Effect of Three Methods for Cleaning Dentures on Biofilms Formed In Vitro on Acrylic Resin

Effect of disinfectants on multispecies biofilm, the physical and mechanical properties of polymethyl methacrylate, and the corrosion of cobalt chromium alloy

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.

Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review

Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.

Elimination of detached Listeria monocytogenes from the biofilm on stainless steel surfaces during milk and cheese processing using natural plant extracts

Bacterial cells can form biofilm on food contact surfaces, becoming a source of food contamination with profound health implications. The current study aimed to determine some Egyptian medicinal plants antibacterial and antibiofilm effects against foodborne bacterial strains in milk plants. Results indicated that four ethanolic plant extracts, Cinnamon (Cinnamomum verum), Chamomile (Matricaria chamomilla), Marigold (Calendula officinalis), and Sage (Salvia officinalis), had antibacterial (12.0-26.5 mm of inhibition zone diameter) and antibiofilm (10-99%) activities against Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes and Salmonella Typhimurium. The tested extracts had minimum inhibitory concentration values between 0.14 and 2.50 mg/ml and minimum bactericidal concentration values between 0.14 and 12.50 mg/ml. L. monocytogenes was more sensitive for all tested ethanolic extracts; Sage and Cinnamon showed a bacteriocidal effect, while Chamomile and Marigold were bacteriostatic. The ethanolic extracts mixture from Chamomile, Sage, and Cinnamon was chosen for its antibiofilm activity against L. monocytogenes using L-optimal mixture design. Gas chromatography and mass spectrometry analysis showed that this mixture contained 12 chemical compounds, where 2-Propenal,3-phenyl- had the maximum area % (34.82%). At concentrations up to 500 µg/ml, it had no cytotoxicity in the normal Vero cell line, and the IC50 value was 671.76 ± 9.03 µg/ml. Also, this mixture showed the most significant antibacterial effect against detached L. monocytogenes cells from formed biofilm in stainless steel milk tanks. At the same time, white soft cheese fortified with this mixture was significantly accepted overall for the panelist (92.2 ± 2.7) than other cheese samples, including the control group.

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

OBJECTIVE

To evaluate the anti-biofilm action of chitosan, nanoparticulate chitosan, and denture cleanser Nitradine™ against biofilms comprising Candida albicans, Candida glabrata, Staphylococcus aureus, and Streptococcus mutans.

BACKGROUND

Biofilm removal from removable partial dentures (RPD) is important for success in prosthetic rehabilitation.

MATERIALS AND METHODS

The anti-biofilm action of the experimental chitosan-based solutions and Nitradine™ was evaluated on acrylic resin and cobalt-chromium alloy through assessing cell viability, cell metabolism, residual aggregated biofilm, and extracellular polymeric substance and biofilm morphology.

RESULTS

Only chitosan reduced the viability of C. albicans on cobalt-chromium alloy surface, by 98% (a 1.7 log10 reduction in cfu). Chitosan-based solutions neither promoted substantial alteration of the metabolic activity of the four-species biofilm nor reduced the amount of the aggregated biofilm. After immersion in chitosan and nanoparticulate chitosan, viable microorganisms and extracellular polymeric substances distributed over the entire specimens' surfaces were observed. Nitradine™ reduced the viability and metabolic activity of biofilm grown on both surfaces, but it did not remove all aggregated biofilm and extracellular polymeric substances. After immersion in Nitradine™, approximately 35% of the specimens' surfaces remained covered by aggregated biofilm, mainly composed of dead cells.

CONCLUSION

Although chitosan and Nitradine™ promoted changes in the viability of microorganisms, neither solution completely removed the four-species biofilm from the Co-Cr and acrylic resin surfaces. Thus, isolated use of hygiene solutions is not indicated for biofilm control on RPDs; this requires complementary mechanical removal.

Effect of Different Cleaning Regimes on Biofilm Formation of Acrylic-Based Removable Orthodontic Appliance: A Randomized Clinical Trial

Objectives

This study aimed to evaluate the effects of different cleaning regimes of acrylic-based removable orthodontic appliances on bacterial biofilm formation and whether the surface modification, i.e., polished acrylic fitting surface, reduces biofilm formation.

Materials and Methods

This double-blind, parallel, randomized clinical trial involved thirty-nine orthodontic patients indicated for removable orthodontic appliances. The patients were allocated into three groups according to the cleaning method: brushing with a denture brush and chlorhexidine (CHX) toothpaste, Lacalut cleaning tablet, and a combination of both cleaning methods. Each patient wore an upper removable appliance containing eight wells fitted with eight detachable acrylic tiles (four polished and four unpolished) for seven days. Five types of oral microbiota were evaluated using selective growth media and biochemical tests. The biofilm cleaning efficacy was assessed using the colony-forming unit (CFU) and scanning electron microscopy (SEM). Statistical Analysis. Data from the CFU using different cleansing regimes were compared, following log transformation, using one-way analysis of variance (ANOVA). The polished and unpolished tiles were compared for biofilm formation on each cleansing method using an independent t-test.

Results

There was no significant difference among the three cleaning methods on the polished or unpolished tiles. However, in polished tiles, streptococci were significantly reduced in all cleaning methods, whereas staphylococci and Staphylococcus aureus were markedly decreased in brushing and combination cleaning methods. However, the total number of anaerobic bacteria was significantly reduced in polished tiles using the combination method only.

Conclusions

Polishing the fitting surface of an acrylic-based orthodontic appliance reduced the tested bacterial biofilm formation and may enhance cleaning efficiency. Brushing and combination methods showed superior cleaning effects compared to cleaning tablets. This trial is registered with NCT05707221.

Antimicrobial activity of cleansers on the cobalt-chromium surface of removable partial denture: a systematic review

This study aimed to review systematically the literature about the antimicrobial action of evaluated cleansers on the Co-Cr alloy of RPD. The search was conducted in MEDLINE/PubMed, Scopus, Lilacs, Embase and Science Direct May, 2022. The review was performed based on PRISMA guidelines and recorded in Open Science Framework. Independent reviewers performed the search, selection, extraction, and analysis of the data. The risk of bias of the in vitro and clinical trials studies was analyzed by the Joanna Briggs Institute tool. A total of 187 articles were found and 9 were included. The cleansers that showed antimicrobial action were 2% and 5.25% sodium hypochlorite, 0.12% chlorhexidine and NitrAdine effervescent tablet. Polident, Corega Tabs effervescent tablets and 5 mg/mL chitosan solution showed intermediate effects. Propolis and green tea toothpaste were not effective. Three articles presented a high risk of bias and 6, low risk. The cleansers that showed the highest antimicrobial efficacy on Co-Cr alloy were 0.12% chlorhexidine digluconate and NitrAdine and can be safely used on RPD framework.

Microbiological evaluation in invisible aligner chemical cleaning methods against Candida albicans and Streptococcus mutans

INTRODUCTION

This study aimed to assess the efficacy of chemical agents in removing Candida albicans and Streptococcus mutans biofilm from invisible aligners.

METHODS

The samples were made of EX30 Invisalign trays, biofilm was cultured by standardized suspensions of C. albicans ATCC strain and S. mutans clinical strain on the sample. The treatments used were 0.5% sodium hypochlorite (NaClO) (20 minutes), 1% NaClO (10 minutes), chlorhexidine (5 minutes), peroxide (15 minutes), and orthophosphoric acid (15 seconds). The control group received phosphate-buffered saline for 10 minutes. The colony-forming units per milliliter of each microorganism were determined by serial dilutions seeded in plates with selective culture mediums for each one. Data were analyzed by the Kruskal-Wallis and Conover-Iman tests at an α of 0.05.

RESULTS

For the C. albicans biofilm group, the control group had 9.7 Log10 of microorganism growth, and all treatment groups had statistically significant biofilm reduction, in which chlorhexidine presented the highest inhibition of 3 Log10, followed by alkaline peroxide and orthophosphoric acid both with 2.6 Log10, 1% NaClO (2.5 Log10), and 0.5% NaClO (2 Log10). As for S. mutans, the control group had 8.9 Log10 of growth, and a total microorganism inhibition was reached by chlorhexidine, 1% NaClO, and orthophosphoric acid, whereas alkaline peroxide inhibited growth to 7.9 Log10 and 0.5% NaClO 5.1 Log10.

CONCLUSIONS

Within the limitations, chlorhexidine and orthophosphoric acid had greater efficacy in both biofilms. In addition, 1% NaClO and alkaline peroxide also had significant effects; therefore, their incorporation aligners disinfection protocols are valid.

Evaluation of candida albicans adherence to CAD-CAM milled, 3D-printed, and heat-cured PMMA resin and efficacy of different disinfection techniques: an in-vitro study

PURPOSE

Candida albicans has been regarded as the most predominant oral fungal pathogen and the main cause of denture stomatitis. This study aimed to investigate C. albicans adherence to three types of denture base polymers: heat-cured polymethylmethacrylate (PMMA), CAD-CAM milled and 3D-printed. The efficacy of four common disinfection techniques, glutaraldehyde, brushing, microwave irradiation, and Polident overnight tablets, were also examined.

MATERIAL AND METHODS

Sixty blocks of pink acrylic specimens were fabricated from each polymer group. To investigate the C. albicans adherence, as well as the efficacy of different disinfection techniques on removing the yeast from the different materials, specimens were cultured within the fungal culture overnight followed by disinfection. The adhered C. albicans on the materials were then obtained by vortexing in phosphate buffered saline (PBS), and the numbers of the yeast in the suspensions were evaluated by measuring the optical density and/or colony-forming units on agar plates. Data were expressed as mean ± SEM (standard error of the mean). Statistical differences were evaluated by one-way analysis of variance (ANOVA) followed by the post-hoc Tukey HSD tests.

RESULTS

Significant differences in C. albicans adherence to the three polymers were noted. CAD-CAM milled and heat-cured PMMA showed significantly less C. albicans adherence compared with 3D printed PMMA. No significant difference was noted between milled and heat-cured PMMA. In the disinfection test, microwave irradiation, mechanical brushing, and Polident tablets were found to be effective in removing fungal attachment on the different denture materials, while glutaraldehyde was found to be the least effective.

CONCLUSION

C. albicans adherence to the polymers varies greatly based on the types of PMMA. 3D-printed had the highest fungal biofilm attachment. Microwave irradiation, mechanical brushing, and Polident overnight tablets had comparable results in removing C. albicans from all types of PMMA, while glutaraldehyde was not as effective. This article is protected by copyright. All rights reserved.

Soft Denture liner and microbial disinfection with contemporary and conventional agents

AIM

The present study aimed to assess the effect of PDT, herbal and chemical disinfectants on the dental pathogen adherence to soft denture liner colonized with E. coli, C. Albicans, S.aureus, and S. mutans.

MATERIAL AND METHODS

A total of 20 samples of soft-lined removable acrylic complete dentures were fabricated and subjected to the American Type Culture Collection (ATCC) for the inoculation of E.coli, C.albicans, S.mutans and S.aureus in an in-vitro setup. The samples were then randomly divided into four groups and immersed in group 1: 5 µm of Rose Bengal (RB), group 2: Neem extract, group 3: Tea tree oil (TTO), and group 4: 0.12% CHX solutions respectively. Statistical analysis was accomplished by the SPSS 10 statistical software for Windows at a significance level p< 0.05. Two-way ANOVA and Tukey's multiple comparison test were used to analyze the data and compare the means and standard deviation values of CFU/mL (log10) for exposed E. coli, C. albicans, S aureus, and S. mutans.

RESULTS

Intragroup comparison indicated E.coli and C.albicans did not unveil a decrease in reduction CFU/mL (log10) when SDL irradiated with RB 5 µm. Whereas, CFU/mL (log10) values of S.aureus; 2.62±0.68 CFU/mL and S.mutans: 3.41±0.13 CFU/mL plunged significantly (p<0.05). Likewise, S. aureus and S. mutans CFU/mL (log10) strain values display reduction when treated with all four disinfectants while the count of C.albicans unveiled a significant plunge with CHX, TTO and neem extract except RB (p<0.05) CONCLUSION: 0.12% CHX and TTO have enhanced antimicrobial efficacy in reducing adhered bacterial colonies of E.coli, C.albicans, S.aureus, and S.mutans (CFU)/mL on a denture soft liner.

Efficacy of contemporary agents on disinfection and surface roughness of polyetheretherketone implant abutments

AIM

The present study was designed to estimate the disinfection and surface roughness (Ra) of colonized (E. coli, C. albicans, S.aureus, and S. mutans) PEEK implant abutment disinfected with PDT, chemical, and herbal agents.

MATERIAL AND METHODS

The American Type Culture Collection (ATCC) inoculated E.coli, C.albicans, S.mutans, and S.aureus in an in-vitro scenario using 60 PEEK implant abutment samples provided by the manufacturer. Following that, the samples were distributed in four disinfection methods categories - group 1: 5mM Rose Bengal PS (RB), group 2: ultrasonic disinfection (UD), group 3: 2% glutaraldehyde (GaH), and group 4: tea tree oil (TTO). To scrutinize the data and compare the means and standard deviations of CFU/mL (log10) for exposed E. coli, Candida albicans, S.aureus, and S.mutans, a two-way ANOVA and Tukey's multiple comparison test were performed.

RESULTS

Specimens treated with 2% GaH, UD, and TTO validated a significant reduction in E. coli, C. albicans, S aureus, and S. mutans CFU/mL (log10) colonies. Intragroup assessment designated that there is no reduction in CFU/mL (log10) of E.coli and C.albicans when PEEK implant abutment specimens are irradiated with 5Mm RB. A decline is seen in values of S. aureus, and S. mutans microbial strains on treatment with all four cleansers while the computation of C.albicans and E.coli colonies unveiled significant reduction with GaH, UD, and TTO except RB (p<0.05). The results of Ra showed that PEEK fabricated implant abutment specimens, when treated with UD (3.472±0.561μm), displayed a significantly higher Ra value as compared to other analyzed cleansing methods.

CONCLUSION

. Disinfection with 2% glutaraldehyde and Tea tree oil showed maximum antimicrobial efficacy and lower Ra values for PEEK implant abutments colonized with bacterial strains of E.coli, C.albicans, S.aureus, and S.mutans.

Effect of Denture Hygiene Protocols on Patient Satisfaction, Oral Health-Related Quality Of Life, and Salivary Parameters: A Randomized Clinical Trial

PURPOSE

This randomized controlled trial compared four denture hygiene protocols in terms of patient satisfaction, oral health-related quality of life (OHRQoL), and salivary parameters in complete denture wearers with denture stomatitis.

MATERIAL AND METHODS

For this randomized, double-blind controlled clinical trial, 108 participants were assigned to soak their dentures in one of the following solutions: (1) 0.25% sodium hypochlorite (positive control), (2) 0.15% Triclosan, (3) denture disinfecting tablets, or (4) denture disinfecting tablets plus palatine mucosa brushing solution. The outcomes of patient satisfaction, OHRQoL, and salivary parameters (salivary flow rate and pH) were measured at baseline and after 10 days. Results were compared by Kruskal-Wallis, between-group by the Dunn test, and Wilcoxon tests between times (α = 0.05).

RESULTS

After the hygiene protocols, and when compared with baseline, the overall patient satisfaction, maxillary denture satisfaction, maxillary denture comfort, and maxillary denture retention were ameliorated. A significant improvement was noted in OHRQoL in 3 of 4 domains evaluated (orofacial pain and discomfort, masticatory discomfort and disability, and psychological disability and discomfort). The salivary flow rate (unstimulated and stimulated); and pH were not significantly affected at the times evaluated.

CONCLUSIONS

Complete denture wearers may feel more satisfied with their complete dentures when treated for denture stomatitis. The tested treatments lead to similar improvement in terms of patient satisfaction and OHRQoL. This article is protected by copyright. All rights reserved.

Novel Artificial Biofilm Equivalent for Denture Surfaces: A Pilot Study

The microbial population of the dental biofilm is embedded in an extracellular matrix that contains organic polymers such as polysaccharides. The extracellular matrix promotes biofilm adhesion on surfaces of dental prostheses and acts as a protective barrier. Thus, a breakdown of the extracellular matrix is crucial for an effective mechanical biofilm removal by brushing. The purpose of this study was to develop an artificial biofilm equivalent (ABE) that is able to mimic the mechanical properties of a natural biofilm concerning abrasion resistance. It contains the two polysaccharides chitosan (ChS) and methylcellulose (MC). Polymethylmethacrylate (PMMA) cylinders ( $n=80$ ) were manufactured and coated with the ABE with varying concentration ratios of ChS and MC. Eight test series ( $n=8$ each) with different mixing ratios of ChS/MC were tested for their abrasion resistance to brushing in a toothbrush simulator. For the ABE, a total of 2.0 g of polysaccharides were added to 100 ml of 2% acetic acid: 0.3–1.0 g ChS and 1.0–1.7 MC, respectively. Furthermore, two control series ( $n=8$ each) with 2.0 g of ChS only or 2.0 g of MC only were performed. Coated specimens were subjected to an increasing number of brushing strokes from 5 to 45 via abrasion test. The specimens were photographed, and a computerized planimetric method (CPM) was used to calculate the percentage of remaining ABE on the brushed areas of the PMMA cylinders. The abrasion resistance of the ABE to brushing decreased with an increasing ratio of MC in the mixture. The abrasion resistance of the ABE can be adjusted by changing the ratio of ChS and MC.

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.

Efficacy of porphyrin derivative, Chlorhexidine and PDT in the surface disinfection and roughness of Cobalt chromium alloy removable partial dentures

AIM

The present study aimed to evaluate the effect of different cleansers and photodynamic therapy (PDT) on disinfection of Co/Cr removable partial denture colonized with C. albicans, S.aureus and S.mutans.

MATERIAL AND METHODS

Twenty-five Co/Cr removable partial dentures were constructed. and inoculated by American Type Culture Collection (ATCC) of Candida albicans, S.aureus, and S.mutans in an in-vitro setup. Co/Cr removable partial dentures were randomly allocated into five groups and framework was immersed in 15 mL of contaminated culture medium broth. Based on the cleansing method, disinfected dentures in group 1 were cleansed with porphyrin derivative; group 2 was exposed to 0.12% chlorhexidine digluconate; samples in group 3 and group 4 were subjected to sodium perborate enzyme and citric acid respectively. Through a surface analyzer, the surface roughness of Co/Cr and methacrylate resin was measured in 3 different zones in micrometers before and after disinfection. Two-way ANOVA and Tukey's test was used to analyze the data. Levene test was used to assess the normal distribution of data. Significance level p< 0.05 RESULTS: The results of metal roughness displayed that Co/Cr used as an alloy did not exhibit significant difference when exposed to different chemical disinfectants and photosensitizer (p > 0.05). Similarly, surface roughness (Ra) of heat polymerized acrylic resin using cleansers and PDT demonstrated no significant difference. Intergroup comparison showed that, hematoporphyrin derivative displayed comparable cleansing property against S. aureus, C.albicans, and S. mutans compared to to 0.12% CHX digluconate (p>0.05). The intragroup comparison showed hematoporphyrin derivative and CHX were equally effective against all bacteria (p>0.05).

CONCLUSION

CHX digluconate and hematoporphyrin derivative demonstrated high antimicrobial activity against S.aureus, S.mutans, and C.albicans with minimum Ra of an acrylic denture and Co/Cr metallic framework.

Effectiveness of Oil-Based Denture Dentifrices-Organoleptic Characteristics, Physicochemical Properties and Antimicrobial Action

Denture dentifrices must be effective and not deleterious to prosthetic devices. This study formulated and evaluated dentifrices based on oils of Copaifera officinalis, Eucalyptus citriodora, Melaleuca alternifolia, Pinus strobus, and Ricinus communis. Organoleptic characteristics (appearance, color, odor, taste), physicochemical properties (pH, density, consistency, rheological, abrasiveness, weight loss, and surface roughness) and antimicrobial (Hole-Plate Diffusion–HPD)/anti-biofilm (Colony Forming Units–CFU) action against Staphylococcus aureus, Streptococcus mutans, and Candida albicans were evaluated. Formulations were compared with water (negative control) and a commercial dentifrice (positive control). The data were analyzed by Kruskal-Wallis and Dunn tests (α = 0.05). The organoleptic and physicochemical properties were adequate. All dentifrices promoted weight losses, with high values for C. officinalis and R. communis, and an increase in surface roughness, without differing from each other. For antimicrobial action, C. officinalis and E. citriodora dentifrices were similar to positive control showing effectiveness against S. mutans and C. albicans and no dentifrice was effective against S. aureus; regarding the anti-biofilm action, the dentifrices were not effective, showing higher CFU counts than positive control for all microorganisms. The dentifrices presented satisfactory properties; and, although they showed antimicrobial action when evaluated by HPD, they showed no effective anti-biofilm action on multispecies biofilm.

Disinfection of acrylic denture resin polymer with Rose Bengal, Methylene blue and Porphyrin derivative in photodynamic therapy

AIM

The study aimed to assess the effect of in-vitro chlorhexidine and antimicrobial photodynamic therapy (aPDT) disinfection protocols against acrylic resin specimens colonized with S. mutans, S. aureus, E. coli, and C. albicans.

MATERIAL AND METHODS

Reference strains of S. mutans, S. aureus, E. coli, and C. albicans were tested. Sixteen blocks of acrylic specimens were prepared by heat-cure acrylic resin and contaminated by in-vitro biofilm growth. Specimens in group 1, group 2 and group 3 were treated with Rose Bengal (RB), methylene blue (MB) 500 mg/L and porphyrin derivative (PD) 5 ml respectively, for the sensitization of biofilms. All photosensitizers (PS) were activated by LED at different wavelength. CHX was prepared in sterile distilled water and applied for 60 s. Each contaminated specimen was sprayed on all its surfaces with the aforementioned photosensitizers and control CHX. One-way analysis of variance (ANOVA) model was used to test the effect of the treatments and Tukey multiple comparison tests to compare means OF CFU/mL (log10) for exposed E. coli, C. albicans, S aureus, and S. mutans RESULTS: Specimens treated with 0.12% CHX (control) demonstrated a significant reduction in CFU/mL (log10) for exposed E. coli; 2.04±0.07 CFU/mL, C. albicans; 2.09±0.85 CFU/mL, S aureus; 3.04±0.11 CFU/mL, and S. mutans; 2.54±0.91 CFU/mL. The intragroup comparison revealed E.coli did not exhibit a decrease in reduction CFU/mL (log10) when acrylic resin irradiated with RB 5 µm. Whereas, CFU/mL (log10) values of S.aureus; 3.62±0.68 and S.mutans; 3.41±0.13 plummeted (p<0.05). Intergroup comparison showed E.coli values to display comparable reduction when disinfected with MB 500 mg/L and 0.12% CHX; 3.16±0.34 and 2.04±0.07 CFU/mL (log10) (p<0.05).

CONCLUSION

Photosensitizers (RB, MB, PD) are selective in reducing bacterial count on acrylic resin blocks. CHX was found to be effective against all bacteria E.coli, C.albicans, S.aureus, and S.mutans at a concentration of 0.12%.

Evaluation of antibacterial activity against Candida albicans according to the dosage of various denture cleansers

PURPOSE

The purpose of this study is to compare the antibacterial activity of currently purchasable denture cleansers against Candida albicans.

MATERIALS AND METHODS

This study used tablet-type denture cleansers, Polident®, Coolingdent® and Fittydent®, along with liquid denture cleansers, Hexamedine®, Listerine® and Apple vinegar®. The antibacterial activities of denture cleansers were evaluated based on the number of C. albicans and concentrations of the denture cleansers.

RESULTS

In the 0.5 × 10⁶ cfu/ml culture medium, the C. albicans' death rate of Polident® was significantly lower than those of Fittydent®, Hexamedine®, Listerine®, and Apple vinegar®(P<.05). In the 0.5 × 10⁷ cfu/, the C. albicans' death rates of Polident® and Coolingdent® were significantly lower than those of Fittydent®, Hexamedine®, Listerine® and Apple vinegar®(P<.05). The C. albicans' death rates of Polident® and Coolingdent® were significantly decreased at 0.02 g and 0.01 g. The C. albicans' death rate of Fittydent® was significantly decreased at 0.005 g (P<.05). The C. albicans' death rate of Hexamedine® was significantly decreased at 1/16 dilution. The C. albicans' death rate of Listerine® was decreased at 1/8 dilution, and the antibacterial activity of Apple vinegar® was decreased at 1/4 dilution (P<.05).

CONCLUSION

As the number of C. albicans increased, the antibacterial activities of the denture cleansers decrease. In the tablet-type denture cleanser, all denture cleansers showed 100% C. albicans' death rate when used at a dose of 1 tablet. One denture cleanser showed the same antibacterial effect with only 1/3 of a tablet. In the liquid type denture cleanser, the level of dilution required was different for each denture cleanser.

Antimicrobial activity of effervescent denture tablets on multispecies biofilms

PURPOSE

To investigate the impact of peroxide-based solutions in reducing viability and metabolic activity of multispecies biofilms on denture base acrylic resin surfaces and for removing them from these surfaces.

BACKGROUND

Denture cleansers are effective in reducing monospecies biofilm; however, studies evaluating their action on multispecies biofilms are scarce.

MATERIALS AND METHODS

Sixty-nine denture base acrylic resin specimens (Ø 15 × 3 mm) were sterilised then contaminated with Candida albicans, Staphylococcus aureus and Pseudomonas aeruginosa to form multispecies biofilms. Biofilms were grown for 24 hours; subsequently, specimens were immersed in three different cleansing solutions (n = 9): nitradine (NI), fixodent (FX) and phosphate-buffered saline (Control), according to the respective manufacturer's instructions. After applying the hygiene protocols, viability of microorganisms was evaluated by counting colony-forming units and assessing metabolic activity. Moreover, biofilm removal capacity was estimated based on extension of cell-covered areas visualised in fluorescent microscopy micrographics.

RESULTS

Microbial counts were solution-dependent; NI was effective against all microorganisms (P < .05). FX exhibited moderate antimicrobial action, reducing P aeruginosa (P < .05) and S aureus (P < .05) viability by approximately 2 logs. Both peroxide-based solutions reduced metabolic activity (P < .001) and biofilm-covered areas on specimen surfaces (P < .001).

CONCLUSION

Under the experimental conditions tested, these results demonstrated that peroxide-based solutions had favourable antimicrobial activity but promoted no broad elimination of aggregated multispecies biofilm. NI might be more suitable as complementary chemical agent for controlling multispecies denture biofilm.

Assessment of surface roughness changes on orthodontic acrylic resins by all-in-one spray disinfectant solutions

Background. The disinfection of orthodontic acrylic resins might change the physical and mechanical properties of these materials. We aimed to investigate the impact of four different commercially available disinfectants on the surface roughness of acrylic resins used for orthodontic appliances.

Methods. Four disinfectant solutions (BirexSE, Opti-Cide3, COEfect MinuteSpray, and CaviCide Spray) were used to disinfect orthodontic acrylic resins using the spraying method. The resins were subjected to repeated disinfection protocols. Distilled water, also applied via spraying method, was used as a control. Surface roughness was scrutinized to examine the extent of surface topography changes by stylus profilometry. Data normality was evaluated via the Shapiro–Wilk test, followed by the Wilcoxon Signed-Rank test for non-parametric data or paired Student’s t-test for parametric data to compare intra-group differences in roughness before and after the use of the disinfectant solutions.

Results. Some of the disinfectants (BirexSE and CaviCide) resulted in significant changes in surface roughness values before and after the disinfection compared to the controls (P<0.05). The groups that were in contact with distilled water, Opti-Cide, and Coeffect did not exhibit significant differences in surface roughness before and after the intervention (P>0.05). However, from a clinical perspective, the resulting variations in surface roughness (<%0.15) induced by these solutions might not reflect clinically significant differences.

Conclusion. The use of disinfectant solutions is unlikely to harm the surface of orthodontic acrylic resins. Oral care providers need to be attentive to the interpretation and implementation of clinically significant changes in their evidence-based approach regarding potential material damages by disinfection sprays.

Suppressive effects of 2-methacryloyloxyethyl phosphorylcholine (MPC)-polymer on the adherence of Candida species and MRSA to acrylic denture resin

Objectives

The effects of 2-methacryloyloxyethyl phosphorylcholine (MPC)-polymer on the adherence of microorganisms such as non-Candida albicans Candida (NCAC) and methicillin-resistant Staphylococcus aureus (MRSA), frequently detected in oral infections in immunocompromised and/or elderly people, to denture resin material, are still unclear. Here, we report the effects of MPC-polymer on the adherence of C. albicans, NCAC, and MRSA to acrylic denture resin.

Methods

Sixteen strains of C. albicans, seven strains of C. glabrata, two strains of C. tropicalis, one strain of C. parapsilosis, and six strains of MRSA were used. We cultured the fungal/bacterial strains and examined the cell growth and adherence of fungi/bacteria to mucin-coated acrylic denture resin plates (ADRP) with or without MPC-polymer coating, by scanning electron microscopy. The cell surface hydrophobicity of the fungal/bacterial strains was measured by the adsorption to hydrocarbons.

Results

MPC-polymer did not affect the growth of all strains of Candida species and MRSA, but significantly suppressed adherence to ADRP in most strains of C. albicans and all strains of NCAC and MRSA. A significant positive correlation was found between cell hydrophobicity and the reduction rates of microbial adherence to ADRP treated with 5% of MPC-polymer.

Conclusions

MPC-polymer treatment for acrylic resin material suppresses the adherence of C. albicans, NCAC and MRSA via their hydrophilicity interaction.

Clinical significance

The application of MPC-polymer for denture hygiene is potent to prevent oral candidiasis, denture stomatitis and opportunistic infection, caused by Candida species and MRSA, via suppressing the adherence of those fungus/bacteria.

Study on oral hygiene by nanobubbles from high-density nozzle

An experiment was performed on oral bacteria removal using the design variables, which included the three-segment rotor speed of the testing device and three types of stainless steel meshes (with different layers). The overall hygienic results showed an effect of up to 95% bacteria removal, and some combinations had 100% hygienic effect. The study proposed that the use of nanobubble generated by a high-density stainless-steel mesh-manufactured nozzle removes dental bacteria. In addition, the device could also be used for auxiliary oral hygiene to decrease the frequency of future medical visits due to periodontal diseases or to enable the device to assist patients with severe periodontal disease more conveniently for oral hygiene.

Antibiofilm Activity of an Experimental Ricinus Communis Dentifrice on Soft Denture Liners

The disadvantage of liners materials is the difficulty of biofilm control. It was compared an experimental dentifrice contained Ricinus communis, with commercials dentifrices as antibiofilm activity against microorganisms on denture liner. Six hundred specimens were distributed in 5 groups (n=18/ microorganism): water; experimental dentifrice; specific dentifrice for denture and two conventional dentifrices against C. albicans; C. glabrata; S. mutans; S. aureus; E. coli. Each group had a negative (n=5; without contamination) and positive control (n=15/ microorganism; without cleaning). The antibiofilm activity was evaluated by the method of biofilm formation in triplicate. The specimens were contaminated in a standard way and incubated. After that, manual brushing was performed (60 s), washed with PBS, immersed in liquid culture medium for resuspension and sowing in solid medium. The results (mean of triplicates) were expressed in CFU/mL. The data was submitted to Shapiro-Wilk, ANOVA and Tukey test (p<0.05). The specific dentifrice (1.27±1.20) was the most effective against S. mutans, followed by conventional (Trihydral, 3.13±0.88; Colgate, 2.16±2.02) and experimental (3.81±1.37) dentifrices, which were similar to each other (p=0.008). All of them were different from water (4.79±1.42). The specific (0.21±0.21) and experimental (0.36±0.25) dentifrices were similar against S. aureus, with a higher mean of CFU when compared to conventional (Colgate, 0.06±0.13), which was more efficient (p=0.000). For C. albicans, C. glabrata and E. coli, all dentifrices were similar to water (p=0.186). It was concluded, that the experimental dentifrice was effective against S. aureus and had not efficacy against Candida spp.; S. mutans; E. coli, as occurred with the commercials dentifrices.

Efficacy of removing Candida albicans from orthodontic acrylic bases: an in vitro study

Background

This study evaluated the efficacy of four methods in removing Candida albicans from the acrylic base material used to fabricate removable orthodontic appliances.

Methods

Heat-processed bars of orthodontic acrylic were incubated in a suspension of C. albicans for 2 h at 37 °C. Samples were allocated into five groups (five bars per group) according to the cleaning method: (1) manual brushing using a toothbrush; (2) soaking in a commercial denture cleaning solution; (3) soaking in a commercial mouthwash solution; (4) using an ultrasonic cleaner; and (5) soaking in distilled water as a negative control. Yeast remaining attached to the bars after cleaning were removed by vortexing in growth medium and plated on Sabouraud dextrose agar. The reduction in yeast colony count after cleaning was calculated and expressed as the number of colony forming units per acrylic bar (CFU/bar). The experiment was carried out three times.

Results

All four cleaning methods resulted in a significant decrease in viable yeast cells associated with the acrylic bars compared to the control group. The mean percentage reduction in viable yeast cells affected by the cleaning methods was: brushing 89.9%; chlorhexidine 95.8%; ultrasonic cleaning 99.9%; and denture tablet 100%.

Conclusions

All four methods evaluated in this study were effective, to some extent, in removing C. albicans from orthodontic acrylic samples. The most effective, and readily available, cleaning method was the use of commercial denture sterilizing tablets.

Efficacy of using oxygen microbubble device for facultative anaerobe removal

Patients with serious gingivitis or periodontal diseases suffer from receding gums. Brushing teeth with a toothbrush may result in bleeding gums and new wounds, which increases the difficulty of removing facultative anaerobes from gum pockets, to decrease the damage inflicted on gums, this study proposed a cleaning device that can generate and emit oxygen microbubbles for eliminating facultative anaerobes in the mouth cavity. In this study, the authors conducted simulations with a denture to investigate the efficacy of using this method to remove facultative anaerobes. In this research for the optimal device design, several variables were manipulated including rotation speeds of the bubble generator, different nozzle diameters, and different numbers of nozzle holes. The results revealed that the device is effective in removing facultative anaerobes; moreover, of all design variables, the number of nozzle holes was the factor having the largest effect on anaerobe removal, as it influenced the flow volume and oxygen content of the discharge: the greater the number of nozzles, the greater the flow volume, oxygen content, and efficacy of anaerobe removal.

Application of micro-bubbles on oral care

OBJECTIVE

This study proposed a method of using a modified micro-bubble generator with its ejection nozzle connected to an ergonomically designed soft teeth-tray for plaque removal. The applicability of this method was verified and the influence on plaque removal efficacy of some parameters of this device was clarified.

METHODS

The micro-bubble generator used in this study has 5 rotation speed settings, 5 nozzle sizes, and a soft teeth-tray ejection pore diameters. These were used as independent variables to investigate their effect on the ejected flow volume, velocity and micro-bubble dimension, and how they eventually affect the plaque removal efficacy from a denture.

RESULTS

When the micro-bubble generator coupled with large (4.8 mm) ejection pore teeth-tray and the largest (1.2 mm) nozzle diameter more than 98% of plaque can be removed; its applicability on cleaning denture can be verified. In general, the larger nozzle diameter and teeth-tray ejection pore diameter will remove more plaques; while the higher the flow velocity and the smaller the micro-bubble of the ejected stream, better cleaning efficacy can be achieved.

CONCLUSION

The application of micro-bubble on plaque removal seems effective, although at this moment it is applied on denture cleaning. The finding of the influence of some critical design parameters of micro-bubble generator and variables of ejected stream can be referred to further design a new micro-bubble cleaner for effective plaque removal from the teeth in human oral cavity.

Effect of chitosan nanoparticles on the inhibition of Candida spp. biofilm on denture base surface

OBJECTIVES

Chitosan nanoparticles (ChNPs) have antifungal effects, however there is a lack of information about the effects of ChNPs against Candida biofilm on denture base surface. This study investigated the ChNPs effect against C. albicans biofilm adhesion and formation, and against Candida spp. biofilm on heat-cured acrylic resin.

DESIGN

The ChNPs were synthetized (3800 μg/mL) and characterized by infra-red spectrophotometry and transmission electron microscopy. The minimum inhibitory/fungicidal concentrations (MIC/MFC) against Candida spp. were determined. The time-kill assay and changes on C. albicans micromorphology were evaluated. The % inhibition of ChNPs on C. albicans biofilm formation and reduction were investigated using 1 min and 8 h exposure. Candida biofilm was developed on resin surfaces and ChNPs were applied every 8 h for 5 days. After, fungal cells were counted (CFU/mL) and the surface roughness (Ra) and vickers microhardness (HV) of resin were analysed. For all experiments, sodium hypochlorite (NaOCl) was used as control. Data were analyzed by ANOVA, Tukey and paired t-tests (α = 0.05).

RESULTS

The MIC_80% of ChNPs was 30.1 μg/mL. ChNPs at 4 MIC showed complete inhibition in the time-kill assays. Blastoconidia cells were predominant after ChNPs application. The % inhibition ChNPs on C. albicans was proportional to its concentration, regardless of the exposure time. ChNPs decreased the CFU/mL of Candida spp. and showed lower alteration of HV and Ra values of resin surface compared to NaOCl.

CONCLUSIONS

The ChNPs inhibited C. albicans biofilm, reduced Candida biofilm on resin and caused small changes in roughness and hardness of acrylic resin surface.

Influence of denture surface roughness and host factors on dental calculi formation on dentures: a cross-sectional study

BACKGROUND

Dental calculi formation on dentures can worsen the oral cavity environment by complicating oral hygiene. However, few studies have investigated the effect of how patients use and manage their dentures, denture surface roughness, and host factors such as oral cavity dryness and saliva properties on denture cleanliness and denture dental calculi formation. Accordingly, we conducted the present survey to evaluate these factors to clarify the strength of the influence of each factor.

METHODS

We enrolled 53 patients who had used dentures for at least 3 months and used a dental prosthesis that covered at least the six front teeth including the left and right mandibular canines. After staining the dentures, we divided the participants into a group that was positive for dental calculi (DCP group) and a group that was negative for dental calculi (DCN group). After removing all the stains, we evaluated the surface roughness of the dentures. A questionnaire was used to survey how the participants used and managed their dentures. Oral cavity dryness was evaluated, and resting saliva samples were collected to assess saliva properties. Correlations between the presence or absence of dental calculi and denture use and management were evaluated using a chi-square test. Correlations with denture surface roughness, oral cavity dryness, and saliva properties were evaluated using the Mann-Whitney U test. Correlations between the presence or absence of dental calculi and all factors were analyzed using multivariate analysis (quantification II).

RESULTS

Surface roughness was significantly greater in the DCP group (p < 0.01), and the DCP group members wore their dentures during sleep significantly more often and used a denture cleaner when storing their dentures significantly less often (both p < 0.01). No significant differences were observed for oral cavity dryness or saliva properties. The multivariate analysis showed significant correlations of dental calculi formation with denture surface roughness and items related to denture use and management, but not for oral cavity dryness or saliva properties.

CONCLUSIONS

Our findings indicate that dental calculi formation is influenced by how dentures are used and managed and by denture surface roughness, but not by oral cavity dryness and saliva properties.

Development of antibacterial denture cleaner for brushing containing tea tree and lemongrass essential oils

We evaluated effectiveness of tea tree oil (TO) and lemongrass oil (LO) for removal of Candida biofilm from denture base resin and their influence on that surface. Biofilm of C. albicans was formed on resins, and immersed in various concentrations of each oil and distilled water (DW). The biofilm removal effect was determined by incubating specimens in RPMI medium containing Alamar blue (AB) and measuring absorbance. Wear test was also conducted, and surface condition of resins was determined using laser scanning microscope and digital microscope. Specimens immersed in the TO and LO solutions tended to have a lower AB value at higher concentrations and longer soaking times. Use of these agents resulted in less surface roughness as compared to DW. Our results suggest that TO and LO were valid to remove biofilm attached to resin with lower levels of abrasion, and these are effective for use in denture cleaner.

Preliminary studies on the inhibition potential of Indian domestic curd against coliforms, an emerging periodontal pathogen

Background:

Coliforms colonize in dental plaques via oral route and may lead to systemic complications. Escherichia coli and its lipopolysaccharide-induced periodontitis is an emerging threat. Clinical management necessitates antibiotic regimens with risk of resistance and upsetting the gut. There is urgent need for better, sustainable, and economical alternative.

Aim:

To investigate the inhibition of coliforms, a potential periodontopathogen directly by Indian domestic curd (IDC) “in situ".

Materials and Methods:

Coliforms from natural habitat (Municipal sewage in Agartala, Tripura), a source of infection through food and water, were used as target organism. Domestically prepared curd without any fortification is used to explore its true inhibition potential. Assays of agar well diffusion performed with IDC (ultraviolet sterilized and pH adjusted 6.5) against isolated pure cultures of coliforms. The study protocol nullified effect of organic acids, volatile compounds, bacteriophages, and peroxides in IDC. Peptide nature of inhibitory ingredient was studied by Sodium Dodecyle Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE), urea treatment. Computational phylogenetics revealed structural features of inhibitory ingredient. Statistical comparisons were done by analysis of variance. Second-order polynomial regression was done to evaluate the effect of IDC dilution on coliform inhibition. Mann–Whitney U-test performed to analyze different sample treatments.

Results:

Agar well diffusion (sealed bottom wells) shows inhibition of catalase-negative coliforms (confirmed by Gram staining and triple sugar iron agar assay) in pure culture (MacConkey agar). Activity diminished in urea, potentiated in ethylene diamine tetra acetic acid, remains unchanged by heat treatment (121°C, 15 min). SDS-PAGE revealed three distinct peptides (>10–15KDa). Hence, thermostable inhibitory peptides attached to target cell lead to observed activity (titer up to 1204.82 AU/ml with minimum 8 mm inhibition).

Conclusions:

IDC adequately inhibits sewage coliforms and may prevent dental plaques coliform colonization and its associated risks.

Effectiveness of a combination denture-cleaning method versus a mechanical method: comparison of denture cleanliness, patient satisfaction, and oral health-related quality of life

PURPOSE

Effective denture plaque control is necessary in elderly individuals to prevent oral and systemic diseases. However, comparative studies of denture cleaning methods are limited, especially those investigating patient satisfaction. The present study aimed to evaluate effectiveness of a mechanical denture cleaning method versus a combination of mechanical and chemical methods in terms of denture cleanliness, patient satisfaction, and oral health-related quality of life (OHRQoL).

METHODS

Thirty edentulous participants were allocated to one of two groups: mechanical or combination method. The mechanical method group was instructed to brush dentures after each meal for 2min using tap water and a denture brush, and to soak them in saline solution while sleeping. The combination method group was instructed to brush dentures the same way, but to soak them in denture cleansers while sleeping. Both groups cleaned their dentures according to the respective method for 3 weeks. Denture cleanliness, patient satisfaction, and OHRQoL were examined.

RESULTS

There were significant differences in adenosine triphosphate bioluminescence (p=0.00003), staining (p=0.003), and Candida albicans (C. albicans) abundance in upper complete dentures (p=0.002) between methods. There were no significant differences in oral mucosa C. albicans abundance, participant satisfaction, ease of cleaning, comfort, esthetics, or Oral Health Impact Profile for edentulous patients (Japanese version) scores between methods.

CONCLUSIONS

A combination of mechanical and chemical denture cleaning methods was more effective at cleaning dentures than the mechanical method alone. Even if denture cleaning improves denture hygiene, it may not increase patient satisfaction or OHRQoL.

Efficacy of denture cleaners on the surface roughness and Candida albicans adherence of sealant agent coupled denture base materials

This study investigated the effect of denture cleansers on the surface roughness and Candida albicans adherence of surface sealant agent coupled denture base resins. One hundred and twenty specimens were fabricated from 2 polymethyl methacrylate (PMMA) (Meliodent; Acron MC) and 1 polyamide (Deflex) denture base materials, coated with a sealant agent (Palaseal) and divided into 4 groups (n=10) according to overnight cleaning procedures: distilled water (control), 5% sodium hypochlorite (NaOCl) and two different sodium perborate (Corega; Rapident). The surface roughness values were measured with a profilometer before (R_a0) and after 90 days immersion in denture cleaners (R_a1). Specimens were incubated with Candida albicans suspension and Candida colony- forming units (CFU) (Cfu/mm) were counted. Significant differences were found, between the R_a0 and R_a1 values of 5% NaOCl applied Acron MC, Deflex and also Rapident applied Deflex groups (p<0.05). Denture cleaning procedures had no significant effects on the quantitiy of Candida albicans.

Effect of Different Dentifrices on the Surface Roughness of Acrylic Resins: An in vitro Study

AIM

This study was undertaken to study the effect of three most commonly used dentifrices for denture cleaning and to find out any positive association between number of strokes by toothbrush and surface roughness of acrylic resin.

MATERIALS AND METHODS

About 40 acrylic rectangular blocks with high finish were polished until surface roughness was calculated as 0 pirn. The materials tested were distilled water as a control group, Patanjali Dant Kanti, Colgate Total Cream, and Cleansodent as dentifrices. Stroking was done with dentifrices, and surface roughness readings were recorded at 1,000, 9,000, and 18,000 strokes.

RESULTS

Patanjali Dant Kanti was found to have maximum abrasive potential followed by Colgate Total Cream, followed by Cleansodent and least by distilled water.

CONCLUSION

Surface roughness was found to be directly proportional to the type, size, and fineness of the abrasive component used; the professional denture cleanser (Cleansodent) has less abrasive potential than the regular toothpastes. Among those tested, the highest abrasive potential was found in Patanjali Dant Kanti and lowest by Cleansodent (denture cleanser).

CLINICAL SIGNIFICANCE

The patient as well as dentist should choose the dentifrice with utmost care noting the size and type of abrasives used. Washing the dentures normally with water without toothbrush daily and cleaning of dentures once in 10 to 15 days with a soft toothbrush and professional denture cleanser should be the line of maintenance of dentures.

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.

Comparative assessment of the effectiveness of different cleaning methods on the growth of Candida albicans over acrylic surface

Context:

This study evaluated the efficacy of denture adhesive, cleanser, chlorhexidine, and brushing against Candida albicans biofilm developed on an acrylic surface and predicted the most effective, simple, and inexpensive way to maintain denture health, thereby preventing denture stomatitis.

Aims:

To find the best possible method for maintaining denture hygiene.

Settings and Design:

This retrospective analysis was conducted in the Guru Nanak Institute of Dental Sciences and Research, Kolkata, and this in vitro study was designed to minimize denture stomatitis among denture wearing population.

Subjects and Methods:

Sixty acrylic discs of equal dimensions after exposure to C. albicans were treated for a duration of 24 h with denture adhesive, cleanser, 0.2% chlorhexidine individually, or in combinations simulating clinical conditions dividing in six groups, ten samples each (n = 10).

Statistical Analysis Used:

After treatment, colony count was evaluated and statistically analyzed by post hoc Tukey's test and Dunnett's test to determine the most effective way of prevention.

Results:

The statistical post hoc analysis (Tukey's test and Dunnett's test) showed high significance (P < 0.0001). The group treated with adhesive showed high fungal growth compared to the control group, whereas chlorhexidine showed high potency to prevent C. albicans, whereas adhesive increased the adhesion of C. albicans to acrylic surface.

Conclusions:

Denture adhesive increases the adherence of C. albicans to denture surface. Other cleaning chemicals such as cleanser and chlorhexidine decrease the adherence. Moreover, among the all denture cleaning protocol, chlorhexidine drastically inhibit the adherence, as well as growth of C. albicans over denture surface.

A Comparative Clinical Study of the Effect of Denture Cleansing on the Surface Roughness and Hardness of Two Denture Base Materials

AIM:

This study aimed to verify the influence of oral environment and denture cleansers on the surface roughness and hardness of two different denture base materials.

METHODS:

A total of sixteen identical removable disc specimens (RDS) were processed. Eight RDS were made from heat-cured acrylic resin (AR) and the other eight were fabricated from thermoplastic injection moulded resin (TR). Surface roughness and hardness of DRS were measured using ultrasonic profilometry and Universal testing machine respectively. Then the four RDS (two AR and two of TR) were fixed to each maxillary denture, after three months RDS were retrieved. Surface roughness and hardness of RDS have measured again.

RESULTS:

The surface roughness measurements revealed no significant difference (p >0.05) for both disc groups at baseline. However, both groups showed a significant increase in the surface roughness after three months with higher mean value for (TR) group. On the other hand, the (AR) group showed higher hardness mean value than (TR) group at baseline with no significant decrease in the hardness values (p >0.05) following three months follow-up period.

CONCLUSIONS:

Denture cleansers have an effect on the denture’s surface roughness and hardness concurrently with an oral condition which will consequently influence the complete dentures’ lifetime and patients’ satisfaction.

Trial of an experimental castor oil solution for cleaning dentures

Denture hygiene is essential because denture biofilm is involved in oral infections and systemic diseases. Although there are chemical agents available on the market, none of them have ideal properties and research on such products is still necessary. The aim of this study was to evaluate the efficacy of a castor bean (Ricinus communis)-based solution for removing denture biofilm, compared to two traditional products (sodium hypochlorite and alkaline peroxide). Fifty maxillary complete denture wearers were instructed to brush their dentures after meals and to immerse their dentures once a day in the following solutions: Saline (20 min; control), Polident alkaline peroxide (3 min), NaOCl (20 min) and 2% castor oil solution (20 min). Participants used each solution for a period of 7 consecutive days, according to a random sequence. After each period, the internal surfaces of maxillary complete dentures were stained with a disclosing solution (1% neutral red), photographed and the disclosed biofilm was quantified with the aid of specific software. The influence of treatments on results was verified by the Friedman test (α=0.05). Tested solutions presented significant difference (Fr=51.67; p<0.001). Saline and NaOCl were significantly different (median: 2.0% and 0.0%) whereas Polident and castor oil presented intermediate results (median: 1.0% and 1.5%, respectively). It can be concluded that the castor oil solution tested in this study was comparable to alkaline peroxide in terms of efficiency in denture biofilm removal.

In vitro study of the antibacterial properties and impact strength of dental acrylic resins modified with a nanomaterial

STATEMENT OF PROBLEM

The accumulation of bacteria on the surface of dental prostheses can lead to systemic disease.

PURPOSE

The purpose of this in vitro study was to evaluate the growth of Staphylococcus aureus and Pseudomonas aeruginosa on the surface of autopolymerizing (AP) and heat-polymerizing (HP) acrylic resins incorporated with nanostructured silver vanadate (β-AgVO3) and its impact strength.

MATERIAL AND METHODS

For each resin, 216 circular specimens (9 × 2 mm) were prepared for microbiologic analysis and 60 rectangular specimens (65 × 10 × 3.3 mm) for mechanical analysis, according to the percentage of β-AgVO3: 0%, control group; 0.5%; 1%; 2.5%; 5%; and 10%. After a biofilm had formed, the metabolic activity of the bacteria was measured using the XTT reduction assay (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) (n=8), and the number of viable cells was determined by counting colony forming units per milliliter (CFU/mL) (n=8). Confocal laser scanning microscopy (CLSM) was used to complement the analyses (n=2). The mechanical behavior was evaluated by impact strength assays (n=10). Data were analyzed by 2-way ANOVA, followed by the Tukey honestly significant difference (HSD) post hoc test (α=.05).

RESULTS

The addition of 5% and 10% β-AgVO3 significantly decreased the metabolic activity of P. aeruginosa for both resins (P<.05). The HP resin promoted a greater reduction in metabolic activity than the AP resin (P<.05). No difference was found in the metabolic activity of S. aureus according to the XTT (P>.05). The number of CFU/mL for S. aureus and P. aeruginosa decreased significantly when 5% and 10% β-AgVO3 were added (P<.001). These concentrations significantly reduced the impact strength of the resins (P<.001) because the system was weakened by the presence of clusters of β-AgVO3.

CONCLUSION

The addition of β-AgVO3 can provide acrylic resins with antibacterial activity but reduces their impact strength. More efficient addition methods should be investigated.

Antimicrobial action of sodium hypochlorite and castor oil solutions for denture cleaning - in vitro evaluation

The objective of this in vitro study was to evaluate the antimicrobial action of sodium hypochlorite (0.25% and 0.50%) and 10% castor oil solutions against specific microorganisms, by counting Colony Forming Units (CFU) of clinically important bacteria and Candida species. Acrylic resin specimens (n = 320; Lucitone 550) were obtained from square metal matrices (10 x 10 x 2 mm), sterilized by microwave (650W, for 6 minutes) and contaminated by Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, Bacillus subtilis, Escherichia coli, Streptococcus mutans, Enterococcus faecalis and Candida glabrata. The specimens were immersed for 20 minutes in one of the following hygiene solutions (n = 10/each): A - 0.25% Sodium hypochlorite; B - 0.5% Sodium hypochlorite; C - 10% Castor oil solution; and D (Control) - saline. Adhered cells were suspended and inoculated into a selective solid medium (37ºC for 24 h). The Student's t-test (α = 0.05) was performed to compare log10(CFU+1)/mL between Groups C and D. The results showed that sodium hypochlorite (0.25% and 0.5%) completely eliminated all detectable microorganisms. The castor oil solution eliminated B. subtilis and reduced counts for other strains. Differences between C and D were significant (p < 0.05) for all species except for E. faecalis. Both sodium hypochlorite solutions (0.25% and 0.5%) were effective in eliminating all microorganisms evaluated, and may be useful as cleaning solutions for complete dentures. The castor oil solution provided moderate efficacy and performed differently on the tested species, with the strongest effect on B. subtilis and with non-significant action on E. faecalis.

Silver nanoparticles in dental biomaterials

Silver has been used in medicine for centuries because of its antimicrobial properties. More recently, silver nanoparticles have been synthesized and incorporated into several biomaterials, since their small size provides great antimicrobial effect, at low filler level. Hence, these nanoparticles have been applied in dentistry, in order to prevent or reduce biofilm formation over dental materials surfaces. This review aims to discuss the current progress in this field, highlighting aspects regarding silver nanoparticles incorporation, such as antimicrobial potential, mechanical properties, cytotoxicity, and long-term effectiveness. We also emphasize the need for more studies to determine the optimal concentration of silver nanoparticle and its release over time.

In Vitro Antimicrobial Activity of an Experimental Dentifrice Based on Ricinus Communis

This study evaluated the antimicrobial activity of a Ricinus communis-based experimental dentifrice for denture hygiene against the following standard strains: Staphylococcus aureus, Escherichia coli, Streptococcus mutans, Enterococcus faecalis, Candida albicans and Candida glabrata. The minimum inhibitory concentration (MIC) assay was performed with R. communis in pure oil at 2.5%. Only E. coli was not inhibited by R. communis, but the MIC (0.0781%) was effective against the other microorganisms. From these results it was determined the R. communis concentrations for experimental dentifrices, 1, 2, 5 and 10%, which were evaluated by the test-well diffusion in agar. The commercial dentifrices Colgate, Trihydral and Corega Brite were tested for comparative purposes. The diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a rule under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (α=0.05). Neither the commercial nor the experimental dentifrices were effective against E. coli. The experimental dentifrices containing R. communis at 2, 5 and 10% presented action against S. mutans, S. aureaus and E. faecallis. The experimental dentifrices showed no antimicrobial activity against Candida spp. and E. coli in any of the tested concentrations. Trihydral was the most effective. Comparing the experimental dentifrices, the product with 10% R. communis produced the largest zones of bacterial growth inhibition and had similar antimicrobial activity to the commercial dentifrices, except against S. aureus.

Photosensitization of in vitro biofilms formed on denture base resin

STATEMENT OF PROBLEM

Proper sterilization or disinfection of removable prostheses and surgical guides has been problematic in dental practice because of the absence of simple and low-cost techniques that do not cause damage to acrylic resins.

PURPOSE

The purpose of this study was to study the effect of photodynamic therapy against Streptococcus mutans, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans biofilms formed on acrylic resin specimens.

MATERIAL AND METHODS

The specimens were sterilized in ethylene oxide gas and submitted to in vitro biofilm growth. The photodynamic therapy consisted of the application of 0.05% methylene blue (P+) conjugated to irradiation with a light-emitting-diode of 630 nm and 150 mW (L+). The specimens were randomly divided into groups (n=5): negative control (P-L-); stained and irradiated at 10 J/cm(2) (P+L+ 10); stained and irradiated at 30 J/cm(2) (P+L+ 30); stained and not irradiated (P+L-); not stained and irradiated at 10 J/cm(2) (P-L+ 10); not stained and irradiated at 30 J/cm(2) (P-L+ 30); and gold standard (GS), sterilized. Afterward, the specimens were submitted to contact with culture medium agar for 10 minutes in petri plates, which were incubated for 48 hours at 37°C. The number of colony-forming units was obtained, and the data were expressed according to scores (1=0; 2=1-10; 3=11-100; 4=101-1000) and analyzed by the Friedman and Dunn tests (α=.05).

RESULTS

Streptococcus mutans was sensitized by (P+L-); P aeruginosa and C albicans were also sensitized by the dye but showed a slight microbial reduction with (P+L+ 30), as did S aureus (P>.05); E coli presented an initial score of 3 and achieved a bacterial reduction to score 2 with (P+L+ 30) (P=.039).

CONCLUSIONS

Photodynamic therapy was effective in reducing E coli counts on biofilms formed on acrylic resin specimens. The inhibition of microorganism growth tended to be directly proportional to the amount of energy provided by the light-emitting diode.

Effectiveness of mechanical brushing with different denture cleansing agents in reducing in vitro Candida albicans biofilm viability

The adhesion of Candida albicans to surfaces is the prerequisite for occurrence of denture stomatitis, a common disease diagnosed among denture wearers. A routine of denture cleansing is essential to prevent biofilm formation and the onset of this infection. The aim of this study was to investigate the effectiveness of combining brushing and cleansing agents in killing C. albicans biofilm. Disks of acrylic resin were made, sterilized, and inoculated with C. albicans (10(7) cfu/mL). After incubation (37°C/48 h), specimens were randomly assigned to 10 experimental groups (n=9): 5 subjected to brushing with distilled water or cleansing agents - dentifrice slurry, 2% chlorhexidine gluconate (CHX), 1% sodium hypochlorite (NaOCl), and Polident fresh cleanse(®) (combined method) - and 4 exposed to the cleansing agents without brushing (immersion). Non-cleansed specimens were used as positive controls. The viability of cells was evaluated by XTT reduction method. Results were analyzed by Mann-Whitney and Kruskal-Wallis tests (α=0.05). The combined method was significantly more effective (p<0.0001) in reducing biofilm viability than the immersion. Brushing with CHX and NaOCl resulted in 100% removal of the biofilm. Immersion in the agents reduced significantly (p<0.0001) the biofilm viability, with CHX being the most effective (p<0.0001). The use of the combined method of brushing with cleansing agents is an effective method to reduce C. albicans biofilm, being CHX and NaOCl the most effective solutions.

Effect of biofilm formation, and biocorrosion on denture base fractures

PURPOSE

The aim of this study was to investigate the destructive effects of biofilm formation and/or biocorrosive activity of 6 different oral microorganisms.

MATERIALS AND METHODS

Three different heat polymerized acrylic resins (Ivocap Plus, Lucitone 550, QC 20) were used to prepare three different types of samples. Type "A" samples with "V" type notch was used to measure the fracture strength, "B" type to evaluate the surfaces with scanning electron microscopy and "C" type for quantitative biofilm assay. Development and calculation of biofilm covered surfaces on denture base materials were accomplished by SEM and quantitative biofilm assay. According to normality assumptions ANOVA or Kruskal-Wallis was selected for statistical analysis (α=0.05).

RESULTS

Significant differences were obtained among the adhesion potential of 6 different microorganisms and there were significant differences among their adhesion onto 3 different denture base materials. Compared to the control groups after contamination with the microorganisms, the three point bending test values of denture base materials decreased significantly (P<.05); microorganisms diffused at least 52% of the denture base surface. The highest median quantitative biofilm value within all the denture base materials was obtained with P. aeruginosa on Lucitone 550. The type of denture base material did not alter the diffusion potential of the microorganisms significantly (P>.05).

CONCLUSION

All the tested microorganisms had destructive effect over the structure and composition of the denture base materials.

Cytocompatible antifungal acrylic resin containing silver nanoparticles for dentures

Background

Inhibition of Candida albicans on denture resins could play a significant role in preventing the development of denture stomatitis. The safety of a new dental material with antifungal properties was analyzed in this work.

Methods

Poly(methyl methacrylate) [PMMA] discs and PMMA-silver nanoparticle discs were formulated, with the commercial acrylic resin, Nature-Cryl^TM, used as a control. Silver nanoparticles were synthesized and characterized by ultraviolet-visible spectroscopy, dispersive Raman spectroscopy, and transmission electron microscopy. The antifungal effect was assessed using a luminescent microbial cell viability assay. Biocompatibility tests were carried out using NIH-3T3 mouse embryonic fibroblasts and a Jurkat human lymphocyte cell line. Cells were cultured for 24 or 72 hours in the presence or absence of the polymer formulations and analyzed using three different tests, ie, cellular viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and cell proliferation by enzyme-linked immunosorbent assay BrdU, and genomic DNA damage (Comet assay). Finally, the samples were evaluated mechanically, and the polymer-bearing silver nanoparticles were analyzed microscopically to evaluate dispersion of the nanoparticles.

Results

The results show that PMMA-silver nanoparticle discs significantly reduce adherence of C. albicans and do not affect metabolism or proliferation. They also appear not to cause genotoxic damage to cells.

Conclusion

The present work has developed a new biocompatible antifungal PMMA denture base material.

A comparative in vitro study of two denture cleaning techniques as an effective strategy for inhibiting Candida albicans biofilms on denture surfaces and reducing inflammation

PURPOSE

 Candida albicans is the predominant oral yeast associated with denture-induced stomatitis, and with an increasing population of denture wearers its incidence is increasing. Maintaining good oral and denture hygiene, through chemical and/or mechanical intervention, is essential to reducing this disease. The aim of this study, using a robust adherent C. albicans cell model system, was to evaluate and compare the efficacy of a novel denture cleanser to the efficacy of a commonly used dentifrice coupled with brushing.

MATERIALS AND METHODS

Four C. albicans strains isolated from individuals diagnosed as having denture-induced stomatitis, were adhered to denture acrylic resin sections (1 cm(2) by 1 mm thickness) and after 4 hours of growth, challenged daily sequentially for 4 days with a denture cleanser (Polident) or intermittently with denture cleanser (day 1), then dentifrice (Colgate Cavity Protection Toothpaste) and brushing (days 2 and 3) and denture cleanser (day 4). Colony forming units were evaluated for each treatment, as were the levels of regrowth. Scanning electron microscopy (SEM) was also performed. Microbial susceptibility testing and time-kill studies were performed on biofilms. A coculture model was also used to assess interleukin-8 (IL-8) production from treated biofilms.

RESULTS

It was shown that sequential treatment with the denture cleanser killed and inhibited regrowth each day. Intermittent treatment showed that viable C. albicans biofilms were only retained rather than being dispersed, which could be visualized by SEM. Time-kill studies demonstrated that the novel denture cleanser was highly active and killed quickly, unlike the dentifrice. IL-8 was expressed in greater levels in 24-hour biofilms than in 4-hour biofilms, but treatment with denture cleanser reduced IL-8 output.

CONCLUSIONS

The data indicate that maintaining good oral health for denture wearers requires daily use of a denture cleanser rather than an alternating regimen. The inability of the denture cleanser to sterilize during intermittent treatments demonstrates the difficulty in controlling established biofilm. Moreover, the presence of mature biofilm may result in high levels of inflammation, but this can be controlled through denture cleansing.

Clinical and antimicrobial efficacy of NitrAdine ™-based disinfecting cleaning tablets in complete denture wearers

Objective

This study evaluated the efficacy of NitrAdine^TM-based disinfecting cleaning tablets for complete denture, in terms of denture biofilm removal and antimicrobial action.

Material and methods

Forty complete denture wearers (14 men and 26 women) with a mean age of 62.3±9.0 years were randomly assigned to two groups and were instructed to clean their dentures according to two methods: brushing (control) - 3 times a day with denture brush and tap water following meals; brushing and immersion (experimental) - brushing the denture 3 times a day with denture brush and tap water following meals and immersion of the denture in NitrAdine^TM-based denture tablets (Medical Interporous^TM). Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface before and after the use of the product. Microbiological assessment was conducted to quantify Candida sp.

Results

An independent t-test revealed a significant lower biofilm percentage for the experimental group (4.7, 95% CI 2.4 to 7.9) in comparison with the control group (mean 37.5, 95% CI 28.2 to 48.1) (t38=7.996, p<0.001). A significant reduction of yeast colony forming units could be found after treatment with Medical Interporous^TM denture tablets as compared to the control group (Mann-Whitney test, Z=1.90; p<0.05).

Conclusion

The present findings suggest that NitrAdine^TM-based disinfecting cleaning tablets are efficient in removal of denture biofilm. In addition, a clear antimicrobial action was demonstrated. Therefore, they should be recommended as a routine denture maintenance method for the prevention of the development of microbial biofilm-induced denture stomatitis.

Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists

The current rates of edentulism have been estimated to be between 7% and 69% of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence-based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, American Dental Association (ADA) Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories, and representatives from GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence-based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and were published in February 2011 issue of The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force.