Silver-Coated Silica Nanoparticles Modified with MPS: Potential Antimicrobial Biomaterials Applied in Glaze and Soft Reliner.

Soft reliner and glaze are materials used over full or partial dental prosthesis to prevent excessive pressure on the supporting tissues. They are also indicated as supportive treatment for dental stomatitis, especially when modified by the addition of medications. The objective of the work was to evaluate the antimicrobial effect of silver-coated silica nanoparticles in a glaze and a soft reliner. The nanoparticles were synthesized, characterized, and tested by minimum inhibitory concentration (MIC) for C. albicans SC5314. Then, the nanoparticles were incorporated to a glaze and a soft reliner, which were called nanocomposites. Then, the nanocomposites were divided into six groups (n = 12): CG: glaze/reliner; CR: reliner; G1: glaze + 1% nanoparticles/reliner; G2: glaze + 2.5% nanoparticles/reliner; R1: reliner + 1%; R2: reliner + 2.5%. The nanocomposites were characterized by a goniometer and by a scanning electron microscope. The antibiofilm test was performed against C. albicans SC5314. According to the MIC results, the non-functionalized nanoparticles reduced fungal growth at 1000 µg/mL and the functionalized nanoparticles at 2000 µg/mL. The functionalized nanoparticle had a superior dispersion being selected for the antibiofilm test. There was a reduction of 64% in CFU/specimen count for the glaze, not statistically significant (p = 0.244). For the soft reliner, there was an increase in CFU/specimen with the presence of nanoparticles, still not statistically significant (p = 0.264). In conclusion, it is necessary to conduct new studies to increase the release of silver, thus improving nanoparticles' antifungal potential.

Resilient liner modified by antimicrobials for denture stomatitis treatment: A randomized controlled trial.

OBJECTIVES: This randomized clinical trial evaluated the effectiveness of an interim denture resilient liner (Trusoft) modified with minimum inhibitory concentrations (MICs) of antimicrobial agents for Candida albicans biofilm in the denture stomatitis (DS) treatment. METHODS: Forty participants with DS and maxillary complete denture (MCD) wearers were randomly assigned to one of the treatments for 14 days (n=10): nystatin oral suspension (Control-100,000IU/mL; 4 × /day), MCD relined with Trusoft either without (Tru) or with nystatin (Ny) or chlorhexidine diacetate (Chx) at MICs. Cytological smears and mycological quantitative cultures were taken from the palate and denture before treatment (baseline), at the end of treatment (day 14), and at follow-up (days 30, 45, and 60). Photographs of the palate were made at each visit. Data were analyzed by the Cochran and χ2 tests, ANOVA and the Tukey test or the Friedman and Kruskal-Wallis tests (α=0.05). RESULTS: Palatal smears of the Ny and Chx groups exhibited no mycelial Candida (0%) on day 14, and, at the 60-day follow-up, it was observed for only 1 participant from Chx group. MCD smears showed reduction in mycelial forms for all groups on day 14 (P<0.05), but this difference was maintained at follow-up only for the relined dentures (P<0.05). Unlike Tru and the control groups, Ny and Chx groups evidenced a significant reduction in CFU/mL values and DS severity throughout the trial (P<0.05). CONCLUSIONS: The addition of nystatin and chlorhexidine at MICs to an interim resilient liner is a promising treatment for DS, with better results than those for conventional therapy with nystatin suspension, including the follow-ups. CLINICAL SIGNIFICANCE: Compared with conventional topical antifungal therapy, modifying a denture reline material with antimicrobials provided a therapeutic option for denture stomatitis. This non-invasive, straightforward therapeutic approach can be easily adopted by dentists and has the advantage of not requiring patient compliance while maintaining therapeutic concentrations on the denture base.

Effect of denture liners surface modification with Equisetum giganteum and Punica granatum on Candida albicans biofilm inhibition.

Aim: This study investigated the effect of denture liners surface modification with Equisetum giganteum (EG) and Punica granatum (PG) on Candida albicans biofilm inhibition supposing its usage as a sustained-release therapeutical delivery system for Candida-associated denture stomatitis. Materials & methods:C. albicans biofilm (SC5314 or ATCC 90028) was formed on soft liners superficially modified by a primer mixed to drugs at minimum inhibitory concentrations (0.100 g for EG and PG or 0.016 g for nystatin per ml of primer). After 24 h, 7 or 14 days, antibiofilm activity was evaluated by colony-forming unit counts. Results: Not all groups were equi-efficient to nystatin after 24 h and 7 days. After 14 days, EG and PG efficacies were not different from nystatin (almost 100% inhibition). Conclusion: The proposed protocol presents a promising option to allopathic drugs for Candida-associated denture stomatitis treatment.

Microbiological evaluation for antifungal activity of some metal oxides nanofillers incorporated into cold cured soft lining materials: clinical based study / Avaliação microbiológica da atividade antifúngica de algumas nanopartículas de óxidos metálicos incorporadas em materiais de revestimento macio curados a frio: estudo clínico

Objetivo: O objetivo do presente estudo foi avaliar a eficácia da adição de nanopartículas de óxido de zircônio (ZrO2), óxido de titânio (TiO2) e óxido de sílica (SiO2) a um material de revestimento macio curado a frio na adesão de Candida albicans (CA). Material e Método: Cinquenta e quatro pacientes foram selecionados e divididos em três grupos de acordo com a modificação do revestimento com nanopartículas de ZrO2, TiO2 e SiO2 (18 cada). Cada paciente recebeu prótese total maxilar com três cavidades, as cavidades foram revestidas com forro macio curado a frio modificado com diferentes concentrações (0%, 3% e 7%) de nanopartículas de óxido metálico. Nos dias 14 e 28, as trocas foram retiradas do local de realinhamento e imediatamente cultivadas para avaliação fúngica. O número de colônias foi contado, os dados coletados e explorados para normalidade usando o teste de Shapiro-Wilk e a transformação logarítmica da contagem de CA foi realizada. ANOVA para medidas repetidas e de uma via (one-way) foram usados, seguidos por teste de Tukey (HSD). O teste t independente foi usado para comparar as contagens de CA em diferentes períodos. Resultados: A adesão do CA foi significativamente diminuída pela adição de nanopartículas de ZrO2, TiO2 e SiO2 em comparação com o grupo controle, também a cobertura antifúngica aumentou com o aumento da concentração de nanopartículas (p <0,005). A maior contagem de CA foi identificada no grupo SiO2 seguido por ZrO2, enquanto TiO2apresentou a menor contagem de CA (p <0,001). Conclusão: Adição de diferentes nanopartículas; ZrO2, TiO2 e SiO2para revestimento macio curado a frio é um método eficaz para reduzir a adesão de CA (AU)

Objective: The aim of the current study was to evaluate the efficacy of addition of zirconium oxide (ZrO2), titanium oxide (TiO2), and silica oxide (SiO2) nanoparticles to cold-cured soft liner on adhesion of Candida albicans (CA). Material and Methods: Fifty-four patients had been selected and divided into three groups according to the modification of soft liner with ZrO2, TiO2, and SiO2 nanoparticles (18 each of). Each patient received maxillary complete denture having three cavities, the cavities were lined using cold cured soft liner modified with different concentration (0%, 3%, and 7%) of metal oxide nanoparticles. On days 14 and 28, swaps were taken out from relining site and immediately cultured for fungal evaluation. The number of colonies were counted, data collected and explored for normality using Shapiro-Wilk test, logarithmic transformation of CA count was performed. Repeated and one-way ANOVA were used followed by Tukey HSD. Independent-t test used to compare between CA counts at different periods. Results: The CA adhesion was significantly decreased by the addition of ZrO2, TiO2 and SiO2 nanoparticles in comparison with control group, also the antifungal coverage increased with nanoparticles concentration increased (P<0.005). The highest CA count was identified in group SiO2 followed by ZrO2, while TiO2 showed the lowest CA count (P <0.001). Conclusion: Addition of different nanoparticles; ZrO2, TiO2 and SiO2 to cold-cured soft liner is an effective method for reducing CA adhesion. (AU)

Is there an optimal method to detach Candida albicans biofilm from dental materials?

Introduction. Candida albicans can produce a complex, dynamic and resistant biofilm on the surface of dental materials, especially denture base acrylic resins and temporary soft liners. This biofilm is the main aetiological factor for denture stomatitis, an oral inflammatory condition characterized by chronic and diffuse erythema and oedema of the denture bearing mucosa.Gap Statement. There is no consensus in the literature regarding the best method to detach biofilms from dental materials. In order to assess the antifungal efficacy of new materials and treatments, the biofilm needs to be properly detached and quantified.Aim. This study compared different methods of detaching C. albicans biofilm from denture base acrylic resin (Vipi Cril) and temporary soft liner (Softone) specimens.Methodology. Specimens of each material were immersed in an inoculum of C. albicans SC5314 and remained for 90 min in orbital agitation at 75 r.p.m. and 37 °C. After the removal of non-adherent cells, the specimens were immersed in RPMI-1640 medium for 48 h. Biofilm formation was evaluated with confocal laser scanning microscopy (n=5). Then, other specimens (n=7) were fabricated, contaminated and immersed in 3 ml of sterile phosphate-buffered saline (PBS) and vortexed or sonicated for 1, 2, 5, or 10 min to detach the biofilm. The quantification of detached biofilm was performed by colony-forming unit (c.f.u.) ml-1 count. Results were submitted to one-way analysis of variance (ANOVA)/Tukey HSD test (α=0.05).Results. A mature and viable biofilm was observed on the surfaces of both materials. For both materials, there was no significant difference (P>0.05) among detachment methods.Conclusion. Any of the tested methods could be used to detach C. albicans biofilm from hard and soft acrylic materials.

Estimation of the autoclave and different surface treatments on microleakage between soft liner and heat-cured acrylic / Estimativa da autoclavagem e diferentes tratamentos de superfície na microinfiltração entre o soft liner e o acrílico termopolimerizável

Objective: The present study was oriented to estimate the effect of different surface treatments on the microleakage between the soft liner and acrylic with and without the use of autoclave as disinfection method. Material and Methods: Sixty samples were split into two groups: the autoclaved groups and non-autoclaved groups. Each one subdivided into three groups: first one without any treatments as a control group; in the second group surface of the samples were treated with CO2 laser (10.6 nm wavelength for 15 seconds), and in the third group the surface was treated with sandblasting (250 µm Al2O3). All the samples exposed to thermocycling, then the microleakage test was evaluated by gauging dye penetration depth between the soft liner and acrylic disc using a digital microscope. Data analyzed statistically by One-way ANOVA and Tukey's post-hoc tests. In addition, t-test was used for comparison between two groups (P-value ≤ 0.05). Results: The maximum mean values for the microleakage were observed in the untreated group (control) followed by the group treated by CO2 laser and the lowest mean value of microleakage was related to the third group for both non-autoclaved and autoclaved groups with significant differences among them. In addition, depending on the use of autoclave, there was non-significant in all studied groups. Conclusions: There was a decrease in the microleakage when the surface treated with CO2laser and sandblast. The use of autoclave did not badly change the microleakage between the soft liner and denture base. (AU)

Objetivo: O presente estudo teve como objetivo estimar o efeito de diferentes tratamentos de superfície na microinfiltração entre o soft liner e o acrílico usando ou não a autoclve como método de desinfecção. Material e Métodos: Sessenta amostras foram divididas em dois grupos: grupo com uso da autoclave e grupo sem uso da autoclave. Cada um subdivide em três grupos: o primeiro sem nenhum tratamento como grupo controle; no segundo grupo, a superfície das amostras foi tratada com laser de CO2 (comprimento de onda de 10,6 nm por 15 segundos) e, no terceiro grupo, a superfície foi tratada com jateamento (250 µm Al2O3). Todas as amostras foram expostas à termociclagem, em seguida o teste de microinfiltração foi realizado medindo-se a profundidade de penetração do corante entre o soft liner e o disco de acrílico em microscópio digital. Os dados foram analisados estatisticamente por One-way ANOVA e testes post-hoc de Tukey. Além disso, o teste t foi usado para comparação entre dois grupos (P-valor ≤ 0,05). Resultados: Os valores médios máximos de microinfiltração foram observados no grupo não tratado (controle) seguido pelo grupo tratado com laser de CO2 e o valor médio mínimo de microinfiltração foi relacionado ao terceiro grupo para ambos os grupos não autoclavado e autoclavado com diferenças significativas entre eles. Além disso, dependendo do uso de autoclave, não houve significância em todos os grupos estudados. Conclusão: Houve diminuição da microinfiltração quando a superfície foi tratada com laser de CO2e jateamento. O uso de autoclave não alterou a microinfiltração entre o soft liner e a base da prótese (AU)

Antimicrobial and protective effects of non-thermal plasma treatments on the performance of a resinous liner.

OBJECTIVE: Overcoming substantial shortcomings of soft liners as physico-chemical changes and liner-biofilm-related infections remains a challenge in the rehabilitation treatment. In this study, protective non-thermal plasma (NTP) treatments were developed on the soft liner surface to improve its surface and physico-chemical properties and to reduce fungal colonization after biofilm inhibition challenge. METHODS: Resinous liner specimens (Coe-Soft) were prepared and distributed in 3 groups according to the surface treatments: (1) untreated (control); (2) treated with sulfur hexafluoride-based NTP (SF6); and (3) treated with hexamethyldisiloxane-based NTP (HMDSO). To test the NTP stability and their protective and antimicrobial effect on the liner surface over time, the morphology, chemical composition, roughness, water contact angle, shore A hardness, sorption and solubility were evaluated before and after the specimens were exposed to dual-species biofilm of Candida albicans and Streptococcus oralis for 14 days. Colony forming units and biofilm structure were assessed. Data were submitted to ANOVA and Tukey tests (α = 0.05). RESULTS: Both treatments modified the surface morphology, increased hydrophobicity and roughness of the liner, and were effective to reduce C. albicans adhesion without affecting the commensal health-associated S. oralis. HMDSO presented chemical stability and lower hardness in both periods, whereas SF6 exhibited higher initial hardness than control and the highest sorption; contrarily, similar solubility was noted for all groups. CONCLUSION: HMDSO-based film showed improved physico-chemical properties and inhibited C. albicans biofilm. Thus, it has potential for use to control candida-related stomatitis and improve liner's stability even after being exposed to biofilm inhibition challenge.

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.

Surgical and nonsurgical treatment of papillary hyperplasia: A case report / Tratamiento quirúrgico y no quirúrgico de la hiperplasia papilar inflamatoria: Reporte de Caso

Dentures with dental plaque predispose recurrent hyperplasia on the palatal mucosa. Surgical procedures for the treatment of inflammatory papillary hyperplasia involve postsurgical discomfort and morbidity. This repot describes clinical and histologic aspects of a patient with severe akantolitic inflammatory papillary hyperplasia. The palatal mucosa was treated with a surgical bur with a low-speed handpiece. A new removable denture was performed and adapted. A follow-up of 4 years showed staility of health at palatal mucosa. Patient referred low discomfort and morbidity when using bur technique. Control of removable denture was critical for long-term healing and soft tissue stability.

Las prótesis dentales con placa bacteriana predisponen a la hiperplasia recurrente en la mucosa palatina. Los procedimientos quirúrgicos para el tratamiento de la hiperplasia papilar inflamatoria implican molestias y morbilidad posquirúrgicas. Este reporte describe los aspectos clínicos e histológicos de un paciente con hiperplasia papilar inflamatoria acantolítica severa. La mucosa palatina fue tratada con una fresa quirúrgica con una pieza de mano de baja velocidad. Se realizó y adaptó una nueva prótesis parcial removible. Después de un seguimiento de 4 años, se encontró estabilidad de la salud de la mucosa palatina. El paciente se refirió a la baja incomodidad y morbilidad al usar la técnica de la fresa. El control de la prótesis parcial removible fue crítico para la cicatrización a largo plazo y la estabilidad de los tejidos blandos, evitando la recidiva de la hiperplasia papilar inflamatoria.

Evaluation of the effect of coating vertex denture lining material with plant oils on microbial growth and hardness

Aims: To evaluate the effect of surface coating with natural plant oils (Salvia officinalis, ginger and eucalyptus) on Candida growth and the hardness of Vertex denture lining material. Materials and method: Forty five specimens were prepared from soft acrylic lining material, twenty five of which were 10x10x2mm in size for testing antifungal activity, and twenty samples were 20mm in diameter and 12mm in thickness, for testing shore A hardness after coating samples with three types of natural oils (Salvia officinalis, ginger and eucalyptus oils). Significant differences among the groups at (p≤0.05) level of significance were determined statistically with one way analysis of variance and Duncan's multiple range test Result: Antifungal assay showed a significant difference between five groups regarding Candida albicans growth (p≤ 0.05). For the hardness test, comparing different times of storage in water (1, 7, 14, 30 days) revealed a significant difference within all groups (p≤0. 05). While comparing the groups coated with natural oils with the control group, significant differences were found between different times of storage in water (1, 7, 30 day) (p≤0.05), except at 14 days of water storage there was no significant difference between groups (p>0.05). Conclusion: All tested natural oils were effective as fungicidal agents and increased the softness and duration of soft acrylic lining material.

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.

Antibiofilm activity of an experimental ricinus communis dentifrice on soft denture liners

Abstract The disadvantage of liners materials is the difficulty of biofilm control. It was compared an experimental dentifrice contained Ricinus communis, with commercials dentifrices as antibiofilm activity against microorganisms on denture liner. Six hundred specimens were distributed in 5 groups (n=18/ microorganism): water; experimental dentifrice; specific dentifrice for denture and two conventional dentifrices against C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Each group had a negative (n=5; without contamination) and positive control (n=15/ microorganism; without cleaning). The antibiofilm activity was evaluated by the method of biofilm formation in triplicate. The specimens were contaminated in a standard way and incubated. After that, manual brushing was performed (60 s), washed with PBS, immersed in liquid culture medium for resuspension and sowing in solid medium. The results (mean of triplicates) were expressed in CFU/mL. The data was submitted to Shapiro-Wilk, ANOVA and Tukey test (p<0.05). The specific dentifrice (1.27±1.20) was the most effective against S. mutans, followed by conventional (Trihydral, 3.13±0.88; Colgate, 2.16±2.02) and experimental (3.81±1.37) dentifrices, which were similar to each other (p=0.008). All of them were different from water (4.79±1.42). The specific (0.21±0.21) and experimental (0.36±0.25) dentifrices were similar against S. aureus, with a higher mean of CFU when compared to conventional (Colgate, 0.06±0.13), which was more efficient (p=0.000). For C. albicans, C. glabrata and E. coli, all dentifrices were similar to water (p=0.186). It was concluded, that the experimental dentifrice was effective against S. aureus and had not efficacy against Candida spp.; S. mutans; E. coli, as occurred with the commercials dentifrices.

Resumo A desvantagem dos materiais resilientes é a dificuldade de controle do biofilme. Este estudo comparou um dentífrico experimental contendo Ricinus communis, com dentifrícios comerciais quanto atividade contra biofilme formado em reembasador de próteses totais. Seiscentos espécimes foram distribuídos em 5 grupos (n=18/microrganismo): água; dentifrício experimental; dentifrício específico para próteses totais e dois convencionais; contra C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Cada grupo teve um controle negativo (n=5; sem contaminação) e um positivo (n=15/ microrganismo; sem higienização). A atividade contra biofilme foi avaliada pelo método de formação do biofilme, em triplicata. Os espécimes foram contaminados, padronizadamente, e incubados. Posteriormente, foi realizada escovação manual (60 s), lavagem em PBS, imersão em meio de cultura líquido para ressuspensão e semeadura em meio sólido. Os resultados (média das triplicatas) foram expressos em UFC/mL. Os dados foram submetidos aos testes Shapiro-Wilk, ANOVA e Tukey (p<0,05). O dentifrício específico (1,27±1,20) foi o mais eficaz contra S. mutans, seguido dos convencionais (Trihydral, 3,13±0,88; Colgate, 2,16±2,02) e experimental (3,81±1,37), que foram semelhantes entre si (p=0,008). Todos eles foram diferentes da água (4,79±1,42). O dentifrício específico (0,21±0,21) e o experimental (0,36±0,25) foram semelhantes contra S. aureus, com maiores médias de UFC quando comparado ao convencional (Colgate, 0,06±0,13), que foi mais eficiente (p=0,000). Para C. albicans, C. glabrata e E.coli, todos os dentifrícios foram similares à água (p=0,186). Conclui-se que o dentifrício experimental foi efetivo somente contra S. aureus e não foi eficiente perante Candida spp.; S. mutans; E. coli, como ocorrido com os dentifrícios comerciais.

In Vitro Evaluation of Resilient Liner after Brushing with Conventional and Experimental Ricinus communis-Based Dentifrices.

PURPOSE: To evaluate the effect of experimental (Ricinus communis) and commercial dentifrices used for denture cleaning on abrasiveness (gravimetric method; roughness), hardness, and color stability of a resilient relining material. MATERIALS AND METHODS: Sixty circular (15 × 3 mm) specimens were distributed into four groups: C (control; brushing with water); CO (brushing with Colgate - for natural teeth); CB (brushing with Corega Brite - for complete dentures); RC (brushing with experimental dentifrice). Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension for 50 minutes, calculated to correspond to 1 year of regular brushing. Variables were measured initially and after the trial period. For the gravimetric method, the difference in mass was considered. The surface roughness was measured by a rugosimeter, and the hardness test was performed by a Shore A durometer. Color changes (ΔE; CIE L*a*b* and NBS systems) were measured by a portable spectrophotometer. Results were analyzed by ANOVA/Tukey's test (α = 0.05). RESULTS: The largest mass variation (µg; p < 0.0001) occurred in C (-6.21 ± 3.18). Concerning roughness, CB (0.26 ± 0.04) showed the lowest value, followed by RC (0.29 ± 0.08) and CO (0.34 ± 0.24) (p < 0.0001). Group C produced the greatest surface roughness (0.72 ± 0.25). Hardness values decreased after brushing with water (p = 0.014). No significant differences were found among RC (50.31 ± 1.03), CO (49.11 ± 1.31), CB (49.17 ± 1.23), and C (48.02 ± 1.26). Color stability was similar in all groups (p = 0.135; C: 2.3 ± 0.77; CO: 2.6 ± 0.54; CB: 2.2 ± 0.44; RC: 2.9 ± 1.56). CONCLUSIONS: The use of experimental dentifrice could be indicated, as it showed similar results to the specific dentifrice, keeping the resilient material properties within acceptable values.

Effect of Incorporation of Antifungal Agents on the Ultimate Tensile Strength of Temporary Soft Denture Liners.

PURPOSE: To investigate the ultimate tensile strength of temporary soft denture liners modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm (SC5314) determined in previous microbiological research. MATERIALS AND METHODS: Dumbbell-shaped specimens (n = 7) with a central cross-sectional area of 6 × 3 × 33 mm were produced by Softone and Trusoft, without (control) or with incorporation of drugs in powder form at MICs for C. albicans biofilm (per g of material powder): nystatin (0.032 g), chlorhexidine diacetate (0.064 g), ketoconazole (0.128 g), miconazole (0.256 g), and itraconazole (0.256 g). After plasticization, specimens were immersed in distilled water at 37°C for 24 hours, 7 or 14 days, and then tested in tension in a universal testing machine at 40 mm/min. Data of tensile strength (MPa) and elongation percentage (%) were submitted to 3-way ANOVA and Tukey's test (α = 0.05). RESULTS: At the end of 14 days, the tensile strength for both materials was significantly lower in the groups modified by miconazole and itraconazole compared to the other groups (p < 0.0001), which showed no significant difference between them (p > 0.05). After 7 and 14 days in water, miconazole and itraconazole added into both materials resulted in significantly lower elongation percentages compared to the other antifungal agents and control (p < 0.0001), which were similar to each other (p > 0.05). CONCLUSIONS: The addition of the nystatin, chlorhexidine, and ketoconazole at MICs for C. albicans biofilm resulted in no harmful effects on the tensile strength and elongation percentage of the temporary soft denture liner materials up to 14 days.

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.

Intraoral Device for Optimal Antifungal Delivery in a Rat Model.

BACKGROUND: Antifungal agents incorporated into temporary denture resilient liners as drug carriers and delivery have been suggested as an alternative treatment for denture stomatitis. However, to test the in vivo biocompatibility of this protocol, standardization of an intraoral device for optimal drug delivery is required. OBJECTIVE: Standardized criteria were produced to adjust an acrylic intraoral device (IOD) for rats feasible for denture stomatitis treatment by sustained drug-delivery based on minimal inhibitory drug concentrations (MICs) of antifungals for Candida albicans biofilm. METHOD: Adjustments methodological involved diet, impression technique, type of retention device to the palate and histopathological analysis. 115 Wistar rats were tested without IOD, with devices without relining or relined with temporary resilient material (Trusoft) modified or not by drugs at MICs (nystatin-0.032g/mL; chlorhexidine diacetate-0.064g/mL; ketoconazole-0.128g/mL). The animals were sacrificed after 7 or 14 days from the IOD installation. RESULTS: Paste diet enabled the best animal survival conditions. The IODs that most satisfactorily remained in position were those designed only to the posterior palatal mucosa and cement-retained in molars, being all obtained from impressions highly detained and individual. In both periods, Trusoft without/with drugs showed good performance. Only histological samples from hard/soft tissues were considered appropriate for region of interest-RI determination (n=12), which corresponded to the area restricted to the first molars between the palatal neurovascular bundles. Final samples of all groups allowed a standardized descriptive histopathological analysis in both periods. CONCLUSION: The methodological standardization of this rat model resulted in IODs for optimal antifungal delivery for denture stomatitis treatment.

Prevalence of Candida albicans and Streptococcus aureus on maxillary obturators, maxillary defects and in saliva: A cross-sectional study / Prevalência de Candida albicans e Streptococcus aureus em obturadores superiores, nos defeitos maxilares e na saliva: Um estudo transversal

Objetivo: este estudo investigou a incidência da adesão de Candida albicans e Staphylococcus aureus em próteses superiores obturadoras com materiais de reembasamento macio utilizados por protesistas. Material e Métodos: entre os anos 2013 e 2014, foram avaliados clinicamente, pacientes com defeitos maxilares devido a cirurgia para remoção de tumores e usuários de próteses obturadoras (n = 21, grupo de estudo) e, as consequências microbiológicas foram comparadas com usuários de prótese total superior (n = 21, controle grupo). Os dados foram coletados sobre características demográficas, tipo histológico de câncer, emprego de quimioterapia ou radioterapia, identificação dos materiais reembasamento macio utilizados e métodos de limpeza praticados nas próteses obturadoras e totais. A presença de Candida albicans foi determinada nos materiais de reembasamento macio ou nas superfícies de polimetilmetacrilato e na cavidade bucal e, Staphylococcus aureus na mucosa nasal e na saliva. Os dados foram analisados utilizando os testes Kruskal Wallis, Fisher-Freeman-Halton (p<0,05). Resultados: A maior quantidade de Candida albicans foi encontrada nas superfícies das próteses, na saliva, nos defeitos no palato duro e no material de reembasamento macio definitivo com 90%, 90% e 70%, respectivamente. A maior quantidade de Staphylococcus aureus foi observada na saliva e na cavidade nasal no grupo de material de reembasamento macio definitivo (50%). Conclusão: o curto período de renovação dos materiais de revestimento pode causar menos colonização de Candida albicans e estomatite protética na cavidade bucal. Os pacientes que sofreram maxilectomia foram mais propensos à colonização de Staphylococcus aureus.(AU)

Objective: This study investigated on the incidence of Candida albicans and Staphylococcus aureus adhesion onto maxillary obturator prostheses with soft lining materials placed by prosthodontists. Material and Methods: Between years 2013 and 2014, patients with maxillary defects due to maxillary tumor surgery and acquired obturator prostheses (n = 21, study group) were clinically evaluated and microbiological outcomes were compared with complete maxillary denture wearers (n = 21, control group). Data were collected on demographic features, histological type of cancer, presence of chemotherapy or radiotherapy, identification of soft lining materials used on obturator prostheses, cleansing methods practiced for obturator and maxillary complete prostheses. The presence of Candida albicans was determined on soft lining materials or polymethylmethacrylate surfaces and in the oral cavity, and Staphylococcus aureus in nasal mucosa and saliva. Data were analyzed using Kruskal Wallis, Fisher-Freeman-Halton tests (p<0.05). Results: The highest amount of Candida albicans was found on surfaces of prostheses, in the saliva and on maxillary defects on the hard palate and on definitive soft lining material with 90%, 90%, and 70%, respectively. The highest amount of Staphylococcus aureus was observed in the saliva and nasal cavity in the definitive soft lining material group (50%). Conclusion: Short renewal period of lining materials may cause less Candida albicans colonisation and denture stomatitis in the oral cavity. Patients who have undergone maxillectomy were more prone to Staphylococcus aureus colonisation.(AU)

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.

In vitro Analysis of Cytotoxicity of Temporary Resilient Relining Materials.

AIMS: The aim of this study is to evaluate the in vitro response of human gingival fibroblasts in primary cultures to two materials for temporary relining of dentures: Temporary Soft (TDV, Brazil) and Trusoft (Bosworth, USA) for 24 hours, 7 and 30 days by using a multi-parametric analysis. MATERIALS AND METHODS: Each material sample (TDV, TS, Polystyrene, Latex) was prepared and incubated in a culture medium for 1, 7, and 30 days at 37°C. Human gingival fibroblasts were exposed to the extracts and cell viability was evaluated by a multi-parametric assay, which allowed sequential analysis of mitochondrial activity (XTT), membrane integrity [neutral red (NR)], and cell density [crystal violet dye exclusion (CVDE)] in the same cells. Analysis of variance (ANOVA) was used to test the interactions of the three sources of variation (material, test method, and time) with the proportions of viable cells for each relining material. RESULTS: Both evaluated materials (TDV and TS) had low cytotoxic effects during 1, 7, and 30 days after manipulation of the material, as assessed by all three methods used. A statistical difference was found when comparing the negative control group (latex fragments) with the other groups, which showed high toxicity and low percentage of cell viability in all tests used. There was no significant difference among other materials (p > 0.05). CONCLUSION: Low cytotoxicity levels were detected by representatives of the major groups of temporary prosthetic relining materials, as evaluated by multiple cellular viability parameters in human fibroblasts. CLINICAL SIGNIFICANCE: There are various soft materials on the market for relining prostheses; however, the effects of these materials on tissues need to be clarified to avoid problems for patients.

Efeito da incorporação de agentes antifúngicos na resistência à tração e porosidade de materiais resilientes temporários para base de próteses / Effect of incorporation of antifungal agents on the ultimate tensile strength and porosity of temporary soft denture liners

Este estudo investigou a resistência à tração (ou limite de resistência à tração- LRT) e a porosidade de reembasadores resilientes temporários modificados por concentrações inibitórias mínimas (CIMs) de agentes antifúngicos para o biofilme Candida albicans (SC5314). Para os testes de LRT, corpos de prova em forma de halteres (n=7) com uma área transversal de 33 mm x 6 mm x 3 mm foram produzidos para os materiais resilientes (Trusoft e Softone) sem (controle) ou com incorporação de cinco fármacos em suas CIMs: nistatina- 0,032 g; diacetato de clorexidina- 0,064; cetoconazol- 0,128 g; miconazol- 0,256 g; itraconazol-0,256 g (grama de fármaco por grama de pó de material resiliente). Após a plastificação, as amostras foram imersas em água destilada a 37°C durante 24 h, 7 e 14 dias e, então, testadas em tensão em uma máquina universal de ensaios (EMIC DL-500 MF) a 40 mm/min. A porosidade foi mensurada por absorção de água, com base na exclusão do efeito plastificante. Inicialmente, determinou-se por isotermas de sorção, que a solução de armazenagem adequada para os corpos de prova (65 mm x 10 mm x 3,3 mm) de ambos os materiais foi o cloreto de cálcio anidro a 50% (S50). Assim, o fator de porosidade (FP) foi calculado para os grupos de estudo (n=10) formados por espécimes sem (controle) ou com incorporação de fármaco em suas CIMs (nistatina, clorexidina ou cetoconazol) após a armazenagem em água destilada ou S50 por 24 h, 7 e 14 dias. Os dados de resistência à tração (MPa) e percentagem de alongamento (%) foram submetidos à ANOVA de 3 fatores seguida pelo teste de Tukey (=0,05). Os dados de porosidade foram analisados estatisticamente por ANOVA de medidas repetidas para 4 fatores e teste de Tukey (=0,05). Ao final de 14 dias, a resistência à tração para ambos os materiais foi significativamente menor nos grupos modificados pelo miconazol e itraconazol em relação aos outros grupos (P<0,0001), que não mostraram diferenças significativas entre si (P>0,05). Após 7 e 14 dias em água, o miconazol e itraconazol adicionados a ambos os materiais resultaram em percentagens significativamente menores de alongamento em comparação com os outros fármacos e ao controle (P<0,0001), que foram semelhantes entre si (P>0,05). O cetoconazol não resultou em alterações significativas no FP para ambos os materiais resilientes em água ao longo de 14 dias (P>0,05). Em comparação aos controles, houve aumento dos FPs do Softone e Trusoft aos 14 dias de imersão em água somente após a adição de nistatina e clorexidina e de clorexidina, respectivamente (P<0,05). Ambos os materiais não apresentaram alterações significativas no FP em até 14 dias de imersão na S50, em comparação aos controles (P>0,05). Em todas as condições experimentais, os FPs do Softone e Trusoft foram significativamente menores quando imersos em S50 em comparação com a água destilada (P<0,05). Concluiu-se que a adição de nistatina, clorexidina e cetoconazol nas CIMs para o biofilme de C. albicans não resultou em efeitos deletérios na resistência à tração e na percentagem de alongamento dos materiais resilientes temporários para base de prótese até o período de 14 dias. A adição de antifúngicos nas CIMs não resultou em efeitos adversos à porosidade de ambos os materiais resilientes temporários em diferentes períodos de imersão em água, com exceção da clorexidina e nistatina no Softone e clorexidina no Trusoft aos 14 dias. Não foram observados efeitos deletérios para a porosidade de ambos os materiais resilientes modificados com as CIMs dos fármacos durante os 14 dias de imersão na S50.(AU)

This study investigated the tensile strength (ultimate tensile strength- UTS) and porosity of temporary soft denture liners modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm (SC5314). For UTS tests, dumbbell-shaped specimens (n=7) with a central cross-sectional area of 33 mm x 6 mm x 3 mm were produced by resilient materials (Trusoft and Softone) without (control) or with incorporation of five drugs at MICs: nystatin- 0.032 g; chlorhexidine diacetate-0.064 g; ketoconazole- 0.128 g; miconazole- 0.256 g; itraconazole- 0.256 g (each per gram of soft liner powder). After plasticization, specimens were immersed in distilled water at 37°C for 24 h, 7 and 14 days, and then tested in tension in a universal testing machine (EMIC DL-500 MF) at 40 mm/min. 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 mm x 10 mm x 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, chlorhexidine or ketoconazole) after storage in distilled water or S50 for 24 h, 7 and 14 days. Data of tensile strength (MPa) and elongation percentage (%) were submitted to 3-way ANOVA followed by Tukey's test (=0.05). Data of porosity were statistically analyzed by 4-way repeated measures ANOVA and Tukeys test (=0.05). At the end of 14 days, the tensile strength for both materials was significantly lower in the groups modified by miconazole and itraconazole compared to the other groups (P<0.0001), which showed no significant difference between them (P>0.05). After 7 and 14 days in water, miconazole and itraconazole added into both materials result in significant lower elongation percentages compared to the other drugs and control (P<.0001), which were similar to each other (P>0.05). Ketoconazole resulted in no significant changes in PF for both liners in water over 14 days (P>0.05). Compared to the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of nystatin and chlorhexidine, and chlorhexidine, respectively (P<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared to the controls (P>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared to distilled water (P<0.05). It was concluded that the addition of the nystatin, chlorhexidine and ketoconazole at MICs for C. albicans biofilm resulted in no harmful effects on the ultimate tensile strength and elongation percentage of the temporary soft denture liners up to 14-day period. The addition of antifungals at MICs resulted in no detrimental effects for the porosity of both temporary soft liners in different periods of water immersion, except for chlorhexidine and nystatin in Softone and chlorhexidine 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.(AU)