Comparative analysis of Candida spp. isolated from complete denture wearers with and without an HIV diagnosis.

STATEMENT OF PROBLEM: Denture-related stomatitis (DRS), an inflammation frequently present in human immunodeficiency virus-positive (HIV+) individuals, can be attributable to colonization by Candida spp., which is considered a main factor. The virulence factors of these species are often modulated by the systemic condition of their hosts. PURPOSE: The purpose of this clinical study was to evaluate the incidence, virulence, and morphology of Candida spp. isolated from biofilms of complete denture wearers with DRS, with and without an HIV diagnosis. In addition, the interaction of the systemic condition with the ability of Candida spp. to colonize was evaluated. MATERIAL AND METHODS: Fifty-five complete denture wearers diagnosed with DRS were divided into 2 groups: experimental (HIV+) and control (human immunodeficiency virus-noninfected participants [HIV-]). Biofilm was collected by a standardized method of ultrasonification of prostheses. The incidence was evaluated by a chromogenic method and polymerase chain reaction (PCR). The virulence factors were assessed by using the capacity for biofilm formation by counting colony-forming units (CFUs/mL), biofilm metabolism by tetrazolium salt metabolization, and proteinase and phospholipase production by using a fluorimetric kit. Morphology was verified by using the hyphae-inducing test, and participants' health data were collected with a form. Data were analyzed by using the Student t, Mann-Whitney U, Spearman, and Fisher tests (α=.05). RESULTS: The results of incidence were related to 55 participants (22 experimental and 33 control); in total, 63 Candida spp. samples were isolated, showing 28 Candida albicans and 36 nonalbicans strains. No significant difference was found between groups in baseline CFU/mL counts, biofilm formation capacity, cell metabolism, and phospholipase production. Proteinase production was higher for C. albicans in the control (P=.031) and for nonalbicans in the experimental (P=.016) groups. Relative to health data, the experimental group showed a moderate negative correlation between the CFU count/mL at baseline for nonalbicans and DRS classification (P=.020). CONCLUSIONS: C. albicans was the most prevalent species. No difference was found in the Candida spp. of complete denture wearers with DRS, with and without an HIV diagnosis, with regard to virulence factors (except for proteinase production) and morphology.

Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality of Life, and Salivary Parameters: A Randomized Clinical Trial.

PURPOSE: This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis. MATERIAL AND METHODS: For this randomized, double-blind, controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. The Kruskal-Wallis and Dunn tests (between groups), and Wilcoxon test (between times) were used to compare the results. (α = 0.05). RESULTS: After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated) and salivary pH were not significantly affected at the times evaluated. CONCLUSIONS: Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL.

Comparative effects on acrylic resin properties of short- and long-term immersion in alkaline peroxide solution.

PURPOSE: To evaluate the color stability (ΔE), surface roughness (ΔRa), and flexural strength of denture base acrylic resin after short (20 minutes) and long-term (8 hours) immersions simulating a period of 5 years of use. METHODS: 120 disk-shaped (16 mm x 4 mm) and 120 rectangular (65 mm x 10 mm x 3.3 mm) specimens were prepared (Lucitone 550) and distributed into three groups (n=20): distilled water (Control); Corega Tabs (CT) and Polident (Po), for immersions of 20 minutes and 8 hours. ΔE were determined by a colorimeter, ΔRa by a profilometer and the flexural strength by a universal testing machine. Data were evaluated by two-way ANOVA followed by Tukey's test and Bonferroni correction (α= 0.05). RESULTS: Short-term immersions for 20 minutes resulted in significant differences in ΔE, as CT values (1.46 ± 1.41) were higher than Po (0.55 ± 0.25) and Control (0.47 ± 0.21). Specimens immersed for 8 hours showed more extensive alterations overall than the control (ΔE [Po: 7.27 ± 0.53; CT: 5.58 ± 0.49; Control: 1.26 ± 0.23]; 916;Ra [Po: 0.16 ± 0.08; CT: 0.12 ± 0.11; Control: 0.07 ± 0.06]; flexural strength [Po: 42.99 ± 9.34; CT: 63.96 ± 12.98; Control: 64.59 ± 12.87]). The tested alkaline peroxide-based solutions promoted significant alteration on acrylic resin properties after overnight immersion. Therefore, short-term immersions seem to be more suitable for daily denture hygiene. CLINICAL SIGNIFICANCE: Alkaline peroxides were able to alter color stability, surface roughness and flexural strength of acrylic resin after overnight immersions, in a 5-year-simulated period of use.

In Vitro Antimicrobial Activity of Effervescent Denture Tablets on the Components of Removable Partial Dentures.

PURPOSE: To evaluate the antimicrobial activity of effervescent tablets on the surfaces of cobalt-chromium (Co-Cr) and heat-polymerized resin. MATERIALS AND METHODS: From a metal matrix, 55 circular wax patterns (Ø 12 × 3 mm) were obtained and cast in Co-Cr alloy. Muffles for acrylic resin were prepared from circular wax patterns (Ø 20 × 5 mm). The metal specimens were positioned in the muffle, and the resin was pressed into its surroundings to simulate the composition of a removable partial denture (RPD). The mixed specimens were sterilized and contaminated with Streptococcus mutans, Staphylococcus aureus, Candida albicans, and Candida glabrata, composing a multispecies biofilm, and subsequently immersed according to the manufacturer's instructions in four cleansing solutions: Polident 3 Minute denture cleanser (P3M), Polident for Partials (PP), Corega Tabs (CT), and NitrAdine (Ni); as well as distilled water (positive control) and no contamination (negative control). After cleansing, viable microorganisms were quantified by counting the number of colony-forming units (CFU/mL). From the CFU values, log10(CFU + 1) values were calculated for statistical analysis. Kruskal-Wallis test with Dunn post hoc test were performed (α = .05). RESULTS: There was a significant reduction (P = .001) of S mutans after immersion in Ni (median [95% CI] 3.27 [2.92; 3.45]) compared to the CT (3.86 [3.75; 4.01]) and control (4.08 (3.73; 4.22]) groups, while the PP (3.63 [3.28; 4.11]) and P3M (3.83 [3.61; 4.04]) groups presented an intermediate action. The effervescent tablets did not present antimicrobial action against S aureus (P = .537), C albicans (P = .795), or C glabrata (P = .519). CONCLUSION: Ni exhibited moderate antimicrobial action. The effervescent tablets did not promote reduction of multispecies biofilm, and their daily use should be carefully considered.

Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial.

STATEMENT OF PROBLEM: The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism. PURPOSE: The purpose of this randomized crossover trial was to evaluate the efficacy of denture cleansers in terms of biofilm removal, antimicrobial action, and the remission of denture stomatitis. MATERIAL AND METHODS: Fifty denture wearers with denture stomatitis were instructed to brush their dentures (brush and soap) and to soak them (20 minutes/14 days) in 4 solutions, as follows: C (control), 0.85% saline; SH1, 0.1% sodium hypochlorite; SH2, 0.2% sodium hypochlorite; and RC, 8% Ricinus communis. The biofilm in the intaglio surface of maxillary dentures was stained, photographed, and quantified by software (Image Tool). It was then collected (brushed with saline solution), and the obtained suspension was diluted (100 to 10-3) and seeded (50 µL) in CHROMagar for Candida spp. After incubation, colony-forming units per milliliter values were calculated. Denture stomatitis remission was classified according to the Newton classification. Data were analyzed by Friedman (α=.05) and Wilcoxon tests and corrected by the Bonferroni test (α=.005). RESULTS: SH1 (mean rank [MR]=1.98) and SH2 (MR=1.64) showed lower biofilm coverage than C (MR=3.73) that was similar to RC (MR=2.92). SH1 (MR=2.43) and SH2 (MR=2.10) showed antimicrobial action for Candida spp, and RC (MR=3.36) showed similar results to C (MR=3.51) and baseline (MR=3.50). Clinical signs of denture stomatitis were reduced by SH1 (MR=2.44), while SH2 (MR=2.56) and RC (MR=2.74) showed intermediate results. CONCLUSIONS: The two sodium hypochlorite solutions were the most effective means of biofilm control. All tested solutions were effective in reducing the signs of denture stomatitis.

Effect of denture cleansers on physical properties of heat-polymerized acrylic resin.

PURPOSE: This study aimed to measure the color change, surface roughness and flexural strength of heat-polymerized acrylic resin after its immersion in denture cleansers, simulating a 180-day use. METHODS: Thirty disk-shaped (15mm x 4mm) and 30 rectangular samples (65mm x 10mm x 3.3mm) were prepared from heat-polymerized acrylic resin and immersed in Corega Tabs, Bony Plus, and distilled water. Color measurements (DeltaE) were determined by a portable colorimeter. A surface analyzer was used to measure the roughness before and after immersion (DeltaRa). The flexural strength (S) was measured using a 3-point bending test. The DeltaE values were submitted to statistical analysis by the Kruskal-Wallis test, followed by Dunn's Multiple Comparisons test. The DeltaRa and S values were submitted to statistical analysis by ANOVA, followed by a Student-Newman-Keuls test (alpha=.05). RESULTS: The color changes were significantly higher for the Corega Tabs than for the control group. The mean DeltaE values quantified by the National Bureau of Standards (NBS) were classified as Trace (0.0-0.5). The Bony Plus group had significantly higher surface roughness than the other groups. Corega Tabs and Bony Plus groups presented lower flexural strength than the control group. CONCLUSIONS: Although the color changes after the immersion in denture cleansers were clinically insignificant, the Corega Tabs group showed higher color differences. The Bony Plus group showed significantly increased surface roughness. Both effervescent tablets Corega Tabs and Bony Plus significantly diminished the flexural strength of the acrylic resin.

Interventions for cleaning dentures in adults.

BACKGROUND: Removing denture plaque may be essential for maintaining the oral health of edentulous people. Brushing and soaking in chemical products are two of the most commonly used methods of cleaning dentures. OBJECTIVES: To evaluate the effectiveness and safety of different methods for cleansing removable dentures. SEARCH STRATEGY: We searched the following databases: the Cochrane Oral Health Group Trials Register (to May 2009); CENTRAL (The Cochrane Library 2009, Issue 2); MEDLINE (1965 to May 2009); EMBASE (1980 to May 2009); LILACS (1980 to May 2009); and CINAHL (1997 to May 2009). There were no language restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any mechanical method (e.g. brushing or ultrasound) or chemical (e.g. enzymes, sodium hypochlorite, oral rinses or peroxide solutions) in adults over the age of 18 wearing removable partial dentures or complete dentures.The primary outcomes considered were the health of denture bearing areas (soft tissues, periodontal tissues and teeth) and participants' satisfaction and preference. Secondary outcomes included denture plaque coverage area, indicators of halitosis and microbial counts on abutment teeth, soft tissues or denture base or saliva. DATA COLLECTION AND ANALYSIS: Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials. MAIN RESULTS: Although six RCTs were included in this review, the wide range of different interventions and outcome variables did not permit pooling of data in a meta-analysis. Isolated reports indicated that chemicals and brushing appear to be more effective than placebo in the reduction of plaque coverage and microbial counts of anaerobes and aerobes on complete denture bases. AUTHORS' CONCLUSIONS: There is a lack of evidence about the comparative effectiveness of the different denture cleaning methods considered in this review. Few well designed RCTs were found. Future research should focus on comparisons between mechanical and chemical methods; the assessment of the association of methods, primary variables and costs should also receive future attention.

Use of the DNA Checkerboard hybridization method for detection and quantitation of Candida species in oral microbiota.

The DNA Checkerboard method enables the simultaneous identification of distinct microorganisms in a large number of samples and employs up to 45 whole genomic DNA probes to gram-negative and gram-positive bacterial species present in subgingival biofilms. Collectively, they account for 55%-60% of the bacteria in subgingival biofilms. In this study, we present the DNA Checkerboard hybridization as an alternative method for the detection and quantitation of Candida species in oral cavities. Our results reveal that DNA Checkerboard is sensitive enough and constitutes a powerful and appropriate method for detecting and quantifying Candida species found in the oral cavity.

Prótesis total: protocolo de evaluación de la instalación / Complete dentures: protocol for install evalution

Durante el período de instalación y adaptación de la prótesis total el odontólogo debe tener en mente algunos factores a ser observados para que el paciente pueda recibir el tratamiento estético y funcional adecuado. Es de fundamental importancia seguir un orden de atención que lo facilite. Se realizó una revisión de la literatura y un protocolo de evaluación con el objetivo de auxiliar al cirujano dentista en el acto de la instalación y en los controles siguientes, hasta la adaptación y utilización de los aparatos protéticos

Prótesis total: protocolo de evaluación de la instalación / Complete dentures: protocol for install evalution

Durante el período de instalación y adaptación de la prótesis total el odontólogo debe tener en mente algunos factores a ser observados para que el paciente pueda recibir el tratamiento estético y funcional adecuado. Es de fundamental importancia seguir un orden de atención que lo facilite. Se realizó una revisión de la literatura y un protocolo de evaluación con el objetivo de auxiliar al cirujano dentista en el acto de la instalación y en los controles siguientes, hasta la adaptación y utilización de los aparatos protéticos (AU)