RESUMEN
OBJECTIVE: To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction. METHODS: A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models. RESULTS: Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284). CONCLUSION: This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults. CLINICAL SIGNIFICANCE: Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.
Asunto(s)
Estudios Cruzados , Placa Dental , Limpiadores de Dentadura , Higiene Bucal , Satisfacción del Paciente , Estomatitis Subprotética , Humanos , Anciano , Femenino , Masculino , Limpiadores de Dentadura/uso terapéutico , Método Simple Ciego , Estudios Prospectivos , Placa Dental/prevención & control , Estomatitis Subprotética/prevención & control , Estomatitis Subprotética/microbiología , Cepillado Dental/métodos , Anciano de 80 o más Años , Dentaduras , Resultado del Tratamiento , Terapia por Ultrasonido/métodos , Dentadura Completa , Servicios de Atención de Salud a Domicilio , Persona de Mediana Edad , UltrasonidoRESUMEN
Denture stomatitis (DS) is one of the frequent oral diseases caused by multiple factors among denture wearers and is an erythematous lesion of the mucosa in the denture-bearing area, which is a limited and non-specific damage that seriously endangers the oral health of denture wearers. Traditional drug treatment for DS is effective, but it is prone to the development of drug-resistant strains. Therefore, it is important to find new treating options. For the prevention and treatment of DS, there are various methods such as direct administration of azole and polyene antibiotics to the mucosal lesions, extra-oral cleaning of the denture by cleansers and physical disinfection, and modification of denture materials. Natural ingredient preparations that have emerged in recent years are safe, convenient, inexpensive, and less likely to produce drug-resistant strains, and are seen as new sources of drugs for DS treatment. Photodynamic therapy has shown superior antibacterial properties and is also considered promising due to the convenience and safety of the treatment process and the ease of developing drug resistance. Antibacterial agents endow dentures with new characteristics, and denture modification will be a new way to treat DS. In addition, combining different prevention and control methods has shown better antibacterial activity against Candida albicans, which also provides new ideas for prevention and treatment of DS in the future.
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Enfermedades de la Boca , Fotoquimioterapia , Estomatitis Subprotética , Humanos , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/prevención & control , Candida albicans , Antibacterianos/uso terapéutico , Antibacterianos/farmacologíaRESUMEN
STATEMENT OF PROBLEM: Dental hygiene for institutionalized patients and recurring Candida-associated denture stomatitis remain problematic because of a patient's limited dexterity or inability to eliminate Candida from denture surfaces. Although there has been extensive research into antimicrobial modification of denture base resins with inorganic materials, scoping reviews of the literature to identify knowledge gaps or efficacy of inorganic antimicrobial materials in denture base resins are lacking. PURPOSE: The purpose of this scoping review was to provide a synopsis of the efficacy of the major classes of inorganic antimicrobial materials currently incorporated into denture base resins. MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews was applied. Four electronic databases, including Embase, PubMed, Web of Science, and Google Scholar, were accessed for articles in the English language, up to February 2019, without restrictions on the date of publication. RESULTS: From the 53 articles selected, 25 distinguishable inorganic materials were found and divided into 3 subgroups. Forty-three articles evaluated nanomaterials, where mostly silver ion nanoparticles and/or titanium dioxide nanoparticles were incorporated into denture base resins. Fourteen articles examined antimicrobial drugs and medications, including azole group medications, amphotericin-B, Bactekiller, chlorhexidine, Novaron, and Zeomic. Two articles classified as others explored hydroxyapatite- and fiber-incorporated denture base resins. CONCLUSIONS: Although nanotechnology and antimicrobial medications or drugs have been successfully used to reduce Candida-associated denture stomatitis, long-term solutions are still lacking, and their disadvantages continue to outweigh their advantages.
Asunto(s)
Antiinfecciosos , Nanopartículas , Estomatitis Subprotética , Humanos , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/prevención & control , Bases para Dentadura , Antiinfecciosos/uso terapéutico , Candida , Ensayo de MaterialesRESUMEN
STATEMENT OF PROBLEM: Denture stomatitis is a chronic inflammatory condition caused by the formation of Candida albicans biofilm on denture bases. It is associated with aggravating intraoral pain, itching, and burning sensations. It can also potentiate cardiovascular diseases and aspiration pneumonia. The problem has thus far eluded efficient, toxic-free, and cost-effective solutions. PURPOSE: The purpose of this in vitro study was to investigate the effectiveness of organoselenium to inhibit the formation of C. albicans biofilm on the surface of acrylic resin denture base materials when it is either incorporated into the acrylic resin material or coated on the denture surface as a light-polymerized surface sealant. MATERIAL AND METHODS: Sixty heat-polymerized polymethyl methacrylate disks were fabricated and assigned to 4 groups (n=15): disks coated with a light-polymerized organoselenium-containing enamel surface sealant (DenteShield), disks impregnated with 0.5% organoselenium (0.5% selenium), disks impregnated with 1% organoselenium (1% selenium), and disks without organoselenium (control). C. albicans biofilm was grown on each disk which had been placed in a well of the microtiter plate containing 1-mL brain heart infusion broth inoculated with C. albicans. The plates were incubated aerobically at 37 °C for 48 hours. A confocal laser scanning microscope was used to determine the biofilm thickness, biomass, and live/dead cell ratio. Biofilm morphology was examined with scanning electron microscopy, whereas microbial viability was quantified by the spread plate method. The data were analyzed by using ANOVA and Tukey-Kramer multiple comparisons (α=.05). RESULTS: The microbial viability, biofilm thickness, biofilm biomass, and live/dead cell ratio were lower (P<.001) on disks in the test groups (DenteShield, 0.5% selenium, 1% selenium) when compared with the control group, with these variables being lowest in the 0.5% selenium and 1% selenium groups. The 0.5% selenium and 1% selenium groups did not differ significantly from each other in any of the variables (P>.05). Scanning electron microscope images showed inhibition of both biofilm growth and yeast to hyphae transition in the DenteShield, 0.5% selenium, and 1% selenium groups, with visible disruption of the biofilm morphology. CONCLUSIONS: The present study demonstrated that organoselenium, whether incorporated into or coated on the surface of an acrylic resin denture base material, has the potential to inhibit Candida albicans biofilm growth on denture surfaces and as such can be clinically useful for the prevention of denture stomatitis.
Asunto(s)
Selenio , Estomatitis Subprotética , Humanos , Candida albicans , Selladores de Fosas y Fisuras/farmacología , Estomatitis Subprotética/prevención & control , Selenio/farmacología , Resinas Acrílicas/farmacología , Resinas Acrílicas/uso terapéutico , Biopelículas , Dentaduras , Bases para Dentadura , Propiedades de SuperficieRESUMEN
STATEMENT OF PROBLEM: Denture stomatitis is a prevalent condition in denture wearers. Economic evaluations of health care can help stakeholders, including patients, make better decisions about treatments for a given condition. Economic models to assess the costs and benefits of different options for managing denture stomatitis are lacking. PURPOSE: The purpose of this study was to explore the feasibility of developing a cost-effectiveness model to assess denture cleaning strategies aimed at preventing denture stomatitis from a denture-wearer perspective in the United Kingdom. MATERIAL AND METHODS: A model was developed to identify and estimate the costs and effects associated with 3 denture cleaning strategies. These were low care (LC)-cleaning by brushing and soaking overnight in water; medium care (MC)-brushing with toothpaste and soaking overnight in water; and optimum care (OC)-brushing and soaking overnight in water and antimicrobial denture cleanser. Costs, outcome measures (denture stomatitis-free days), and probabilities (incidence of stomatitis, unscheduled dentist visits, prescription charges, self-medication) associated with each strategy were defined. A sensitivity analysis was used to identify key drivers and test the robustness of the model. RESULTS: The model showed that the total costs for 2015 ranged from £1.07 (LC) to £18.42 (OC). Costs associated with LC were derived from unscheduled dentist visits and use of medication and/or prescription charges. Incremental costs per denture stomatitis-free day were £0.64 (MC) and £1.81 (OC) compared with LC. A sensitivity analysis showed that varying either or both key parameters (baseline incidence of denture stomatitis and relative effectiveness of MC and OC strategies) had a substantial effect. Incremental cost-effectiveness ratios ranged from £4.11 to £7.39 (worst-case scenario) and from £0.21 to £0.61 (best-case scenario). CONCLUSIONS: A model was developed to assess the relative cost-effectiveness of different denture cleaning strategies to help improve denture hygiene. An important finding of the study was the lack of evidence on the relative effectiveness of different cleaning strategies, meaning that several assumptions had to be incorporated into the model. The model output would therefore likely be considerably improved and more robust if these evidence gaps were filled.
Asunto(s)
Higiene Bucal , Estomatitis Subprotética , Análisis Costo-Beneficio , Limpiadores de Dentadura/uso terapéutico , Dentaduras , Humanos , Estomatitis Subprotética/prevención & control , Cepillado Dental/efectos adversos , Pastas de DientesRESUMEN
This systematic review aimed to evaluate the antifungal effectiveness of polymethylmetacrylate (PMMA) modified by nanoparticles (NPs) and to compare it with conventional acrylic resins for denture bases. The present study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Searches were performed using PubMed, SCOPUS, SciELO, EMBASE, and LILACS. Eligibility criteria were as recommended by PRISMA. The studies presented great variability regarding NP type, synthesis method, antifungal evaluation method, and antifungal effect. The most commonly used NPs were silver (AgNP) and zinc oxide (ZnONP), ranging in size from 10 to 100 nm. The incorporation methods were mechanical or agitated. Despite PMMA modification by ZnONP being shown in vitro to be a combination with the best antifungal effect, future studies are still needed to determine the minimum inhibitory concentration for Candida spp. and assess its biocompatibility before the protocol is clinically tested.
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Nanopartículas , Estomatitis Subprotética , Candida albicans , Bases para Dentadura , Humanos , Polimetil Metacrilato , Estomatitis Subprotética/prevención & controlRESUMEN
OBJECTIVE: To evaluate the effectiveness of microwave disinfection in treating Candida-associated denture stomatitis (CADS). MATERIALS AND METHODS: The PubMed/MEDLINE, Embase, and Scopus databases were searched for reports on randomized clinical trials (RCTs) published in English until May 2020 (PROSPERO CRD42020192062) that evaluated the treatment of CADS by using microwave disinfection. The main outcomes were the improvement of clinical signs and/or the decrease in the residual yeast present on the dentures and palatal mucosa. The mean differences, standard deviations, risk ratio, and 95% confidence interval were calculated by using the random-effects model. Heterogeneity was assessed by using Cochran's Q test and I2 values. The level of significance was set at α = 0.05. RESULTS: Five RCTs with 245 participants were included. The descriptive investigations demonstrated that microwave disinfection was as effective (p > 0.05) as 0.2% chlorhexidine, 0.02% sodium hypochlorite, and topical nystatin (100.000 IU/mL), and was superior to topical miconazole in treating CADS. The metaanalysis did not show a statistical difference between microwave disinfection and nystatin (100.000 IU/mL) treatment in terms of mycological counts, cure, and recurrence rates (p > 0.05). CONCLUSION: Microwave disinfection showed comparable results with those of conventional therapies for treating CADS. In addition, treatment with 650 W for 3 min once a week for 14 days had better cost-effect results, indicating both the prevention and treatment of CADS. CLINICAL RELEVANCE: Our findings provide evidence regarding the treatment of CADS using microwave disinfection, and also indicating the best cost-effective option for this treatment modality.
Asunto(s)
Candida , Estomatitis Subprotética , Desinfección , Humanos , Microondas , Nistatina , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/prevención & controlRESUMEN
Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been suggested for the prevention and treatment of DS. Among the different approaches that have been implemented to inhibit and control DS there are the topical application of antifungal agents, the surface modification of the denture base and the incorporation of antimicrobial agents into the denture base material. Antifungal agents can effectively control DS, but the recurrence of the disease is common. Accordingly, it has been suggested that coating the surface of the acrylic denture base may result in a decreased fungal adhesion. In recent years, nanotechnology has dominated the research, and several nanoparticles have demonstrated antifungal effects. Therefore, the aim of this article was to review the antifungal effects of the different methods that have been suggested for the prevention and/or control of DS as well as the antimicrobial activity of denture base acrylic resin additives, including nanoparticles. Studies reporting the incorporation of antifungal/antimicrobial agents into the polymethyl methacrylate (PMMA) denture base were included in this review. The PubMed, Web of Science, Google Scholar, and Scopus databases were searched for the articles published between January 2000 and December 2018 using the following key words: dental prosthesis, denture stomatitis, candidiasis, antifungal agents, biofilm formation, polymethyl methacrylate, and PMMA. The antimicrobial material incorporated into the resin may have a superior effect in preventing DS over simply coating the surface of the denture base. However, some antimicrobial fillers can have adverse effects on the physical and mechanical properties of the denture base resin.
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Candida albicans , Estomatitis Subprotética , Resinas Acrílicas , Antifúngicos/uso terapéutico , Bases para Dentadura , Humanos , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/prevención & controlRESUMEN
RESUMEN Introducción: La estomatitis subprotésica es un proceso inflamatorio de la mucosa bucal que se encuentra cubierta por una prótesis removible, de causa multifactorial y alta prevalencia. Objetivo: Caracterizar la estomatitis subprotésica en pacientes portadores de prótesis removible atendidos en las clínicas odontológicas de la Universidad San Gregorio de Portoviejo en el período marzo-noviembre de 2019. Método: Se realizó un estudio descriptivo transversal, con los criterios de inclusión siguientes: mayores de 18 años, ambos sexos, buen estado de salud general, no practicar hábitos tóxicos, usar prótesis removible, total o parcial, confeccionada de acrílico o metales. Todos los sujetos de la investigación firmaron el consentimiento informado antes de realizarles la historia clínica de odontología del Ministerio de Salud Pública del Ecuador de donde se extrajeron los datos sociodemográficos, signos clínicos y características de la prótesis. Resultados: Fueron evaluados 100 pacientes. El 45 %, presentaba signos clínicos de estomatitis subprotésica; predominó el sexo femenino con el 33 % y el grupo de edad de 40 a 59 años con un 26 %. La mayoría de las prótesis no se ajustan ni adaptan de manera correcta, y tienen un mal estado físico, en el 80, 82,2 y el 91 %, respectivamente. El 84,4 % de los pacientes utilizaba prótesis parcial removible, confeccionadas con acrílico, por un periodo de 1 a 6 años en el 60 % de los casos. Conclusiones: El diagnóstico de estomatitis subprotésica se asocia con el mal estado físico, desajuste e inadecuada adaptación de las prótesis removibles, lo que indica la necesidad de la institución para el establecimiento de estrategias docentes hacia la comunidad para su prevención y diagnóstico temprano.
ABSTRACT Introduction: Subprosthetic stomatitis is an inflammatory process of the mucosa in the oral cavity covered by a removable prosthesis, with a multifactorial cause and high prevalence. Objective: To characterize subprosthetic stomatitis in patients with removable prosthesis treated at the dental clinics of San Gregorio University in Portoviejo in the period March-November 2019. Method: A cross-sectional descriptive study was conducted, with the following inclusion criteria: patients over 18 years old, both sexes, good general health, no toxic habits, use of removable prosthesis, total or partial, made of acrylic or metals. All the patients involved in the research signed their consent, information given to them before taking their dental records taken by the Ministry of Public Health of Ecuador, from which socio-demographic data, clinical signs and characteristics of the prosthesis were extracted. Results: 100 patients were evaluated. Forty-five per cent showed clinical signs of subprosthetic stomatitis; the female sex (33%) predominated and the age group 40-59 years with (26%). Most of the prosthesis did not fit or adapt correctly and were in poor physical condition in 80%, 82.2% and 91% respectively. 84.4% of the patients used removable partial prosthesis, made of acrylic, for a period of 1 to 6 years, (60%) of the cases. Conclusions: The diagnosis of subprosthetic stomatitis is associated with poor physical condition, maladjustment and inadequate adaptation of removable prostheses, which indicates the need for the institution to establish educational strategies towards the community for prevention and early diagnosis.
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Estomatitis Subprotética/diagnóstico , Estomatitis Subprotética/etiología , Estomatitis Subprotética/prevención & control , Dentadura Parcial Removible/efectos adversos , Estudios TransversalesRESUMEN
Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. OBJECTIVE: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. METHODOLOGY: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. RESULTS: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. CONCLUSION: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.
Asunto(s)
Resinas Acrílicas/química , Candida albicans/efectos de los fármacos , Bases para Dentadura/microbiología , Nanodiamantes/química , Nanodiamantes/microbiología , Polimetil Metacrilato/química , Análisis de Varianza , Humanos , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Valores de Referencia , Reproducibilidad de los Resultados , Estomatitis Subprotética/microbiología , Estomatitis Subprotética/prevención & control , Propiedades de SuperficieRESUMEN
Candida-associated denture stomatitis (DS) is a persistent and chronic oral infection of the denture-bearing palatal mucosa. DS stems from the ability of the fungal opportunistic pathogen Candida albicans to adhere to denture material and invade palatal tissue. Although DS is the most prevalent form of oral candidiasis, there are currently no feasible therapeutic strategies for the prevention of this recurrent condition. We developed a peptide-based antimicrobial bioadhesive formulation specifically designed for oral topical formulation. In this study, we aimed to evaluate the applicability of the novel formulation for the prevention of C. albicans colonization on denture material and development of clinical disease. To that end, using the latest technological advances in dental digital design and three-dimensional (3D) printing, we fabricated an intraoral device for rats with universal fit. The device was successfully installed and used to develop clinical DS. Importantly, by taking a preventative therapeutic approach, we demonstrated the potential clinical utility of the novel formulation as a safe and feasible prophylactic agent against DS.
Asunto(s)
Antifúngicos/farmacología , Candida albicans/efectos de los fármacos , Candidiasis Bucal/prevención & control , Cementos Dentales/farmacología , Estomatitis Subprotética/prevención & control , Animales , Antifúngicos/química , Biopelículas/efectos de los fármacos , Biopelículas/crecimiento & desarrollo , Candida albicans/crecimiento & desarrollo , Candidiasis Bucal/tratamiento farmacológico , Candidiasis Bucal/microbiología , Cementos Dentales/química , Dentaduras/microbiología , Modelos Animales de Enfermedad , Masculino , Mucosa Bucal/microbiología , Ratas , Ratas Sprague-Dawley , Estomatitis Subprotética/tratamiento farmacológico , Estomatitis Subprotética/microbiologíaRESUMEN
Abstract Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.
Asunto(s)
Humanos , Resinas Acrílicas/química , Candida albicans/efectos de los fármacos , Polimetil Metacrilato/química , Bases para Dentadura/microbiología , Nanodiamantes/microbiología , Nanodiamantes/química , Valores de Referencia , Estomatitis Subprotética/microbiología , Estomatitis Subprotética/prevención & control , Propiedades de Superficie , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Reproducibilidad de los Resultados , Análisis de VarianzaRESUMEN
Denture stomatitis, periodontitis, and peri-implantitis are the growing problems in restorative dentistry. Chemicals play an important role as an adjuvant to mechanical cleaning of teeth, implants, surrounding tissues, and prostheses. Current mouth rinses are reported to affect the tissues and prostheses if used on a long-term basis. Sodium bicarbonate, the common baking soda, has been reported to be versatile. A search of the resources through Medline and Google Scholar was made to understand the current status of the mouth rinses and the use of sodium bicarbonate. Different MeSH and search criteria were used for the different search engines. Baking soda, being a common household item, with its ready availability, safety, minimal abrasivity, and bactericidal property makes it a patient-friendly mouthwash, component in the dentifrice, or chewing gum, which can be used on a long-term basis as an adjunct virtually free of any side effects.
Asunto(s)
Antisépticos Bucales , Bicarbonato de Sodio , Antibacterianos , Goma de Mascar , Caries Dental/prevención & control , Dentífricos , Limpiadores de Dentadura , Humanos , Antisépticos Bucales/efectos adversos , Higiene Bucal , Periimplantitis/prevención & control , Seguridad , Bicarbonato de Sodio/administración & dosificación , Bicarbonato de Sodio/farmacología , Estomatitis/prevención & control , Estomatitis Subprotética/prevención & control , Abrasión de los Dientes/inducido químicamente , Abrasión de los Dientes/prevención & control , Blanqueadores DentalesRESUMEN
Denture stomatitis triggered by Candida species requires better preventive measures. This study evaluated the physical and biological properties of a denture base acrylic resin after immersion in antiseptic soaps. Acrylic resin specimens were prepared and stored in distinct solutions for 0, 7, 14, 21, and 28 days. The solutions were as follows: DW: distilled water at 37°C (control group); DS: cycles of daily immersion in Dettol soap for 8 hours at room temperature, followed by immersion in distilled water for 16 hours at 37°C; PS: cycles of daily immersion in Protex soap, as described for the previous group; LS: cycles of daily immersion in Lifebuoy soap, as described for the DS group. The parameters evaluated at each time point were the following: biofilm formation capacity by Candida albicans and reduction of preformed fungal biofilms, cytotoxicity, surface roughness, hardness, and color change. For the fungal adhesion phase, the type of soap had a statistically significant effect (p = 0.0292), but after 24 hours, no differences were found between solutions or between storage times. Regarding the efficacy of biofilm reduction, there was a significant difference when the groups were compared to each other (p = 0.014). Dettol and Lifebuoy eliminated the preformed biofilm on the specimens. Moreover, all the soaps were classified as non-cytotoxic (on HaCaT cell line) because there was no difference in cell viability between the different groups, except after 21 days, when a decrease in cell viability occurred, regardless of the type of soap. Regarding the roughness, there was no statistically significant difference (p > 0.05) between the groups. Lifebuoy decreased resin hardness regardless of storage time (p = 0.003). After 21 and 28 days of storage, there was an increase in hardness value, regardless of the type of soap. The specimens' color, according to the National Bureau of Standards values, ranged from 0.27 to 0.58 (i.e., imperceptible or mild color changes). In general, the disinfectant soaps were not able to prevent biofilm formation, but all the soaps were effective in reducing the preformed biofilm. In addition, all soaps were non-cytotoxic and did not change surface roughness, hardness (except Lifebuoy), and color (except Lifebuoy). Therefore, immersion in two antiseptic soaps (Protex and Dettol) may be a cheap and easy procedure for preventing denture stomatitis.
Asunto(s)
Resinas Acrílicas , Antiinfecciosos Locales/administración & dosificación , Limpiadores de Dentadura , Jabones , Estomatitis Subprotética/prevención & control , Biopelículas/efectos de los fármacos , Candida albicans/efectos de los fármacos , Candida albicans/fisiología , Color , Materiales Dentales , Desinfección/métodos , Dureza , HumanosRESUMEN
Candida biofilms adhere to the internal surface of removable dentures, which is an etiological factor in the pathogenesis of denture stomatitis (DS). Adhesive materials are used at the base of maxillary complete dentures to improve their retention and chewing qualities. This article reports the antimicrobial activity of the enriched fractions of Equisetum giganteum and Punica granatum incorporated into a denture adhesive against C. albicans biofilm. The biofilms were induced on the surface of heat-cured acrylic resin specimens that were previously treated with a mixture of adhesive/herb extracts. The antimicrobial activity was evaluated by CFU counts, XTT reduction, and SEM and CLSM analysis. Both herb extracts amplified the anti-biofilm action of the adhesive on the acrylic resin by up to 12 h. Therefore, when these extracts were combined with COREGA®, they played a collaborative and innovative role in biofilm control and can be considered alternatives for temporary use in the treatment and/or prevention of DS.
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Adhesivos/farmacología , Antiinfecciosos/farmacología , Biopelículas/efectos de los fármacos , Candida albicans/efectos de los fármacos , Bases para Dentadura/microbiología , Equisetum/química , Lythraceae/química , Resinas Acrílicas/química , Adhesivos/química , Antiinfecciosos/química , Biopelículas/crecimiento & desarrollo , Cementos Dentales/química , Cementos Dentales/farmacología , Humanos , Estomatitis Subprotética/prevención & controlRESUMEN
Removable dentures are worn by 20% of the UK population and two thirds of these individuals have denture stomatitis. Poor oral hygiene is commonplace among this group, as is smoking and xerostomia, which also contribute to the development of denture stomatitis. A complex polymicrobial biofilm is able to proliferate on the surface of denture materials and matures to form visible denture plaque. This denture plaque biofilm stimulates a local inflammatory process that is detectable clinically as erythema, and hyperplasia. Systemically, denture plaque represents a potential risk factor for systemic disease, in particular aspiration pneumonia. Respiratory pathogens have been detected in the denture plaque and overnight denture wear has been linked to an increased risk of aspiration pneumonia. There is a general lack of evidence on the adequate management of denture stomatitis and we present a protocol for use in the primary care setting.
Asunto(s)
Odontología General , Higiene Bucal , Estomatitis Subprotética , Biopelículas , Placa Dental/complicaciones , Humanos , Factores de Riesgo , Fumar/efectos adversos , Estomatitis Subprotética/etiología , Estomatitis Subprotética/microbiología , Estomatitis Subprotética/prevención & control , Estomatitis Subprotética/terapia , Xerostomía/complicacionesRESUMEN
BACKGROUND: Despite drawbacks, cold-cured acrylic resin is still the most common material used in denture repair. Zirconia nanoparticles were among the reinforcements added to increase the strength of the resin. The effect on Candida due to the addition of zirconia nanoparticles to the resin has not been investigated. PURPOSE: The aim of this study was to evaluate the effect of zirconia nanoparticles added to cold-cured acrylic resin on Candida albicans adhesion. MATERIALS AND METHODS: A total of 120 acrylic resin specimens with dimensions measuring 22×10×2.5 mm3 were prepared and divided into two equal groups. One group (repair) comprised heat-polymerized specimens that were sectioned at the center and prepared to create a 2 mm repair area that was repaired with cold-cured resin reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. The second group contained intact cold-cured acrylic resin specimens reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. Specimens were incubated at 37°C in artificial saliva containing C. albicans, and the effect of zirconia nanoparticles on C. albicans was assessed using two methods: 1) a slide count method and 2) a direct culture test. Variations in the number of living Candida were observed in relation to the different concentrations of zirconia nanoparticles. Analysis of variance (ANOVA) and post hoc Tukey's tests were performed for data analysis. If the P-value was ≤0.05, then the difference was considered as statistically significant. RESULTS: It was found that C. albicans adhesion to repaired specimens was significantly decreased by the addition of zirconia nanoparticles (P<0.00001) in comparison with the control group. Intact cold-cured groups and groups repaired with cold-cured resin reinforced with 7.5% wt zirconia nanoparticles showed the lowest Candida count. Tukey's test showed a significant difference between the repaired group and the intact cold-cured group, while the later demonstrated a lower Candida count. CONCLUSION: The addition of zirconia nanoparticles to cold-cured acrylic resin is an effective method for reducing Candida adhesion to repaired polymethyl methacrylate (PMMA) denture bases and cold-cured removable prosthesis. CLINICAL SIGNIFICANCE: Based on the results of the current study, zirconia nanoparticles have an antifungal effect, which could be incorporated in the repair material for repairing denture bases and in PMMA removable prostheses as a possible approach for denture stomatitis prevention.
Asunto(s)
Candida albicans/efectos de los fármacos , Bases para Dentadura/microbiología , Nanopartículas , Estomatitis Subprotética/prevención & control , Circonio/farmacología , Resinas Acrílicas , Antifúngicos/química , Antifúngicos/farmacología , Prótesis Dental de Soporte Implantado/microbiología , Reparación de la Dentadura , Humanos , Nanopartículas/química , Polimerizacion , Polimetil MetacrilatoRESUMEN
Candida albicans adhesion and proliferation on denture bases may lead to denture stomatitis, which is a common and recurrent problem in denture wearers. The goal of this study was to assess the inhibitory effect of thymoquinone incorporated in the polymethyl methacrylate denture base material against Candida albicans. Eighty acrylic resin specimens were fabricated and divided into eight groups (n = 10) according to thymoquinone concentrations of 0.5%, 1%, 1.5%, 2%, 2.5%, 3%, and 5% of acrylic powder. Two methods were used to evaluate the effect of thymoquinone on Candida albicans: the slide count and the serial dilution test. A multivariate analysis of variance (MANOVA) and the post-hoc Tukey's Honestly Significant Difference (HSD) test were performed to compare the difference of means between the observations taken at various intervals with baseline. The p value was statistically significant at ≤0.05. According to the slide count and the serial dilution test, the mean number of adhered Candida albicans in the control group was 5436.9 ± 266 and 4691.4 ± 176.8; however, this number dramatically decreased to 0 ± 0 and 32.4 ± 1.7 in group 8 (concentration 5%). These results suggest that the incorporation of thymoquinone into the acrylic resin denture base material might be effective in preventing Candida albicans adhesion.
Asunto(s)
Benzoquinonas/administración & dosificación , Candida albicans/efectos de los fármacos , Bases para Dentadura , Sistemas de Liberación de Medicamentos , Polimetil Metacrilato , Benzoquinonas/farmacología , Benzoquinonas/uso terapéutico , Biopelículas/efectos de los fármacos , Candida albicans/crecimiento & desarrollo , Estomatitis Subprotética/prevención & controlRESUMEN
Denture adhesives are widely used in dentistry. The growth of Candida albicans on the denture base is common on both jaws, particularly in elderly patients. A strong correlation has been found between the growth of Candida albicans and dentures, potentially leading to denture stomatitis. Recent studies show that the addition of chlorhexidine diacetate (CHDA) to denture adhesives can have a protective effect against denture stomatitis. The aim of this research is to examine the antifungal properties of three denture adhesives when CHDA is added. We hypothesize that the addition of CHDA to denture adhesives will result in antifungal activity against Candida albicans. Three denture adhesive materials (Corega, Protefix and Kukident) were prepared with and without the addition of CHDA in order to measure whether CHDA increased the resistance of the adhesives to the growth of Candida albicans. Dynamic and static intercellular changes were assessed through direct contact test (DCT) and confocal microscopy. The tested materials were evaluated immediately after setting and at 14 days post-setting. When combined with CHDA, all three denture adhesive materials decreased Candida albicans growth compared to the control (p less than 0.0001). This inhibition of growth was more prominent in the first 24 h. The confocal microscopy results supported the DCT findings. The addition of CHDA to denture adhesive pastes inhibits growth of Candida albicans, and may potentially reduce the incidence of denture stomatitis. Further studies are warranted.
Asunto(s)
Candida albicans/efectos de los fármacos , Candida albicans/crecimiento & desarrollo , Clorhexidina/farmacología , Cementos Dentales/química , Cementos Dentales/farmacología , Dentaduras/microbiología , Estomatitis Subprotética/prevención & control , Anciano , Candidiasis Bucal/prevención & control , Proliferación Celular/efectos de los fármacos , Humanos , Estomatitis Subprotética/microbiologíaRESUMEN
STATEMENT OF PROBLEM: The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism. PURPOSE: The purpose of this randomized crossover trial was to evaluate the efficacy of denture cleansers in terms of biofilm removal, antimicrobial action, and the remission of denture stomatitis. MATERIAL AND METHODS: Fifty denture wearers with denture stomatitis were instructed to brush their dentures (brush and soap) and to soak them (20 minutes/14 days) in 4 solutions, as follows: C (control), 0.85% saline; SH1, 0.1% sodium hypochlorite; SH2, 0.2% sodium hypochlorite; and RC, 8% Ricinus communis. The biofilm in the intaglio surface of maxillary dentures was stained, photographed, and quantified by software (Image Tool). It was then collected (brushed with saline solution), and the obtained suspension was diluted (100 to 10-3) and seeded (50 µL) in CHROMagar for Candida spp. After incubation, colony-forming units per milliliter values were calculated. Denture stomatitis remission was classified according to the Newton classification. Data were analyzed by Friedman (α=.05) and Wilcoxon tests and corrected by the Bonferroni test (α=.005). RESULTS: SH1 (mean rank [MR]=1.98) and SH2 (MR=1.64) showed lower biofilm coverage than C (MR=3.73) that was similar to RC (MR=2.92). SH1 (MR=2.43) and SH2 (MR=2.10) showed antimicrobial action for Candida spp, and RC (MR=3.36) showed similar results to C (MR=3.51) and baseline (MR=3.50). Clinical signs of denture stomatitis were reduced by SH1 (MR=2.44), while SH2 (MR=2.56) and RC (MR=2.74) showed intermediate results. CONCLUSIONS: The two sodium hypochlorite solutions were the most effective means of biofilm control. All tested solutions were effective in reducing the signs of denture stomatitis.