Effect of Disinfection Treatments on the Hardness of Soft Denture Liner Materials

Efficacy of an impression disinfectant solution after repeated use: An in vitro study

Statement of problem

There are very few studies using Benzalkonium Chloride (BAC) as an active disinfection agent for immersion techniques and there are no studies investigating the efficacy of repeated use of a disinfectant solution.

Purpose

This study evaluated an impression disinfectant by testing bacterial contamination of disinfectant batches used in a clinical setting after repeated use.

Materials and methods

Liquid samples were collected from impression disinfectant solutions used to disinfect dental impressions taken at a university dental clinic. The experimental samples (500 ml from 1 L of solution) were collected from teaching and professional clinics and the in-house commercial processing laboratory and stored at room temperature each day of clinic operation over five weeks. To determine to what extent the disinfectant efficacy of the active product decreased over time, the following tests were carried out: a. Inoculation b. Gram staining technique c. Matrix Assisted Laser Desorption/Ionization Mass spectrometry (MALDI- MS). Microbial growth was monitored and photographed. A culture revival was made from colonies grown on sheep blood agar, to isolate pure colonies incubated for 24 h at 37 °C. Each morphologically distinct type of colony was gram stained and MALDI spectrometry analysis was performed using the VITEK MS (BioMerieux Inc.).

Results

Evidence of growth of bacteria was detected in teaching clinics' samples, and no growth from the professional clinic or the commercial laboratory.

Conclusions

The study demonstrated that impression disinfectanat solution tested is effective against common oral bacteria, despite some rare species such as Bacillus circulans, Bacillus horneckiae, Bacillus altitudinis/pumilus and Bacillus cereus showing evidence of survival in solutions used for disinfection of impressions. However, in a high use teaching clinic environment its efficacy deteriorated. Though a second level disinfection protocol in the commercial laboratory-maintained impression disinfection.

Assessing the Antifungal Activity of a Soft Denture Liner Loaded with Titanium Oxide Nanoparticles (TiO2 NPs)

Aim: Soft denture lining materials are susceptible to be colonized by different microorganisms, especially by Candida albicans (C. albicans), causing denture-induced stomatitis. This study was designed to evaluate the effectiveness of incorporating titanium dioxide nanoparticles (TiO2 NPs) into a soft denture liner towards reducing microbial activity. Method: A total of 40 PEMA-TiO2 nanocomposites samples were fabricated by adding 0.0 wt.% (control), 1.0 wt.%, 1.5 wt.%, and 2 wt.% TiO2 NPs to a heat cured soft denture lining material (polyethyl methacrylate, PEMA). The prepared samples were divided into four groups (n = 10) according to the content of TiO2 NPs. The uniformity of TiO2 NPS distribution within the denture liner matrix was assessed using a Scanning Electron Microscope (SEM). The viable count of C. albicans was evaluated to test the antifungal resistance of the developed composite. Results: The SEM images showed fairly homogeneous dispersion, with patches of TiO2 NPs agglomeration within the PEMA matrix and an increasing concentration of NPs with higher NP content. The particle map and EDX analysis confirmed the evidence of the TiO2 NPs. The mean viable count results for the control (0.0 wt.%) and 1.0 wt.%, 1.5 wt.%, and 2 wt.% TiO2 groups were 139.80, 12.00, 6.20, and 1.00, respectively, with a significant difference from the control group (p < 0.05). The antifungal activity also increased with the increase in the concentration of TiO2 NPs. Conclusions: The addition of TiO2 NPs into a heat-cured soft denture liner provided antifungal activity as evidenced by the reduced colonization of C. albicans. The antimicrobial activity of the liner material increased with the increased concentration of TiO2 NPS.

Chlorhexidine as a Disinfectant in the Prosthodontic Practice: A Comprehensive Review

INTRODUCTION

Controlling the cross-contamination between the dental clinic and laboratory is of utmost importance to maintain the health of dental healthcare personnel (DHCP) and patients. The aim of this paper was to review the current literature with regard to the use of chlorhexidine as a prosthetic disinfectant in prosthodontic practice.

MATERIALS AND METHODS

A scoping review of the literature was performed in Medline/PubMed, Ovid Embase, and the Cochrane Library. A search for all literature published from 1980 to 2021 was based on the following keywords: ['Chlorhexidine/gluconate' OR 'chlorhexidine', OR 'gluconate', OR 'denture disinfectants', OR 'antimicrobial', OR 'disinfectant', OR 'impression disinfectants, OR prosthesis' OR 'biofilm, microbiology'] OR [teeth]. We reviewed the disinfectant in terms of its mechanism of action, antimicrobial effectiveness, disinfection techniques, clinical applications, corrosiveness/damage to the structure of prostheses, and reasonable shelf life.

RESULTS

Chlorhexidine was tested under different concentrations ranging from 0.2 to 5%. It provided a significant reduction in biofilm viability but had a minimum effect on Candida albicans with a variable effect result that showed no significant differences in the dimensional changes by immersion of alginate dental impressions for no more than 10 minutes and no clinically significant dimensional differences on aluwax, polyether, condensation siloxane, and polyvinyl siloxane were noticed. Nonetheless, chlorhexidine altered the surface of the silicone and acrylic resins and affected the long-term hardness of the relining material.

CONCLUSION

Within the limitations of this review, the use of chlorhexidine disinfectant demonstrates a good measure in the reduction of contamination and cross-infection and has a minimal effect on the dimensional stability of most impression materials. Further studies with in-vitro testing are required to confirm these findings.

The Influence of Decontamination Procedures on the Surface of Two Polymeric Liners Used in Prosthodontics

Polymeric liners are materials commonly used in prosthodontics to reshape denture surfaces contacting the soft tissues of the oral cavity. The aim of the study was to determine the impact of different cleaning methods on two polymeric materials used in prosthodontics as non-adhesive permanent liners. The material for the research consisted of samples made from Mollosil Plus (Detax, Ettlingen, Germany)-direct polysiloxan liner; and Plastitanium (Pressing Dental, San Marino, Republic of San Marino)-an injection-molded liner. A total of 198 samples were made, 99 of each assessed material. They were exposed to different cleaning methods-a toothbrush, a toothbrush and soap, a toothbrush and toothpaste (BlendaMed, Procter&Gamble, Cincinnati, OH, USA), a toothpaste and denture cleaning paste (Protefix Hygiene Denture Paste, Queisser Pharma, Germany), denture cleansing tablets (Protefix Hygiene Cleaning Tablets, Queisse Pharma, Germany), and a disinfecting spray (Aftermat, Port Jefferson Station, New York City, NY, USA)-for 1 min, 5 min, 10 min, and 15 min. The image acquisition was performed with scanning electron microscopy and samples were analyzed for the homogeneity of their surfaces-the presence of holes, grooves, precipitate, and small and large separating pieces of the material marking departures from this homogeneity. For each type of damage, one point was given. Continuous data from two groups were compared with Mann-Whitney U testing. Due to a small sample size and distribution of variables other than normal, to compare more than two groups, Kruskal-Wallis testing with post hoc analysis (Dunn test with Bonferroni correction) was used. Categorical data were compared with the chi-square test and the Fisher's exact test. The Mollosil Plus material should be decontaminated with the use of a toothbrush or toothbrush with soap, while Plastitanium material should be disinfected. Plastitanium samples are more susceptible to damage during the decontamination procedures than Mollosil Plus.

Antifungal activity and Shore A hardness of a tissue conditioner incorporated with terpinen-4-ol and cinnamaldehyde

PURPOSE

This study investigated the anti-Candida activity and the Shore A hardness of a tissue conditioner (Softone™) modified by incorporation of terpinen-4-ol and cinnamaldehyde.

MATERIAL AND METHODS

Agar diffusion, microdilution, and mechanism of action methods were performed to determine to evaluate the antifungal activity of phytoconstituents. Then, phytoconstituents in varying concentrations were incorporated into the tissue conditioner. The anti-Candida effect of the modified conditioner was evaluated through agar punch well and biofilm formation methods. Shore A hardness of the experimental liners was evaluated after baseline, 24 h, 48 h, 4 days, and 7 days immersion on artificial saliva.

RESULTS

The phytoconstituents incorporated into Softone showed completely inhibited fungal growth in concentrations of 20-40% and did not present significant antifungal activity until their concentrations where higher than 5%. There were differences between non-modified Softone and M5, M10, C10, and T10% (p < 0.05). The groups containing 10-40% of cinnamaldehyde incorporated into Softone were able to completely inhibit the biofilm. Concentrations below 40% of terpinen-4-ol showed unsatisfactory biofilm inhibition. The T40% and C40% groups presented the lowest Shore A hardness values. Hardness values from groups T40% at 7 days (p = 0.476); C40% at 4 days (p = 0.058); and T20% (p = 0.058), C20% (p = 0.205), T30% (p = 0.154), and C30% (p = 0.874) after 48 h did not differ from the control group.

CONCLUSIONS

Cinnamaldehyde incorporated into Softone inhibited Candida biofilm formation at concentrations of 10-40%, being more effective than terpinen-4-ol modification despite of halo inhibition observed by both products.

CLINICAL RELEVANCE

All modifications showed a very similar pattern of hardness being useful for clinical practice.

The Effect of Microwave Disinfection on Denture Base Polymers, Liners and Teeth: A Basic Overview

The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties. Cross-infection control in dentistry is a significant issue in everyday clinical practice due to the recent increase in some infectious diseases such as hepatitis B, C and AIDS and therefore numerous methods of disinfection have been used. The most widespread method of disinfection used in everyday practice is chemical, however, studies have suggested that chemical disinfectants alter the physical and mechanical properties of the acrylic resins and enable the growth and proliferation of certain bacteria. Therefore, microwaves were introduced as an easy to use-and-access, low cost, chemical free alternative. The question that arose was if and in what way the microwave irradiation affected the denture related material properties. Microwaving affects the denture resin bases, liners and teeth in different ways. The results showed that microwave disinfection could be a safe alternative for the disinfection of denture bases and liners compared to the chemical one, when the procedure is carried out in dry conditions, but could possibly cause dimensional changes of clinical significance on them when the irradiation takes place in wet environment. It also seems to have no detrimental effects of clinical importance on the flexural properties, impact strength and hardness of denture resins and the bond, flexural strength, porosity and hardness of denture liners. The effects of microwave disinfection on the hardness of denture teeth and teeth/denture bond strength are still controversial and no safe conclusions can be drawn.

Long-Term Soft Denture Lining Materials

Long-term soft denture lining (LTSDL) materials are used to alleviate the trauma associated with wearing complete dentures. Despite their established clinical efficacy, the use of LTSDLs has been limited due to the unfavorable effects of the oral environment on some of their mechanical and performance characteristics. The unresolved issue of LTSDL colonization by Candida albicans is particularly problematic. Silicone-based LTSDL (SLTSDL) materials, which are characterized by more stable hardness, sorption and solubility than acrylic-based LTSDLs (ALTSDLs), are currently the most commonly used LTSDLs. However, SLTSDLs are more prone to debonding from the denture base. Moreover, due to their limitations, the available methods for determining bond strength do not fully reflect the actual stability of these materials under clinical conditions. SLTSDL materials exhibit favorable viscoelastic properties compared with ALTSDLs. Furthermore, all of the lining materials exhibit an aging solution-specific tendency toward discoloration, and the available cleansers are not fully effective and can alter the mechanical properties of LTSDLs. Future studies are needed to improve the microbiological resistance of LTSDLs, as well as some of their performance characteristics.

A conventional microwave oven for denture cleaning: a critical review

INTRODUCTION

Denture cleaning should be quick and easy to perform, especially in long-term care facilities. The lack of proper oral hygiene can put older adults at higher risk from opportunistic oral infections, particularly fungal. As an alternative to regular brushing, the use of a microwave oven has been suggested for cleaning and disinfecting dentures.

OBJECTIVES

To synthesise and discuss the advantages and disadvantages of the use of a conventional microwave oven for cleaning and disinfecting complete dentures.

METHODS

A brief literature search focused on papers dealing with microwave therapy for denture cleaning through PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, Ovid MEDLINE(R) In-Process, and Scifinder Scholar.

RESULTS

One hundred and sixty-seven manuscripts published in English with full text were found, and 28 were accepted and discussed in the light of the advantages and disadvantages of the use of conventional microwave oven for cleaning and disinfecting complete dentures.

CONCLUSIONS

There was no standardisation for microwave use for denture cleaning. Manual cleaning still seemed to be the optimal method for controlling fungal infection and denture stomatitis. However, such a daily routine appeared to be underused, particularly in long-term care facilities.

Evaluation of Hardness and Colour Change of Soft Liners after Accelerated Ageing

Introduction

Soft liners have been developed to offer comfort to denture wearers. However, this comfort is compromised when there is a change in the properties of the material, causing colour change, solubility, absorption and hardening. These characteristics can compromise the longevity of soft liners.

Aim

The aim of this in vitro study was to investigate the effect of ageing on both the hardness and colour change of two soft liners following accelerated ageing.

Methods

Two denture liners, one resin based (Trusoft, Bosworth, Illinois, USA) and one silicone based (Ufi Gel P, Voco GMBH, Cuxhaven, Germany), were tested in this study for both hardness (using the Shore A scale) and colour change (using the CIE L*a*b* colour scale), initially and after 1008 hours (6 weeks) of accelerated ageing. Statistical analysis was performed using the unpaired t-test with the Welch correction.

Results

These indicated that both materials increased in hardness and underwent colour change after accelerated ageing. The initial hardness of Trusoft was far lower than that of Ufi Gel P (18.2 Shore A units vs 34.8 Shore A units). However, for Trusoft the changes for both hardness (from 18.2 to 52.1 Shore A units) and colour change (16.85 on the CIE L*a*b* colour scale) were greater than those for Ufi Gel P, for which hardness changed from 34.8 to 36.5 Shore A units and the colour change was 5.19 on the CIE L*a*b* colour scale.

Conclusions

Ufi Gel P underwent less hardness and colour change after accelerated ageing than Trusoft. On the other hand, the use of Trusoft may be preferable in cases where initial softness is a major consideration, such as when relining an immediate denture after implant surgery.