Influence of brushing with an antiseptic soap solution on the surface and biological properties of a hard chairside reline resin.

PURPOSE: To evaluate the influence of brushing with a specific antiseptic soap solution on the surface (roughness and hardness) and biological properties of a specific hard chairside reline resin. METHODS: The hard chairside reline resin specimens were made and distributed to the following groups according to disinfectant solution: sodium hypochlorite 0.5% (SH), Lifebuoy solution 0.78%; experimental group (LS) and phosphate-buffered saline PBS to be submitted to the brushing cycle for 10 seconds. The roughness and hardness were assessed before and after the cycle. For the biological properties, the colony-forming unit and Alamar Blue assays were performed. For all the properties evaluated the sample size consisted of nine specimens. The data were submitted to two-factor ANOVA (surface properties) and one-way ANOVA (biological properties) and Tukey's post-test with a significance level of 5% (α= 0.05). RESULTS: The Lifebuoy group did not present a statistical difference (P> 0.05) in relation to the other groups for the evaluated surface properties. Furthermore, the Lifebuoy solution showed a statistically significant difference (P> 0.05) in relation to the negative control in the reduction of biofilm on the resin and no significant difference (P> 0.05) was observed when compared to the positive control group. Thus, it was concluded that brushing with the Lifebuoy soap solution did not interfere with the surface properties of the hard chairside reline resin, and was able to reduce the biofilm of C. albicans. CLINICAL SIGNIFICANCE: Disinfectant liquid soap can be used for brushing of relined removable dentures as a simple, low-cost, and effective method for removing the biofilm.

Influence of brushing with antiseptic soap solution on the surface and biological properties of an acrylic denture base resin.

PURPOSE: To evaluate the influence of brushing with specific antiseptic soap solution on the surface (roughness, hardness, and color stability) and biological properties of a specific heat-polymerized denture base resin. METHODS: 189 denture base acrylic resin specimens (10 mm x 1.2 mm) were made and distributed into three groups: sodium hypochlorite 0.5% (SH), Lifebuoy solution 0.78% (LS) and phosphate-buffered saline (PBS) and were submitted to the brushing cycle for 10 seconds. For each property assessed the sample size was composed of nine specimens. Roughness, hardness, and color stability were assessed before and after the cycle. For the biological properties (biofilm formation and reduction capacity) the colony forming unit and Alamar Blue assays were performed. For this, the specimens were placed separately in a 24-well plate with medium containing C. albicans. The plate was incubated for 48 hours for the formation of mature biofilm. The data were submitted to two-factor ANOVA (roughness and hardness) and one-way ANOVA (color stability and biological properties) and Tukey's post-test (α= 0.05). RESULTS: The Lifebuoy group did not present a statistical difference (P> 0.05) in relation to the other groups for the evaluated surface properties (roughness, hardness, and color stability). Also, from the colony-formation unit and Alamar Blue assays, there was no statistical difference (P> 0.05) between the groups. Regarding biofilm reduction capacity formed on the samples, the results obtained from the count of colony forming units (CFU/mL) showed a reduction of approximately 1.3 logs in the number of CFU/mL in the Lifebuoy group (µ = 4.78 log¹º) compared to the negative control group (µ = 6.02 log¹º) (P< 0.05). When evaluating the cellular metabolism of C. albicans cells, the experimental group did not show any statistical difference compared to controls (P> 0.05). Brushing with Lifebuoy soap solution did not alter the surface properties of the acrylic resin, and reduced the C. albicans biofilm. CLINICAL SIGNIFICANCE: Brushing removable partial or total dentures can be performed using Lifebuoy liquid disinfectant soap, as a simple, low-cost, and effective method for removing biofilm.

Biological and physical properties of a reline acrylic resin after immersion in liquid antiseptic soaps.

PURPOSE: To evaluate some biological (Candida albicans biofilm formation and cytotoxicity) and mechanical (roughness and hardness) properties of a hard reline acrylic resin after immersion in liquid disinfectant soaps. METHODS: Reline samples were made (14 mm in diameter and 1.2 mm in thickness) and immersed in different disinfectant solutions: DW: distilled water at 37°C (control group); DS: Dettol liquid soap; and LS: Lifebuoy liquid soap. After immersion in the different groups, the properties of C. albicans biofilm formation, cytotoxicity, hardness, and roughness were evaluated. Each sample was immersed in the disinfectant solutions for 8 hours for microbiological testing and for 0, 7, 14, 21, and 28 days, with daily immersion cycles, for cytotoxicity and mechanical testing. Data were tabulated and analyzed by Shapiro-Wilk and Levene statistical tests. Based on these results, the appropriate tests for finding statistically significant differences were applied (α= 0.05). RESULTS: There was a reduction of roughness after immersion of the samples in DS for 21 days (P= 0.0001) and LS for 28 days (P= 0.0218). Hardness values significantly increased after storage of samples in solutions (0.0007≥ P≥ 0.0076), especially considering the longer period of immersion (28 days). The viability and metabolic activity of the biofilm formed on the hard reline samples were significantly reduced (P< 0.05) after soaking in Lifebuoy liquid soap in relation to DW. In addition, the samples immersed in the different solutions were not cytotoxic, as they inhibited less than 25% in relation to the control group (100% of cell viability). CLINICAL SIGNIFICANCE: This study showed that, in general, immersion in liquid disinfectant soaps had no adverse effect on the physical properties of the hard reline acrylic resin evaluated. In addition, Lifebuoy liquid soap reduced the biofilm formed on the samples and the solutions did not affect the cytotoxicity of the material. Disinfectant liquid soaps could be an alternative method for disinfection of relined dentures.

Biological and physicochemical implications of the aging process on titanium and zirconia implant material surfaces.

STATEMENT OF PROBLEM: Changes in physicochemical properties because of implant material aging and natural deterioration in the oral environment can facilitate microbial colonization and disturb the soft-tissue seal between the implant surfaces. PURPOSE: The purpose of this in vitro study was to investigate the effect of aging time on the physicochemical profile of titanium (Ti) and zirconia (ZrO2) implant materials. Further microbiology and cell analyses were used to provide insights into the physicochemical implications of biological behavior. MATERIAL AND METHODS: Disk-shaped specimens of Ti and ZrO2 were submitted to roughness, morphology, and surface free energy (SFE) analyses before nonaging (NA) and after the aging process (A). To simulate natural aging, disks were subjected to low-temperature degradation (LTD) by using an autoclave at 134 ºC and 0.2 MPa pressure for 20 hours. The biological activities of the Ti and ZrO2 surfaces were determined by analyzing Candida albicans (C. albicans) biofilms and human gingival fibroblast (HGF) cell proliferation. For the microbiology assays, a variance analysis method (ANOVA) was used with the Tukey post hoc test. For the evaluation of cellular proliferation, the Kruskal-Wallis test followed by Dunn multiple comparisons were used. RESULTS: Ti nonaging (TNA) and ZrO2 nonaging (ZNA) disks displayed hydrophilic and lipophilic properties, and this effect was sustained after the aging process. Low-temperature degradation resulted in a modest change in intermolecular interaction, with 1.06-fold for TA and 1.10-fold for ZA. No difference in biofilm formation was observed between NA and A disks of the same material. After 48 hours, the viability of the attached HGF cells was very similar to that in the NA and A groups, regardless of the tested material. CONCLUSION: The changes in the physicochemical properties of Ti and ZrO2 induced by the aging process do not interfere with C. albicans biofilm formation and HGF cell attachment, even after long-term exposure.

Effectiveness of chemical disinfection on biofilms of relined dentures: A randomized clinical trial.

PURPOSE: To evaluate the effect of disinfection with sodium perborate or chlorhexidine (when combined with brushing) on the removal of biofilm in relined dentures. METHODS: Swabs were collected 48 hours after the relining procedure and at the follow-up time intervals of 7, 15, 30, 90, and 180 days. The dentures' surface roughness was measured at the same times. 45 subjects were randomly divided into three groups of 15 subjects each. The control group brushed with coconut soap and a soft toothbrush. The sodium perborate group followed the same procedure and also disinfected with sodium perborate solution for 5 minutes per day. The chlorhexidine group followed the control group procedure and disinfected with 2% chlorhexidine digluconate solution for 5 minutes per day. The number of colony forming units and the surface roughness were evaluated statistically by 2-way repeated-measure ANOVA (α = 0.05). RESULTS: The control group dentures exhibited similar levels of microbial cells throughout the experiment. However, after 15 days, no microbial growth was observed on the dentures for which either disinfection agent was used. There were no statistically significant differences in superficial roughness between the groups (P = 0.298). The disinfection agents used, combined with brushing, were able to remove the relined dentures' biofilm after 15 days of disinfection. Roughness was not a predominant factor in CFU reduction.

A Survey of the Management of Patients with Temporomandibular Disorders by General Dental Practitioners in Southern Brazil.

PURPOSE: Temporomandibular disorders (TMD) are recognized as one of the most controversial topics in dentistry, despite the fact that both basic science and clinical researchers have currently reached some degree of consensus. This study aimed to conduct a questionnaire-based survey about the management of TMD patients by general dental practitioners (GDPs). MATERIALS AND METHODS: One hundred fifty-one GDPs with a private practice in a city of southern Brazil were included, independent of school of origin, gender, graduation year, and curriculum content. All participants were administered a questionnaire about the management of patients with TMD, and the responses were analyzed by binomial and chi-square tests (α = 0.05). RESULTS: Of the GDPs, 88.7% received TMD patients, who were primarily diagnosed on the basis of medical history (36.6%) or physical examination (30.4%). Of these, 65.4% referred the patients elsewhere, primarily to specialists in occlusion (36.1%) or orthodontics (29.7%). Occlusal splinting was the most commonly used management modality (20.8%), followed by occlusal adjustment (18.1%) and pharmacotherapy (16.6%). Splints were fabricated in maximum habitual intercuspation or centric relation depending on individual patient (54.8%). The hard stabilization form was the most common type of appliance used (35.0%). Moreover, 73.8% of the GDPs did not employ semi-adjustable articulators, and 69.5% adjusted the appliances at the time of fixing. The duration of splint use and the frequency of follow-up were considered patient dependent by 62.1% and 72.8%, respectively. GDPs considered the two major TMD etiologic categories as multifactorial (20.8%) and occlusion (19.9%). Multidisciplinary medical and dental treatment was considered necessary by 97.9%. CONCLUSIONS: The evaluated general dental practitioners manage TMD patients according to international guidelines.

Uncaria tomentosa Gel against Denture Stomatitis: Clinical Report.

The objective of this study is to report the clinical use of 2% Uncaria tomentosa gel against denture stomatitis (DS) as an alternative treatment. The patient was a 65-year-old, denture-wearing woman. At the clinical examination, her palate showed hyperplasic and erythematous mucosa indicating DS type II. DS is a chronic oral disease that affects denture wearers. It occurs as an inflammatory reaction in denture-wearing patients under maxillary prostheses. Candida albicans has been reported as the principal etiological agent. An alternative treatment, the topical application of a gel of 2% U. tomentosa three times a day for 1 week was given to the patient. After 1 week of this treatment, she had significantly reduced signs of the disease. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Phytotherapy is becoming more popular worldwide. Currently, the most promising medicinal Amazonian herb is U. tomentosa (Willd.) DC., known as Cat's Claw. Studies of the chemical and pharmacological properties of this medicinal plant have allowed researchers to develop indications for its use. This report demonstrates the effectiveness of U. tomentosa against DS.

Surface roughness and Candida albicans biofilm formation on a reline resin after long-term chemical disinfection and toothbrushing.

STATEMENT OF PROBLEM: Routine cleaning of a denture may increase the surface roughness of the material. PURPOSE: The purpose of this study was to investigate the effect of denture cleansers and time on the roughness and Candida albicans biofilm formation on a reline resin. MATERIAL AND METHODS: Specimens of Tokuyama Rebase Fast II (20 × 10 × 2 mm) were prepared and divided into 9 groups (n=15): Test groups were toothbrushed (30 cycles per day) in 1 of the following solutions: water, soap, or toothpaste. After toothbrushing, the specimens were immersed in solutions of water, sodium perborate, or chlorhexidine. These treatments were done once a day for 365 days. The surface roughness was evaluated at 0, 7, 15, 30, 90, 180, 270, and 365 days, and the C albicans biofilm formation was measured after 365 days. The roughness data were analyzed by 3-way repeated measures ANOVA and the Tukey test (α=.05), and the C albicans biofilm formation was analyzed by 2-way ANOVA. RESULTS: Significant differences were found in the toothbrush and time interaction and in the toothbrush, immersion, and time interaction (P<.001). No significant differences were found between the toothbrush agent and chemical disinfection (P=.085) or between chemical disinfection and time interaction (P=.604). Brushing with dentifrice (PPb and PCh) showed a gradual decrease in surface roughness. The comparison among groups showed that PCh produced the lowest values of roughness. For C albicans biofilm formation, no significant differences were found among the experimental groups. CONCLUSIONS: The roughness values ranged from 0.31 to 0.69 µm for all evaluated groups. For all groups, no significant differences were found in the quantification of C albicans.

Failures in the rehabilitation treatment with removable partial dentures.

BACKGROUND: Despite being functional and having aesthetic benefits, the acceptance of patients regarding the use of removable partial dentures (RPDs) has been low. In part, this is due to the deleterious effects that causes discomfort to the patient. Success depends not only on the care expended by the patient, including daily care and oral hygiene, but also on common goals set by their professional and clinical staff, aiming beyond aesthetics, to incorporate issues of functionality and the well-being of patients. METHODS AND RESULTS: For rehabilitation treatment with RPDs to reach the desired level of success without damaging the support structure, all the steps (diagnose, cavity preparation, adaptation of the metal structures, functional of distal extension and posterior follow-up) in the rehabilitative treatment should be carefully developed. A literature review was carried out, searching through MEDLINE (PubMed) articles published between 1965 and December 2012 including clinical trials and reviews about the use of RPDs. CONCLUSIONS: This study describes factors that lead to failures and complications in oral rehabilitation through the use of RPDs and suggests possible solutions.

Clinical evaluation of failures in removable partial dentures.

The aim of this clinical study was to evaluate the effects of removable partial dentures on the support tissues and changes occurring in lower tooth-supported and bilateral distal-extension dentures, 5 years after placement. The study involved analysis of a total of 53 patients who received prosthetic treatment for removable partial dentures. The patients were divided into two groups. In group 1, the patients had a completely edentulous maxilla and an edentulous area with natural teeth remaining in both the anterior and posterior regions. In group 2, the patients had a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. Tooth mobility, prevalence of caries, fracture of the abutment teeth, fracture and/or deformation of the removable partial denture components and stability of the denture base were evaluated. The use of a removable partial denture increased tooth mobility, reduced the prevalence of caries, and did not cause loss or fracture of the abutments or damage to their components, when compared with the baseline. It was concluded that there was no difference between the groups as evaluated in terms of tooth mobility, prevalence of caries, loss and fracture of the abutments or damage to the components of the removable partial denture.

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin

In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37ºC for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Impact strength of denture base and reline acrylic resins: An in vitro study.

This study evaluated the impact strength of a denture base resin (Lucitone 550-L) and four reline resins (Tokuyama Rebase II-T; Ufi Gel Hard-U; New Truliner-NT, and Kooliner-K), both intact and in a reline combination (L/L, L/T, L/U, L/NT, and L/K). For each group (n = 20), half of the specimens were thermocycled before testing. Charpy tests were performed, and the impact strengths were calculated. Data were analyzed by two-way analyses of variance and Tukey's test (p = 0.05). For the intact groups, mean impact strength values for L (1.65 and 1.50) were significantly higher than those of the reline resins (0.38-1.17). For the relined groups, the highest mean impact strength values were produced by L/T (5.76 and 5.12), L/NT (6.20 and 6.03), and L/K (5.60 and 5.31) and the lowest by L/U (0.76 and 0.78). There were no significant differences between L and L/L. Thermocycling reduced the impact strength of T (from 0.73 to 0.38) and L/L (from 1.82 to 1.56).

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin.

UNLABELLED: In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 ºC for 48 h. The drug powder concentrations (nystatin 500,000 U--G2; nystatin 1,000,000 U--G3; miconazole 125 mg--G4; miconazole 250 mg--G5; ketoconazole 100 mg - G6; ketoconazole 200 mg--G7; chlorhexidine diacetate 5%--G8; and 10% chlorhexidine diacetate--G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Adaptação marginal em coroas ceramo-cerâmicas / Marginal fit of all-ceramic crowns

As restaurações confeccionadas pelos recentes sistemas cerâmicos apresentam uma aparência aproximada do dente natural por não interromper a transmissão de luz e, assim, possuir alta translucidez e profundidade de cor. Uma vez que estes sistemas possuem técnicas sensíveis de confecção, a adaptação marginal das coroas resultantes se torna crítica, sendo este um fator indispensável para o sucesso clínico das mesmas. Após revisar a literatura, com o propósito de levantar dados quanto à adaptação marginal de coroas totais confeccionadas pelos sistemas In-Ceram, IPS Empress e Procera, observou-se que toda a desadaptação encontrada para tais sistemas foi considerada, pelos autores, clinicamente aceitável.