Evaluation of adherence of Candida albicans to differently manufactured acrylic resin denture base materials.

STATEMENT OF PROBLEM: Though computer-aided design and computer-aided manufactured (CAD-CAM) denture bases have become popular, evidence on the ability of C. albicans cells to adhere to these denture bases is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the adherence of Candida albicans to differently manufactured acrylic resin denture bases. MATERIAL AND METHODS: Acrylic resin disks were fabricated using a total of 6 different fabrication methods (compression molding, injection molding, CAD-CAM milling, and rapid prototyping on 3 different printers with 3 different resins). Each material was evaluated for adherence of C. albicans using 2 different experimental methods - suspension in inoculated tryptic soy broth (TSB) or placed onto a uniform lawn of C. albicans on tryptone soya agar (TSA) with 5% sheep's blood. Attached cells were quantified by spiral plating and then used to re-inoculate sterile plates. Logarithmic transformation was completed to normalize data. For the broth suspension, the Kruskal-Wallis test was used to identify any differences between the 6 specimen types in terms of recovery, and the Dunn test was used for post hoc analysis. For the microbial lawn experiment, 1-way analysis of variance (ANOVA) and then the Tukey Honestly Significant Difference (HSD) post hoc test were used. RESULTS: Statistically significant differences were found between the numbers of adherent cells based on manufacturing method and between experimental designs (P<.05). All resins demonstrated growth with re-inoculation. CONCLUSIONS: Though statistical significance was noted, neither experimental technique demonstrated what is likely a clinically significant preferential binding to any particular resin surface. Attached Candida cells are effective carriers of pathogens to uninfected surfaces. Further studies are indicated for potential virulence factors and differences in printed resins.

Rehabilitation of Edentulism and Mortality: A Systematic Review.

PURPOSE: It has been shown that tooth loss is associated with an increased risk of early mortality, and that prosthetic rehabilitation of edentulism improves quality of life and reduces morbidity. This review examines association between prosthetic rehabilitation of the edentulous state with a complete denture and mortality. METHODS: A systematic search using combinations of related keywords for "complete denture" and "mortality" was performed on PubMed, Web of Science, and Google Scholar. A reference search of included articles and author contacts was also performed. RESULTS: None of the studies reported results for association between mortality and wearing complete dentures among edentulous individuals; however, based on the published methods and results, a total of 15 studies were found to be eligible for author contacts to obtain relevant data. Overall, 5 eligible studies were included and critically evaluated to summarize their findings. The follow-up period in these studies ranged from 3 to 24 years, and the age group of included samples ranging from 52 to 105 years. The proportion of individuals not wearing dentures ranged from 3.0% to 13.3%. Four of the included studies showed fewer individuals without complete dentures surviving over the follow-up years as compared to the group wearing complete dentures. One of two studies that could adjust for certain confounders found no significant difference in mortality after adjusting, but another study found a 42% reduced risk of dying among those wearing complete dentures, as compared to those not wearing complete dentures after adjusting for age, sex, educational level, smoking, alcohol drinking, body mass index, time spent walking daily, medical history, psychological distress score, energy intake, and protein intake. Due to the small sample size of nondenture wearers, it was not possible to analyze with statistical rigor the comparative risk of dying associated with wearing or not wearing complete dentures. CONCLUSION: Most of the included studies indicated a higher proportion of deceased edentulous patients not using dentures as compared to denture wearers. Nevertheless, small sample size prevents a definite conclusion being drawn regarding a relationship between prosthetic rehabilitation and mortality among edentulous individuals.

Complete Edentulism and Comorbid Diseases: An Update.

The relationship between complete edentulism, which is the terminal outcome of a multifactorial oral disease process and other comorbid diseases, was first reported in 2009. Although the relationship between edentulism and a multitude of systemic diseases was reported, none of the publications studied could determine causality of tooth loss on the incidence of any comorbid disease. Since that publication, there has been a renewed interest in this relationship, and a plethora of new articles have been published. This article will provide an update on articles published since 2008 on the relationship between edentulism and comorbid diseases, and will include the relationship between complete edentulism and such comorbid conditions as malnutrition, obesity, cardiovascular disease, rheumatoid arthritis, pulmonary diseases (including chronic obstructive pulmonary disease), cancer, and even mortality.