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.

Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure.

Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p < 0.05). A significant difference was found in the DRS degree (p < 0.001), biofilm (p < 0.001), microbial load of Candida spp. (p < 0.001), Gram-negative (p < 0.004), Staphylococcus spp. (p < 0.001), and S. mutans (p < 0.001) of the denture, and S. mutans (p < 0.001) of the palate after use of the protocol. The salivary flow (p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients.

Complete denture hygiene solutions: antibiofilm activity and effects on physical and mechanical properties of acrylic resin.

BACKGROUND: Appropriated denture hygiene is a predictive factor for longevity of rehabilitation treatment and maintenance of the oral mucosal health. Although, disinfectant solutions are commonly used as denture cleansers, the impact of these solutions on acrylic resin-based dentures remain unclear. OBJECTIVE: To evaluate, in vitro, the antibiofilm activity of complete denture hygiene solutions and their effects on physical and mechanical properties of acrylic resin. METHODOLOGY: For antibiofilm activity measurement acrylic resin specimens were contaminated with Candida albicans, Candida glabrata and Streptococcus mutans. After biofilm growth, the specimens were assigned to the hygiene solutions: Distilled water (Control); 0.2% Sodium hypochlorite (SH); Efferdent Power Clean Crystals (EPC) and 6.25% Ricinus communis (RC). The viability of microorganisms was evaluated by agar plate counts. In parallel, physical, and mechanical properties of the acrylic resin were evaluated after simulating a 5-year period of daily immersion in the previously mentioned solutions. The changes in surface roughness, color, microhardness, flexural strength, impact strength, sorption and solubility were evaluated. Data were compared by ANOVA followed by the Tukey test or Kruskal-Wallis followed by the Dunn test depending on the distribution (α=0.05). RESULTS: Regarding antibiofilm action, SH eliminated all microorganisms while EPC and RC exhibited moderate action against S. mutans (p=0.001) and C. glabrata (p<0.001), respectively. Relative to effects on the physical and mechanical properties of the acrylic resin, RC led to higher values of color change (p=0.030), hardness (p<0.001), surface roughness (p=0.006) and flexural strength (p<0.001). Moreover, RC induced the highest values of changes in solubility (p<0.001). EPC promoted greater changes in surface morphology, whereas immersion in SH retained the initial appearance of the acrylic resin surface. All hygiene solutions reduced the impact strength (p<0.05). CONCLUSION: SH presented the most effective antibiofilm activity. In addition, changes on properties were observed after immersion in RC, which were considered within acceptable limits.

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.

Expression of virulence factors by Pseudomonas aeruginosa biofilm after bacteriophage infection.

The use of bacteriophages for the treatment of bacterial infections has been extensively studied. Nonetheless, the stress response regarding bacteriophage infection and the expression of virulence factors of Pseudomonas aeruginosa after phage infection is poorly discussed. In this study, we evaluated biofilm formation capacity and expression of virulence factors of P. aeruginosa after bacteriophage infection. Biofilm growth rates, biofilm morphology, pyocyanin production and elastase activity were evaluated after 2, 8, 24 and 48 h of co-cultivation with bacteriophages that was recently characterized and showed to be infective towards clinical isolates. In parallel, quantitative real-time polymerase chain reactions were carried out to verify the expression of virulence-related genes. Bacteriophages promoted substantial changes in P. aeruginosa biofilm growth at early co-culture time. In addition, at 8 h, we observed that some cultures developed filaments. Although bacteriophages did not alter both pyocyanin and protease activity, changes on the expression level of genes related to virulence factors were detected. Usually, lasI, pslA, lasB and phzH genes were upregulated after 2 and 48 h of co-culture. These results highlight the need for extensive investigation of pathways and molecules involved in phage infection, since the transcriptional changes would suggest a response activation by P. aeruginosa.

Using denture cleansers to control biofilm from dentures and brushes: A randomized crossover clinical trial.

PURPOSE: To evaluate the effects of 0.2% sodium hypochlorite, Efferdent (Prestige Consumer Healthcare), and 6.25% Ricinus communis on biofilm removal and antimicrobial action on dentures and brushes using nonimmersion or immersion protocols for the brushes. MATERIALS AND METHODS: A total of 45 denture wearers were randomly assigned to a denture immersion protocol for 7 days: 0.85% saline solution for 20 minutes (control); 0.2% sodium hypochlorite for 20 minutes (SH); Efferdent for 3 minutes; or 6.25% Ricinus communis for 20 minutes (RC). The participants were also randomized to immersion (n = 23) or no immersion (n = 22) of their brushes with their dentures in the same solutions. For biofilm evaluation, the dentures were stained and photographed, and the area of the biofilm was measured using Image Tool 3.0 (University of Texas Health Science Center). To evaluate microbial load on dentures and brushes, the biofilm was collected, and the Candida spp and Streptococcus mutans colonies were counted. RESULTS: The SH, Efferdent, and RC groups showed reduced biofilm and Candida spp on dentures regardless of the immersion protocol for the brushes. However, no difference was found in the Candida spp counts collected from the brushes immersed compared to the brushes not immersed in the solutions. The SH and Efferdent groups showed reduced S mutans on both dentures and brushes, except for in the nonimmersion subgroups. CONCLUSION: All solutions reduced denture biofilm and microbial load. However, immersion of brushes in the solutions did not contribute to reducing the microbial load.

Brushing associated with oral irrigation in maintaining implants and overdentures hygiene - a randomized clinical trial.

Evaluate, through a randomized clinical trial, the efficacy of brushing associated with oral irrigation in maintaining implant and overdenture hygiene. Thirty-eight participants, who had a clinically acceptable conventional maxillary complete denture and mandibular overdenture retained by either implants or mini-implants using an O-ring-retained system, were enrolled to participate in the study. They were instructed to use two different hygiene methods, in a random sequence for a period of 14 days, with a 7-day wash-out interposed period: (I) mechanical brushing (MB); (II) association of mechanical brushing with oral irrigation (WP). Biofilms from both subgingival sulci and overdentures were collected and processed by Checkerboard DNA-DNA hybridization method at baseline and after using the proposed hygiene protocols. Comparisons were performed using Wilcoxon test and Friedman test with Benjamini-Hochberg false discovery rate, followed by Conover post-hoc test (α = 0.05). In the subgingival sulci-related biofilm, a lower number of microbial cells were detected, after WP compared to the MB method (P < 0.001). The findings of overdenture-related biofilm suggest that both methods were similar (P = 0.607) being the identified microbiota qualitatively coincident after each method. Despite the number of microbial counts, it was concluded that the association of mechanical brushing with oral irrigation was more effective in reducing microorganisms in the subgingival sulci biofilm; however, the same outcome was not observed in the overdentures.

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.

Complete denture hygiene solutions: antibiofilm activity and effects on physical and mechanical properties of acrylic resin

Abstract Appropriated denture hygiene is a predictive factor for longevity of rehabilitation treatment and maintenance of the oral mucosal health. Although, disinfectant solutions are commonly used as denture cleansers, the impact of these solutions on acrylic resin-based dentures remain unclear. Objective To evaluate, in vitro, the antibiofilm activity of complete denture hygiene solutions and their effects on physical and mechanical properties of acrylic resin. Methodology For antibiofilm activity measurement acrylic resin specimens were contaminated with Candida albicans, Candida glabrata and Streptococcus mutans. After biofilm growth, the specimens were assigned to the hygiene solutions: Distilled water (Control); 0.2% Sodium hypochlorite (SH); Efferdent Power Clean Crystals (EPC) and 6.25% Ricinus communis (RC). The viability of microorganisms was evaluated by agar plate counts. In parallel, physical, and mechanical properties of the acrylic resin were evaluated after simulating a 5-year period of daily immersion in the previously mentioned solutions. The changes in surface roughness, color, microhardness, flexural strength, impact strength, sorption and solubility were evaluated. Data were compared by ANOVA followed by the Tukey test or Kruskal-Wallis followed by the Dunn test depending on the distribution (α=0.05). Results Regarding antibiofilm action, SH eliminated all microorganisms while EPC and RC exhibited moderate action against S. mutans (p=0.001) and C. glabrata (p<0.001), respectively. Relative to effects on the physical and mechanical properties of the acrylic resin, RC led to higher values of color change (p=0.030), hardness (p<0.001), surface roughness (p=0.006) and flexural strength (p<0.001). Moreover, RC induced the highest values of changes in solubility (p<0.001). EPC promoted greater changes in surface morphology, whereas immersion in SH retained the initial appearance of the acrylic resin surface. All hygiene solutions reduced the impact strength (p<0.05). Conclusion SH presented the most effective antibiofilm activity. In addition, changes on properties were observed after immersion in RC, which were considered within acceptable limits.

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.

Idiopathic exostosis: rarity on maxillary sinus

Introduction: Exostoses in the paranasal sinuses have been reported in a greater number in the dental radiological literature, despite the extensive citation in the otorhinolaryngology literature. Objective: This case report was a rare idiopathic expression that grew in the maxillary sinus. Case report: A 68-year-old black patient, BGS, followed up by the Odontology Service of Cancer Hospital for treating oral lesions (Mucositis) and other conditions resulting from radiation therapy and hormone therapy (Tamoxifen), presented malignant neoplasm at the right breast in 2015; an exostosis biopsy was not performed, since the patient is being treated and followed up by the hospital service. Panoramic radiography and clinical examination were performed. By analyzing the tests, it was possible to notice an image with double radiodensity, more radiopaque in the external portion and less radiopaque in the internal portion, with an aspect of trabecular bone, circumscribed, unilocular, in the region of pedunculated premolar, inside the left maxillary sinus. In order to have a better assessment and diagnostic hypothesis of the case, a CT scan was performed, a tool was applied to measure the density of the profile of the lesion, thus evidencing that the supposed injury invaginates to the interior of the maxillary sinus and had bone density similar to the alveolar crest bone. Conclusion: Simultaneously to other lesions, exostoses are benign lesions, present low aggression and rare symptomatology; exeresis is indicated only when it prevents functioning, or for aesthetics reasons, or when it is not possible to make prostheses. Many cases are incidentally diagnosed from routine radiographic review in medical or dental offices and should be followed up for analysis and verification of their growth.

Introdução: Exostoses nos seios paranasais têm sido muito mais relatados na literatura radiológica odontológica, apesar da extensa citação na literatura otorrinolaringológica. Objetivo: Neste relato de caso, encontramos uma exostose idiopática rara, que cresceu no seio maxilar. Relato de caso: Paciente negra de 68 anos, BGS, acompanhada pelo Serviço de Odontologia do Hospital do Câncer para tratamento de lesões orais (mucosite) e outras condições decorrentes da radioterapia e terapia hormonal (Tamoxifeno), apresentou neoplasia maligna da mama direita em 2015. Não foi realizada biopsia da exostose, pois a paciente está em tratamento e está sendo acompanhada pelo serviço do hospital. Realizaram-se radiografia panorâmica e exame clínico. Ao examinar os exames, foi possível notar uma imagem com dupla radiodensidade, mais radiopaca numa parte externa e menos radiopaca na parte interna, com aspecto de osso trabecular, circunscrito, unilocular, na região do ré-molar pediculado, no interior do seio maxilar esquerdo. Para melhor avaliação e hipótese diagnóstica, foi realizada uma tomografia computadorizada, aplicou-se uma ferramenta para mensuração da densidade do perfil da lesão, evidenciando-se que a suposta lesão invagina para o interior do seio maxilar e tinha densidade óssea semelhante ao osso da crista alveolar. Conclusão: Simultaneamente a outras lesões, as exostoses são lesões benignas, apresentam baixa agressividade e rara sintomatologia, sendo indicada exérese somente quando acomete a função, ou por motivos estéticos, ou quando não é possível a confecção de próteses. Muitos dos casos são diagnosticados de modo incidental e a partir de exames radiográficos de rotina em consultórios médicos ou odontológicos e devem ser acompanhados para análise e verificação de seu crescimento.

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.

Genomic identification of microbial species adhering to maxillofacial prostheses and susceptibility to different hygiene protocols.

This study investigated the microbial colonization of maxillofacial prostheses and support tissues using the Checkerboard DNA-DNA hybridization method, and the efficacy of 0.12% chlorhexidine gluconate, 10% Ricinus communis solutions, or brushing, on colony forming unit (CFU) reduction in monospecies biofilms (Candida glabrata, Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa) formed on two silicones (MDX 4-4210 and Bio-Skin). Biofilm was harvested from 43 maxillofacial prosthesis wearers for detection of 38 species of microorganisms. The CFU counts of the six above mentioned species were recorded after using the hygiene protocols. All 38 investigated species were identified in prostheses and tissues, with a higher prevalence in the prostheses. 0.12% chlorhexidine gluconate immersion showed the greatest antimicrobial effectiveness, followed by mechanical brushing protocols. MDX 4-4210 silicone produced lower CFU counts than Bio-Skin.

Alkaline Peroxides Versus Sodium Hypochlorite for Removing Denture Biofilm: a Crossover Randomized Trial.

This study evaluated the efficacy of cleanser solutions on denture biofilm removal by a crossover randomized clinical trial. Thirty two edentulous patients were instructed to brush their dentures (specific brush and liquid soap) three times a day (after breakfast, lunch and dinner) and to soak them (≥ 8 h) in: (C) control -water; (AP): alkaline peroxide; or (SH) 0.5% sodium hypochlorite. Each solution was used for 21 days (three cycles of 7 days). At the end of each cycle, the inner surfaces of maxillary dentures were disclosed (1% neutral red) and photographed (HX1 - Sony). Areas (total and stained biofilm) were measured (Image Tool software) and the percentage of biofilm calculated as the ratio between the area of the biofilm multiplied by 100 and total surface area of the internal base of the denture. Data were compared by means of generalized estimating equation (α=5%) and multiple comparisons (Bonferroni; α=1.67%). Immersion in SH reduced biofilm (%) (8.3 ± 13.3B) compared to C (18.2 ± 14.9A) and AP (18.2 ± 16.6A). The 0.5% sodium hypochlorite solution was the most efficacious for biofilm removal. Alkaline peroxides may not lead to further biofilm removal in patients with adequate denture maintenance habits.

Alkaline Peroxides Versus Sodium Hypochlorite for Removing Denture Biofilm: a Crossover Randomized Trial

Abstract This study evaluated the efficacy of cleanser solutions on denture biofilm removal by a crossover randomized clinical trial. Thirty two edentulous patients were instructed to brush their dentures (specific brush and liquid soap) three times a day (after breakfast, lunch and dinner) and to soak them (≥ 8 h) in: (C) control -water; (AP): alkaline peroxide; or (SH) 0.5% sodium hypochlorite. Each solution was used for 21 days (three cycles of 7 days). At the end of each cycle, the inner surfaces of maxillary dentures were disclosed (1% neutral red) and photographed (HX1 - Sony). Areas (total and stained biofilm) were measured (Image Tool software) and the percentage of biofilm calculated as the ratio between the area of the biofilm multiplied by 100 and total surface area of the internal base of the denture. Data were compared by means of generalized estimating equation (α=5%) and multiple comparisons (Bonferroni; α=1.67%). Immersion in SH reduced biofilm (%) (8.3 ± 13.3B) compared to C (18.2 ± 14.9A) and AP (18.2 ± 16.6A). The 0.5% sodium hypochlorite solution was the most efficacious for biofilm removal. Alkaline peroxides may not lead to further biofilm removal in patients with adequate denture maintenance habits.

Resumo Este estudo avaliou a eficácia de soluções higienizadoras na remoção do biofilme de dentadura por meio de ensaio clínico randomizado cruzado. Trinta e dois pacientes desdentados foram instruídos a escovar suas dentaduras (escova específica e sabão líquido) três vezes ao dia (após café da manhã, almoço e jantar) e imergi-las (≥ 8 horas) em: (C) controle - água; (PA): peróxido alcalino; ou (HS) hipoclorito de sódio a 0,5%. Cada solução foi usada por 21 dias (três ciclos alternados de 7 dias). Ao final de cada ciclo, a superfície interna da dentadura maxilar foi evidenciada (vermelho neutro 1%) e fotografada (HX1- Sony). As áreas (total e corada com biofilme) foram medidas (software Image Tool), e a porcentagem de biofilme calculada como a relação entre a área do biofilme multiplicado por 100 e área da superfície total da base interna da dentadura. Os dados foram comparados por meio de equações de estimação generalizadas (α=5%) e comparações múltiplas (Bonferroni - α=1,67%). A imersão em HS reduziu o biofilme (%) (8,3 ± 13,3B) em comparação com C (18,2 ± 14,9A) e PA (18,2 ± 16,6A). A solução de hipoclorito de sódio a 0,5% foi a mais eficaz na remoção do biofilme. Peróxidos alcalinos podem não levar a maior remoção do biofilme em pacientes com hábitos adequados de manutenção de dentadura.

Antimicrobial efficacy of complete denture cleansers.

PURPOSE: To evaluate the in vitro antimicrobial efficacy of alkaline peroxides against microbial biofilms on acrylic resin surfaces. METHODS: Denture base acrylic resin (Lucitone 550; n= 360) circular specimens (15 x 3 mm) were obtained from a circular metal matrix and sterilized with microwave irradiation (650 W, 6 minutes). The specimens were then contaminated with suspensions [106 colony-forming units (CFU)/mL] of Candida albicans (Ca), Candida glabrata (Cg), Staphylococcus aureus (Sa), Streptococcus mutans (Sm), Bacillus subtilis (Bs), Enterococcus faecalis (Ef), Escherichia coli (Ec), and Pseudomonas aeruginosa (Pa). After contamination, the specimens were incubated at 37 degrees C for 48 hours and then placed in a stainless steel basket, which was immersed in a beaker with one of the following solutions prepared and used according to the manufacturers' instructions (n= 10 per group): Group PC (positive control), phosphate-buffered saline (PBS) solution; Group MI, NitrAdine, Medical Interporous; Group EF, Efferdent Plus; Group CT, Corega Tabs; and Group NC (negative control; n= 5), no contamination and immersed in PBS. After incubation (37 degrees C, 24 hours), the number of colonies with characteristic morphology was counted, and CFU/mL values were calculated. The data were processed following the transformation into the formula log" (CFU + 1) and statistically analyzed by the Kruskal-Wallis and Dunn's tests (alpha = 0.05). RESULTS: There were significant differences between the groups for the evaluated microorganisms with a significant reduction in the CFU/mL. MI was effective for Ca, Cg, Sa, Sm, Ef, Ec and Pa; EF was effective for Cg, Sm, Ef, Ec and Pa; and CT was effective for Sa, Bs and Ec, when compared with the PC group.

Effect of toothbrushes and denture brushes on heat-polymerized acrylic resins.

It is important to choose an appropriate brush for denture cleaning to prevent damage to the surface properties of prosthetic devices. The purpose of this study was to evaluate the abrasiveness of toothbrushes and denture brushes on boiled and microwave-processed acrylic resins. Specimens of 4 resin brands were prepared (n = 30). Five brands of brushes (n = 6) were used in a toothbrushing machine, first for 17,800 strokes and then for an additional 35,600 strokes (total of 53,400), at a load of 200 g. An analytical balance and a profilometer were used to assess the weight and surface roughness, respectively, before and after 17,800 and 53,400 strokes. Analysis of variance and Tukey tests were used for data analysis (α = 0.05). Weight loss increased with time, while surface roughness remained the same. There were no statistically significant differences among toothbrushes and denture brushes in the resulting weight loss (17,800 strokes, 1.83 mg; 53,400 strokes, 3.78 mg) or surface roughness (17,800 or 53,400 strokes, 0.14 µm). The weight loss values after 53,400 brush strokes indicated that Clássico (2.28 mg) and VIPI Wave (2.75 mg) presented significantly greater abrasion resistance than Lucitone 550 (3.36 mg) and Onda-Cryl (2.85 mg) (P < 0.05). The type of brush and the polymerization method did not influence resin wear after brushing.

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.

Effects of Denture Cleansers on Heat-Polymerized Acrylic Resin: A Five-Year-Simulated Period of Use.

This study evaluated color stability, surface roughness and flexural strength of acrylic resin after immersion in alkaline peroxide and alkaline hypochlorite solutions, simulating a five-year-period of use. Sixty disc-shaped (16 x 4 mm) and 60 rectangular specimens (65 x 10 x 3.3 mm) were prepared from heat-polymerized acrylic resin (Lucitone 550) and assigned to 3 groups (n = 20) of immersion (20 min): C1: distilled water; AP: warm water and one alkaline peroxide tablet; SH: 0.5% NaOCl solution. Color data (∆E) were determined by a colorimeter and also quantified according to the National Bureau of Standards units. A rugosimeter was used to measure roughness (µm) and the flexural strength (MPa) was measured using a universal testing machine. Data were evaluated by Kruskal-Wallis followed by Dunn tests (color stability and surface roughness) and by one-way ANOVA and Bonferroni test (flexural strength). For all tests was considered α = 0.05. AP {0.79 (0.66;1.42)} caused color alteration significantly higher than C1 {0.45 (0.37;0.57)} and SH {0.34 (0.25;0.42)}. The mean ∆Ε values quantified by NBS were classified as "trace" for C1 (0.43) and SH (0.31) and "slight" for AP (0.96). SH {-0.015 (-0.023;0.003)} caused significantly higher ΔRa than the C1 {0.000 (-0.004;0.010)} and AP {0.000 (-0.009;0.008)} groups. There was no statistically significant difference among the solutions for flexural strength (C1: 84.62 ± 16.00, AP: 85.63 ± 12.99, SH: 84.22 ± 14.72). It was concluded that immersion in alkaline peroxide and NaOCl solutions simulating a five-year of 20 min daily soaking did not cause clinically significant adverse effects on the heat-polymerized acrylic resin.