of the maxillary complete dentures were stained and photographed at 45º. The photographs were processed and the areas (total internal surface stained with biofilm) quantified (Image Tool 2.02). The percentage of the biofilm was calculated by the ratio between the biofilm area multiplied by 100 and the total area of the internal surface of the maxillary complete denture. RESULTS: The Kruskal-Wallis test was used for comparison among groups followed by the Dunn multiple-comparison test. All tests were performed respecting a significance level of 0.05. Significant difference was found among the treatments (KW=21.18; P<0.001), the mean ranks for the treatments and results for Dunn multiple comparison test were: Control (60.9); Chemical (37.2); Mechanical (35.2) and Combined (29.1). CONCLUSION: The experimental methods were equally effective regarding the ability to remove biofilm and were superior to the control method (brushing with water). Immersion in alkaline peroxide and ultrasonic vibration can be used as auxiliary agents for cleaning complete dentures.

Prevalence of mutans streptococci isolated from complete dentures and their susceptibility to mouthrinses

The aims of this study were to evaluate the incidence of mutans streptococci (MS - sessile form) on complete maxillary dentures after use of a specific denture paste, and to determine the minimum inhibitory concentration (MIC) and maximum inhibitory dilution (MID) of 3 oral mouthrinses: Cepacol, Plax and Periogard. Seventy-seven complete denture wearers were randomly assigned into 2 groups, according to the product used for denture cleaning: Control group - conventional dentifrice (Kolynos-Super White); and Test group: experimental denture cleaning paste. Denture biofilm was collected at baseline and after 90 and 180 days after treatment by brushing the dentures with saline solution. After decimal serial dilution, samples were seeded onto agar sucrose bacitracin to count colonies with morphological characteristics of MS. MS identification was performed by the sugar fermentation tests. After this procedure, brain heart infusion broth (BHI) was added to oral mouthrinses (Plax, Cepacol e Periogard) and seeded on Petri dishes. The colonies were seeded using the Steers multiplier and, after the incubation, the MIC and MID of the mouthrinses were calculated. The results showed an incidence of 74.0 percent (n=57) of MS in the 77 complete dentures examined in the study, being 76.3 percent (n=29) of the Control group (conventional dentifrice) and 71.8 percent (28) of the Test group (experimental denture cleaning paste). In both groups, the number of positive cases for MS decreased from day 0 to day 180. In the Test group there was a slight decrease in the incidence of Streptococcus mutans 90 days after use of the experimental denture cleaning paste, which was not observed in the Control group. As regards to mouthrinses, for both groups, Periogard showed antimicrobial action with the highest dilution, followed by Cepacol and Plax. In conclusion, the incidence of MS in complete dentures was high and Periogard was the mouthrinse with the strongest antimicrobial action against MS. The experimental denture cleaning paste showed a slight action against S. mutans after 90 days of treatment.

O objetivo deste estudo foi avaliar a incidência de estreptococos do grupo mutans (forma séssil) de próteses totais superiores após o uso de uma pasta específica para higienização de próteses totais, bem como determinar a concentração inibitória mínima (CIM) e diluição inibitória máxima (DIM) de 3 enxaguatórios bucais: Cepacol, Plax e Periogard. Setenta e sete usuários de próteses totais foram distribuídos em 2 grupos: (A) grupo Controle: dentifrício convencional (Kolynos Super Branco) e (B) grupo Teste: pasta experimental para higiene de próteses (1). O biofilme das próteses foi coletado no início e após 90 e 180 dias dos tratamentos, por meio de escovação das próteses com solução salina. Após a diluição decimal seriada, as amostras foram semeadas em agar sacarose bacitracina para a contagem de colônias características de estreptococos do grupo mutans. A identificação dos estreptococos do grupo mutans foi realizada por meio de testes de fermentação de açúcares. Após este procedimento, o caldo de infusão de cérebro e coração (BHI) foi adicionado aos antissépticos (Plax, Cepacol e Periogard) e semeado em placas de Petri. As colônias foram semeadas usando o mutiplicador de Steers e após a incubação, a concentração inibitória mínima e a concentração inibitória máxima dos enxaguatórios foram calculadas. Os resultados mostraram que a incidência de estreptococos do grupo mutans nas 77 próteses totais examinadas foi de 74,0 por cento (n=57), sendo 76,3 por cento (n=29) do grupo Controle (pasta convencional) e 71,8 por cento (n=28) do grupo Teste (pasta experimental). Em ambos os grupos, o número de casos positivos para estreptococos do grupo mutans diminuiu, do início (0 dias) para 180 dias. Houve uma pequena diminuição da incidência de Streptococcus mutans após 90 dias do uso da pasta experimental, o que não foi observado no grupo controle. Com relação aos enxaguatórios, para ambos os grupos, o Periogard apresentou atividade antimicrobiana com diluições maiores, seguido do Cepacol e Plax. Pôde-se concluir que a incidência de estreptococos do grupo mutans em próteses totais foi elevada e que o Periogard foi o enxaguatório com melhor ação antimicrobiana contra os estreptococos do grupo mutans. A pasta experimental mostrou uma pequena ação contra S. mutans após 90 dias de tratamento.

Clinical and antimicrobial efficacy of NitrAdineTM-based disinfecting cleaning tablets in complete denture wearers

OBJECTIVE: This study evaluated the efficacy of NitrAdineTM-based disinfecting cleaning tablets for complete denture, in terms of denture biofilm removal and antimicrobial action. MATERIAL AND METHODS: Forty complete denture wearers (14 men and 26 women) with a mean age of 62.3±9.0 years were randomly assigned to two groups and were instructed to clean their dentures according to two methods: brushing (control) - 3 times a day with denture brush and tap water following meals; brushing and immersion (Experimental) - brushing the denture 3 times a day with denture brush and tap water following meals and immersion of the denture in NitrAdineTM-based denture tablets (Medical InterporousTM). Each method was used for 21 days. Denture biofilm was disclosed by a 1 percent neutral red solution and quantified by means of digital photos taken from the internal surface before and after the use of the product. Microbiological assessment was conducted to quantify Candida sp. RESULTS: An independent t-test revealed a significant lower biofilm percentage for the experimental group (4.7, 95 percent CI 2.4 to 7.9) in comparison with the control group (mean 37.5, 95 percent CI 28.2 to 48.1) (t38=7.996, p<0.001). A significant reduction of yeast colony forming units could be found after treatment with Medical InterporousTM denture tablets as compared to the control group (Mann-Whitney test, Z=1.90; p<0.05). CONCLUSION: The present findings suggest that NitrAdineTM-based disinfecting cleaning tablets are efficient in removal of denture biofilm. In addition, a clear antimicrobial action was demonstrated. Therefore, they should be recommended as a routine denture maintenance method for the prevention of the development of microbial biofilm induced denture stomatitis.

Effect of a denture cleanser on hardness, roughness and tensile bond strength of denture liners

Aim: This study aim to investigate the effect of a denture cleanser on hardness, roughness and tensile bond strength of a rigid (Kooliner) and a soft denture liner (Elite Soft) after 7, 60 and 120 days of immersion. Methods: Thirty circular and twenty rectangular specimens of each material were randomly distributed in two groups: control - immersion in artificial saliva at 37°C; and experimental - immersion in artificial saliva at 37ºC combined with immersion in the cleanser for 5 min. Hardness was measured using either a Vickers or Shore A hardness tester, and a surface roughness tester was used to measure the surface roughness. Tensile bond strength was carried out on a universal testing machine. Data were analyzed statistically by ANOVA or Kruskal-Wallis test (alpha=0.05). Results: No significant difference was found between the groups for the tested properties (p>0.05). There was an increase in the hardness of both materials after 60 days (p>0.05). No difference between the immersion periods was found for the roughness of Kooliner (p>0.05), although the roughness of Elite Soft decreased after 120 days in both groups (p>0.05). Kooliner presented higher tensile bond strength than Elite Soft (p>0.05). Conclusions: Both materials showed alterations on the tested properties during the experimental period, but these changes were not promoted by the denture cleanser.