RESUMO
STATEMENT OF PROBLEM: The optimal disinfection protocol that controls adverse effects and promotes effective antimicrobial action on removable prostheses is unclear. PURPOSE: This in vitro study investigated the effect of disinfectant solutions on the biological, physical, mechanical, and chemical properties of removable prosthesis materials. MATERIAL AND METHODS: Specimens of polymethyl methacrylate (PMMA) and cobalt chromium (Co-Cr) alloy were immersed in distilled water (PMMA) or artificial saliva (Co-Cr) as the control and in 0.25% sodium hypochlorite (NaOCl0.25%), 0.5% chloramine T (CT0.5%), and 0.15% Triclosan (TR0.15%). The antibiofilm activity was evaluated by microbial load and cell metabolisms of the mixed biofilm. Physical (color change, sorption, solubility, and surface roughness), mechanical (hardness, flexural, and impact strength), and chemical (corrosion) properties were analyzed before and after simulating a 5-year immersion. Laser confocal microscopy, scanning electron microscopy (SEM), and dispersive energy spectroscopy (EDS) complemented the analyses. The data were analyzed by using the Mann-Whitney U test, Kruskal-Wallis with Dunn posttests, 1-way ANOVA, and repeated measures ANOVA (α=.05). RESULTS: All solutions were effective against bacteria, but only NaOCl0.25% eliminated Candida spp. TR0.15%, and CT0.5% increased cell metabolisms. For interaction (time and solution), there was a reduction in PMMA hardness in the control and TR0.15%. Color, sorption, solubility, and flexural strength did not change. CT0.5% and TR0.15% were similar for impact resistance. CT0.5% caused the lowest roughness. NaOCl0.25% showed the greatest corrosive potential. Dark spots were seen under SEM in Co-Cr stored with NaOCl0.25% and TR0.15%. EDS indicated different proportions of oxygen, cobalt, chromium, and molybdenum. CONCLUSIONS: NaOCl0.25% had the best antimicrobial action. CT0.5% and TR0.15% have potential. Hardness and roughness changes were clinically acceptable, and the other properties remained unchanged. All the solutions caused color changes. NaOCl0.25% was unsatisfactory for use with Co-Cr, CT0.5% was intermediate, and TR0.15% was suitable.
RESUMO
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.
Assuntos
Candida , Desinfetantes , Resinas Acrílicas , Candida albicans , Biofilmes , Fatores de VirulênciaRESUMO
ABSTRACT The aim of this case report was to describe a prosthetic rehabilitation associated with an alternative model of polymer capsule for fixation system of implant-retained overdentures. Patient sought treatment at the clinic of School of Dentistry of Ribeirão Preto, due to lack of retention of their conventional total superior prostheses and inferior overdenture. The initial complaint was clinicallyconfirmed by altered intermaxillary relationships and severe reabsorption of the maxillary crest. In order to restore the function and improve its quality of life, it was proposed a prosthetic solution including implant fixed prosthesis to maxilla and a mandibular overdenture, with ball-type attachments associated with an alternative model of polymer capsule. This treatment was proposed inorder to reestablish the intermaxillary relationships and adequate occlusion, maintain retention and stability of the prosthesis. At the end of treatment and during a one-year follow-up of the case, the patient reported satisfaction and significant improvement in quality of life.
RESUMO O objetivo deste relato de caso foi descrever uma reabilitação protética associada a um modelo alternativo de cápsula polimérica para sistema de fixação de overdentures implantado-retidas. Paciente procurou tratamento na clínica da Faculdade de Odontologia de Ribeirão Preto, devido falta de retenção de suas próteses totais superiores convencionais e overdenture inferior. A queixa inicialfoi clinicamente confirmada por relações intermaxilares alteradas e reabsorção severa da crista maxilar. Para restaurar a função e melhorar sua qualidade de vida, propôs-se como solução protética, a confecção de prótese fixa sobre implantes para a maxila e overdenture mandibular, com acessórios tipo bola associados a um modelo alternativo de cápsula polimérica. Esse tratamento foiproposto a fim de restabelecer as relações intermaxilares e a oclusão adequada, manter a retenção e a estabilidade da prótese. Ao final do tratamento e durante o acompanhamento de um ano do caso, o paciente relatou satisfação e melhora significativa na qualidade de vida.