A Randomized Clinical Trial of Oral Health-Related Quality of Life, Peri-Implant and Kinesiograph Parameters in Wearers of One-or Two-Implant Mandibular Overdentures.

PURPOSE: The present randomized clinical trial compared the oral health-related quality of life (OHRQoL), peri-implant parameters, mandible movements, and maxillary complete denture movement during chewing between wearers of single- (1-IOD) and wearers of two-implant overdentures (2-IODs) for a period of 12 months. MATERIALS AND METHODS: Twenty-one complete denture wearers were randomly allocated into two parallel groups: 1-IOD (n = 11) or 2-IODs (n = 10). The validated Brazilian version of the OHIP-EDENT was used to evaluate the OHRQoL. A kinesiograph recorded maxillary complete denture movement during chewing of hard food testing (polysulphide impression material) and soft food testing (bread). Peri-implant parameters were also recorded: plaque index (PI), bleeding on probing (BOP), and probing depth (PD). The Friedman test was used to compare the OHRQoL data and peri-implant parameters among periods; the Mann-Whitney test was performed to compare the groups (1- and 2-IODs). One-way ANOVA and the Bonferroni test were used to compare mandible movement during chewing among periods, and the t-test for independent samples was used to compare the groups. Maxillary complete denture movement was analyzed using three-way ANOVA followed by the Bonferroni test. All statistical analyses were performed at α = 0.05. RESULTS: Both treatments led to better general OHRQoL in comparison to conventional complete dentures (p < 0.001). Better OHRQoL was observed among 2-IOD patients at the 12-month follow up (p = 0.034). Peri-implant parameters were similar irrespective of the group and follow-up period. Vertical opening was significantly higher among 1-IOD patients at 3 months (p = 0.038). Decreased maxillary denture vertical intrusions were observed with complete dentures in comparison with overdentures (p = 0.006), regardless of the food test (p = 0.251); however, vertical intrusion was significantly higher among 1-IOD patients (p = 0.043). CONCLUSIONS: This study suggested that 1-IOD can improve patient OHRQoL and may be similar to 2-IODs in preservation of both peri-implant parameters and masticatory movements.

Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind, randomized clinical trial.

STATEMENT OF PROBLEM: Limited mandibular movements are one of the most important signs of temporomandibular disorders (TMDs) and may cause functional difficulties. PURPOSE: The purpose of this double-blind, randomized clinical trial was to evaluate the effect of treatment with only educational or education associated with self-care therapies on the pattern of mandibular movements of women with chronic painful TMDs. MATERIAL AND METHODS: Forty-two women were selected and randomly divided into 3 groups, control group (CG, n=13), education group (EG, n=16), and education and self-care group (ESG, n=13), according to the sequence of treatment they received. A kinesiograph device recorded mandibular movements during maximum mouth opening and mastication at baseline (T0) and at 30-day (T1) and 60-day (T2) follow-up. Kinesiographic data were statistically analyzed using 1-way ANOVA, followed by the Bonferroni test for multiple comparisons of means (α=.05). RESULTS: The ESG group demonstrated an improvement in the maximum vertical opening (MVO= 5.1 ±3.4 mm; P=.012) and anteroposterior mandibular movement (MAM) during maximum opening (7.4 ±9.5; P=.019), significantly higher than that of the EG (MVO=1.8 ±3.5 mm; MAM=0.8 ±5.0 mm) and the CG (MVO=0.9 ±3.8 mm; MAM=0.8 ±4.4 mm) after 30 days of follow-up. Moreover, at T1, vertical mandibular movement during mastication was significantly higher in the ESG group (17.4 ±1.7 mm) than in the EG group (15.0 ±2.8, P=.027). No significant differences were found between the women who received treatment with educational and self-care therapies for 60 days and the women who received this treatment for 30 days. CONCLUSIONS: In the short-term, education and self-care treatment positively influenced the mandibular movement pattern of women with chronic painful TMDs.

Crossover clinical trial of different methods of removing a denture adhesive and the influence on the oral microbiota.

STATEMENT OF PROBLEM: The difficulty of removing denture adhesive is a common problem reported by users of these products. PURPOSE: The purpose of this clinical study was to investigate the effectiveness of different cleaning protocols for removing a denture adhesive (DA) and the influence on the oral microbiota. MATERIAL AND METHODS: Twenty participants wearing well-fitting complete dentures were instructed to use a denture adhesive 3 times a day during a 4-week trial, divided into 4 stages: (A) control-3 daily denture brushings using water at ambient temperature, (B)-3 daily denture brushings using water at ambient temperature plus coconut soap, (C)-3 daily denture brushings using water at ambient temperature plus dentifrice; (D)-3 daily denture brushings using water at ambient temperature combined with immersion in sodium perborate solution for 5 minutes before nocturnal sleep. After each 1-week stage, saliva specimens were collected. A dye was used to display and quantify the remaining DA on the internal surface of the maxillary dentures as a percentage. For microbiological analysis, the saliva was diluted and plated onto Petri dishes containing a nonselective culture medium and Candida spp culture media. After the incubation period, Candida species were identified and the number of colony forming units (CFU/mL) was calculated. RESULTS: A significant difference was found among the 4 cleaning methods for the quantification of remaining DA (Friedman, P=.036). Brushing the dentures with coconut soap, dentifrice, or water combined with immersion in sodium perborate solution was more effective in removing DA than brushing with only water. The cleaning methods did not influence the quantification of microorganisms in general or Candida albicans and other Candida species in particular. CONCLUSIONS: Brushing the dentures with coconut soap, dentifrice, or water combined with immersion in sodium perborate solution was more effective for removing cream-type denture adhesive than brushing with only water.

In Vitro Assessment of the Abrasion Resistance of Two Types of Artificial Teeth Submitted to Brushing.

PURPOSE: To assess the effect of brushing with different solutions on the abrasion resistance of two types of acrylic resin teeth. MATERIALS AND METHODS: Maxillary premolars from two types of acrylic teeth (Biotone and Biotone IPN) were divided into six groups (n = 12), according to the solution used during brushing: distilled water (control), coconut soap, or dentifrice. A mechanical brushing machine was used to simulate approximately 1 year of brushing (11,000 strokes). The weight loss (WL) of teeth was obtained from the difference between the initial (IW) and final weight (FW) of each specimen, and the mean of percentage of weight loss (PWL) was calculated for each group. Data were analyzed using the Kruskal-Wallis test, followed by Bonferroni's post-test comparison (α = 0.05). RESULTS: A statistically significant difference was found for the factor solution (p < 0.001). Brushing using dentifrice caused the highest values of weight loss (-0.50%), in comparison with the groups brushed with coconut soap (0.00%) or distilled water (0.00%). CONCLUSIONS: For both types of artificial teeth, brushing with dentifrice produced higher abrasion than brushing with coconut soap or water.

Influence of the height of the mandibular ridge on the masticatory function during the functional adaptation with new complete dentures.

BACKGROUND: The period of functional adaptation to a new conventional complete denture embraces many transitory issues, and this period is directly related to the rehabilitation success. OBJECTIVE: This clinical trial evaluated the influence of the height of mandibular ridge on the masticatory function of complete denture (CD) wearers during the adaptation period. METHODOLOGY: A total of 28 individuals wearing new CDs (NR, n=14, normal mandibular ridges, 64±12.5 years, 9 female; RR, n=14, resorbed mandibular ridges, 69±6.8 years, 9 female) were assessed at 24 hours, 30 days, three months and six months after the insertion of the CDs for masticatory performance (MP, sieves method), satisfaction with CDs (questionnaire) and maximum occlusal bite force (MOBF) (gnatodynamometer). The classification of the mandibular ridges followed the Kapur index. Data of MP and MOBF were analyzed by two-way ANOVA and satisfaction with CDs was analyzed by Generalized Estimating Equations (GEE), α=.05. RESULTS: Participants with NR presented better masticatory performance (p=.000 - NR 30.25±9.93%, RR 12.41±7.17%), general satisfaction (p=.047), retention of mandibular denture (p=.001), chewing ability (p=.037), and comfort of wearing a mandibular denture (p=.000). Regardless of the mandibular ridge, MP (p=.000) was higher at three (21.26±12.07%) and six months (24.25±12.26%) in comparison to 24 hours (18.09±10.89%), the MOBF (p=.000) was higher at three months (78.50±6.49 N) compared to 24 hours (57.34±5.55 N) and 30 days (62.72±5.97 N), and the comfort of wearing a mandibular denture (p=.002) at three months (1.61 ± 0.07) was greater than 24 hours (1.29±0.10) and 30 days (1.36±10). CONCLUSIONS: The study suggests that the participants with NR have higher MP and satisfaction with their CD, regardless of the follow-up period after the insertion of the new CD. After subjects received the CD, a period of 3 months was necessary for achieving better achievement MOBF, MP, and self-perceived comfort with the mandibular denture, regardless of the height of the mandibular ridge.

Influence of adhesives usage in complete dentures during adaptation period varying the degree of resorption of mandibular ridges.

PURPOSE: This study evaluated the effect of the use of a powder-type adhesive on masticatory performance and oral health related quality of life (OHRQoL) in patients with normal and resorbed mandibular ridges during adaptation period with complete dentures. METHODS: Forty-two edentulous subjects (12 men, 30 women) were distributed in four groups: normal mandibular ridges with adhesive, n = 10; normal mandibular ridges without adhesive, n = 10; resorbed mandibular ridges with adhesive, n = 11; resorbed mandibular ridges without adhesive, n = 11. Masticatory performance was evaluated by sieving method and OHRQoL by Oral Health Impact Profile in Edentulous Adults (OHIP-EDENT) inventory at 30, 60 and 90 days after the insertion of new complete dentures. Data were analyzed using 2-way ANOVA test and Generalized Estimating Equations (GEEs), α = 0.05. RESULTS: The use of adhesive resulted in better masticatory performance at 30 (35.76 ± 12.63%) and 60 days (30.06 ± 10.54%) after the insertion of the dentures and did not influence on OHRQoL in participants with normal ridges during the adaptation period. The use of adhesive did not interfere on masticatory performance during adaptation period and had a negative effect on masticatory discomfort/disability subscale OHRQoL at 30-day period [5.2(3.6, 6.8)] for resorbed mandibular ridges with new complete dentures. CONCLUSIONS: The use of adhesive can improve masticatory performance of new complete dentures users with normal mandibular ridges in the initial adaptation period up to 60 days after insertion. For resorbed ridges subjects, the use of adhesive had a negative impact on masticatory discomfort/disability OHRQoL at 30 days after insertion.

Influence of the use of complete denture adhesives on microbial adhesion and biofilm formation by single- and mixed-species.

OBJECTIVES: To verify whether the Ultra Corega Cream and Corega Strip Denture Adhesive adhesives interfere in the microbial adhesion and biofilm formation by Candida albicans and Lactobacillus casei in single- and mixed-species settings, and observe whether synergistic or antagonistic relationships between these species occur. METHODS: Specimens made from heat-polymerized acrylic resin (Lucitone 550) were fabricated (n = 144) with a circular shape and standardized roughness (3.0 µm ±0.3 Ra) and were divided into three groups: Without Adhesive (WA), with Ultra Corega Cream adhesive (CA) and Corega Strips adhesive (SA). These groups were divided into three subgroups each: C. albicans single-species, L. casei single-species and C. albicans with L. casei (mixed-species). Microbial adhesion and biofilm formation assays were performed in duplicate at four distinct experimental times (n = 8 per experimental condition). The amount of each microorganism on the surfaces of the specimens was observed by counting of the Colony Forming Units (CFU) per substrate. Additional specimens were characterized by Scanning Electron Microscopy (SEM), with 18 specimens being used in this analysis (n = 18), 2 per experimental condition (n = 2). Two-way ANOVA and Tukey's test for multiple comparisons were employed, using α≤0.05. RESULTS: L. casei (mixed-species) adhered more on the WA substrate than the CA, while C. albicans (single- and mixed-species) adhered more on the SA. C. albicans, both single- and mixed-species adhered more than the L. casei (single- and mixed-species), regardless of the substrate. L. casei (single-species) formed more biofilm on the WA, but in its mixed cultivation, it had no difference of growth among the tested situations. C. albicans (single- and mixed-species) formed more biofilm on the SA than the CA, and the fungus formed more biofilm when compared to L. casei. In general, whenever a species was compared in its single- and mixed-species situation, no statistically significant difference was observed. SEM of biofilm formation assays demonstrated that L. casei single-species WA formed more biofilm than when the adhesives tested were used, and C. albicans (both single- and mixed-species) formed more biofilm on the SA than on the CA. CONCLUSIONS: (1) The two denture adhesives tested increased the adhesion of C. albicans but not of L. casei; (2) biofilm formation by C. albicans (single- and mixed-species) was increased on the SA; (3) Relations of synergism or antagonism was not observed between the two microorganisms studied.

Retention Force and Wear Characteristics of three Attachment Systems after Dislodging Cycles.

Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values ​​were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.

Free Gingival Graft to Increase Keratinized Mucosa after Placing of Mandibular Fixed Implant-Supported Prosthesis.

Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis. The treatment included the manufacturing of a maxillary complete denture and a mandibular fixed implant-supported prosthesis followed by a free gingival graft to increase the width of the mandibular keratinized mucosa. Free gingival graft was obtained from the palate and grafted on the buccal side of interforaminal area. The follow-up of 02 and 12 months after mucogingival surgery showed that the free gingival graft promoted peri-implant health, hygiene, and patient comfort. Clinical Significance. The free gingival graft is an effective treatment in increasing the width of mandibular keratinized mucosa on the buccal side of the interforaminal area and provided an improvement in maintaining the health of peri-implant tissues which allows for better oral hygiene.

Custom Cast Ball Attachments Used on Outdated Implants to Restore a Maxillary Implant-Supported Overdenture.

The lack of compatible prosthetic components can be a complication during oral rehabilitation using outdated implants. The aim of the present clinical report was to describe an alternative technique for the fabrication of a maxillary implant-supported overdenture in a patient with 20-year-old dental implants using castable spherical patterns and ball attachments. The patient had been wearing a relined bar/clip overdenture in the mandible on 4 external-hexagon dental implants and a relined complete denture in the maxilla on 4 internal-hexagon implants due to abutment screw fracture inside of the implants, losing the attachment system. The remaining maxillary dental implants did not possess attachments compatible with current systems due to configuration changes by the manufacturer in the dental implant's platform and the components over time. Therefore, castable spherical patterns and cast ball attachments were used to fabricate a maxillary implant-supported overdenture. The mandible rehabilitation was performed using 4 osseointegrated dental implants with a fixed implant-supported prosthesis. The use of cast ball attachments on the maxillary dental implants avoided invasive procedures on the remaining implants. Considering the lack of available compatible prosthetic components for the osseointegrated implants, this technique was considered a viable and satisfactory treatment option.

Reestablishment of Occlusal Vertical Dimension in Complete Denture Wearing in Two Stages.

The assessment and reestablishment of the occlusal vertical dimension (OVD) are considered important factors in the treatment of complete denture wearers. The long-time use of a complete denture can result in jaw displacement due to abrasion of the artificial teeth and residual ridge resorption, causing esthetic complications. Most patients with old dentures and incorrect OVD accept reestablishment of the OVD with new complete dentures, even if they were used to their old dentures. The present clinical report describes a method of gradual reestablishment of OVD using a diagnostic acrylic splint on artificial teeth in old complete dentures before the manufacture of new complete dentures. Clinical Significance. The use of a reversible treatment for reestablishment of the OVD in old complete dentures with a diagnostic occlusal acrylic splint allows for the reestablishment of the intermaxillary relationship, providing physiological conditions of masticatory performance associated with the recovery of facial esthetics in edentulous patients.

Influence of the height of the mandibular ridge on the masticatory function during the functional adaptation with new complete dentures

Abstract The period of functional adaptation to a new conventional complete denture embraces many transitory issues, and this period is directly related to the rehabilitation success. Objective This clinical trial evaluated the influence of the height of mandibular ridge on the masticatory function of complete denture (CD) wearers during the adaptation period. Methodology A total of 28 individuals wearing new CDs (NR, n=14, normal mandibular ridges, 64±12.5 years, 9 female; RR, n=14, resorbed mandibular ridges, 69±6.8 years, 9 female) were assessed at 24 hours, 30 days, three months and six months after the insertion of the CDs for masticatory performance (MP, sieves method), satisfaction with CDs (questionnaire) and maximum occlusal bite force (MOBF) (gnatodynamometer). The classification of the mandibular ridges followed the Kapur index. Data of MP and MOBF were analyzed by two-way ANOVA and satisfaction with CDs was analyzed by Generalized Estimating Equations (GEE), α=.05. Results Participants with NR presented better masticatory performance (p=.000 - NR 30.25±9.93%, RR 12.41±7.17%), general satisfaction (p=.047), retention of mandibular denture (p=.001), chewing ability (p=.037), and comfort of wearing a mandibular denture (p=.000). Regardless of the mandibular ridge, MP (p=.000) was higher at three (21.26±12.07%) and six months (24.25±12.26%) in comparison to 24 hours (18.09±10.89%), the MOBF (p=.000) was higher at three months (78.50±6.49 N) compared to 24 hours (57.34±5.55 N) and 30 days (62.72±5.97 N), and the comfort of wearing a mandibular denture (p=.002) at three months (1.61 ± 0.07) was greater than 24 hours (1.29±0.10) and 30 days (1.36±10). Conclusions The study suggests that the participants with NR have higher MP and satisfaction with their CD, regardless of the follow-up period after the insertion of the new CD. After subjects received the CD, a period of 3 months was necessary for achieving better achievement MOBF, MP, and self-perceived comfort with the mandibular denture, regardless of the height of the mandibular ridge.

Effect of a denture adhesive on the satisfaction and kinesiographic parameters of complete denture wearers: a cross-over randomized clinical trial.

The aim of the present study was to assess the effect of a denture adhesive (DA) on patient satisfaction and kinesiographic parameters of complete denture wearers by a cross-over study. Fifty edentulous patients received a set of new complete dentures. After an adaptation period, the participants were enrolled in the trial and randomized to receive a sequence of treatment protocols: Protocol 1- DA use during the first 15 days, followed by no DA for the next 15 days; Protocol 2- no DA during the first 15 days, followed by use of DA for the next 15 days. Outcomes were assessed after 15 days of each sequence of treatment. A questionnaire was used to assess the patients' satisfaction. A kinesiograph was used to record mandible movements and patterns of maxillary complete denture movement during chewing. The Wilcoxon test (α=0.05) and a paired sample t-test (α=0.05) were used to compare satisfaction levels and kinesiographic data, respectively. Use of DA improved the overall level of patient satisfaction (p<0.001). The kinesiographic recordings revealed a significant increase (1.7 mm) in vertical mandible movements (p<0.001) during chewing and a lower (0.3 mm) vertical intrusion of the maxillary complete dentures (p=0.002) during chewing after using the DA. Use of DA in complete denture wearers improved the patients' satisfaction and altered mandible movements, with increases in vertical movements during chewing and less intrusion of maxillary complete dentures.

Retention force and wear characteristics of three attachment systems after dislodging cycles

Abstract Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values ​​were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.

Resumo Vários sistemas de encaixe para sobredentaduras mandibulares implantossuportadas estão atualmente disponíveis e estudos são necessários para entender as suas propriedades mecânicas. O objetivo deste estudo foi avaliar a força de retenção e as características de desgaste de três sistemas de encaixe por meio de uma simulação de deslocamento cíclico de sobredentaduras implantossuportadas. Trinta amostras foram fabricadas e divididas em 3 grupos: 1-O-ring; 2-Mini Ball; e 3-Equador. Um teste de fadiga mecânica foi aplicado aos espécimes utilizando uma máquina de teste universal servo-hidráulica com 5500 ciclos de inserção/remoção (f = 0,8 Hz), imersos em saliva artificial. Os valores da força de retenção foram obtidos antes e após 1500, 3000 e 5500 ciclos utilizando uma velocidade de 1 mm/min e uma célula de carga de 1 kN. Um espécime de cada grupo foi selecionado aleatoriamente e analisado por microscopia eletrônica de varredura. O teste de Análise de Variância a dois fatores para medidas repetidas e o teste de comparações múltiplas de Bonferroni foram utilizados para análises estatísticas (α = 0,05). O sistema de O-ring permaneceu estável durante todos os períodos testados e apresentou valores de força de retenção significativamente menores do que os sistemas Mini Ball e Equator. O sistema Mini Ball apresentou um aumento significativo na força de retenção após o teste mecânico (controle = 21,04 ± 3,29N; 5500 ciclos = 24,01 ± 3,30N). O sistema Equator apresentou uma diminuição significativa na força de retenção após cada período testado, mas os valores eram maiores do que os outros sistemas. O tipo de sistema de encaixe influenciou na força de retenção de diferentes maneiras após testes mecânicos. O sistema do Equador exibiu os maiores valores de força de retenção. As matrizes dos sistemas Mini Ball e Equator produziram deformação e desgaste nas superfícies sem ruptura dos anéis de poliamida.

Effect of an acrylic resin combined with an antimicrobial polymer on biofilm formation.

OBJECTIVES: The purpose of this study was to evaluate the antimicrobial activity of an acrylic resin combined with an antimicrobial polymer poly (2-tert-butylaminoethyl) methacrylate (PTBAEMA) to inhibit Staphylococcus aureus, Streptococcus mutans and Candida albicans biofilm formation. MATERIAL AND METHODS: Discs of a heat-polymerized acrylic resin were produced and divided according to PTBAEMA concentration: 0 (control), 10 and 25%. The specimens were inoculated (10(7) CFU/mL) and incubated at 37ºC for 48 h. After incubation, the wells were washed and each specimen was sonicated for 20 min. Replicate aliquots of resultant suspensions were plated at dilutions at 37ºC for 48 h. The number of colony-forming units (CFU) was counted and expressed as log (CFU+1)/mL and analyzed statistically with α=.05. RESULTS: The results showed that 25% PTBAEMA completely inhibited S. aureus and S. mutans biofilm formation. A significant reduction of log (CFU+1)/mL in count of S. aureus (control: 7.9±0.8A; 10%: 3.8±3.3B) and S. mutans (control: 7.5±0.7A; 10%: 5.1±2.7B) was observed for the group containing 10% PTBAEMA (Mann-Whitney, p<0.05). For C. albicans, differences were not significant among the groups (control: 6.6±0.2A; 10%: 6.6±0.4A; 25%: 6.4±0.1A), (Kruskal-Wallis, p>0.05, P=0.079). CONCLUSIONS: Acrylic resin combined with 10 and 25% of PTBAEMA showed significant antimicrobial activity against S. aureus and S. mutans biofilm, but it was inactive against the C. albicans biofilm.

Evaluation of methods for stain removal in acrylic resin denture teeth: in vitro study / Avaliação de métodos de remoção de manchas em dentes de resina acrílica para prótese total: estudo in vitro

Introduction: The staining of artificial teeth can be related to the acrylic resin abrasion caused by brushing, resulting in higher deposition of dyes from the beverage, and consequently higher aesthetic damage. Objective: The aim of this in vitro study was to evaluate methods for removal of stains from acrylic denture teeth using spectrophotometric analysis. Material and method: Artificial teeth were divided into twelve groups (n=10) according to the type of treatment (re-polishing - Re or immersion in Corega Tabs - Sp), staining solutions, coffee (Cf) and Coca-Cola® (Cc) or water (W) and with/without toothbrushing (B). The Sp specimens were submitted to seven immersion cycles (5 min each). The Re specimens were polished with pumice stone followed by Spain white paste. Color differences (ΔE) were captured by a spectrophotometer: T0 (baseline), T1 (after brushing/immersion in solutions) and T2 (after Re or Sp). Result: Statistically significant color change between T1 and T2 (paired T-test; α =.05) was observed for the group CfSp (p=.032); and for the groups BWRe (p=.000), BCfRe (p=.049) and CcRe (p=.042). Higher color changes were observed for the specimens submitted to toothbrushing (ANOVA two way; p<.001). Conclusion: It could be concluded that the immersion in sodium perborate (Corega Tabs) can be used for removal of coffee stains from denture teeth, and re-polishing for removal of Coca-Cola® stains. Still, toothbrushing produced greater color changes on denture teeth, regardless of the immersion solution.

Introdução: O manchamento dos dentes artificiais pode estar relacionado à abrasão da resina acrílica provocada pela escovação, resultando na maior deposição de corantes provenientes de bebidas, e consequentemente maior prejuízo estético. Objetivo: O objetivo do presente estudo foi avaliar métodos de remoção de manchas extrínsecas por meio de analise com espectofotômetro. Material e método: Dentes artificiais foram divididos em 12 grupos (n=10), de acordo com o tipo de tratamento (repolimento – Re ou imersão em perborato de sódio, Corega Tabs – Sp), tipo de solução de manchamento, café (Cf) ou Coca-Cola® (Cc) ou água (W) e com/sem escovação (B). Os métodos de remoção de manchas propostos (Re e Sp) foram realizados de acordo com protocolos pré-estabelecidos. Os espécimes Sp foram submetidos a 7 ciclos de imersão (5 minutos cada). O repolimento foi realizado com pastas de pedra pomes e branco de espanha, utilizando escovas de cerdas macias e rodas de feltro. As leituras de estabilidade de cor (ΔE) foram realizadas por meio de um espectrofotômetro: T0 (baseline), T1 (após escovação/imersão em bebidas), e T2 (após Re ou Sp). Resultado: Alterações de cor entre T1 e T2 (teste T pareado; α=0,05) foram observadas para o grupo CfSp (p=.032); e para os grupos BWRe (p=.000), BCfRe (p=.049) e CcRe (p=.042). Os dentes artificiais submetidos à escovação mostraram maior alteração de cor (ANOVA 2 fatores; p<0,001). Conclusão: Conclui-se que a imersão em perborato de sódio (Corega Tabs) pode ser utilizada para remoção de manchas de café e o repolimento para remoção de manchas de Coca-Cola®. Ainda, a escovação produziu as maiores alterações de cor nos dentes artificiais, independentemente da solução de imersão.

Diabetes mellitus and oral mucosa alterations: prevalence and risk factors.

AIMS: To investigate the prevalence of oral mucosa alterations in patients with type 2 diabetes and to identify possible risk factors related to oral mucosa alterations. METHODS: 146 patients with type 2 diabetes and 111 age- and gender-matched healthy controls subjects were consecutively recruited from Araraquara School of Dentistry to answer a structured questionnaire designed to collect demographic data as well as current and former history of diabetes. Clinical examination of the oral mucosa was carried out by a stomatologist. RESULTS: A higher prevalence of oral mucosa alterations was found in patients with diabetes than in patients without diabetes (p<0.001), with significant difference to development conditions (p<0.0001), potentially malignant disorders (p<0.0001) and fungal infections (p<0.05). In the multiple logistic regression, diabetes (odds ratio 9.9 IC 5.11-19.16) and smoking habit (odds ratio 3.17 IC 1.42-7.12) increased the odds of oral mucosa alterations significantly. CONCLUSIONS: Patients with diabetes mellitus not only showed an increased prevalence of oral mucosa alterations but also a significant percentage of potentially malignant disorders. These findings elucidate the necessity of regular clinical examination to ensure early diagnosis and prompt management of oral mucosa lesions in patients with diabetes.

Effect of a Denture Adhesive on the Satisfaction and Kinesiographic Parameters of Complete Denture Wearers: A Cross-Over Randomized Clinical Trial

The aim of the present study was to assess the effect of a denture adhesive (DA) on patient satisfaction and kinesiographic parameters of complete denture wearers by a cross-over study. Fifty edentulous patients received a set of new complete dentures. After an adaptation period, the participants were enrolled in the trial and randomized to receive a sequence of treatment protocols: Protocol 1- DA use during the first 15 days, followed by no DA for the next 15 days; Protocol 2- no DA during the first 15 days, followed by use of DA for the next 15 days. Outcomes were assessed after 15 days of each sequence of treatment. A questionnaire was used to assess the patients´ satisfaction. A kinesiograph was used to record mandible movements and patterns of maxillary complete denture movement during chewing. The Wilcoxon test (α=0.05) and a paired sample t-test (α=0.05) were used to compare satisfaction levels and kinesiographic data, respectively. Use of DA improved the overall level of patient satisfaction (p<0.001). The kinesiographic recordings revealed a significant increase (1.7 mm) in vertical mandible movements (p<0.001) during chewing and a lower (0.3 mm) vertical intrusion of the maxillary complete dentures (p=0.002) during chewing after using the DA. Use of DA in complete denture wearers improved the patients´ satisfaction and altered mandible movements, with increases in vertical movements during chewing and less intrusion of maxillary complete dentures.

O objetivo deste estudo foi avaliar o efeito da utilização de um adesivo para prótese na satisfação e nos parâmetros cinesiográficos em usuários de próteses totais por meio de um estudo "cross-over". Cinquenta pacientes desdentados receberam novas próteses totais bimaxilares. Após um período de adaptação, os participantes incluídos no estudo receberam uma sequência de tratamento: Protocolo 1- utilização do adesivo para prótese durante os primeiros 15 dias, seguida por não utilização do adesivo os próximos 15 dias; Protocolo 2- não utilização do adesivo durante os primeiros 15 dias; seguida por utilização do adesivo nos próximos 15 dias. Os resultados foram avaliados após 15 dias de cada sequência de tratamento. Um questionário para avaliar a satisfação dos pacientes e um cinesiógrafo para registrar os movimentos mandibulares e o padrão de movimento da prótese total maxilar durante mastigação foram utilizados. O teste de "Wilcoxon" (α=0,05) e o "t-test" de Student para amostras pareadas (α=0,05) foram utilizados para comparar o grau de satisfação dos pacientes e os dados cinesiográficos, respectivamente. O adesivo para prótese melhorou significativamente a satisfação geral dos participantes (p<0,001). Os registros cinesiográficos mostraram um aumento significativo (1,7 mm) no movimento mandibular vertical (p<0,001) e uma menor intrusão (0,3 mm) da prótese total superior (p=0,002) durante a mastigação após o uso de adesivo. O uso de adesivo para prótese melhorou a satisfação dos usuários de próteses totais e gerou um aumento no movimento mandibular vertical e uma menor intrusão da prótese total maxilar durante a mastigação.

Reabilitação oral de paciente com Síndrome da Combinacão: relato de caso / Oral rehabilitation of a patient with combination syndrome: a case report

A Síndrome da Combinação representa uma importante condição patológica do sistema mastigatório que precisa de um tratamento reabilitador complexo. A presença de mucosa flácida é uma das caraterísticas mais comuns quando ocorre a reabsorção óssea anterior da pre-maxila ocasionada pela hiperfunção anterior dos dentes inferiores sobre a prótese total superior, onde a incidência de cargas nessa região resulta na movimentação da pró tese em direção ao rebordo, resultando no aumento da reabsorção do rebordo residual, na desadaptação interna da prótese e na perda de retenção da prótese. A presença de mucosa flácida, nesses casos, acarreta ainda problemas de suporte e estabilidade da prótese total superior, que podem ser tratados com redução cirúrgica da espessura do tecido ou usando técnicas específicas de confecção das próteses. Este artigo descreve a reabilitação oral de um paciente com Síndrome da Combinação onde a redução cirúrgica da mucosa flácida não foi realizada, utilizando uma técnica modificada de moldagem funcional em duas etapas, com o objetivo de gerar menos forças e distorções na fibromucosa flácida durante a moldagem funcional.

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and 1055 of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Avaliação subjetiva do uso de adesivos por usuários de próteses totais bimaxilares em uma população brasileira / Subjective assessment of adhesives usage by complete denture wearers in a brazilian population

Introdução: Estudos subjetivos sobre o conhecimento e uso de adesivos para prótese ainda são limitados, especialmente em populações brasileiras. Objetivo: O objetivo deste estudo foi investigar os aspectos relacionados ao uso ou não de adesivos para prótese por usuários de próteses totais. Material e método: Foram aplicados a 100 usuários de próteses totais bimaxilares questionários relativos à utilização de adesivos para prótese. A pesquisa foi realizada de acordo com três categorias: aqueles que nunca tinham utilizado o adesivo, aqueles que já tinham utilizado o adesivo pelo menos uma vez e que já não utilizavam mais, e aqueles que utilizam regularmente. Resultado: Dos 100 participantes, 80% nunca haviam utilizados adesivos, 16 porcentagem já haviam experimentado pelo menos uma vez, mas já não utilizavam mais e 4 porcentagem utilizavam regularmente. Conclusão: Dentro das limitações deste estudo, os resultados desta avaliação subjetiva sugerem que entre os participantes que nunca haviam experimentado adesivos, 77,5 porcentagem informaram que o adesivo não era necessário, e todos os participantes que utilizam regularmente informaram a sua eficiência.

Introduction: The information about the knowledge and usage of denture adhesives is still limited, particularly in Brazilian populations. Objective: The purpose of this study was to investigate the aspects related to the use or nonuse of denture adhesives by complete denture wearers. Material and method: Questionnaires were applied to 100 bimaxillary complete denture wearers concerning their usage of denture adhesives. The survey was carried out according to three categories: those who had never tried adhesive, those who had tried adhesive at least once but no longer used it, and those who currently used it. Result: Of the 100 participants, 80 percentage had never tried adhesives, 16 percentage had tried at least once but no longer used it and 4 percentage had used on a regular basis. Conclusion: Within the limitations of this study, the results of this subjective assessment suggest that within the participants that had never tried adhesives, 77.5 percentage inform that the adhesive is not needed, and all participants who regularly use it inform its efficiency.