Denture cleanliness and hygiene: an overview.

Dentures are an excellent treatment modality for partial and edentate patients; however, improper denture care and hygiene can result in both decreased longevity of the prosthesis and increased risk of developing dental caries, periodontal disease and oral candidosis. Previously, it has been shown that patients and dental professionals are unaware of the different materials and methods available for optimum denture care and hygiene. This article provides an overview of the key legislation and main commercially available methods for denture cleanliness and hygiene, and serves as a basis for providing tailored denture hygiene for denture wearers.

An ex-vivo model to determine dental pulp responses to heat and light-curing of dental restorative materials.

AIM: Based on histological studies from the 1960s, it is recommended that dental pulp temperature increases should not exceed 5.5 °C. However, no contemporary reliable models exist to explore the effects of heat on living dental pulp. The aim of this project was to develop a clinically valid model for studying temperature increases caused by three commonly-used light curing units (LCUs). METHODS: Temperature increases caused by LCUs at varying exposure times and via various thicknesses of dentine were recorded using traditional approaches (i.e. thermocouple device on a laboratory bench) and an ex-vivo tooth slice model. Histomorphometric and immunohistochemical (IL-1ß, HSP70, caspase-3) analysis was performed of the tooth slice model following varying exposure and culture times. RESULTS: Reduced dentine thickness and increased exposure time led to increases in temperature. Whilst the majority of temperature increases recorded using the traditional approach (53 of 60) were greater than the recommended 5.5 °C, 52 of the 60 reference points recorded using the ex-vivo tooth slice model resulted in temperature increases of less than 5.5 °C. Temperature increases of 5.5 °C or more that are prolonged for 40 s caused an immediate decrease in cell number. IL-1ß was not detected in any samples, while HSP70 was detectable immediately after exposure to a temperature increase of 6 °C or more. Higher levels of HSP70 were detected after 24 h culture in tooth slices that experienced a temperature increase of 7.5 °C or more. Low levels of caspase-3 were detected in tooth slices exposed to temperature increase of 7.5 °C or more. CONCLUSION: Experimental arrangements for assessing LCU performance that measure temperature increases using a thermocouple device on a laboratory bench should no longer be used. Future studies in this area should include replication of the clinical environment using greater sophistication, such as the use of an ex-vivo tooth slice model as described here. Temperature increases of 5.5 °C or more for 40 s caused an immediate decrease in cell number, which supports previous findings. However, complex interactions at an immunohistochemical level suggest that while temperature increases of 5 °C or less are ideal, there may be some cell damage between 5-7 °C which might not result in pulpal death. Further investigations are indicated.

The effectiveness of adhesives on the retention of mandibular free end saddle partial dentures: An in vitro study.

OBJECTIVES: Existing in vitro methods for testing denture adhesives do not fully replicate the complex oral geometries and environment; and in vivo methods are qualitative, prone to bias and not easily reproducible. The purpose of this study was to develop a novel, quantitative and more accurate model to test the effect of adhesives on the retentive force of mandibular free end saddle partial dentures. METHODS: An in vitro model was developed based on an anatomically accurate cast of a clinical case. Experimentally, the amount of adhesive was varied (0.2g-1g) and the tensile force required for displacement was measured. Different commercially available adhesives were then tested at the optimum volume using the in vitro model. A 3D finite element model of the denture was used to assess how the forces to induce denture displacement varied according to the position of the force along the saddle length. RESULTS: The mass of adhesive was found to significantly alter retention forces, with 0.4-0.7g being the optimum range for this particular scenario. Use of adhesives significantly improved mandibular free end saddle partial denture retention with the worst performing adhesive increasing retention nine-fold whilst the best performing adhesive increased retention twenty three-fold. The finite element model revealed that 77% more force was required to displace the denture by positioning forces towards the mesial end of the saddle compared to the distal end. CONCLUSIONS: An in vitro denture adhesive model was developed, which demonstrated that mass of adhesive plays a significant role in enhancing denture retention and supported the design principle of placing as few teeth as clinically necessary on the distal end of the free end saddles. CLINICAL SIGNIFICANCE: Limiting the position of teeth on free end saddles to the mesial and mid portion of the saddle will reduce displacements caused by mastication. The movement of mandibular free end saddle partial dentures can be restricted with the use of denture adhesives. Altering the mass of adhesive used can further improve the retention of mandibular free end saddle partial dentures for patients.

Effect of Preoperative Occlusal Matrices on the Vickers Microhardness of Composite Disks Polymerized with QTH and LED Lamps.

PURPOSE: This study aimed to assess the reliability of the preoperative occlusal matrix technique in terms of the surface Vickers microhardness (VMH) of the underlying composite restorative material. MATERIALS AND METHODS: Two hundred microhybrid composite cylinders were built up and light-cured in a single-layer step, forming two experimental groups (N = 100) according to their heights (1.5 mm/2 mm). Each group was divided into five subgroups (N = 20) depending on the matrix thickness (no matrix/0.5 mm/1 mm/2 mm/3 mm). Half the specimens per subgroup (N = 10) were randomly polymerized with a quartz-tungsten-halogen (QTH) light-curing unit (LCU). The remaining half were cured using a light-emitting diode lamp. The top and bottom samples' sides were tested for VMH at 1 hour and 24 hours post-curing using a universal VMH machine. A multiple analysis of variance with repeated measurements for the "surface" factor and the Student-Newman-Keuls test were run (α = 0.05). Bottom/top microhardness ratios were compared with the empirically accepted limit (0.8). Surface topography was analyzed under a scanning electron microscope. RESULTS: The thinnest matrices provided the significantly best VMH values. LCU, disc height, and time also contributed to VMH. At 24 hours, 2-mm high discs polymerized with QTH resulted in inadequate microhardness ratios when 1-mm thick to 3-mm thick matrices were used. CONCLUSION: The thinnest matrices are the most recommendable ones. CLINICAL SIGNIFICANCE: The esthetics and occlusal reproducibility achieved with customized occlusal matrices fabricated before cavity preparation have been widely demonstrated. However, their effect on the physical properties of the restorations deserves further investigation. Although more studies are necessary, the thinnest matrices seem to be the most suitable to preserve the composite surface VMH and the curing depth.

Virulence and pathogenicity of Candida albicans is enhanced in biofilms containing oral bacteria.

This study examined the influence of bacteria on the virulence and pathogenicity of candidal biofilms. Mature biofilms (Candida albicans-only, bacteria-only, C. albicans with bacteria) were generated on acrylic and either analysed directly, or used to infect a reconstituted human oral epithelium (RHOE). Analyses included Candida hyphae enumeration and assessment of Candida virulence gene expression. Lactate dehydrogenase (LDH) activity and Candida tissue invasion following biofilm infection of the RHOE were also measured. Candida hyphae were more prevalent (p < 0.05) in acrylic biofilms also containing bacteria, with genes encoding secreted aspartyl-proteinases (SAP4/SAP6) and hyphal-wall protein (HWP1) up-regulated (p < 0.05). Candida adhesin genes (ALS3/EPA1), SAP6 and HWP1 were up-regulated in mixed-species biofilm infections of RHOE. Multi-species infections exhibited higher hyphal proportions (p < 0.05), up-regulation of IL-18, higher LDH activity and tissue invasion. As the presence of bacteria in acrylic biofilms promoted Candida virulence, consideration should be given to the bacterial component when managing denture biofilm associated candidoses.

Improving some selected properties of dental polyacid-modified composite resins.

OBJECTIVES: Polyacid-modified composite resins (compomers) are restorative dental materials that exhibit certain features of traditional dental composites and glass-ionomer cements. The aim of this paper was to develop experimental compomers with enhanced properties, based on adhesive monomers vinyl phosphonic acid and pyromellitic dianhydride glycerol dimethacrylate, and to compare their properties to those of commercially available products. METHODS: Factorial experimental design was employed to optimize both chemical and physical properties. Properties such as biaxial flexural strength (BFS), wear resistance (WR), water uptake (WU), and adhesion using shear bond strength (SBS) as well as fluoride release (FR) were evaluated and compared with those of commercial products. RESULTS: Results were subjected to one-way ANOVA (p<0.05); significant differences were observed in properties of materials such as WR, BFS and SBS but not in WU and FR compared to commercial products. Experimental materials exhibited significantly higher WR, BFS and SBS values than commercial materials. Properties of materials were affected by their respective storage media with time. SIGNIFICANCE: Based on the results of this study, higher amounts of vinyl phosphonic acid (VPA), pyromellitic dianhydride glycerol dimethacrylate (PMGDM) and reactive glasses render the material with enhanced fluoride release and adhesion with properties similar to glass-ionomers whereas their decrease gives properties similar to conventional dental composite resins with improved properties such as strength and wear resistance.

An assessment of shade taking by dental undergraduates.

This study investigated the shade recording abilities of dental students using the traditional methods and that incorporating a colour correcting device to that of a digital shade recording device. Shade matching ability was evaluated between different groups of students at Malmö and Cardiff. The use of the colour correcting device improved a student's ability to match shades when compared to the traditional method under normal lighting conditions. There was no gender difference to match shade amongst the participants. We observed that at one of the test sites the ability to take the correct shade improved as clinical experience was gained.