The Effect of Exposure to Candida Albicans Suspension on the Properties of Silicone Dental Soft Lining Material.

While functioning in the oral cavity, denture soft linings (SL) are exposed to contact with the microbiota. Dentures can offer perfect conditions for the multiplication of pathogenic yeast-like fungi, resulting in rapid colonisation of the surface of the materials used. In vitro experiments have also shown that yeast may penetrate SL. This may lead to changes in their initially beneficial functional properties. The aim of this work was to investigate the effect of three months of exposure to a Candida albicans suspension on the mechanical properties of SL material and its bond strength to the denture base polymer, and to additionally verify previous reports of penetration using a different methodology. Specimens of the SL material used were incubated for 30, 60 and 90 days in a suspension of Candida albicans strain (ATCC 10231). Their shore A hardness, tensile strength, and bond strength to acrylic resin were tested. The colonization of the surface and penetration on fractured specimens were analysed with scanning electron and inverted fluorescence microscopes. Exposure to yeast did not affect the mechanical properties. The surfaces of the samples were colonised, especially in crystallized structures of the medium; however, the penetration of hyphae and blastospores into the material was not observed.

Dental Implant Abutment Screw Loss: Presentation of 10 Cases.

Re-tightening the loosened dental implant abutment screw is an accepted procedure, however the evidence that such screw will hold sufficiently is weak. The purpose of this study was material analysis of lost dental implant abutment screws made of the TiAlV alloy from various manufacturers, which became lost due to unscrewing or damaged when checking if unscrewed; undamaged screws could be safely re-tightened. Among 13 failed screws retrieved from 10 cases, 10 screws were removed due to untightening and 3 were broken but without mechanical damage at the threads. Advanced corrosion was found on nine screws after 2 years of working time on all surfaces, also not mechanically loaded. Sediments observed especially in the thread area did not affect the corrosion process because of no pit densification around sediments. Pitting corrosion visible in all long-used screws raises the question of whether the screws should be replaced after a certain period during service, even if they are well-tightened. This requires further research on the influence of the degree of corrosion on the loss of the load-bearing ability of the screw.

The effect of porous compliance bushings in a dental implant on the distribution of occlusal loads.

Porous dental implants are clinically used, but the mechanism of load distribution for stepped implant shaft surrounded by compliance bushings is still not known, especially for different bone conditions. The aim of the study was to assess the impact of the design of a dental implant with compliance bushings (CBs) on the occlusal load distribution during primary and secondary stability using finite element simulation (FEA), with a distinction between low and high quality cervical support under primary stability. The FEA of the oblique occlusal load transfer (250 N; 45°) was carried out for implants under variable bone conditions. The stepped shaft in the intermediate part of the dental implant was surrounded by CBs with an increasing modulus of elasticity of 2, 10 and 50 GPa. With a smaller Young's modulus of the bushings the increase of stress in the trabecular bone indicated that more bone tissue can be protected against disuse. The beneficial effect for the trabecular bone derived from the reduction of the stiffness of the bushings in relation to the loss of the implant's load bearing ability can be assessed using the FEM method.

Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System.

Clinical problems of the temporomandibular joint (TMJ) and the masticatory musculature are both included in the term temporomandibular disorder (TMD). The purpose of the present study was to examine the pathology of the joints of patients diagnosed with TMD utilizing the dedicated Piper MRI-based classification, and to link these pathologies with various symptoms while considering their severity. In total, 64 patients with clinical TMD were examined. Symptoms were recorded using a questionnaire. The clinical examination included diagnosing the occlusion in centric relation, which was followed by a standardized MRI. It was confirmed that, although they occurred in a high percentage in all classes, muscle pain and occlusal interference are not indicators of TMJ damage. The results indicate that the progressive degradation of the TMJ, represented by qualification to the higher Piper classes, is associated with an increase in TMJ pain only up to a certain stage. For the highest Piper classes, the joint pain occurs in a smaller percentage of patients, but sounds are more frequent.

Effect of Antibacterial Silver-Releasing Filler on the Physicochemical Properties of Poly(Methyl Methacrylate) Denture Base Material.

Colonization of polymeric dental prosthetic materials by yeast-like fungi and the association of these microorganisms with complications occurring during prosthetic treatment are important clinical problems. In previously presented research, submicron inorganic particles of silver sodium hydrogen zirconium phosphate (S-P) were introduced into poly(methyl methacrylate) (PMMA) denture base material which allowed for obtaining the antimicrobial effect during a 90 day experiment. The aim of the present study was to investigate the flexural strength, impact strength, hardness, wear resistance, sorption, and solubility during three months of storage in distilled water. With increasing S-P concentration after 2 days of conditioning in distilled water, reduced values of flexural strength (107-72 MPa), impact strength (18.4-5.5 MPa) as well as enhanced solubility (0.95-1.49 µg/mm3) were registered, but they were at acceptable levels, and the sorption was stable. Favorable changes included increased hardness (198-238 MPa), flexural modulus (2.9-3.3 GPa), and decreased volume loss during wear test (2.9-0.2 mm3). The percentage changes of the analyzed properties during the 90 days of storage in distilled water were similar for all materials.

Relevance of Tongue Force on Mandibular Denture Stabilization during Mastication.

PURPOSE: Tongue activity, involving stereognosis of denture position, food bolus distribution, and direct denture pressing, can affect the stability of removable mandibular dentures. Knowledge of details of tongue activity in patients with removable dentures could contribute to the development of training methods to improve bilateral mastication. The hypothesis of this study was that tongue force improves mandibular complete denture stabilization on the atrophied foundation during mastication load transfer with a typical balanced occlusion. MATERIALS AND METHODS: Finite element analysis was used to assess the effect of tongue activity on denture stability, which was evaluated with objective biomechanical criteria. Denture movement (displacement), sliding distance on the mucosal surface, and pressure on the foundation during occlusal load transfer were considered with and without additional tongue forces. RESULTS: Tongue force in the canine zone of the balancing flange contributed to a slight reduction in the sliding distance. An adverse effect of tongue force on the working side and in the posterior zone of the balancing side was found. CONCLUSIONS: Despite the lack of substantial improvement in stability with the addition of tongue forces, tongue action that contributes to a slight reduction in sliding may help reduce common frictional trauma resulting from cyclic movement during chewing. The beneficial impact of tongue force shown in earlier work under conditions of complete adherence of dentures to the foundation indicates a benefit of using adhesives.

Use of finite element analysis for the assessment of biomechanical factors related to pain sensation beneath complete dentures during mastication.

STATEMENT OF PROBLEM: The pain commonly suffered by denture wearers during mastication is not documented in the objective biomechanical criteria for the pressure pain threshold. PURPOSE: The purpose of this finite element analysis study was to determine whether the pressures developed beneath a removable mandibular complete denture during mastication would exceed the average pressure pain threshold in patients for whom the denture foundation had an acceptable load-bearing capacity. MATERIAL AND METHODS: A patient with an acceptable load-bearing denture foundation was modeled with finite element analysis. The denture/mucosa interface was modeled as a sliding or detaching interface. A convex mandibular residual ridge, resilient mucosa, and denture were modeled in computer-aided design (CAD) software using curves and cross sections. A unilateral vertical occlusal load of 100 N was assumed only for model verification, and an oblique mastication load of 141 N was assumed for simulated mastication with balanced articulation. The nonworking-side occlusal contact was simulated in 2 situations: prompt nonworking-side occlusal contact and delayed nonworking-side occlusal contact by setting an initial distance of 0.1 mm or 1 mm between the denture and a flat solid above the nonworking side. RESULTS: The denture was held to the mucosa under vertical force and a maximum pressure of 203 kPa. The denture was tilted under an oblique mastication load and achieved stability through nonworking-side occlusal contact. This means that the denture was supported not only by the denture foundation but also by the nonworking-side occlusal contact and had a downwardly directed stabilizing reaction force. The denture was weakly supported on the delayed nonworking-side occlusal contact compared with the prompt nonworking-side occlusal contact and weakly supported on the denture foundation. In delayed nonworking-side occlusal contact, the pressure beneath the denture was 783 kPa (>pressure pain threshold) compared with 484 kPa (

Influence of aging solutions on wear resistance and hardness of selected resin-based dental composites.

PURPOSE: The purpose of this study was to investigate the effect of different plasticizing aging solutions on wear resistance and hardness of selected universal resin-based dental composites. METHODS: Three light cured (one nanofilled, two microhybride) and one hybride chemical cured composites were aged at 37 °C for 48 h in distillated water, ethyl alcohol solution or Listerine mouthwash. After aging the microhardness tests were carried out and then tribological tests were performed in the presence of aging solution at 37 °C. During wear testing coefficients of friction were determined. The maximal vertical loss in micrometers was determined with profilometer. RESULTS: Aging in all liquids resulted in a significant decrease in hardness of the test materials, with the largest values obtained successively in ethanol solution, mouthwash and water. The effect of the liquid was dependent on the particular material, but not the type of material (interpreted as the size of filler used). Introduction of mouthwash instead of water or ethanol solution resulted in a significant reduction in the coefficient of friction. The lowest wear resistance was registered after aging in ethanol and for the chemical cured hybrid composite, but the vertical loss was strongly material dependent. CONCLUSIONS: The effect of different aging solution, including commercial mouthrinse, on hardness and wear was material dependent, and cannot be deduced from their category or filler loading. There is no simple correlation between hardness of resin-based dental composites and their wear resistance, but softening of particular composites materials during aging leads to the reduction of its wear resistance.

Chewing efficiency and occlusal forces in PMMA, acetal and polyamide removable partial denture wearers.

PURPOSE: Thermoplastic materials, such as acetal (AC) and polyamide (PA), constitute an alternative to polymethyl methacrylate (PMMA) based resins as the materials for removable partial dentures. However, none of the previous studies compared chewing efficiency and occlusal forces in the wearers of dentures made of various materials. Therefore, the aim of this study was to determine and compare the chewing efficiency and occlusal forces in PMMA, PA and AC RPDs' wearers. The hypothesis was that the type of denture base material shows a significant effect on chewing efficiency (expressed as a degree of food fragmentation) and occlusal force. METHODS: The experiment included the group of 30 patients using removable partial dentures. The dentures made of PMMA, acetal and polyamide were tested in each patient. Each denture was worn for 90 days, with a random sequence of the denture manufacturing and insertion. After 7, 30 and 90 days of each denture wear, chewing efficiency coefficient was determined with the aid of a sieving method, and occlusal force was measured with a dynamometer. RESULTS: The use of dentures made of PMMA or acetal was reflected by a marked increase in chewing efficiency and occlusal force. None of these parameters changed significantly with the time of denture wear. Moreover, no significant correlation was found between chewing efficiency and occlusal forces. CONCLUSIONS: Denture base material exerts significant effects on the degree of food fragmentation and the level of occlusal forces. The use of dentures and clasps made of materials with lower modulus of elasticity is associated with lower chewing efficiency and lower occlusal forces.

Effect of Storage in Distilled Water for Three Months on the Antimicrobial Properties of Poly(methyl methacrylate) Denture Base Material Doped with Inorganic Filler.

The colonization of poly(methyl methacrylate) (PMMA) denture base materials by pathogenic microorganisms is a major problem associated with the use of prostheses, and the incorporation of antimicrobial fillers is a method of improving the antimicrobial properties of these materials. Numerous studies have demonstrated the initial in vitro antimicrobial effectiveness of this type of material; however, reports demonstrating the stability of these fillers over longer periods are not available. In this study, silver sodium hydrogen zirconium phosphate was introduced into the powder component of a PMMA denture base material at concentrations of 0.25%, 0.5%, 1%, 2%, 4%, and 8% (w/w). The survival rates of the gram-positive bacterium Staphylococcus aureus, gram-negative bacterium Escherichia coli and yeast-type fungus Candida albicans were established after fungal or bacterial suspensions were incubated with samples that had been previously stored in distilled water. Storage over a three-month period led to the progressive reduction of the initial antimicrobial properties. The results of this study suggest that additional microbiological tests should be conducted for materials that are treated with antimicrobial fillers and intended for long-term use. Future long-term studies of the migration of silver ions from the polymer matrix and the influence of different media on this ion emission are required.

Strength analysis of a three-unit dental bridge framework with the Finite Element Method.

PURPOSE: The aim of the study was to analyse the strength of a prosthetic bridge with variable geometry in the connectors between the span and the retention elements on the pillar teeth crowns. METHODS: Research was carried using the Finite Elements Method (FEM) on a model of the bridge in the anterior teeth arch in the field 21-22-23, obtained using a contact scanner and computer aided design (CAD) system, with four different cross-sectional areas of the connectors: 4.0, 5.0, 5.5, and 6.0 mm2. For that purpose, the impact of the properties of selected metal alloys on the deflection of the prosthesis was analysed. RESULTS: On the basis of the analyses, it was found that when the loading force acted obliquely, the stress was 19% higher compared to the stress with a loading vertical force. In the case of connectors with the smallest cross-sectional area, the stress exceeded permissible value (with safety factor n = 2) for one of the alloys. CONCLUSIONS: Deflection of the bridges tested changed depending on the connector cross-section and the elastic modulus of the selected material.

Biomechanical factors related to occlusal load transfer in removable complete dentures.

Owing to economic conditions, removable dentures remain popular despite the discomfort and reduced chewing efficiency experienced by most denture wearers. However, there is little evidence to confirm that the level of mucosal load exceeds the pressure pain threshold. This discrepancy stimulated us to review the current state of knowledge on the biomechanics of mastication with complete removable dentures. The loading beneath dentures was analyzed in the context of denture foundation characteristics, salivary lubrication, occlusal forces, and the biomechanics of mastication. The analysis revealed that the interpretation of data collected in vivo is hindered due to the simultaneous overlapping effects of many variables. In turn, problems with determining the pressure beneath a denture and analyzing frictional processes constitute principal limitations of in vitro model studies. Predefined conditions of finite element method simulations should include the effects of oblique mastication forces, simultaneous detachment and sliding of the denture on its foundation, and the stabilizing role of balancing contacts. This review establishes that previous investigations may have failed because of their unsubstantiated assumption that, in a well-working balanced occlusion, force is only exerted perpendicular to the occlusal plane, allowing the denture to sit firmly on its foundation. Recent improvements in the simulation of realistic biomechanical denture behavior raise the possibility of assessing the effects of denture design on the pressures and slides beneath the denture.

Long-Term Soft Denture Lining Materials.

Long-term soft denture lining (LTSDL) materials are used to alleviate the trauma associated with wearing complete dentures. Despite their established clinical efficacy, the use of LTSDLs has been limited due to the unfavorable effects of the oral environment on some of their mechanical and performance characteristics. The unresolved issue of LTSDL colonization by Candida albicans is particularly problematic. Silicone-based LTSDL (SLTSDL) materials, which are characterized by more stable hardness, sorption and solubility than acrylic-based LTSDLs (ALTSDLs), are currently the most commonly used LTSDLs. However, SLTSDLs are more prone to debonding from the denture base. Moreover, due to their limitations, the available methods for determining bond strength do not fully reflect the actual stability of these materials under clinical conditions. SLTSDL materials exhibit favorable viscoelastic properties compared with ALTSDLs. Furthermore, all of the lining materials exhibit an aging solution-specific tendency toward discoloration, and the available cleansers are not fully effective and can alter the mechanical properties of LTSDLs. Future studies are needed to improve the microbiological resistance of LTSDLs, as well as some of their performance characteristics.

One versus two implant-retained dentures: comparing biomechanics under oblique mastication forces.

The results from clinical tests of single implant-retained dentures (SIDs) are quite promising. However, the biomechanics of SIDs are still insufficiently determined. The aim of the study was to compare the implant loads and pressures beneath one and two implant-retained dentures (TIDs) under oblique mastication forces. The finite element method was used to conduct a model analysis in order to compare loading of the denture attachment onto the implant that accompanies oblique mastication forces in the cases of SIDs and TIDs. The possibility of a denture detaching and sliding on the mucous membrane surface was simulated. The SID solution faced a more remarkable tilt in the direction of the mastication forces, a higher pressures on the mucous membrane surface, and higher implant loadings. The hingelike restraints in the TID favored utilization of the support in the posterior area. The higher pressure values for the SID can be confusing and could lead to inaccurate conclusions about the acceptability of the SID. In the TID, the same areas of the mucous membrane were persistently loaded, independent of the occlusal force direction. In contrast, in the SID the full freedom of rotational movement enhances alternating use of the mucous membrane. This finding explains the more frequent sores in the mucous membrane beneath the TID than beneath the SID.

Sorption, solubility, bond strength and hardness of denture soft lining incorporated with silver nanoparticles.

The colonization of denture soft lining material by oral fungi can result in infections and stomatitis of oral tissues. In this study, 0 ppm to 200 ppm of silver nanoparticles was incorporated as an antimicrobial agent into composites to reduce the microbial colonization of lining materials. The effect of silver nanoparticle incorporation into a soft lining material on the sorption, solubility, hardness (on the Shore A scale) and tensile bond strength of the composites was investigated. The data were statistically analyzed using two-way ANOVA and Newman-Keuls post hoc tests or the chi-square Pearson test at the p < 0.05 level. An increase in the nanosilver concentration resulted in a decrease in hardness, an increase in sorption and solubility, a decrease in bond strength and a change in the failure type of the samples. The best combination of bond strength, sorption, solubility and hardness with antifungal efficacy was achieved for silver nanoparticle concentrations ranging from 20 ppm to 40 ppm. These composites did not show properties worse than those of the material without silver nanoparticles and exhibited enhanced in vitro antifungal efficiency.

The influence of a complete lower denture destabilization on the pressure of the mucous membrane foundation.

The results of previous studies on the pressures beneath the mucous membrane-supported dentures are contrary to the prevailing pain sensations and discomfort reported in practice. In this work, a FEM analysis of large displacements was used for calculation of the contact stresses beneath a lower denture that accompany destabilization under the realistic oblique mastication forces and stabilization of a non-working flange at the balancing contacts. The pressure on the surface of a mucous membrane beneath a denture that was loaded in a stable manner with a vertical occlusal force of 100 N was lower than the pain threshold. It was even more surprising as the extremely unfavorable lower denture foundation conditions were selected for this analysis. The lateral mastication forces destabilized the denture by means of tilting it and reducing its supporting area. Significant pressures calculated for the destabilization are consistent with the clinically observed decrease or a complete lack of chewing efficiency in the cases of unfavorable foundation conditions. A fundamental importance of the balancing contacts for the chewing efficiency was confirmed quantitatively. A remarkable development which has been achieved in the modeling of the denture functioning conditions is crucial for further biomechanical investigations of the mucous membrane-supported dentures, as well as for the implant-retained dentures.

Antifungal activity of denture soft lining material modified by silver nanoparticles-a pilot study.

Soft liner materials in oral cavity environments are easily colonized both by fungi and dental plaque. These factors are the cause of mucosal infections. The microorganism that most frequently colonizes soft liner materials is Candida albicans. Colonization occurs on the surface of materials and within materials. A solution to this problem might involve modification of soft liner materials with silver nanoparticles (AgNPs). In this article, we present results showing the antifungal efficacy of silicone soft lining materials modified with AgNPs. The modification process was conducted by dissolving both material components (base and catalyst) in a colloidal solution of AgNPs and evaporating the solvent. Composites with various AgNP concentrations (10, 20, 40, 80, 120 and 200 ppm) were examined. The in vitro antifungal efficacy (AFE) of composite samples was 16.3% to 52.5%.

Elastic silicone matrices as a tool for load relief in overdenture implants.

The objective of this study was to analyze how the elasticity of matrices attaching to an overdenture affects implants and how the location of implants affects their loading. The attachments proposed made from elastic matrix increase the denture stability and simultaneously preserve the mechanisms of occlusion load transfer in compliance with principles usually applied in the denture used in the case of edentulous maxilla or mandible. It was revealed that denture dislodgement caused by occlusion forces did not result in the force being greater than the attachment retention force determined empirically. Our analysis also demonstrates that in the case where the implants are inserted in such a way that they are shifted too much to the back area of the tooth arc, an increase in the implant bending occurs, with the supporting capacities of alveolar processes not being fully utilized. This fact suggests the necessity to increase the susceptibility of attachments in a posterior location.

Influence of tongue activity on lower complete denture retention under biting forces.

Tongue activity constitutes a helpful factor in using complete dentures. It has not however been identified, to what extent the force of the tongue can directly stabilize the denture during the occurrence of biting forces. Dislodgement force of the denture held by the patients tongue shows a significant dependence on the tongue strength efficiency, however only few patients are able to analyze the mechanisms of using their tongues to stabilize the denture. The results of the FEM analysis show that the tongue has a strong advantageous influence on denture lateral stability during chewing and also during biting, and a slightly lower ability of counteracting the denture destabilization towards the front. The role played by the tongue in denture retention is not only that it locates the denture by means of tactile sensation but also that it supports the forces counteracting denture dislodgement.