Influence of CAD/CAM fabrication on denture surface properties.

Three main properties are responsible for the microbial attractiveness of denture surfaces: roughness, hydrophilicity and free surface energy. This study investigated whether CAD/CAM-fabricated dentures are more favourable for these surface properties than conventionally fabricated dentures. The mucosal surface roughness of 54 standardised study dentures was measured using contact profilometry. The surface hydrophilicity and free surface energy of 70 standardised denture resin specimens were determined by contact angle measurements. Both experimental settings compared AvaDent (AD), Baltic Denture System (BDS), Vita VIONIC (VV), Whole You Nexteeth (WN) and Wieland Digital Dentures (WDD) surfaces with conventionally manufactured denture surfaces (control group). These data were analysed using ANOVA together with Tukey's test or the Games-Howell post hoc test. All CAD/CAM dentures had lower mean surface roughness values than conventional dentures. For AD, VV, WN and WDD, the differences were statistically significant. Vita VIONIC (P < .001), coated WN (P < .001), AD (P = .023) and BDS specimens (P = .027) were significantly more hydrophilic than the control group. All measured surface energies were of similar magnitude (mean values between 31.82 and 33.68 mJ/m2 ), and only coated WN specimens had a significantly increased mean value (66.62 mJ/m2 , P < .001). Although most CAD/CAM dentures have smoother and more hydrophilic surfaces than conventional dentures, there is no difference in their free surface energy, except for coated dentures.

Shortcomings of prosthodontic rehabilitation of patients living in long-term care facilities.

Removable dentures are a non-invasive, cost-effective prosthodontic solution for the reduced dentition. Their intended purpose is the rehabilitation of harmonious oral function and aesthetics on a long-term basis. The prevalence of removable dentures among patients of advanced age is high and the quality of the dentures is often poor. The aim of this study was to find the most important shortcomings of removable dentures and address the main targets for improving the quality of prosthodontic rehabilitation. The records from dental check-ups in Austrian residential homes were analysed retrospectively. Dental anamnesis questionnaires and data from the clinical examinations of 105 denture wearers were analysed. The functional condition and retention of 192 dentures had been assessed, as well as the impact of the dentures on the intra-oral tissues. Insufficient denture retention was very common, particularly in the lower jaw (56·0%). Problems with the masticatory function were reported by 26.7% of the denture wearers, 11·4% were dissatisfied with the denture aesthetics, and 4·8% had difficulties with phonetics. Traumatic ulcers were found in 18·1%. Cracks, broken pieces (6·3%) or missing denture teeth (2·1%) were rare. It may be assumed that the findings of the present study also apply to a great percentage of community-dwelling seniors. The most important issues in prosthodontic rehabilitation with removable dentures are denture retention and masticatory function. Regular dental check-ups, denture adjustment and, when necessary, relining can maintain the primary denture quality and prevent damages of the oral tissues caused by ill-fitting dentures.

The effect of secretory leukocyte protease inhibitor (SLPI) on ischemia/reperfusion injury in cardiac transplantation.

We investigated the role of secretory leukocyte protease inhibitor (SLPI) in ischemia/reperfusion injury in cardiac transplantation. SLPI-/- mouse hearts and wild-type (WT) controls were transplanted immediately or after 10 h of cold ischemia (CI). Recombinant SLPI (rSLPI) was added to the preservation solution or given systemically. After evaluation of myocardial performance, grafts were investigated for histology, SLPI, TNF-alpha, TGF-beta, NF-kappaB and protease expression at indicated time points. Early myocardial contraction was profoundly impaired in SLPI-/- hearts exposed to CI and associated with high intra-graft protease expression. Systemic administration of rSLPI had no effect, however, when SLPI was added to the preservation solution, myocardial contraction was restored to normal. At 10 days, inflammation, myocyte vacuolization and necrosis were significantly more severe in SLPI-/- hearts. SLPI gene expression was detected in WT mice at 12 and 24 h and was significantly higher after CI. SLPI protein was observed at 24 h and 10 days. High intra-graft concentrations of SLPI after administration of rSLPI were inversely correlated with protease levels early and TGF-beta expression late after reperfusion. SLPI plays a crucial role in early myocardial performance and postischemic inflammation after cardiac transplantation. A dual inhibitory effect on protease and TGF-beta expression might be the underlying mechanism.