Utilization of denture adhesives and the factors associated with its use: a cross-sectional survey.

BACKGROUND: An increase in the number of elderly edentulous patients likely leads to a greater demand for dentures and denture adhesives. As denture adhesives have both positive and negative features, dentists need to know the types of denture adhesive users to be able to provide instruction to denture wearers on how to use denture adhesives effectively. This study aims to examine the utilization of denture adhesives and associated factors. METHODS: Seven closed-ended questionnaires were developed for a web-based survey. After that, Fisher's exact tests were performed to determine the difference in the denture adhesive usage rate by gender, type of denture, last dental visit, and smoking status. A multivariate-adjusted logistic regression analysis was performed with denture adhesive use or non-use as the dependent variable and the other items as independent variables. Next, Fisher's exact tests and a multivariate-adjusted logistic regression analysis were performed with the type of denture adhesives as the dependent variable in the same way. Statistical analyses were performed for all denture wearers, complete denture wearers, and partial denture wearers. The level of statistical significance was set at p = 0.05. RESULTS: A total of 1470 denture wearers in Japan participated in this study. Of these, 318 used denture adhesives, while 212 (66.7%) used cream; 74 (23.3%) used home liner; 25 (7.9%) used powder; four (1.3%) used sheets; and three (0.9%) used several types. The Fisher's exact tests revealed that the ratios of using denture adhesives were significantly higher for complete denture wearers (p < 0.001), last dental visit over 1 year (p = 0.005), and smokers (p = 0.005). For partial denture wearers, the ratio was significantly higher in smokers (p = 0.262). The multivariate adjusted logistic regression revealed that denture adhesive use or non-use were significantly associated with the type of denture and smoking status in all denture wearers, and just smoking status in partial denture wearers. There were no significant results about the type of denture adhesive selection. CONCLUSIONS: From all denture wearers, complete denture wearers and smokers are more likely to use denture adhesives. In addition, smokers significantly use denture adhesives if they are partial denture wearers.

Development of soft denture lining materials containing fluorinated monomers.

PURPOSE: To develop a new fluorine-containing soft denture lining material, the influences of fluorinated monomers on physical properties and contamination resistance were examined. METHODS: Five experimental materials of different chemical compositions in fluorinated monomer and two plasticized acrylics (Supersoft, VertexSoft) were used to evaluate water sorption, solubility, staining resistance, Shore A hardness, and contact angle. Five specimens for each test were fabricated. The results were analyzed with one-way analysis of variance (ANOVA) and Tukey's HSD test using statistical software at p=0.05. RESULTS: The amount of water sorption tended to decrease as the number of the fluorine atoms in fluorinated monomers increased. Similar solubility was shown regardless of the type of fluorinated monomer. The use of fluorinated monomers for immersion in coffee allowed suppression of discoloration. In beta -carotene, there were no significant differences in color changes among four experimental materials with fluorinated monomer. Shore A hardness was decreased and the contact angles tended to increase as the number of fluorine atoms in fluorinated monomers increased. When comparing the experimental materials and commercially available materials, the experimental materials containing fluorinated monomers with large numbers of fluorine atoms showed adequate clinical properties except for staining test of beta -carotene. CONCLUSION: Monomers with a large number of fluorine atoms can be used to develop applicable soft denture lining materials in clinical practice.

Influence of water immersion on the transmitted load of home reliners.

This study aimed to clarify how composition and water immersion of home reliners affect the attenuation of the transmitted load. To conduct a transmitted load measurement, we used three different home reliners (Tafugurippu Pink A, Liodent Pink, and Cushion Correct), which were combined acrylic resin disks. They were immersed in distilled water and then placed on a silicone quasi-mucosa (φ20×1.5 mm), which was set on a pressure sensor (φ8×0.35 mm), followed by the application of static load. Subsequently, gel permeation chromatography (GPC) and gas chromatography (GC) were used to clarify the composition of each home reliner. The attenuation of the transmitted load began 3 h after immersion. Moreover, both GPC and GC revealed a difference in composition among the three products. Further, the difference in the vinyl acetate molecular weight distribution and ethyl alcohol content affected the attenuation of the transmitted load of home reliners after water absorption.

[Effect of the viscosity of alginate impression materials on the preliminary impression for complete dentures].

The purpose of this study was to clarify the effect of the viscosity of alginate impression materials on the results of the preliminary impressions for complete dentures. Five experimental alginate impression materials with different viscosity were prepared based on a conventional material. Fifteen complete denture wearers were selected and impressions on using the experimental materials were taken. Impressions were evaluated by the success rates at the mylohyoid ridge area (MR), buccal area (BL) and retromolar pad area (RP). The success rates had a tendency to increase as the viscosity rose at MR and RP. The success rates at BL were not significantly different among the materials. Our results indicate that the viscosity of alginate impression materials has a great effect on the results of preliminary impression for complete dentures, especially at MR. Impression materials with high viscosity may be suitable for recording the anatomical form of the alveolar ridge better than those with low viscosity.

Hydrophilic nano-silica coating agents with platinum and diamond nanoparticles for denture base materials.

Preventing microorganisms from adhering to the denture surface is important for ensuring the systemic health of elderly denture wearers. Silica coating agents provide high hydrophilicity but lack durability. This study investigated solutions to improve the durability of the coating layer, determine an appropriate solid content concentration of SiO2 in the silica coating agent, and evaluate the effect of adding platinum (Pt) and diamond nanoparticles (ND) to the agent. Five coating agents were prepared with different SiO2 concentrations with/without Pt and ND additives. The contact angle was measured, and the brush-wear test was performed. Scanning electron microscopy was used to investigate the silica coating layer. The appropriate concentration of SiO2 was found to be 0.5-0.75 wt%. The coating agents with additives showed significantly high hydrophilicity immediately after coating and after the brush-wear test. The coating agents with/without additives formed a durable coating layer even after the brush-wear test.

An objective estimation of the removability of three home reliners.

The purpose of this study was to investigate methods for evaluating objectively the removability of three commercially available home reliners (Cushion Correct, Tafugurippu Pink A and Liodent Pink). After immersing each of the reliners in distilled water at 37ºC for 24 h, we compared their removability using the peel test with a finger, which was evaluated based on a visual analogue scale and the percentage of the residual area. An experimental rake-up test was also undertaken to quantify removability, evaluated based on the total amount of work required to remove it. The Tafugurippu Pink A product was easier to remove with a finger than the other two home reliner products, and required the least total amount of work to be removed in the experimental rake-up test. Furthermore, the rake-up test performed could possibly be used for objective evaluation of the removability of home reliner.

Effects of temperature-responsive hydrogel on viscosity of denture adhesives.

The cream type of denture adhesives after use cannot be easily removed from oral mucosa and have the potential risk to change the oral flora. The effects of the temperature-responsive hydrogel Pluronic F-127 (PF) on the complex viscosity of denture adhesives were evaluated. Carboxy methylcellulose (CMC) mass fractions (1, 2, 3 and 4%) were added to 20 and 25% PF hydrogels. Complex viscosity was measured over a temperature cycle (40→10→40°C) and fixed temperature points (23 and 37°C). Adhesive strength tests were performed with 2 resin plates at 23 and 37°C. One commercial cream-type denture adhesive, New Poligrip® (NP), was evaluated as a control. Complex viscosity values for PF20% groups at 23°C were lower than those for NP at 37°C. Adhesive strength of PF20% with CMC2%, was higher at 23°C when compared to NP at 37°C, which suggests that PF20%CMC2% is an effective adhesive and is easily removed after mouth rinsing.

Antifungal effects of a tissue conditioner coating agent with TiO2 photocatalyst.

Tissue conditioners are susceptible to colonization by microorganisms. Therefore, the prevention of biofilm formation are important for oral hygiene. However, mechanical and chemical cleaning methods may cause clinical problems such as deformation or surface degradation of tissue conditioners. The objective of this study is to evaluate the antifungal effects of coating agents with a TiO2 photocatalyst. Photocatalytic antifungal effects on C. albicans biofilms and photodegradation effects of adsorbed protein were measured by colorimetric assays. Scanning electron microscopy was used to examine morphological changes in C. albicans. Viscosities of coating agents increased with incorporation of TiO2. However, both of coating agents with TiO2 were acceptable to the application by brush. The antifungal and protein degradation effects increased with the concentration of TiO2 in the coating agents. These effects also increased with radiation time. After 90 min radiation, the viability of C. albicans was reduced to 16.2+/-3.3 %. Scanning electron microscopy observation showed C. albicans remained on the coated surfaces even after 90 min radiation. These results suggest that coating agents with TiO2 photocatalyst can be effective for the maintenance of tissue conditioners when dentures are removed; during sleep.

Effect of home reliner on occlusal relationships and oral mucosa: viscoelastic analyses by smoothed particle hydrodynamics simulation.

BACKGROUND: For decades, many reports have expressed negative opinions about home reliner (HR), because it may result in residual ridge resorption. Recently, some clinical studies evaluated HR. However, the effect of HR on occlusal relationships and the oral mucosa remains unclear. Here, we dynamically analyzed the situation in which a patient applies HR to an upper complete denture. METHODS: We numerically simulated the effect of HR on occlusal relationships and the oral mucosa. In the simulation, the thickness of HR was set to 2mm as a proper amount and 4mm as an excessive amount. The loading points were set at the center of the right and left occlusal surfaces of the denture. RESULTS: Compared with the case without using HR, at proper amounts (2mm on the right and left sides), HR suppressed the depression of the ill-fitting denture, and stress on the oral mucosa was decreased. In the excessive HR model (4mm on the right and left sides), the vertical occlusal dimension was increased, and stress on the oral mucosa originally fitted with the denture base was increased. When the denture was modeled in an inclined position (2mm on the left side and 4mm on the right side), stress on the oral mucosa on the left buccal side was markedly increased. CONCLUSION: It was found that when an improper amount of HR was applied, the occlusal vertical dimension increased and the oral mucosa was pressured more than that under non-HR conditions.

A randomized controlled trial of the different impression methods for the complete denture fabrication: Patient reported outcomes.

OBJECTIVES: To compare the effect of conventional complete dentures (CD) fabricated using two different impression methods on patient-reported outcomes in a randomized controlled trial (RCT). METHODS: A cross-over RCT was performed with edentulous patients, required maxillomandibular CDs. Mandibular CDs were fabricated using two different methods. The conventional method used a custom tray border moulded with impression compound and a silicone. The simplified used a stock tray and an alginate. Participants were randomly divided into two groups. The C-S group had the conventional method used first, followed by the simplified. The S-C group was in the reverse order. Adjustment was performed four times. A wash out period was set for 1 month. The primary outcome was general patient satisfaction, measured using visual analogue scales, and the secondary outcome was oral health-related quality of life, measured using the Japanese version of the Oral Health Impact Profile for edentulous (OHIP-EDENT-J) questionnaire scores. RESULTS: Twenty-four participants completed the trial. With regard to general patient satisfaction, the conventional method was significantly more acceptable than the simplified. No significant differences were observed between the two methods in the OHIP-EDENT-J scores. CONCLUSIONS: This study showed CDs fabricated with a conventional method were significantly more highly rated for general patient satisfaction than a simplified. CLINICAL SIGNIFICANCE: CDs, fabricated with the conventional method that included a preliminary impression made using alginate in a stock tray and subsequently a final impression made using silicone in a border moulded custom tray resulted in higher general patient satisfaction. TRIAL REGISTRATION: UMIN000009875.

Influence of monomer content on the viscoelasticity, water sorption and solubility of experimental fluorinated soft lining materials.

The influence of monomer content on the viscoelasticity, water sorption and solubility of experimental fluorinated soft lining materials was investigated. Changes in the viscoelastic properties of the materials were also examined after thermal cycling. Four fluorinated soft lining materials containing different amounts of methoxy diethylene glycol methacrylate (MDGMA) and tridecafluorooctyl methacrylate (13FMA) were prepared. The viscoelastic displacement for specimens containing 13FMA was found to be less than that without 13FMA (p<0.05), and the values tended to decrease with increasing 13FMA content. Reduction of the MDGMA content and addition of 13FMA caused a decrease of water sorption and solubility (p<0.05). Thermal cycling was found to affect the viscoelastic deformation of the specimens without 13FMA and those specimens with relatively large amounts of 13FMA.

Effect of composition of experimental fluorinated soft lining materials on bond strength to denture base resin.

The purpose of the present study was to investigate the effect of the composition of experimental fluorinated soft lining materials on bond strength to denture base resin. Vinylidene fluoride/hexafluoro propylene copolymer (2-6F), tridecafluorooctyl methacrylate (13FMA), methoxy diethylene glycol methacrylate (MDGMA), and silica (as filler) were used for fabrication of the experimental soft lining materials. Nine experimental soft lining materials having various compositions of 2-6F, 13FMA, and MDGMA were prepared. Shear and tensile bond strength tests were performed before and after immersion in water. The water sorption for the materials was also measured. An increase in the content of acrylic monomer, MDGMA, in the experimental materials increased the bond strength before immersion in water but reduced the bond strength after immersion in water as compared to that before immersion in water. The inclusion of fluorinated monomer (13FMA) in the materials appeared to affect water sorption.

Evaluation of the marginal fit at implant-abutment interface by optical coherence tomography.

Vertical misfit of implant-abutment interface can affect the success of implant treatment; however, currently available modalities have limitations to detect these gaps. This study aimed to evaluate implant-abutment gaps in vitro using optical coherence tomography (OCT). Vertical misfit gaps sized 50, 100, 150, or 200 µm were created between external hexagonal implants and titanium abutments (Nobel Biocare, Göteborg, Sweden). A porcine gingival tissue slice, 0.5, 1.0, 1.5, or 2.0 mm in thickness, was placed on each implant-abutment interface. The gaps were evaluated by swept-source OCT at a center wavelength of 1330 nm (Panasonic Healthcare, Ehime, Japan) with beam angles of 90, 75 and 60 deg to the implant long-axis. The results suggested that while the measurements were precise, gap size and gingival thickness affected the sensitivity of detection. Gaps sized 100 µm and above could be detected with good accuracy under 0.5- or 1.0-mm-thick gingiva (GN). Around 70% of gaps sized 150 µm and above could be detected under 1.5-mm-thick GN. On the other hand, 80% of gaps under 2.0-mm-thick GN were not detected due to attenuation of near-infrared light through the soft tissue. OCT appeared as an effective tool for evaluating the misfit of implant-abutment under thin layers of soft tissue.

Hydrophilic surface modification of acrylic denture base material by silica coating and its influence on Candida albicans adherence.

Silica coating modifies hydrophobic denture base materials to have a hydrophilic surface. The purpose of this study was to evaluate the effect of silica coating to a denture base material on resistance to Candida albicans (C. albicans) adherence. Specimens were prepared by polymerizing an acrylic denture lining material and polished using silicon carbide paper up an abrasive grade of 1000. The specimens of a coated group were treated three times by a silica coating agent using a nonwoven cloth. The surface properties were evaluated by contact angle measurement, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). A C. albicans adherence assay was performed after 1.5, 6, and 24 h incubation. The mean contact angle of the coated group showed significantly lower than that of the non-coated group (p < 0.05). In the coated group, the surface roughness decreased in SEM images, and Si was continuously detected in EDS analysis. At 24 h incubation time, the colony forming unit of C. albicans on the coated group was significantly reduced compared to the non-coated group (p < 0.05). These results suggest that hydrophilic surface modification by the silica coating reduces C. albicans adherence and could contribute to daily denture care.

Basic evaluation on physical properties of experimental fluorinated soft lining materials.

The purpose of the present study was to compare the properties required for the clinical application of soft lining materials containing a fluorinated monomer versus that of conventional materials in an effort to develop a new soft lining material with long-term stable viscoelastic properties. Four soft lining materials were examined. Two experimental materials containing dodecafluoroheptyl methacrylate (SR12F) or tridecafluorooctyl methacrylate (SR13F) were prepared. Two commercial soft lining materials, one acrylic-based and one silicone rubber-based, were selected as reference materials. Shore A hardness, viscoelastic properties, water sorption, solubility, and staining resistance were evaluated. The Shore A hardness and the displacements were analyzed with two-way analysis of variance (ANOVA) and Tukey's HSD test. The water sorption, the solubility and the color change were analyzed with one-way ANOVA and Tukey's HSD test. The significance level was set at 0.05. SR12F and SR13F showed greater viscous flow, low water sorption, low solubility, and good staining resistance compared to the commercial products. The results indicate that the soft lining materials containing fluorinated monomers might have a potentially long-term stable viscoelastic behavior.

Influence of methyl mercaptan at early setting stages on the properties of self curing addition silicone resilient denture lining materials.

PURPOSE: The aim of the present study was to clarify the influence of early setting conditions on the properties of self curing addition silicone resilient denture lining materials. METHODS: Four auto-mix types of commercial self curing addition silicone resilient denture lining materials were used. Agar plates containing various concentrations of methyl mercaptan (MMP) were prepared and cylindrical specimens (10mm in height and 10mm in diameter) of silicone liners were set on the agar plate. The Shore A hardness of the agar-contacted surface of the specimen was measured at 0, 1, 7 and 28 days after stored in 37 degrees C water. The viscoelastic properties (instantaneous elastic modulus, coefficient of viscosity and permanent deformation) of two silicone liners, which showed a great decrease in the Shore A hardness by agar contact, were determined by a creep meter. RESULTS: The Shore A hardness, coefficient of viscosity, and instantaneous elastic modulus deceased when the specimen was set on the MMP containing agar plate, but the permanent deformation of these specimens increased. CONCLUSION: The exposure to MMP at the early setting stage influenced the properties of self curing addition silicone resilient denture lining materials.

Physical properties of a new denture lining material containing a fluoroalkyl methacrylate polymer.

STATEMENT OF PROBLEM: A new fluoride-containing, methacrylate-based denture lining material has been introduced. Because of the fluoride content, this material is expected to demonstrate low water sorption and solubility and high stain resistance, but these attributes remain untested. PURPOSE: This study investigated a wide range of clinically relevant properties for a new fluoroalkyl methacrylate denture base liner product (Maxfit) and compared these properties with those of 3 other commercial products. MATERIAL AND METHODS: Four denture lining materials were tested: Maxfit, Kooliner, Tokuyama Rebase (fast set), and Denture Liner. Water sorption (microg/mm(3)) and solubility (microg/mm(3)) were tested according to International Organization for Standardization (ISO) Standard No. 1567. Stain resistance was evaluated by measuring color change (DeltaE) after immersion in 2 solutions (coffee and turmeric solution). Microhardness was determined using Knoop indentation testing according to American National Standards Institute/American Dental Association Specification No. 17. Relined denture fit was evaluated by measuring the gap (mm) occurring between the relined denture base and the cast after polymerization. Shear bond strength (MPa) to denture base materials (polymethyl methacrylate, cobalt-chromium alloy, and titanium) was tested according to ISO Standard No. 11405. Data were statistically analyzed using nonparametric Kruskal-Wallis (alpha=.05) and Mann-Whitney U tests combined with the Bonferroni correction (alpha=.008). RESULTS: Maxfit showed the lowest water sorption and solubility (8.0 +/- 0.1, 0.5 +/- 0.1 microg/mm(3), respectively). The color change from coffee immersion of Maxfit was significantly less than Tokuyama Rebase and Denture Liner, and significantly less than Tokuyama Rebase and Denture Liner in a turmeric solution (P<.001). Knoop hardness of Maxfit (8.66 +/- 0.51) was higher than Kooliner and Tokuyama Rebase (P<.001). The relined denture fit using Maxfit was not different from other materials. Significantly higher shear bond strength to denture base resin was noted for Maxfit compared to Tokuyama Rebase and Denture Liner (P<.008). CONCLUSIONS: The new fluoroalkyl methacrylate-based denture liner (Maxfit) showed the lowest water sorption and solubility, and superior stain resistance. In spite of the addition of the fluoride content, this product exhibited no deterioration in physical properties, such as surface hardness, fit of the relined denture, and shear bond strengths to denture base materials tested.