Fractal analysis of dental periapical radiographs: A revised image processing method.

OBJECTIVE: To assess trabecular bone structure as calculated with fractal analysis by 2 binarization processes: White and Rudolph's original method (WR.o) and a revised version (WR.r). Fractal dimension (FD) values calculated with WR.r (FD.r) and a gray-scale-based method (FD.f) were also compared. FD, histogram parameters, and lacunarity were compared by dentate status, jaw location, and sex. STUDY DESIGN: Regions of interest from digital periapical radiographs were defined below the teeth roots and in the edentulous sites of 37 patients. Histograms were assessed for pixel values. Binarization was performed with WR.o and then with WR.r, in which the outliers were removed. FD was assessed using WR.r (FD.r) and (FD.f). Histograms were assessed to obtain pixel values. Lacunarity was calculated. RESULTS: WR.r revealed fewer trabeculae, branches, and junctions than WR.o (P < .0001). The majority of the mean differences between FD.r and FD.f were within the 95% CI. Dentate areas had greater mean gray levels than partially edentulous areas (P = .0027). FD.f was higher in the mandible (P = .01), but gray-level SD (P < .0001) and lacunarity (P = .02) were greater in the maxilla. FD.f and lacunarity were higher (P = .0005) and lower (P = .0014) in males, respectively. CONCLUSION: WR.r was effective in revealing skeletonized bone trabeculae by removing non-trabecular noise. FD.r and FD.f revealed good agreement. FD.f, histogram parameters, and lacunarity differed based on dentate status, jaw location, and sex.

Narrow-Diameter Implants for Partial Fixed and Removable Prostheses: A Systematic Review and Meta-Analysis.

PURPOSE: To answer the following focus question: Are narrow-diameter implants feasible to support fixed dental prostheses (FDPs) and partial removable dental prostheses (PRDPs)? MATERIALS AND METHODS: This review followed the PRISMA statement and was registered in the PROSPERO database (CRD42020153729). Six databases and the gray literature were searched through October 2021 without language, publication time, or follow-up restrictions. The main outcomes were survival, success, and marginal bone loss (MBL). Risk of bias was assessed for each study design, and random-effects meta-analyses were performed (α = .05). RESULTS: Seventeen studies were included in the qualitative analysis, and 3 were included in the meta-analyses. In total, 1,624 NDIs and 339 standard-diameter implants (SDIs) were placed in 1,060 patients. Follow-up varied from 1 to 10 years, and 17 failures (implant loss) were recorded. No differences in survival rate for FDPs supported by NDIs vs SDIs were found (odds ratio [OR] = 0.59, 95% CI: 0.18 to 1.92, P = .38). However, Kaplan-Meier analysis evaluating only NDI performance revealed a higher survival rate of NDIs ≥ 3.3-mm diameter (P = .002), placed with delayed loading (P = .024), and placed in the maxilla (P = .014). FDPs supported by NDIs vs SDIs presented similar success rates (OR = 1.48, 95% CI: 0.41 to 5.34, P = .55); however, MBL was lower in the NDI group (mean difference = -0.23 mm, 95% CI: -0.41 to -0.06, P = .01). Insufficient data regarding PRDPs were available. CONCLUSION: Despite the limited studies available, FDPs supported by NDIs presented survival and success rates comparable to those supported by SDIs, with slightly lower MBL. For PRDPs, strong conclusions were not possible.

Action of disinfectant solutions on adaptive capacity and virulence factors of the Candida spp. biofilms formed on acrylic resin.

BACKGROUND: Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. OBJECTIVE: To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions. METHODOLOGY: Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test. RESULTS: NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal. CONCLUSIONS: The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

Failures in Single Extra-Short Implants (≤ 6 mm): A Systematic Review and Meta-analysis.

PURPOSE: The aim of this systematic review with meta-analysis was to compare the survival rate of single crowns supported by extra-short implants (≤ 6 mm) to those supported by conventional implants, with or without previous maxillary sinus augmentation. The proportion of failures was described according to the type of complication and follow-up periods. MATERIALS AND METHODS: Randomized and prospective clinical trials were selected from six databases and gray literature. The risk of bias was evaluated by Joanna Briggs Institute Critical Appraisal Checklist, and the certainty of the evidence was analyzed with Grading of Recommendations Assessment, Development, and Evaluation. Meta-analyses were processed with RevMan and MedCalc Statistical Software. RESULTS: Single crowns supported by extra-short implants had a similar risk of failure to those supported by conventional implants, regardless of previous maxillary sinus augmentation (P > .05). Overall failure proportion of extra-short implants was 5.19%, but it varied according to follow-up (1.18% before loading, 1.56% at 12 months, 1.20% at 24 months, 2.10% at 48 months). Biologic failure complications were 37.90% for bleeding on probing, 22.45% for peri-implantitis, and 11.29% for infection. Prosthodontics failure complications were 14.88% for abutment failures and 14.73% for prosthetic screw loosening. Considering the risk of bias, most studies were classified at moderate risk. CONCLUSION: The risk of failure of single crowns supported by extra-short implants is similar to those supported by conventional implants, regardless of previous maxillary sinus augmentation or follow-up period. The most frequent biologic and prosthetic complications were bleeding on probing and abutment failures, respectively.

Action of disinfectant solutions on adaptive capacity and virulence factors of the Candida spp. biofilms formed on acrylic resin

Abstract Understanding the behavior of Candida spp. when exposed to denture disinfectants is essential to optimize their effectiveness. Changes in the virulence factors may cause increased resistance of Candida spp. to disinfectant agents. Objective To evaluate the microbial load, cellular metabolism, hydrolytic enzyme production, hyphae formation, live cell and biofilm quantification of Candida albicans, Candida tropicalis and Candida glabrata after exposure to disinfectant solutions. Methodology Simple biofilms were grown on heat-polymerized acrylic resin specimens, and divided into groups according to solutions/strains: distilled water (control); 0.25% sodium hypochlorite (NaOCl 0.25% ); 10% Ricinus communis (RC 10%); and 0.5% Chloramine T (CT 0.5%). The virulence factors were evaluated using the CFU count (microbial load), XTT method (cell metabolism), epifluorescence microscopy (biofilm removal and live or dead cells adhered), protease and phospholipase production and hyphae formation. Data were analyzed (α=0.05) by one-way ANOVA/ Tukey post hoc test, Kruskal-Wallis test and Wilcoxon test. Results NaOCl 0.25% was the most effective solution. CT 0.5% reduced the number of CFUs more than RC 10% and the control. RC 10% was effective only against C. glabrata. RC 10% and CT 0.5% decreased the cellular metabolism of C. albicans and C. glabrata. Enzyme production was not affected. Hyphal growth in the RC 10% and CT 0.5% groups was similar to that of the control. CT 0.5% was better than RC 10% against C. albicans and C. tropicalis when measuring the total amount of biofilm and number of living cells. For C. glabrata, CT 0.5% was equal to RC 10% in the maintenance of living cells; RC 10% was superior for biofilm removal. Conclusions The CT 0.5% achieved better results than those of Ricinus communis at 10%, favoring the creation of specific products for dentures. Adjustments in the formulations of RC 10% are necessary due to efficacy against C. glabrata. The NaOCl 0.25% is the most effective and could be suitable for use as a positive control.

The effects of three disinfection protocols on Candida spp., denture stomatitis, and biofilm: A parallel group randomized controlled trial.

STATEMENT OF PROBLEM: Antifungals are used to treat Candida infections. However, because of increased antifungal resistance and the length of antifungal therapy, Candida spp. infections can be prevented using the prosthesis hygiene method. Therefore, establishing efficient, safe, and low-cost hygiene protocols for complete denture wearers is necessary. PURPOSE: The purpose of this clinical trial was to compare 10% Ricinus communis (RC10%) and 0.5% chloramine-T (CT0.5%) with negative (water) and positive (0.25% sodium hypochlorite [SH0.25%]) controls to establish a protocol to treat denture stomatitis (DS), remove denture biofilm, reduce overall microbiota, and decrease Candida spp. on the palate and denture bases. MATERIAL AND METHODS: This randomized, double blind, controlled clinical trial allocated 60 DS-positive participants in parallel groups: RC10%, CT0.5%, negative control, and SH0.25%. All participants brushed their palate and dentures and applied 1 of the solutions only to the denture. The following outcomes were assessed at baseline and after 7 and 37 days: Candida spp. counts, frequency of species by presumptive identification, DS severity, and photographic quantification of biofilm. The Kruskal-Wallis and Friedman tests with stepwise step-down post hoc test compared the anticandidal effect and the DS score (between groups and time). ANOVA and the Tukey post hoc test were used for biofilm removal comparison (α=.05). RESULTS: Microbial counts were solution- and time-dependent for dentures, with C. albicans, C. tropicalis, and C. glabrata being the most prevalent species. RC10% presented similar results to baseline and control after 7 and 37 days. CT0.5% reduced the CFU/mL compared with the baseline. SH0.25% was the most effective. DS reduced in all groups, independent of the solution. SH0.25% reduced biofilm the most, followed by RC10%. CT0.5% was similar to the control. CONCLUSIONS: SH0.25% demonstrated potential for Candida spp. control in denture wearers with DS. The other protocols showed intermediate activity and might be more suitable for longer immersion periods.

Antibiofilm Activity of an Experimental Ricinus Communis Dentifrice on Soft Denture Liners.

The disadvantage of liners materials is the difficulty of biofilm control. It was compared an experimental dentifrice contained Ricinus communis, with commercials dentifrices as antibiofilm activity against microorganisms on denture liner. Six hundred specimens were distributed in 5 groups (n=18/ microorganism): water; experimental dentifrice; specific dentifrice for denture and two conventional dentifrices against C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Each group had a negative (n=5; without contamination) and positive control (n=15/ microorganism; without cleaning). The antibiofilm activity was evaluated by the method of biofilm formation in triplicate. The specimens were contaminated in a standard way and incubated. After that, manual brushing was performed (60 s), washed with PBS, immersed in liquid culture medium for resuspension and sowing in solid medium. The results (mean of triplicates) were expressed in CFU/mL. The data was submitted to Shapiro-Wilk, ANOVA and Tukey test (p<0.05). The specific dentifrice (1.27±1.20) was the most effective against S. mutans, followed by conventional (Trihydral, 3.13±0.88; Colgate, 2.16±2.02) and experimental (3.81±1.37) dentifrices, which were similar to each other (p=0.008). All of them were different from water (4.79±1.42). The specific (0.21±0.21) and experimental (0.36±0.25) dentifrices were similar against S. aureus, with a higher mean of CFU when compared to conventional (Colgate, 0.06±0.13), which was more efficient (p=0.000). For C. albicans, C. glabrata and E. coli, all dentifrices were similar to water (p=0.186). It was concluded, that the experimental dentifrice was effective against S. aureus and had not efficacy against Candida spp.; S. mutans; E. coli, as occurred with the commercials dentifrices.

Antibiofilm activity of an experimental ricinus communis dentifrice on soft denture liners

Abstract The disadvantage of liners materials is the difficulty of biofilm control. It was compared an experimental dentifrice contained Ricinus communis, with commercials dentifrices as antibiofilm activity against microorganisms on denture liner. Six hundred specimens were distributed in 5 groups (n=18/ microorganism): water; experimental dentifrice; specific dentifrice for denture and two conventional dentifrices against C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Each group had a negative (n=5; without contamination) and positive control (n=15/ microorganism; without cleaning). The antibiofilm activity was evaluated by the method of biofilm formation in triplicate. The specimens were contaminated in a standard way and incubated. After that, manual brushing was performed (60 s), washed with PBS, immersed in liquid culture medium for resuspension and sowing in solid medium. The results (mean of triplicates) were expressed in CFU/mL. The data was submitted to Shapiro-Wilk, ANOVA and Tukey test (p<0.05). The specific dentifrice (1.27±1.20) was the most effective against S. mutans, followed by conventional (Trihydral, 3.13±0.88; Colgate, 2.16±2.02) and experimental (3.81±1.37) dentifrices, which were similar to each other (p=0.008). All of them were different from water (4.79±1.42). The specific (0.21±0.21) and experimental (0.36±0.25) dentifrices were similar against S. aureus, with a higher mean of CFU when compared to conventional (Colgate, 0.06±0.13), which was more efficient (p=0.000). For C. albicans, C. glabrata and E. coli, all dentifrices were similar to water (p=0.186). It was concluded, that the experimental dentifrice was effective against S. aureus and had not efficacy against Candida spp.; S. mutans; E. coli, as occurred with the commercials dentifrices.

Resumo A desvantagem dos materiais resilientes é a dificuldade de controle do biofilme. Este estudo comparou um dentífrico experimental contendo Ricinus communis, com dentifrícios comerciais quanto atividade contra biofilme formado em reembasador de próteses totais. Seiscentos espécimes foram distribuídos em 5 grupos (n=18/microrganismo): água; dentifrício experimental; dentifrício específico para próteses totais e dois convencionais; contra C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Cada grupo teve um controle negativo (n=5; sem contaminação) e um positivo (n=15/ microrganismo; sem higienização). A atividade contra biofilme foi avaliada pelo método de formação do biofilme, em triplicata. Os espécimes foram contaminados, padronizadamente, e incubados. Posteriormente, foi realizada escovação manual (60 s), lavagem em PBS, imersão em meio de cultura líquido para ressuspensão e semeadura em meio sólido. Os resultados (média das triplicatas) foram expressos em UFC/mL. Os dados foram submetidos aos testes Shapiro-Wilk, ANOVA e Tukey (p<0,05). O dentifrício específico (1,27±1,20) foi o mais eficaz contra S. mutans, seguido dos convencionais (Trihydral, 3,13±0,88; Colgate, 2,16±2,02) e experimental (3,81±1,37), que foram semelhantes entre si (p=0,008). Todos eles foram diferentes da água (4,79±1,42). O dentifrício específico (0,21±0,21) e o experimental (0,36±0,25) foram semelhantes contra S. aureus, com maiores médias de UFC quando comparado ao convencional (Colgate, 0,06±0,13), que foi mais eficiente (p=0,000). Para C. albicans, C. glabrata e E.coli, todos os dentifrícios foram similares à água (p=0,186). Conclui-se que o dentifrício experimental foi efetivo somente contra S. aureus e não foi eficiente perante Candida spp.; S. mutans; E. coli, como ocorrido com os dentifrícios comerciais.

In Vitro Evaluation of Resilient Liner after Brushing with Conventional and Experimental Ricinus communis-Based Dentifrices.

PURPOSE: To evaluate the effect of experimental (Ricinus communis) and commercial dentifrices used for denture cleaning on abrasiveness (gravimetric method; roughness), hardness, and color stability of a resilient relining material. MATERIALS AND METHODS: Sixty circular (15 × 3 mm) specimens were distributed into four groups: C (control; brushing with water); CO (brushing with Colgate - for natural teeth); CB (brushing with Corega Brite - for complete dentures); RC (brushing with experimental dentifrice). Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension for 50 minutes, calculated to correspond to 1 year of regular brushing. Variables were measured initially and after the trial period. For the gravimetric method, the difference in mass was considered. The surface roughness was measured by a rugosimeter, and the hardness test was performed by a Shore A durometer. Color changes (ΔE; CIE L*a*b* and NBS systems) were measured by a portable spectrophotometer. Results were analyzed by ANOVA/Tukey's test (α = 0.05). RESULTS: The largest mass variation (µg; p < 0.0001) occurred in C (-6.21 ± 3.18). Concerning roughness, CB (0.26 ± 0.04) showed the lowest value, followed by RC (0.29 ± 0.08) and CO (0.34 ± 0.24) (p < 0.0001). Group C produced the greatest surface roughness (0.72 ± 0.25). Hardness values decreased after brushing with water (p = 0.014). No significant differences were found among RC (50.31 ± 1.03), CO (49.11 ± 1.31), CB (49.17 ± 1.23), and C (48.02 ± 1.26). Color stability was similar in all groups (p = 0.135; C: 2.3 ± 0.77; CO: 2.6 ± 0.54; CB: 2.2 ± 0.44; RC: 2.9 ± 1.56). CONCLUSIONS: The use of experimental dentifrice could be indicated, as it showed similar results to the specific dentifrice, keeping the resilient material properties within acceptable values.

Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser.

OBJECTIVE: This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction. MATERIAL AND METHODS: It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire. RESULTS: S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient's satisfaction. CONCLUSIONS: 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser

Abstract The development of opportunistic infections due to poor denture hygiene conditions justified the search for effective hygiene protocols for controlling denture biofilm. Objective This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction. Material and Methods It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire. Results S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient's satisfaction. Conclusions 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

In Vitro Analysis of Surface Roughness of Acrylic Resin Exposed to the Combined Hygiene Method of Brushing and Immersion in Ricinus communis and Sodium Hypochlorite.

PURPOSE: To evaluate a solution based on Ricinus communis (Castor oil) for denture cleansing, comparing it to sodium hypochlorite (NaOCl) for the surface roughness of heat-polymerized acrylic resin. MATERIALS AND METHODS: Forty polished and unpolished resin specimens (90 × 30 × 4 mm) were evaluated before and after their exposure to protocol hygiene: brushing the specimens with a specific denture brush and mild soap for 3 minutes, three times a day, and immersing them in hygiene solutions (0.25% NaOCl-S1 and 0.5% NaOCl-S2; 10% R. communis-S3; saline-S4: control) for 20 minutes. Surface roughness was evaluated by rugosimeter and scanning electron microscopy (SEM) before and after the protocol. For evaluation of surface roughness, polished and unpolished surfaces were used. RESULTS: The roughness of the polished surface was not affected by time (p = 0.062), but was affected by solutions (p < 0.0001) and the interaction between factors (p = 0.005). For S1 and S4, the period did not influence the roughness. For S2, there was a change after 7 days, remaining stable after 14 days. For S3, there were changes, and stabilization occurred after 14 days. After 7 and 14 days, S2 and S3 promoted major changes, but after 21 days, there were no differences among solutions, except saline. The unpolished surface was not influenced by factors: period (p = 0.115), solution (p = 0.120), and their interaction (p = 0.382). SEM analysis showed similar results on the evaluation of surface roughness. CONCLUSIONS: The polished surface of the prosthesis was more susceptible to changes when exposed to hygiene solutions, and although the 0.5% NaOCl solution promoted an increase in the surface roughness compared with the same solution at 0.25% and R. communis at 10%, the values are clinically acceptable.

Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial.

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.

Antimicrobial activity of complete denture cleanser solutions based on sodium hypochlorite and Ricinus communis: a randomized clinical study

ABSTRACT To preserve oral health and to maintain the prosthetic devices, it is important not only to improve the properties of commonly known hygiene products, but also to investigate new materials with antimicrobial action. Objectives This study evaluated the antimicrobial activity of sodium hypochlorite (0.25% and 0.50%) and 10% Ricinus communis’ solutions against specific microorganisms. Material and Methods Sixty four maxillary complete denture wearers were instructed to brush their dentures three times a day and to soak them (20 min/day) in the solutions: SH1: 0.25% sodium hypochlorite; SH2: 0.5% sodium hypochlorite; RC: 10% R. communis oil; and C: 0.85% saline (control). The solutions were used for 7 days in a randomized sequence. Following each period of use, there was a 1-week washout period. Antimicrobial activity was determined by Colony Forming Units (CFU) counts of Streptococcus mutans, Candida spp., and gram-negative microorganisms. For collecting biofilm, the internal surface of maxillary dentures was brushed with saline solution, and biofilm suspension obtained. After dilutions (100 - 10-3), aliquots were seeded in Mitis salivarius, CHROMagar Candida®, and MacConkey agar for detecting S. mutans, Candida spp., or gram-negative microorganisms, respectively. After incubation, colonies were counted, and CFU/mL values were calculated. Then, transformation - log10 (CFU+1) - data were analyzed using the Friedman test (α=0.05). Results showed significant differences between the solutions (p<0.001). Results All three solutions showed antimicrobial activity against S. mutans. Against Candida spp., RC and SH1 solutions showed similar effect while SH2 showed superior activity. SH1 and SH2 solutions showed antimicrobial action against gram-negative microorganisms. The Candida species most frequently isolated was C. albicans, followed by C. tropicalis and C. glabrata. Conclusions The 0.5% sodium hypochlorite solution was the most effective and might be used to control denture biofilm. C. albicans was the most frequently isolated Candida sp.

Soft denture liners and sodium perborate: sorption, solubility and color change

Abstract Aim: To evaluate the sorption, solubility and color change in two lining materials after 120 days of immersion in either sodium perborate or artificial saliva. Methods: Thirty disk-shaped specimens (15×3 mm) of each material, Mucopren(r) soft (MS) and Elite(r) soft (ES) were manufactured and divided into two groups. The specimens in the control group (CG, n=15) were stored in artificial saliva at 37 °C. The specimens in the experimental group (EG, n=15) were stored in artificial saliva at 37 °C and immersed in sodium perborate daily for 5 min. The analysis of sorption and solubility was based on the initial dry weight and on the wet and dry weights after immersion. The color was assessed with a portable spectrophotometer and the NBS system. ANOVA and Tukey test (p<0.05) were used to analyze color and sorption. The solubility was analyzed by KruskalWallis test (p<0.05). Results: Sorption was higher in the EG group (0.31±0.08) than in the control group (0.26±0.05), and higher in Elite(r) soft relining (0.34±0.07) than in Mucopren(r) soft (0.23±0.06). There was no interaction between the factors. Elite(r) Soft presented a higher solubility when immersed in artificial saliva (CG: 0.16±0.07 and EG: 0.13±0.06; p=0.00). Mucopren(r) soft showed no solubility in either treatment. Regarding the color changes, there was a significant difference between the groups (CG: 9.2±1.2 and EG: 9.9±1.2; p=0.025) but not between the materials (Mucopren(r) soft: 9.4±1.3 and Elite(r)soft: 9.7±1.0; p=0.34). Using the NBS system, we verified that both materials presented a high color change. Conclusions: The daily use of sodium perborate promoted changes in the liners' sorption and color. Elite(r) soft relining was more prone to changes than Mucopren(r) soft.

Antimicrobial activity of complete denture cleanser solutions based on sodium hypochlorite and Ricinus communis - a randomized clinical study.

UNLABELLED: To preserve oral health and to maintain the prosthetic devices, it is important not only to improve the properties of commonly known hygiene products, but also to investigate new materials with antimicrobial action. Objectives This study evaluated the antimicrobial activity of sodium hypochlorite (0.25% and 0.50%) and 10% Ricinus communis' solutions against specific microorganisms. MATERIAL AND METHODS: Sixty four maxillary complete denture wearers were instructed to brush their dentures three times a day and to soak them (20 min/day) in the solutions: SH1: 0.25% sodium hypochlorite; SH2: 0.5% sodium hypochlorite; RC: 10% R. communis oil; and C: 0.85% saline (control). The solutions were used for 7 days in a randomized sequence. Following each period of use, there was a 1-week washout period. Antimicrobial activity was determined by Colony Forming Units (CFU) counts of Streptococcus mutans, Candida spp., and gram-negative microorganisms. For collecting biofilm, the internal surface of maxillary dentures was brushed with saline solution, and biofilm suspension obtained. After dilutions (100 - 10-3), aliquots were seeded in Mitis salivarius, CHROMagar Candida, and MacConkey agar for detecting S. mutans, Candida spp., or gram-negative microorganisms, respectively. After incubation, colonies were counted, and CFU/mL values were calculated. Then, transformation - log10 (CFU+1) - data were analyzed using the Friedman test (α=0.05). Results showed significant differences between the solutions (p<0.001). RESULTS: All three solutions showed antimicrobial activity against S. mutans. Against Candida spp., RC and SH1 solutions showed similar effect while SH2 showed superior activity. SH1 and SH2 solutions showed antimicrobial action against gram-negative microorganisms. The Candida species most frequently isolated was C. albicans, followed by C. tropicalis and C. glabrata. CONCLUSIONS: The 0.5% sodium hypochlorite solution was the most effective and might be used to control denture biofilm. C. albicans was the most frequently isolated Candida sp.

Recurrent Infection by varicella-zoster virus with facial scarring / Infecção recorrente pelo vírus varicela-zoster com sequelas cicatriciais na face

Primary contact with the varicella-zoster virus occurs through varicella (chickenpox) and culminates with this virus entering the sensory nerves and remaining latent in the dorsal root ganglion. Transmission occurs by dissemination of infectious particles of the varicella-zoster virus by the aerosol released from nasopharyngeal secretions or skin lesions, or by direct contact with lesions. Herpes zoster occurs after clinically evident reactivation of the virus, affecting the whole distribution of the infected sensory nerve. When compared with primary infection, herpes zoster has a more severe character, requiring the use of pharmaceutical drugs. The cause of reactivation is unknown and may be associated with predisposing factors, such as age, stress or impaired immune system. This study reports a case of a patient who presented clinical manifestations compatible with varicella zoster infection exacerbated by the use of homemade remedies, resulting in a secondary infection and facial scarring.

O contato primário com o vírus varicela-zoster ocorre na varicela (catapora), culminando com a transposição desse vírus para os nervos sensitivos, onde estabelece sua latência no gânglio espinhal dorsal. A transmissão ocorre por disseminação das partículas infecciosas do vírus varicela-zoster através de aerossóis liberados a partir de secreções do nasofaringe ou lesões cutâneas ou, ainda, pelo contato direto com lesões. O herpes-zoster clinicamente evidente ocorre após a reativação do vírus, com o envolvimento da distribuição do nervo sensitivo afetado. Quando comparado com a infecção primária, o herpes-zoster desenvolve um caráter de maior severidade, sendo sempre necessária a administração de uma terapêutica medicamentosa eficaz. A causa dessa reativação é desconhecida, podendo estar relacionada a fatores predisponentes como a faixa etária, estresse ou imunodeficiências. Neste trabalho relata-se um caso clínico em que a paciente apresentou manifestações clínicas condizentes com um quadro característico de infecção por varicela-zoster, complicado por uso de medicação caseira, resultando em infecção secundária e cicatrizes faciais.

Avaliação individualizada do risco circunstancial de cárie em pacientes atendidos na Clínica de Odontologia em Saúde Coletiva II da Universidade Federal do Pará / Individualized assessment of circumstantial caries risk of patients seen at Collective II's Health Dentistry Clinic of the Federal University of Pará

Introdução - Avaliar o risco circunstancial de cárie dos pacientes assistidos ao longo de onze meses na Clínica de Odontologia em Saúde Coletiva II da Faculdade de Odontologia da UFPA (FO/UFPA), através de informações advindas da realização da anamnese e exame clínico, assim como variáveis referentes à idade, gênero e freqüência diária de escovação, já que a determinação do risco é essencial para o correto planejamento e sucesso da terapia estabelecida. Materiaise Métodos - Os dados foram coletados, a partir de fichas clínicas de atendimentos fetuados no período de fevereiro a dezembro de 2007. A amostra foi formada por 61 pacientes de ambos os sexos, com faixa etária variando entre 7 e 51 anos de idade. A determinação do risco de cárie foi realizada pelo aluno e professor como parte do processo ensino/aprendizagem que acontece durante os semestres letivos na FO/UFPA. Resultados - O perfil do paciente assistido recaiu na faixa etária de 18 a 23 anos de idade, gênero feminino, com freqüência de escovação diária de três vezes ao dia e risco de cárie considerado médio (55,74%). Conclusões - Apesar dos pacientes submetidos ao estudo apresentarem médio risco de cárie, os mesmos possuíam um estado de saúde bucal preocupante, que demonstrou a necessidade de intervenções a nível curativo, interceptativo e preventivo. A determinação do risco individual de cárie favorece a elaboração de um plano de tratamento correto e eficaz, permitindo que haja uma margem de segurança maior na qualidade dos tratamentos, reduzindo as chances de recidivas da doença cárie, proporcionando assim, melhora da saúde bucal do paciente.

Introduction - In this way, aims to present the assessment of the risk of caries of patients assisted up to 11 months at Collective II's Health Dentistry Clinic, School of Dentistry, Federal University of Pará, adding information stemming from history and clinical examination performed as well as variables related to age, gender and frequency of daily brushing, as the determination of risk is essential to the proper the planning and success of the therapy established. Materials and Methods - Data were collected from the records of spontaneous demand of caries in the period from February to December 2007. The sample was made up by 61 patients of both sexes, with age ranging between 7 and 51 years, and 57.38% female. The determination of the risk of dental caries was performed by the student and teacher as part of the process teaching / learning what happens during the semester in FO / UFPA. Results - The profile of the patient assisted falls on the age of 18 to 23 years old, female, with a frequency of daily brushing three times a day and considered medium risk of caries (55.74%). Conclusions - Patients undergoing study had a state of oral health concern, which demonstrated necessity for interventions of curative, preventive and intercepted treatment.

Radioterapia em cabeça e pescoço: complicações bucais e a atuação do cirurgião dentista / Head and neck radiotherapy: oral complications and the performance of the surgeon dentist

Objetivo: explicitar as alterações sofridas pelo paciente submetido a tratamento radioterápico e salientar a importância do cirurgião dentista como parte integrante de uma equipe multidisciplinar que assistirá o doente. Método: pesquisa bibliográfica nas fontes: periódicos, livros e acesso à internet. Considerações finais: o cirurgião dentista é o profissional com melhores condições de avaliar e tratar as alterações bucais, assim como, aplicar medidas preventivas de acompanhamento da saúde bucal do paciente radiado na área da cabeça e pescoço, visando minimizar os efeitos estomatológicos e funcionais causados por essa terapia.

Objective: set out alterations and to point out the importance of the surgeon dentist as integrant of a medical team. Method: literature review in: cientific magazine, books and web access. Final considerations: the surgeon dentist is the professional with better conditions to to evaluate and to treat the sick person, as well as applying writ of prevention of accompaniment of the oral health of the patient radiated in the area of the head and neck, aiming at to minimize the estomatologic and functional effect caused by this therapy.