Sleep Disorders and Subjective Well-Being in Portuguese Adults: Evidence from a Representative Study.

Objective The quality and quantity of sleep affect people's well-being, as chronic sleep disorders are associated with social, physical, and psychological problems, as well as low self-reported life satisfaction. The present cross-sectional study examined the associations of sleep disorders with self-reported life satisfaction in Portuguese adults. Materials and Methods Data from a representative sample of the Portuguese population (14,341 participants, aged ≥ 18 years) extracted from the Sixth Portuguese National Health Survey was analyzed. Data on subjective well-being and sleep disorders was collected through a questionnaire, and multivariable regression models were performed to examine the associations between these variables, adjusted for potential confounders such as age, gender, level of schooling, degree of urbanization, and family income. Results Sleep disorders were negatively associated with self-reported life satisfaction. Having at least one sleep disturbance in the last two weeks was significantly associated with a 3-point decrease in life satisfaction: ß = -3.0 (95% confidence interval = -3.2--2.7). Discussion Among Portuguese adults, sleep disorders were associated with a decline in life satisfaction. The present study provides new evidence from a representative sample to support the promotion of good sleep hygiene intervention programs.

An in vitro study using confocal laser scanning microscopy to evaluate the marginal misfits of different implant-supported frameworks.

PURPOSE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. MATERIALS AND METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

DHA and EPA in Sickle Cell Disease Favor Clinical Improvement and Contribute to Better Quality of Life: A Qualitative Systematic Review.

BACKGROUND: Sickle cell disease is a severe genetic disorder, and searching for therapeutic strategies is indispensable for prolonged and improved life for people affected by this condition. OBJECTIVE: This qualitative systematic review aimed to highlight the therapeutic potential of omega- 3 (n-3) in people with sickle cell disease. METHODS: The search was performed by combining sickle cell disease and n-3 descriptors in DeCS/ MeSH databases, including Scopus, PubMed, ScienceDirect, Web of Science, and Virtual Health Library. The risk of bias assessment in the primary studies was performed using the Cochrane risk of bias tool for randomized controlled trials. The evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: From the 187 records identified, seven were selected for data collection. Based on the evidence, n-3 supplementation contributes to lower activation of pro-inflammatory biomarkers, improves the concentration of docosahexaenoic and eicosapentaenoic acids in the erythrocyte membrane, provides better hemostatic response, and helps in vaso-occlusive crisis, pain episodes, and hospitalization reduction. CONCLUSION: The findings suggest that n-3 adjuvant therapy favors the clinical and general aspects of people with sickle cell disease.

Cafeteria Diet Can Affect Bone Microarchitecture in Sedentary and Trained Male Rats.

INTRODUCTION: Poor eating habits and a sedentary lifestyle can impair health. Regular physical activity improves the quality of life and is essential for bone health. Therefore, the present study aimed to evaluate the effects of the cafeteria diet on bone quality of sedentary and exercised rats. METHODS: Sixty young male Wistar rats were divided into six groups (n=10) according to diet composition and activity level, being: SD+CON, standard diet and control; SD+SED, standard diet and sedentary; SD+EX, standard diet and exercised; CD+CON, cafeteria diet and control; CD+SED, cafeteria diet and sedentary; CD+EX, cafeteria diet and exercised. The exercise protocol consisted of 10 ladder-climbing sessions/day, 5 days/week, and the sedentary rats were maintained in individual cages with limited mobility. Body mass and food intake were evaluated weekly. After 10 weeks, the animals were euthanized, and white adipose tissue was collected. The bone structure was evaluated by densitometry, mechanical tests, histomorphometric, and micro-computed tomography analyses. RESULTS: The cafeteria diet increased adipose tissue (p<0.001), decreased bone mineral density (p=0.004), and impaired biomechanical properties (p<0.05) and histomorphometry parameters (p=0.044). The sedentarism decreased bone mineral density (p<0.001) and biomechanical properties (p<0.05), and the exercise did not improve bone properties. CONCLUSION: In this experimental model, it was concluded that the cafeteria diet and a sedentary lifestyle negatively affect bone, and ladder-climbing exercise could not prevent the effects of the unhealthy diet.

Rho-Kinase Is Differentially Expressed in the Adipose Tissue of Rodent and Human in Response to Aging, Sex, and Acute Exercise.

White adipose tissue (WAT) controls energy storage, expenditure, and endocrine function. Rho-kinase (ROCK) is related to impaired thermogenesis, downregulation of preadipocyte differentiation, and adipokine production. Furthermore, WAT ROCK responds to metabolic stress from high-fat diets or diabetes. However, ROCK distribution in adipose depots and its response to aging and sex remain unclear. Thus, we aim to investigate ROCK function in adipose tissue of rodent and human in response to aging and sex. We observed specific differences in the ROCK1/2 distribution in inguinal WAT (ingWAT), perigonadal WAT (pgWAT), and brown adipose tissue of male and female rodents. However, ROCK2 expression was lower in female ingWAT compared with males, a fact that was not observed in the other depots. In the pgWAT and ingWAT of male and female rodents, ROCK activity increased during development. Moreover, middle-aged female rodents and humans showed downregulation in ROCK activity after acute physical exercise. Interestingly, ROCK levels were associated with several inflammatory markers both in rats and humans WAT (Nfkb1, Tnf, Il1b, Il6, and Mcp1). Induction of cell senescence by etoposide elevates ROCK activity in human preadipocytes; however, silencing ROCK1/2 demonstrates improvement in the inflammatory and cell senescence state. Using public databases, several pathways were strongly associated with ROCK modulation in WAT. In summary, WAT ROCK increases with development in association with inflammatory markers. Further, ROCK activity was attenuated by acute physical exercise, implicating it as a possible therapeutic target for metabolism improvement mediated by adipose tissue inflammatory state changes.

Psychometric properties analysis of helping relationships skills inventory for Portuguese nurses and doctors.

This paper answered some authors' requests to analyze the Helping Relationships Skills Inventory psychometric properties, a four dimensions measure. At this level, the study contributed to accessing the first reliable and valid instrument headed to Portuguese nurses and doctors. Methods: An online survey with Portuguese nurses and doctors (n = 262) was managed to assess the psychometrics properties analysis of the Helping Relationships Skills Inventory. Data were analyzed using descriptive statistics, confirmatory factor analysis, the average variance extracted (AVE), the heterotrait-monotrait ratio of correlations (HTMT), Cronbach's Alpha, and McDonald's Omega were computed. Results: The four-factor of the original Helping Relationships Skills Inventory was only supported by Exploratory Factor Analysis, with good internal consistency. Our study accepted this correlational structure hypothesis, which demonstrated acceptable to good sensitivity, convergent validity (AVE: 0.84-0.67), and reliability (Cronbach's Alpha: 0.92-0.88; McDonald'Omega: 0.93-0.79). Also stays verified discriminant validity for the majority of the factors with some reserves between Generics and Emphatics dimensions (HTMT: 0.90), revealing high commonality among them (r = 0.84; p < .001) Conclusions: The findings support the sensitivity, construct validity, and reliability of the Helping Relationships Skills Inventory among Portuguese nurses and doctors. However, will be useful to associate qualitative methodologies to explore the phenomenon better.

Influence of the frameworks of implant-supported prostheses and implant connections on stress distribution.

BACKGROUND: The maintenance of marginal bone integrity around dental implants continues to be a clinical challenge. It is still unclear whether loading multiple implant-supported prostheses that have different implant connections influences bone resorption. OBJECTIVES: The aim of this in vitro study was to compare stress distribution around residual edentulous ridges supported by external hexagon (EH) and Morse taper (MT) implants with screw-retained frameworks obtained with the use of different methods. MATERIAL AND METHODS: Three-element implant-supported prostheses with distal cantilevers were manufactured according to different techniques of obtaining the framework: LAS - framework sectioned and welded with a laser; TIG - framework sectioned and welded with tungsten inert gas (TIG); and CCS - framework obtained using a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Occlusal and punctual loading (150 N) was applied to the cantilevers. In the photoelastic stress analysis, the fringe orders (n) were quanitified using the Tardy method, which calculates the maximum shear stress value (τ) at each selected point. RESULTS: High stress around the implants and tightening were observed in the TIG group, mainly in the crestal bone region for the EH and MT implant connections. The LAS and CCS frameworks exhibited lower stress for the MT connection under occlusal and punctual loading. CONCLUSIONS: The comparative analysis of the models showed that the MT connection type associated with the laser-welded or CAD/CAM frameworks resulted in lower stress values in the crestal bone area, suggesting the preservation of bone tissue in this region.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study.

OBJECTIVE: To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. METHODOLOGY: Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. RESULTS: 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. CONCLUSION: Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.

Risk factors and immunological biomarkers in denture stomatitis: An observational cross-sectional study.

OBJECTIVE: Assess risk factors, local and systemic immunological biomarkers in healthy individuals and with Denture Stomatitis (DS). DESIGN: For this observational transversal study, 27 participants without DS (Group 0), 24 with moderate DS (Group 1), and 25 with severe DS (Group 2) were assessed for sociodemographic, behavioral, and clinical parameters, microbial load of Candida spp., Staphylococcus spp., Streptococcus mutans, Pseudomonas spp., and enterobacteria, and cytokine and C-reactive protein levels. ANOVA, Fisher's exact, Kruskal-Wallis, Mann-Whitney, Wilcoxon and Pearson's chi-square tests were used for data analysis (α = 0.05). RESULTS: Group 1 had a significantly higher mean age compared to the other groups (P = 0.018), but no correlation was identified between age and DS (P = 0.830; r = 0.025). No significant differences were found among the groups for other sociodemographic and behavioral characteristics. Group 1 had significantly older upper and lower dentures; however, no correlation was identified between age of upper (P = 0.522; r = 0.075) and lower (P = 0.143; r = 0.195) dentures and DS. The microbial load of Candida albicans on the dentures (P = 0.035) and Candida spp. on the palate (P = 0.008) of the groups 1 and 2 was higher than group 0. Group 1 and 2 had higher Candida spp. counts on denture (P = 0.003) than group 0. There was no difference among groups for bacterial analyzed. Group 1 showed higher and Group 2 intermediate salivary levels of IL-6 compared to Group 0. There was no difference in the C-reactive protein levels among groups. CONCLUSIONS: Microbial load of Candida spp. is the factor with the strongest relationship with DS, with capacity for local signaling through IL-6.

Time-restricted feeding combined with resistance exercise prevents obesity and improves lipid metabolism in the liver of mice fed a high-fat diet.

Nonalcoholic fatty liver disease (NAFLD), a condition characterized by the accumulation of fat in the liver, is estimated to be the most common liver disease worldwide. Obesity is a major risk factor and contributor, and, accordingly, weight loss can improve NAFLD. Previous studies in preclinical models of diet-induced obesity and fatty liver disease have shown the independent benefits of resistance exercise training (RT) and time-restricted feeding (TRF) in preventing weight gain and hepatic build-up of fat. Here, we tested the combined effect of TRF and RT on obesity and NAFLD in mice fed a high-fat diet. Our results showed that both TRF-8-h food access in the active phase-and RT-consisting of three weekly sessions of ladder climbing-attenuated body weight gain, improved glycemic homeostasis, and decreased the accumulation of lipids in the liver. TRF combined with RT improved the respiratory exchange rate, energy expenditure, and mitochondrial respiration in the liver. Furthermore, gene expression analysis in the liver revealed lower mRNA expression of lipogenesis and inflammation genes along with increased mRNA of fatty acid oxidation genes in the TRF + RT group. Importantly, combined TRF + RT was shown to be more efficient in preventing obesity and metabolic disorders. In conclusion, TRF and RT exert complementary actions compared with isolated interventions, with significant effects on metabolic disorders and NAFLD in mice.NEW & NOTEWORTHY Whether time-restricted feeding (TRF) combined with resistance exercise training (RT) may be more efficient compared with these interventions alone is still unclear. We show that when combined with RT, TRF provided additional benefits, being more effective in increasing energy expenditure, preventing weight gain, and regulating glycemic homeostasis than each intervention alone. Thus, our results demonstrate that TRF and RT have complementary actions on some synergistic pathways that prevented obesity and hepatic liver accumulation.

The long-term effect of sub-boiling water on dental unit waterlines and its ability to control cross-contamination in dentistry.

This study investigated the effect of water at high temperature on the physical and mechanical properties of polyurethane and on biofilm removal, aiming for its applicability in dental unit waterlines. The evaluations were carried out after simulating a 1-year period of daily immersion and measured changes in color, microhardness, surface roughness, and tensile strength before and after reproducing a disinfection protocol. For antibiofilm activity measurement, fragments of waterline were contaminated with Pseudomonas aeruginosa and submitted to the disinfection protocols. Relative to effects on the physical and mechanical properties, immersion in water at 60°C did not promote changes in color and tensile strength. However, lower values were observed for microhardness and increased values for surface roughness. Regarding antibiofilm action, water at 60°C significantly reduced the microbial load and promoted substantial changes in cells morphology. In conclusion, disinfection with water at 60°C demonstrated possible application in controlling cross-contamination in dentistry.

Analysis of stress/strain distribution in dental mini-implants manufactured by additive manufacturing and machining.

The study aimed to analyze the stress/strain distribution of new designs of mini-implants manufactured by machining and additive manufacturing. Four designs were evaluated (Ø2.0 mm × 10 mm): Intra-lock, helical, threaded machined (MN threaded) and threaded by additive manufacturing (AM threaded). Analysis of stress was performed through photoelastic analysis (100 N axial/oblique loads) and analysis of strain by digital image correlation (DIC) (250 N axial/100 N oblique load). Data distribution was verified using the Shapiro-Wilk test and a significance level of 5% was adopted. Quantitative data were analyzed using the non-parametric Kruskal-Wallis test. In photoelastic analysis, the Intra-lock mini-implant showed the highest stresses in the cervical (104 kPa), middle (108 kPa), and apical (212 kPa) thirds. Higher stresses were observed in the oblique loading situation for all designs. For DIC analysis, axial loading, a significant difference was observed for the AM Threaded mini-implants about the other designs in the cervical third (p = .04), with the highest strain value 47 µÎµ [10; 76]. In oblique loading, a significant difference between the mini-implants was observed in the middle and apical thirds, with higher strains for the AM threaded design -185 µÎµ [-173; 162] (p = .009) and 242 µÎµ [87; 372] (p = .013), respectively. In general, the influence of different mini-implant designs and the additive manufacturing method on the stress/strain was observed, in the photoelastic and DIC analysis. The evaluated designs demonstrated a lower concentration of stress/strain in the cervical region compared to the apical region, and higher stress/strain in situations of oblique load compared with axial load.

Mechanical comparison of milled fiber-reinforced resin composite and Co-Cr frameworks with different connector cross-sectional geometries: An in vitro study.

This study compared the effect of using milled fiber-reinforced resin composite and Co-Cr (milled wax and lost-wax technique) frameworks for 4-unit implant-supported partial fixed dental prostheses; and also, evaluated the influence of the connector's cross-sectional geometries on the mechanical behavior. Three groups of milled fiber-reinforced resin composite (TRINIA) for 4-unit implant-supported frameworks (n = 10) with three connectors geometries (round, square, or trapezoid), and three groups of Co-Cr alloy frameworks manufactured by milled wax/lost wax and casting technique, were analyzed. The marginal adaptation was measured before cementation using an optical microscope. Then, the samples were cemented, thermomechanical cycled (load of 100 N/2 Hz, 106 cycles; 5, 37, and 55 ᵒC, a total of 926 cycles at each one), and cementation and flexure strength (maximum force) analyzed. Analysis of stress distribution in framework veneered considering resin and ceramic properties for fiber-reinforced and Co-Cr frameworks, respectively, implant, and bone was by finite element analysis under three contact points (100 N) on the central region. ANOVA and Multiple paired test-t with Bonferroni adjustment (α = 0.05) were used for data analysis. Fiber-reinforced frameworks showed better vertical adaptation (mean ranged from 26.24 to 81.48 µm) compared to the Co-Cr frameworks (mean ranged from 64.11 to 98.12 µm), contrary to horizontal adaptation (respectively, means ranged from 281.94 to 305.38 µm; and from 150.70 to 174.82 µm). There were no failures during the thermomechanical test. Cementation strength showed three times higher for Co-Cr compared to fiber-reinforced framework, as well as flexural strength (P < .001). Regarding stress distribution, fiber-reinforced had a pattern of concentration in the implant-abutment complex. There were no significant differences in stress values or changes observed among the different connector geometries or framework materials. Trapezoid connector geometry had a worse performance for marginal adaptation, cementation (fiber-reinforced 132.41 N; Co-Cr 255.68 N) and flexural strength (fiber-reinforced 222.57 N; Co-Cr 614.27 N). Although the fiber-reinforced framework showed lower cementation and flexural strength, considering the stress distribution values and absence of failures in the thermomechanical cycling test, it can be considered for use as a framework for 4-unit implant-supported partial fixed dental prostheses in the posterior mandible. Besides, results suggest that trapezoid connectors mechanical behavior did not perform well compared to round or square geometries.

Exercise training restores weight gain and attenuates hepatic inflammation in a rat model of non-celiac gluten sensitivity.

Gluten intolerance is associated with several disorders in the body. Although research has grown in recent years, the understanding of its impact on different tissues and the effects of physical exercise in mitigating health problems in the condition of gluten intolerance are still limited. Therefore, our objective was to test whether gliadin would affect metabolism and inflammation in liver tissue and whether aerobic physical exercise would mitigate the negative impacts of gliadin administration in rodents. Wistar rats were divided into exercised gliadin, gliadin, and control groups. Gliadin was administered by gavage from birth to 60 days of age. The rats in the exercised gliadin group performed an aerobic running exercise training protocol for 15 days. At the end of the experiments, physiological, histological, and molecular analyzes were performed in the study. Compared to the control group, the gliadin group had impaired weight gain and increased gluconeogenesis, lipogenesis, and inflammatory biomarkers in the liver. On the other hand, compared to the gliadin group, animals in the exercise-gliadin group had a recovery in body weight, improved insulin sensitivity, and a reduction in some gluconeogenesis, lipogenesis, and inflammatory biomarkers in the liver. In conclusion, our results revealed that the administration of gliadin from birth impaired weight gain and induced an increase in hepatic inflammatory cytokines, which was associated with an impairment of glycemic homeostasis in the liver, all of which were attenuated by adding aerobic exercise training in the gliadin group.

Action of chitosan-based solutions against a model four-species biofilm formed on cobalt-chromium and acrylic resin surfaces.

OBJECTIVE: To evaluate the anti-biofilm action of chitosan, nanoparticulate chitosan, and denture cleanser Nitradine™ against biofilms comprising Candida albicans, Candida glabrata, Staphylococcus aureus, and Streptococcus mutans. BACKGROUND: Biofilm removal from removable partial dentures (RPD) is important for success in prosthetic rehabilitation. MATERIALS AND METHODS: The anti-biofilm action of the experimental chitosan-based solutions and Nitradine™ was evaluated on acrylic resin and cobalt-chromium alloy through assessing cell viability, cell metabolism, residual aggregated biofilm, and extracellular polymeric substance and biofilm morphology. RESULTS: Only chitosan reduced the viability of C. albicans on cobalt-chromium alloy surface, by 98% (a 1.7 log10 reduction in cfu). Chitosan-based solutions neither promoted substantial alteration of the metabolic activity of the four-species biofilm nor reduced the amount of the aggregated biofilm. After immersion in chitosan and nanoparticulate chitosan, viable microorganisms and extracellular polymeric substances distributed over the entire specimens' surfaces were observed. Nitradine™ reduced the viability and metabolic activity of biofilm grown on both surfaces, but it did not remove all aggregated biofilm and extracellular polymeric substances. After immersion in Nitradine™, approximately 35% of the specimens' surfaces remained covered by aggregated biofilm, mainly composed of dead cells. CONCLUSION: Although chitosan and Nitradine™ promoted changes in the viability of microorganisms, neither solution completely removed the four-species biofilm from the Co-Cr and acrylic resin surfaces. Thus, isolated use of hygiene solutions is not indicated for biofilm control on RPDs; this requires complementary mechanical removal.

Antimicrobial Activity of Experimental Chitosan Solutions on Acrylic Resin and Cobalt-Chromium Surfaces.

PURPOSE: To evaluate the application of chitosan as a cleanser in the control of biofilm formation on cobalt-chromium (Co-Cr) alloy and acrylic resin surfaces. MATERIALS AND METHODS: In total, 172 Co-Cr discs and 172 acrylic resin discs (14 mm x 3 mm) were contaminated with Streptococcus mutans, Staphylococcus aureus, Candida albicans, or Candida glabrata and incubated for 48 hours. Then, specimens were randomly divided into groups and immersed in the following solutions for 15 minutes: solution without chitosan (WC/control); chitosan solution (CH: 5 mg/mL); chitosan nanoparticle solu.on (CN: 3.8 mg/mL); and effervescent tablet (ET). Biofilm recovery rates (n = 9) were evaluated by counting the colony-forming units (CFU/mL). Biofilm morphology was evaluated using scanning electron microscopy (SEM). Data were compared using the Kruskal-Wallis or ANOVA tests followed by the Tukey post hoc test. RESULTS: For acrylic resin, ET showed the lowest number of CFU for S aureus and S mutans (P < .001). CH exhibited intermediate values for S mutans, S aureus, and C albicans; CN exhibited intermediate values for S mutans and S aureus. For C glabrata, there was no sta.s.cal difference between the solu.ons (P = .264). For Co-Cr, ET showed the highest level of antimicrobial action against all microorganisms (P < .001), and CH showed an intermediate level of action against S mutans and S aureus. Against C albicans and C glabrata, there was no significant difference among CH, CN, and WC. CONCLUSIONS: Although ET had a broader spectrum of antimicrobial action, CH showed promise as a denture cleanser. Int J Prosthodont 2023;36:e61-e73.

Comparative analysis of Candida spp. isolated from complete denture wearers with and without an HIV diagnosis.

STATEMENT OF PROBLEM: Denture-related stomatitis (DRS), an inflammation frequently present in human immunodeficiency virus-positive (HIV+) individuals, can be attributable to colonization by Candida spp., which is considered a main factor. The virulence factors of these species are often modulated by the systemic condition of their hosts. PURPOSE: The purpose of this clinical study was to evaluate the incidence, virulence, and morphology of Candida spp. isolated from biofilms of complete denture wearers with DRS, with and without an HIV diagnosis. In addition, the interaction of the systemic condition with the ability of Candida spp. to colonize was evaluated. MATERIAL AND METHODS: Fifty-five complete denture wearers diagnosed with DRS were divided into 2 groups: experimental (HIV+) and control (human immunodeficiency virus-noninfected participants [HIV-]). Biofilm was collected by a standardized method of ultrasonification of prostheses. The incidence was evaluated by a chromogenic method and polymerase chain reaction (PCR). The virulence factors were assessed by using the capacity for biofilm formation by counting colony-forming units (CFUs/mL), biofilm metabolism by tetrazolium salt metabolization, and proteinase and phospholipase production by using a fluorimetric kit. Morphology was verified by using the hyphae-inducing test, and participants' health data were collected with a form. Data were analyzed by using the Student t, Mann-Whitney U, Spearman, and Fisher tests (α=.05). RESULTS: The results of incidence were related to 55 participants (22 experimental and 33 control); in total, 63 Candida spp. samples were isolated, showing 28 Candida albicans and 36 nonalbicans strains. No significant difference was found between groups in baseline CFU/mL counts, biofilm formation capacity, cell metabolism, and phospholipase production. Proteinase production was higher for C. albicans in the control (P=.031) and for nonalbicans in the experimental (P=.016) groups. Relative to health data, the experimental group showed a moderate negative correlation between the CFU count/mL at baseline for nonalbicans and DRS classification (P=.020). CONCLUSIONS: C. albicans was the most prevalent species. No difference was found in the Candida spp. of complete denture wearers with DRS, with and without an HIV diagnosis, with regard to virulence factors (except for proteinase production) and morphology.

Relation between the risk factors for the severity of denture stomatitis and quality of life of complete edentulous individuals: a cross-sectional study

Abstract Objective To assess the association between risk factors for developing denture stomatitis (DS) and oral health-related quality of life (OHRQoL) in complete denture wearers. Methodology Participants of both sexes, wearing complete dentures, were classified using the modified Newton classification for the absence or the severity of DS and allocated to groups Normal or zero, IA, IB, II, and III. Lifestyle, oral and denture history, and medication use were assessed using specific questionnaires; clinical parameters such as anatomical characteristics of support were evaluated with the Kapur classification; salivary flow (SF) was calculated by the volume of unstimulated saliva per minute; and microbial load was determined by counting colony forming units (CFU) of target microorganisms present in the biofilm collected from dentures and palate. OHIP-EDENT assessed the OHRQoL. Kendall's tau_b and Spearman tests were applied with a significance level of 5%. Results 184 patients (143 female and 41 male) aged 65.5 ± 6.8 years were evaluated. Positive correlations were found for sex (women; p=0.013, r=0.16), individuals who started to consume alcoholic beverages as a young adult (18-27 years) (p=0.008, r=0.22), CFU of Candida spp. (p<0.001, r=0.27 denture; p<0.001, r=0.31 palate); Candida albicans (p=0.004, r=0.22 denture; p=0.003, r=0.25 palate), and Candida glabrata (p=0.004, r=0.22 denture; p=0.001, r=0.27 palate). Moreover, negative correlations with DS were found for CFU of Staphylococcus spp. (p=0.004, r=-0.20 palate) and enterobacteria (p=0.002, r=-0.24 palate), as well as a negative correlation between SF (p=0.009, r=-0.193) and DS. The CFU of Staphylococcus spp. and enterobacteria on the palate significantly correlated with OHRQoL. Conclusion Being female, consuming alcoholic beverages as a young adult, CFU of Candida spp., Candida albicans, Candida glabrata, and salivary flow may be the most significant risk factors for DS. The microbial load of Staphylococcus spp. and enterobacteria seems to influence the quality of life for complete denture wearers.