Effectiveness of manual and electric brushes in the removal of biofilm from full dentures / Eficácia das escovas manual e elétrica na remoção do biofilme de próteses totais

Objective: To evaluate clinically the ability to remove biofilm from complete dentures. Methods: Thirty patients, users of full upper dentures, participated in a trial period of 21 days and were instructed to brush the dentures three times a day (after breakfast, lunch and dinner) with water, using a manual, special denture brush (Group I - Control) and electric brush (Group II - Experimental). At night, the patients were instructed to immerse their dentures in a container with filtered water. Before and after the use of these methods for 21 days, the internal surfaces of the complete upper dentures were stained (1% neutral red) and photographed. The areas (total of internal surface and the surface stained with biofilm) were quantified using software (Image Tool 2.02). The percentage of the biofilm was calculated as the ratio of the area of the biofilm multiplied by 100 to the total surface area of the internal base of the dentures. Results: The data for the two methods were compared using the Student?s t-test (?? = 0.05). There was a mean area of biofilm coverage (%, ± standard deviation) of 12.5 ± 12.8 and 16.9 ± 17.0 for the manual and electric toothbrushes, respectively. The differences were not significant (t = 0.799, P = 0.431). Conclusion: It was concluded that both brushes tested showed the same capacity for biofilm removal from complete dentures.

Objetivo: Avaliar clinicamente a capacidade de remoção do biofilme de prótese total de dois métodos mecânicos de higiene: escovação manual e elétrica. Métodos: Trinta pacientes, usuários de próteses totais superiores, participaram de um período experimental de 21 dias e foram orientados a escovar as próteses três vezes ao dia (após café da manhã, almoço e jantar) com água empregando escova manual específica para próteses totais (Grupo I - Controle) e elétrica (Grupo II - Experimental). Durante o período noturno o paciente foi orientado a imergir suas próteses em recipiente contendo água filtrada. Antes e após o uso dos métodos por 21 dias, as superfícies internas das próteses totais superiores foram evidenciadas (vermelho neutro 1%) e fotografadas. As áreas (total da superfície interna e corada com biofilme) foram quantificadas com um software (Image Tool 2.02). A porcentagem do biofilme foi calculada como a relação entre a área do biofilme multiplicado por 100 e a área da superfície total da base interna da prótese.Resultados: Os dados dos dois métodos foram comparados por meio do teste t de Student (?? = 0,05). Observou-se uma área média de cobertura por biofilme (%, ±desvio padrão) de 12,5±12,8 e 16,9±17,0 para a escova elétrica e a manual, respectivamente. As diferenças não foram significantes (t=0,799; p=0,431). Conclusão: Concluiu-se que ambas as escovas testadas apresentaram a mesma capacidade de remoção de biofilme das próteses totais.

The effectiveness of chemical denture cleansers and ultrasonic device in biofilm removal from complete dentures

Adequate denture hygiene can prevent and treat infection in edentulous patients. They are usually elderly and have difficulty for brushing their teeth. OBJECTIVE: This study evaluated the efficacy of complete denture biofilm removal using chemical (alkaline peroxide-effervescent tablets), mechanical (ultrasonic) and combined (association of the effervescent and ultrasonic) methods. MATERIAL AND METHODS: Eighty complete denture wearers participated in the experiment for 21 days. They were distributed into 4 groups (n=20): (1) Brushing with water (Control); (2) Effervescent tablets (Corega Tabs); (3) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (4) Association of effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush (Bitufo) and water, 3 times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. To quantify the biofilm, the internal surfaces of the maxillary complete dentures were stained and photographed at 45º. The photographs were processed and the areas (total internal surface stained with biofilm) quantified (Image Tool 2.02). The percentage of the biofilm was calculated by the ratio between the biofilm area multiplied by 100 and the total area of the internal surface of the maxillary complete denture. RESULTS: The Kruskal-Wallis test was used for comparison among groups followed by the Dunn multiple-comparison test. All tests were performed respecting a significance level of 0.05. Significant difference was found among the treatments (KW=21.18; P<0.001), the mean ranks for the treatments and results for Dunn multiple comparison test were: Control (60.9); Chemical (37.2); Mechanical (35.2) and Combined (29.1). CONCLUSION: The experimental methods were equally effective regarding the ability to remove biofilm and were superior to the control method (brushing with water). Immersion in alkaline peroxide and ultrasonic vibration can be used as auxiliary agents for cleaning complete dentures.

Análise crítica do histórico e desenvolvimento das cerâmicas odontológicas / Critical analysis of the dental ceramics historical and development

O uso constante de restaurações estéticas na Odontologia tem promovido cada vez mais o desenvolvimento e o aperfeiçoamento de materiais que atendam a estes requisitos. As restaurações em cerâmica promoveram uma nova era estética e embora, este material restaurador tenha uma história antiga, a sua utilização clínica ainda é controversa. O avanço tecnológico, tanto no surgimento de novos materiais como no desenvolvimento de novas técnicas para a obtenção de resultados mais compatíveis com a dentição natural, tem estimulado cada vez mais o uso destes materiais. As cerâmicas odontológicas têm sido uma alternativa viável de tratamento protético tanto em áreas com perda de apenas um elemento dentário, quanto em áreas com perda de vários elementos. Esta revisão teve por objetivo realizar uma análise crítica a respeito dos diversos tipos de cerâmicas odontológicas utilizadas na confecção de restaurações protéticas indiretas, já que, cada vez mais novos materiais cerâmicos têm sido introduzidos no mercado durante as duas últimas décadas.

The constant use of aesthetic restorations in Dentistry has been promoting the development and the improvement of materials more and more to assist these requirements. Ceramic restorations have been promoted a new age in the aesthetic Dentistry, although, this restoring material has an old history and controversial clinical use. The aim of this review was to perform a critical analysis regarding the dental ceramics, for being a material thoroughly used for making of indirect restorations and still remains in technological development, because new ceramic materials have been introduced during the last two decades.

The effectiveness of chemical denture cleansers and ultrasonic device in biofilm removal from complete dentures.

UNLABELLED: Adequate denture hygiene can prevent and treat infection in edentulous patients. They are usually elderly and have difficulty for brushing their teeth. OBJECTIVE: This study evaluated the efficacy of complete denture biofilm removal using chemical (alkaline peroxide-effervescent tablets), mechanical (ultrasonic) and combined (association of the effervescent and ultrasonic) methods. MATERIAL AND METHODS: Eighty complete denture wearers participated in the experiment for 21 days. They were distributed into 4 groups (n=20): (1) Brushing with water (Control); (2) Effervescent tablets (Corega Tabs); (3) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (4) Association of effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush (Bitufo) and water, 3 times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. To quantify the biofilm, the internal surfaces of the maxillary complete dentures were stained and photographed at 45º. The photographs were processed and the areas (total internal surface stained with biofilm) quantified (Image Tool 2.02). The percentage of the biofilm was calculated by the ratio between the biofilm area multiplied by 100 and the total area of the internal surface of the maxillary complete denture. RESULTS: The Kruskal-Wallis test was used for comparison among groups followed by the Dunn multiple-comparison test. All tests were performed respecting a significance level of 0.05. Significant difference was found among the treatments (KW=21.18; P<0.001), the mean ranks for the treatments and results for Dunn multiple comparison test were: Control (60.9); Chemical (37.2); Mechanical (35.2) and Combined (29.1). CONCLUSION: The experimental methods were equally effective regarding the ability to remove biofilm and were superior to the control method (brushing with water). Immersion in alkaline peroxide and ultrasonic vibration can be used as auxiliary agents for cleaning complete dentures.

Effervescent tablets and ultrasonic devices against Candida and mutans streptococci in denture biofilm.

OBJECTIVE: To evaluate the antimicrobial action of effervescent tablets and ultrasound on Candida spp. and mutans streptococci from denture biofilm. BACKGROUND: It is not uncommon for edentulous patients to be elderly and find it difficult to brush their dentures. Hence, auxiliary methods are required for cleansing dentures as well as treating oral infections. MATERIALS AND METHODS: Seventy-seven complete denture wearers were randomly assigned into four groups: (A) Brushing with water (control); (B) Effervescent tablets; (C) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (D) Effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush and water, three times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. The samples were collected by brushing the dentures with saline and the detached microbial cells were quantified by plating. Counts [log (CFU+1) ml(-1) ] of total aerobes, Candida spp. and mutans streptococci were compared by one-way anova or Kruskal-Wallis test (α = 0.05). RESULTS: No significant difference was found among the methods from C. albicans (p = 0.76), C. tropicalis (p = 0.94) and C. glabrata (p = 0.80). Lower counts were found for methods B and D when compared with the other methods against mutans streptococci (p < 0.001). Method B showed lower total aerobic counts than A, whereas C and D showed intermediate results (p = 0.011). CONCLUSION: The effervescent tablets significantly reduced mutans streptococci and total aerobes from denture biofilm. However, they was not as effective against C. albicans. Ultrasonic cleansing presented a discrete antimicrobial effect and was less effective than the tablets for complete denture disinfection.

In vitro and clinical evaluation of specific dentifrices for complete denture hygiene.

OBJECTIVES: To study the physical properties of two experimental dentifrices for complete denture hygiene, their effect on denture biofilm removal and antimicrobial properties by means of a clinical trial. MATERIALS AND METHODS: The experimental dentifrices comprised two compositions. One was based on the addition of 1% chloramine T (D1) and the other on the presence of 0.01% fluorosurfactant (D2). Measurements of density, pH, consistency, rheological features and abrasiveness were conducted. Sixty complete denture wearers were randomly assigned to three groups and were instructed to brush their dentures with a specific toothbrush: (1) Water (control); (2) D1; or (3) D2. Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface. Microbiological assessment was conducted to quantify Candida sp. and mutans streptococci. Data were evaluated by one-way anova and Tukey HSD, or Kruskal-Wallis (alpha = 0.05). RESULTS: Both dentifrices decreased biofilm coverage when compared with the control group. D1 was the most efficacious treatment to reduce mutans streptococci, whereas D2 showed an intermediate outcome (ANOVA, p < 0.040). No treatment influenced Candida albicans or non-albicans species (Kruskal-Wallis, p = 0.163 and 0.746, respectively). CONCLUSION: It can be concluded that brushing complete dentures with the experimental dentifrices tested could be effective for the removal of denture biofilm.

Levantamento do grau de instruções e dos materiais e métodos de higiene utilizados por usuários de próteses totais / Rising of the instructions degree and of materials and methods of hygiene used by complete dentures users

O objetivo desse trabalho foi realizar um estudo longitudinal a respeito dosmateriais e métodos de higiene utilizados por usuários de próteses totais, bem como avaliar ograu de instruções dos mesmos. O levantamento dos dados foi realizado por meio da aplicaçãode questionário e posterior tabulação dos dados. Foram entrevistados 98 usuários de prótesestotais no ano de 1989 e 100, no ano de 2004 atendidos na Faculdade de Odontologia de RibeirãoPreto-USP. Os resultados foram analisados por meio da comparação dos dados e pelo Teste dasProporções. Em 1989, 93,87% dos entrevistados relataram utilizar escova dental e dentifrício parahigiene de próteses totais. No ano de 2004, 95% dos usuários relataram utilizar o mesmo métodode higiene. Quanto ao grau de instrução, mais de 80% dos pacientes não receberam orientaçãoquanto à higienização ou quanto à necessidade de visita periódica ao cirurgião-dentista no ano de1989, mas em 2004 pôde-se notar que houve uma melhora significativa nesse quadro, uma vezque 52% dos pacientes não receberam orientação quanto à higienização e 77% não receberamorientação quanto à visita periódica ao cirurgião-dentista. Por meio deste estudo verificou-se queo método mais utilizado consiste no método mecânico, uma vez que são aqueles regularmenteencontrados no mercado, porém, estes não são específicos para higienização de próteses totais.Embora o grau de instrução tenha melhorado ao longo dos anos, a higiene oral de usuários deprótese total ainda é precária, havendo necessidade de maior atenção ao idoso, não somente porparte do cirurgião-dentista, mas também de indústrias de produtos de higiene oral, para que osdesdentados totais tenham acesso aos produtos específicos para este fim, podendo assim, controlarde forma adequada sua saúde oral.

The goal of this work was to accomplish a longitudinal study concerning aboutof the materials and methods of hygiene used by complete dentures users, as well as to evaluatethe instructions degree of the same. The rising of the data was accomplished by means of thequestionnaire and posterior table application of the data. They were interviewed 98 completedentures users in year of 1989 and 100, in year of 2004 attended in to Odontology Faculty ofRibeirão Preto. The results were analyzed by means of the comparison of the data and by theProportions Test. In 1989, 93.87% of the interviewees related use dental brush and toothpastefor complete denture hygiene. In year of 2004, 95% of the users related use the same hygienemethod. Regarding the instruction degree, more than 80% of the patients did not receive orientationregarding cleansers or regarding the need to periodic visit to the surgeon-dentist in year of 1989,but in 2004 could notice that there was a significant improvement in this picture, once that 52% of the patients did not receive orientation regarding cleansers and 77% did not receive orientationregarding the periodic visit to the surgeon-dentist. For half of this study it verified that the usedmethod consists in mechanical method, once that are those methods are not regularly found in themarket, however, these are not specific for denture complete hygiene. Although the instructiondegree has improved along years, the users’ oral complete denture hygiene is precarious, therebeing need to larger attention to the senior, not only by the surgeon-dentist, but also of productsindustries of oral hygiene, so that the total toothless have access to the specific products for thisend, could this way, control of adequate your form oral health.

Métodos de quantificação de biofilme em prótese total: revisão da literatura / Methods of denture biofilm quantification: review of literature

O uso adequado de um método de quantificação de biofilme em próteses totais é importante para os testes de efetividade de produtos de higienização específicos e para a avaliação das condições de higiene bucal de portadores de próteses totais. Tais métodos podem ser classificadoscomo laboratoriais (testes in vitro) e clínicos (testes in vivo). Entre os métodos clínicos, os mais empregados são os índices (metodologia de atribuição de escores) e os quantitativos (aplicação de instrumentos de medição). Os Índices mais empregados são o Aditivo, o de Budtz-Jørgensen, o de Higiene de Prótese e o de Augsburger e Elahi, os quais variam de acordo com a escala empregada (4 ou 5 pontos) e com o número de observadores (um ou mais), devendo ser salientada a necessidade de serem confiáveis, eficazes e fáceis de aplicar mesmo sob diferentes condições. Os métodos quantitativos são: morfométrico, pesagem de papel, planímetro e computadorizado, os quais se caracterizam pelo maior tempo desprendido e pela maior precisão nos resultados obtidos. Embora existam informações sobre os métodos de quantificação, elas ainda são escassas tornando a aplicação dos mesmos dificultada. Assim, o presente estudo tem como objetivo realizar umarevisão da literatura sobre os métodos clínicos de quantificação do biofilme da prótese total

It's important the use of an adequate method of denture biofilm quantification to evaluate the effectiveness of specific denture cleansers and the oral hygiene conditions of denture wearers. These methods can be classified between laboratorial (in vitro test) and clinical (in vivo test). Among clinical methods the most routinely employed are the index (score attribution methodology) and the quantitative one (measurements devices employment). Between the Index most employed are the Additive, Budtz-Jørgensen, Denture Hygiene and Augsburger & Elahi. These methods vary within the employed scale (4 or 5 points) and the number of operators (one or more), it must be in mind the importance of the method be confinable, effective and easy to employ on different condition. Quantitative methods are the morphometric, paper weight, planimeter and computadorized, these methods dispend more time but its result are more reliable. Although there is some information about quantification methods they still are insufficient, making its application difficulty. Therefore, this study has the purpose to realize a literature review about clinical and quantification methods to denture biofilm quantification.