Effect of denture adhesives on masticatory performance: Multicenter randomized controlled trial.

PURPOSE: The purpose of this study is to investigate the effects of denture adhesives on masticatory performance via a 10-center, parallel, randomized, controlled trial of complete denture wearers in Japan. METHODS: The trial was conducted between September 2013 and October 2016. The inclusion criteria were complete edentulism, willingness to undergo new complete denture treatment, and willingness to return for recall treatment. The exclusion criteria were age 90 years or older, presence of severe systemic illness, inability to understand the questionnaires, wearing metal base complete dentures, denture adhesive user, wearing prosthetics for maxillofacial defects, wearing complete dentures with tissue conditioners, and severe xerostomia. Randomization of the powder-type denture adhesive (powder), cream-type denture adhesive (cream), and control (saline) groups was performed using a sealed envelope system. Masticatory performance was measured using color-changeable chewing gum. Intervention blinding was not feasible. RESULTS: Sixty-seven control, 69 powder, and 64 cream participants are analyzed using the intention-to-treat principle. The participants in all groups show significantly improved masticatory performance at post-intervention (paired t-test with Bonferroni correction P < 0.0001). However, no significant difference in masticatory performance is detected among the three groups (one-way analysis of variance). A significant negative correlation between pre- and post-changes in masticatory performance and intraoral condition scores is observed (Pearson's correlation coefficient, P < 0.0001). CONCLUSIONS: Although denture adhesives improved the masticatory performance of complete denture wearers, their clinical effects are comparable to those of saline solution. The use of denture adhesives is more effective in complete denture wearers with unsatisfactory intraoral conditions.

Hangeshashinto for prevention of oral mucositis in patients undergoing hematopoietic stem cell transplantation: a randomized phase II study.

PURPOSE: Oral mucositis (OM) is a side effect associated with cancer treatment. Hangeshashinto (HST), a Kampo medicine, was originally prescribed to treat diarrhea, gastritis, and stomatitis. Several reports have described the effects of HST for OM induced by chemotherapy in patients with gastric or colorectal cancer. In this study, the effects of HST for prevention of OM were investigated in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS: Thirty patients scheduled to receive allogeneic grafts were enrolled from July 2020 to December 2021. They were randomly assigned to two groups and instructed to wash their mouth using HST dissolved in saline solution or using only saline solution three times a day. The observation period was from the initiation date of the conditioning regimen to the date of engraftment, and the end point was the incidence of OM. RESULTS: Eighteen patients developed OM, the most severe of which was Grade (G)3. There was no significant difference in the incidence of OM between the HST group and the control group. However, a negative correlation tended to be observed between the duration using HST use and the duration of OM (G2-3: P = 0.027, G3: P = 0.047). CONCLUSIONS: The present study demonstrated that HST use did not clearly inhibit onset of OM but showed a tendency to inhibit OM exacerbation. However, further studies are necessary to fully understand the effects of HST on OM in patients undergoing HSCT. TRIAL REGISTRATION: This study was registered in the Japan Registry of Clinical Trials on 7 May 2020 (jRCTs071200012).

Effects of denture adhesives on denture retention and occlusal forces in complete denture wearers: A multicenter, randomized controlled trial.

PURPOSE: This study aimed to determine the effects of denture adhesives on denture retention and occlusal force in complete denture wearers in a multicenter, randomized, parallel-group controlled trial. METHODS: Two hundred edentulous patients wearing complete dentures were allocated to three groups: powder-type denture adhesive, cream-type denture adhesive, and control (saline solution). Denture adhesives and saline solution were applied to the dentures for 4 days. The retentive force of the dentures and occlusal force were measured using a force transducer occlusal force meter at baseline and after 4 days of intervention. In addition to between-group comparisons, subgroup analyses of denture retention and occlusal force were performed based on the level of difficulty of the edentulism treatment. The levels were ranked as I (easy), II, III, and IV (difficult). RESULTS: Cream-type denture adhesives significantly improved the retentive force of the dentures (P<0.01) and occlusal force (P<0.05), with no significant differences between baseline and post-intervention forces in the powder-type denture adhesive and control groups. In within-group comparisons, cream-type denture adhesives improved both the retentive and occlusal forces at Level II (P<0.05), and powder-type denture adhesives improved the occlusal force at Level II (P<0.01). CONCLUSIONS: Application of cream-type denture adhesives effectively improves the denture retention and occlusal force in complete denture wearers with a moderate degree of difficulty during edentulism treatment.

Oral health-related quality of life of conventional removable partial dentures, unilateral nonmetal clasp dentures, and shortened dental arch with 2- or 3-tooth unilateral distal extension tooth loss in the mandible: A randomized, crossover, clinical trial.

STATEMENT OF PROBLEM: Conventional removable partial dentures with metal clasps are still a common option for patients with distal-extension tooth loss. However, unilateral nonmetal clasp dentures fabricated by using a thermoplastic denture base resin are increasingly being used. Furthermore, the shortened dental arch concept remains controversial, in spite of being advocated for many years. Nevertheless, these treatment options remain controversial, particularly in patients with the loss of a few distal teeth unilaterally. PURPOSE: The purpose of this randomized, crossover, clinical trial was to investigate the oral health-related quality of life of participants who requested a new dental prosthesis (unilateral nonmetal clasp dentures or conventional removable partial dentures) at a private practice. MATERIAL AND METHODS: A 3-period, randomized, crossover design was used in a within-subject, controlled, clinical trial. Twenty-four participants (mean age 59.0 years [7 men: 62.6 {45-85} years; 17 women: 57.5 {24-75} years]) were enrolled. All experimental procedures were approved by the Ethics Committee of Nagasaki University Hospital (#15022313) and registered in the International Standard Randomized Controlled Trial Number registry (ISRCTN49105064). All participants were fully dentate in the maxilla and had unilateral distal-extension loss of 2 or 3 teeth in the mandible. Participants were allocated to 1 of 6 groups and treated with prescribed options in accordance with their allocated sequences and used a dental prosthesis or nothing for 2-week periods. At the end of each intervention, the participants were asked to answer the Oral Health Impact Profile questionnaire. Differences in Oral Health Impact Profile scores among groups were estimated with a mixed-effects model (α=.05). RESULTS: Total Oral Health Impact Profile scores were higher for unilateral nonmetal clasp dentures (P=.002) and shortened dental arch (P=.049) than for conventional removable partial dentures, with medium and small effects. The unilateral nonmetal clasp dentures had a similar effect compared with shortened dental arch (P>.05). unilateral nonmetal clasp dentures (P=.011) and shortened dental arch (P=.005) demonstrated medium effects in the oral function dimension compared with conventional removable partial dentures. Unilateral nonmetal clasp dentures exhibited large and medium effects in the orofacial appearance dimension compared with conventional removable partial dentures (P=.001) and shortened dental arch (P=.006). In the orofacial pain dimension, shortened dental arch showed effects similar to those of conventional removable partial dentures and unilateral nonmetal clasp dentures (P>.05), and no significant differences were observed in the psychosocial impact dimension (P>.05), but the unilateral nonmetal clasp denture score was lower than the conventional removable partial denture score, with a small effect. Men had significantly lower total Oral Health Impact Profile scores for shortened dental arch than women (P=.033). CONCLUSIONS: Unilateral nonmetal clasp dentures and shortened dental arch were better than conventional removable partial dentures for the oral health-related quality of life of individuals with unilateral distal-extension tooth loss in the mandible, and sex had a significant effect on removable prosthetic planning.

Multivariate analysis reveals oral health-related quality of life of complete denture wearers with denture adhesives: a multicenter randomized controlled trial.

Purpose To investigate the difference in improvement of oral health-related quality of life (OHR-QoL) depending on the oral and denture conditions of a complete denture wearer when using a cream or powder type denture adhesive in a 10-center parallel randomized clinical trial.Methods Two hundred edentulous subjects who wore complete dentures were allocated to each of the three groups according to denture adhesive type: cream, powder, and control (saline solution). The materials were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention were collected. OHR-QoL was assessed using the Japanese version of the modified Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) scale for outcome. Multivariate analysis was used to investigate improvements in OHR-QoL according to participant characteristics among complete denture wearers using these materials.Results OHIP-EDENT-J scores were significantly decreased in all groups after the intervention (p < 0.05); however, there were no statistically significant differences among the groups. Multiple logistic regression analysis revealed a significant association between the vertical height of the maxillary and mandibular alveolar ridge and OHIP-EDENT-J scores in the cream-type denture adhesive group. In contrast, there were no significant association between participant characteristics and OHIP-EDENT-J scores in the powder-type adhesive and control groups.Conclusions The use of denture adhesives could improve OHR-QoL for complete denture wearers. The cream-type denture adhesives may be expected to improve OHR-QoL in patients with poor residual ridge conditions compared with patients with good residual ridge conditions.

Comprehensive Prospective Analysis of the Factors Contributing to Aspiration Pneumonia Following Endoscopic Submucosal Dissection in Patients with Early Gastric Neoplasms.

Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups. ESD was performed under deep sedation. Of 60 patients whose data were available for analysis, 5 (8.3%) experienced pneumonia confirmed either by chest radiography or computed tomography. Although no difference in the rate of pneumonia was found between the control and oral care groups, the post-oral care bacteria count was significantly higher in the saliva of patients who developed pneumonia compared to those without pneumonia. In addition, the presence of vascular brain diseases and the dose of meperidine were also significantly associated with the occurrence of pneumonia. These results suggest that the number of oral bacteria as well as pre-existing vascular brain diseases and high-dose narcotics can affect the incidence of post-ESD pneumonia.

Efficacy of silicone soft reliner on the obturator prosthesis after maxillectomy for oral malignant tumors: A single-arm prospective interventional study.

BACKGROUND: There is insufficient evidence for the efficacy of silicone soft reliner on the obturator prosthesis after maxillectomy for oral malignant tumors. OBJECTIVE: To verify the efficacy of silicone soft reliner on the obturator prosthesis after maxillectomy, by evaluating masticatory performance and quality of life (QoL). METHODS: This was a single-arm prospective interventional study, verifying the efficacy of silicone soft reliner (GC RELINE II®) on the maxillary obturator prosthesis. Data were obtained from a comparison of the endpoints after 14 days of continuous use of acrylic and silicone soft-lined prostheses. The primary endpoint was masticatory performance. The secondary endpoints were occlusal performance and oral health-related QoL (OHRQoL). The masticatory performance, occlusal performance, and OHRQoL were assessed by glucose concentration, maximum bite force, and the Japanese version of Oral Health Impact Profile (OHIP-J49), respectively. RESULTS: This study included five patients (two males, three females), aged between 71 and 88 years, with a median of 74 years. The median of glucose concentration indicated a statistically significant improvement between the acrylic resin (99.6 mg/dL) and silicone soft reliner (126.0 mg/dL) obturator prosthesis (p = .043). There was no significant difference in the median of maximum bite force between the acrylic resin (302.0 N) and silicone soft reliner (250.0 N) obturator prosthesis (p = .893). Functional limitations domain of the OHIP-J49 indicated a statistically significant improvement between the acrylic resin and silicone soft reliner obturator prosthesis (p = .043). CONCLUSIONS: This study indicated that an obturator relined with soft silicone improved masticatory performance and the OHRQoL post-maxillectomy.

Risk factors associated with the development of aspiration pneumonia in patients receiving radiotherapy for head and neck cancer: retrospective study.

BACKGROUND: Patients with head and neck cancer who are receiving radiotherapy can develop aspiration pneumonia. Determination of the incidence of aspiration pneumonia and the associated risk factors could facilitate the identification of high-risk patients. METHODS: In this retrospective study, we determined the incidence of aspiration pneumonia in 357 patients receiving radiotherapy along with oral care for head and neck cancer. We also performed univariate and multivariable logistic regression analyses to investigate the risk factors for this complication. RESULTS: The incidence of aspiration pneumonia was 17.6%. Hypopharyngeal cancer, grade 3 oral mucositis, and nasogastric tube feeding were independent risk factors. Moreover, the development of aspiration pneumonia was one of the major effects on the discontinuation of radiotherapy. CONCLUSION: Approximately, one-sixth of the patients developed aspiration pneumonia despite appropriate oral care during radiotherapy for head and neck cancer. Aspiration pneumonia during radiotherapy could adversely affect head and neck cancer management.

Full Regeneration of Maxillary Alveolar Bone Using Autogenous Partially Demineralized Dentin Matrix and Particulate Cancellous Bone and Marrow for Implant-Supported Full Arch Rehabilitation.

Autogenous partially demineralized dentin matrix (APDDM) has been reportedly used as a superior bone graft material. A 52-year-old Japanese man who exhibited severe periodontitis was referred for oral rehabilitation. He underwent wide-range anterior maxillary alveolar bone and bilateral sinus floor augmentation by grafting of a mixture of APDDM and particulate cancellous bone and marrow (PCBM); subsequently, he underwent implant-supported full arch rehabilitation. He has been followed up for 4 years after placement of the final restoration without any complications, and his physiological bone volume has been maintained. APDDM constitutes an alternative treatment that may increase the volume of graft material and might prevent rapid resorption of PCBM, because APDDM served as a scaffold for osteoblasts from PCBM. When possible, it may be useful to apply APDDM as a graft material with PCBM for large-volume alveolar bone regeneration.

Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial.

PURPOSE: The purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial. METHODS: Two hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed. RESULTS: Between-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p<0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p<0.05). CONCLUSIONS: The oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.

The influence of thickeners of food on the particle size of boluses: a consideration for swallowing.

The purpose of this study was to examine the influence of thickeners with different levels of thickness on the sizes of particles in food boluses. In medical and nursing care, thickeners are used to make food safe for patients with dysphagia. However, the effect of thickeners on the foods they are added to, especially during swallowing, is still unclear. The bolus particles of 20 healthy volunteers were photographed, and the digital images were used to estimate the sizes of particles in them. Eight test samples with thickeners with different levels of thickness were tested: six grades of thickened carrot juice with raw carrots in it, raw carrot with banana, and raw carrot alone. The particle homogeneity index (HI) and particle size index (SI) just before swallowing were calculated. The viscosities of the liquid part of the test samples were also measured. The number of mastication cycles across the test samples was not significantly different. However, significant differences were found in SI and HI across the test samples: the absolute values of SI and HI tended to rise as the thickness of the test sample increased. The viscosity of the liquid part of the test sample also increased as the thickness increased. The differences in the thickness of food had an influence on the bolus particle sizes just before swallowing.

Study protocol for a multi-center, randomized controlled trial to develop Japanese denture adhesive guidelines for patients with complete dentures: the Denture Adhesive Guideline trial: study protocol for a randomized controlled trial.

BACKGROUND: Denture adhesives, characterized as medical products in 1935 by the American Dental Association, have been considered useful adjuncts for improving denture retention and stability. However, many dentists in Japan are hesitant to acknowledge denture adhesives in daily practice because of the stereotype that dentures should be inherently stable, without the aid of adhesives. The aim of this study is to verify the efficacy of denture adhesives to establish guidelines for Japanese users. The null hypothesis is that the application of denture adhesives, including the cream and powder types, or a control (isotonic sodium chloride solution) would not produce different outcomes nor would they differentially improve the set outcomes between baseline and day 4 post-application. METHODS: This ten-center, randomized controlled trial with parallel groups is ongoing. Three hundred edentulous patients with complete dentures will be allocated to three groups (cream-type adhesive, powder-type adhesive, and control groups). The participants will wear their dentures with the denture adhesive for 4 days, including during eight meals (three breakfasts, two lunches, and three dinners). The baseline measurements and final measurements for the denture adhesives will be performed on the first day and after breakfast on the fourth day. The primary outcome is a general satisfaction rating for the denture. The secondary outcomes are denture satisfaction ratings for various denture functions, occlusal bite force, resistance to dislodgement, masticatory performance, perceived chewing ability, and oral health-related quality of life. Between-subjects comparisons among the three groups and within-subjects comparisons of the pre- and post-intervention measurements will be performed. Furthermore, a multiple regression analysis will be performed. The main analyses will be based on the intention-to-treat principle. A sample size of 100 subjects per group, including an assumed dropout rate of 10 %, will be required to achieve 80 % power with a 5 % alpha level. DISCUSSION: This randomized clinical trial will provide information about denture adhesives to complete denture wearers, prosthodontic educators, and dentists in Japan. We believe this new evidence on denture adhesive use from Japan will aid dentists in their daily practice even in other countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT01712802 . Registered on 17 October 2012.

Evaluation of glass transition temperature and dynamic mechanical properties of autopolymerized hard direct denture reline resins.

This study assessed methods for evaluation of glass transition temperature (Tg) of autopolymerized hard direct denture reline resins using dynamic mechanical analysis and differential scanning calorimetry in addition to the dynamic mechanical properties. The Tg values of 3 different reline resins were determined using a dynamic viscoelastometer and differential scanning calorimeter, and rheological parameters were also determined. Although all materials exhibited higher storage modulus and loss modulus values, and a lower loss tangent at 37˚C with a higher frequency, the frequency dependence was not large. Tg values obtained by dynamic mechanical analysis were higher than those by differential scanning calorimetry and higher frequency led to higher Tg, while more stable Tg values were also obtained by that method. These results suggest that dynamic mechanical analysis is more advantageous for characterization of autopolymerized hard direct denture reline resins than differential scanning calorimetry.

Influence of composition and powder/liquid ratio on setting characteristics and mechanical properties of autopolymerized hard direct denture reline resins based on methyl methacrylate and ethylene glycol dimethacrylate.

We evaluated the influence of composition and powder/liquid (P/L) ratio on the setting characteristics and mechanical properties of autopolymerized hard direct denture reline resins composed of methyl methacrylate (MMA, monomethacrylate) and ethylene glycol dimethacrylate [EGDMA, dimethacrylate (cross-linking agent)], with poly (ethyl methacrylate) used as the powder, and a mixture of MMA and EGDMA containing p-tolyldiethanolamine as the monomer. Setting times were determined using an oscillating rheometer and mechanical properties were based on ISO specifications. Setting time increased exponentially with an increase in the ratio of EGDMA to MMA and decrease in P/L ratio. Materials with a liquid component of approximately 75-85 wt% EGDMA and a higher P/L ratio showed higher ultimate flexural strength and flexural modulus. Our results suggest that setting characteristics are more influenced by the ratio of monomethacrylate and cross-linking agent, whereas mechanical properties are more influenced by P/L ratio.

Effects of 2,2,2-trifluoroethyl methacrylate on properties of autopolymerized hard direct denture reline resins.

This study evaluated the effects of the fluorinated monomer of 2,2,2-trifluoroethyl methacrylate (TFEMA) on the properties of autopolymerized hard direct denture reline resins. Iso-butyl methacrylate (i-BMA) and 2-hydroxyethyl methacrylate (2-HEMA) containing 30% TFEMA by weight were used as monomers, while poly(ethyl methacrylate) was used as a powder. Setting characteristics, dynamic mechanical properties, and changes over time, as well as wettability were determined by use of an oscillating rheometer, dynamic viscoelastometer, and contact angle meter. Water absorption and solubility were also measured according to ISO specifications. The reline resin based on i-BMA had greater elasticity and stiffness properties, while that based on 2-HEMA showed fewer dynamic mechanical property changes over time with the addition of TFEMA. Furthermore, water absorption and solubility tended to be reduced and contact angle increased. The results of this study suggest that TFEMA improves mechanical properties and durability of reline resins over time.

Effect of melamine foam cleaning on the surface condition of composite resin artificial teeth.

PURPOSE: The purpose of this study was to examine the abrasive and cleaning effects of melamine foam and other cleaning agents on the surfaces of composite resin artificial tooth specimens. MATERIALS AND METHODS: A stained composite resin artificial tooth in a used denture was cleaned using a denture brush and melamine foam, and the stain removal effect was evaluated macroscopically. Next, 5 types of cleaning material (fourfold-compression melamine foam, MEL; brush with water, BRU; denture dentifrice without abrasive, POL; denture dentifrice with abrasive, TAF; conventional dentifrice, AQU) and 15 plate-shaped specimens made of composite resin for artificial teeth were used for wear tests. The surface roughness was measured using a laser scanning microscope. Furthermore, the surface properties were observed using a digital microscope. Surface roughness data were analyzed by two-way ANOVA followed by Tukey's test. RESULTS: Artificial tooth stains that could not be removed by brushing became removable using melamine foam. With regard to surface roughness in the context of the wear test, significant differences were not indicated between MEL and POL, whereas BRU-, TAF-, and AQU-treated specimens showed significantly increased surface roughness (p < 0.05). In the comparison among the cleaning materials, TAF- and AQU-treated specimens showed significantly rougher surfaces than those treated with MEL, BRU, and POL (p < 0.05). CONCLUSIONS: Macroscopic observations suggest that melamine foam would be effective for the removal of stains on composite resin artificial teeth. Traces of wear were not observed in specimens treated with melamine foam and the denture dentifrice not containing abrasives. It was suggested that these two materials would be desirable and useful to use for composite resin tooth cleaning.

Viscosity and adhesion strength of cream-type denture adhesives and mouth moisturizers.

We evaluated adhesion strength to acrylic resins under various experimental conditions and viscosity of 4 cream-type denture adhesives and 2 mouth moisturizers. The viscosity was determined by a sine-wave vibro viscometer. The adhesion strength tests were performed with 2 resin plates at a universal tester. In Method A, various constant thicknesses of material layer were tested and tensile strength was measured, while in Method B a constant load was applied before measurement. Five tests were carried out for each measurement. With Method A, adhesion strength increased exponentially as the layer got thin. Effect of the material thicknesses (contribution ratio ρ=79.0%) was much larger than that of material type (ρ=15.3%). Materials with higher viscosity had greater levels of adhesion strength in Method A, whereas those with the higher viscosity had lower levels of adhesion strength in Method B. Adhesion strength was significantly affected by the experimental condition prior to applying tension.

Dynamic viscoelastic properties, water absorption, and solubility of home reliners.

Scant rheological information is available regarding home reliners (liner type denture adhesives). We evaluated 6 different home reliners in regard to their viscoelastic properties, water absorption and solubility. Dynamic viscoelastic properties and changes over time were determined using a dynamic viscoelastometer, while weight changes, absorption, and solubility during immersion in water were also investigated. We found that the dynamic viscoelasticity of the tested home reliners was sensitive to changes in frequency, while the materials used had nearly no elasticity and exhibited viscous behaviors. They showed a dramatic change in viscoelastic properties and increase in weight after approximately 1 day of water immersion. A considerably high percentage of water absorption was also observed. From the viewpoint of dynamic viscoelastic properties and durability, our results indicate that the tested home reliners would not be suitable for improvement of ill-fitting dentures.

Ion release from casts of commercially pure titanium in mixed solutions of organic acids contained in human saliva.

PURPOSE: The purpose of this study was to investigate the ion release from titanium casts in solutions of mixed organic acids and to reconsider the possibility of allergic reactions to titanium. METHODS: Cast specimens were made from commercially pure titanium. For the immersion solutions, we prepared two types of organic acid solutions, one mixed with organic acids contained in whole stimulated saliva at two different dilutions, and the other, a lactic acid solution. Following immersion, the amounts of dissolved titanium ions, weight loss of the casts, and micrographs of the specimen surfaces were examined. RESULTS: There were significantly larger amounts of dissolved titanium ions in the mixed organic acid solutions than in the lactic acid solution. There was also a significant difference in the weight loss values between the immersion solutions (p < 0.0001), but the significance level was different from that of the difference in the quantity of ion elution. CONCLUSION: The results suggested that a much larger quantity of ions is released from titanium casts attached in the oral cavity than has been reported previously, and that it is necessary to consider the possibility of allergic reactions to titanium casts.

Enhanced initial cell responses to chemically modified anodized titanium.

BACKGROUND: Previously, we reported that anodized porous titanium implants have photocatalytic hydrophilicity. However, this effect was not always sufficient for the significant improvement of bone apposition. PURPOSE: The purpose of this study was to improve the photocatalytic properties of porous titanium implants by the fluoride modification of the anodized titanium dioxide (TiO(2)), and to investigate the initial cell response to it. MATERIALS AND METHODS: The ideal concentration of ammonium hydrogen fluoride (NH(4)F-HF(2)) used in this study was determined by a static water contact angle assay. The ideal concentration of NH(4)F-HF(2) was 0.175%, and experimental disks were treated with this concentration. A pluripotent mesenchymal cell line, C2C12, was cultured on the disks in order to investigate cell attachment, morphology, and proliferation. RESULTS: Cell attachment after 30 minutes of culturing was significantly higher for the ultraviolet-irradiated, fluoride-modified anodized TiO(2) (p < .05), and the simultaneous scanning electron microscope observation showed a rather flattened and extended cell morphology. The proliferation rate after 24 hours was also significantly higher for the fluoride-modified anodized TiO(2). CONCLUSION: Fluoride chemical modification enhances the hydrophilic property of the anodized TiO(2) and improves the initial cell response to it.