Effect of repeated cycles of chemical disinfection on the roughness and hardness of hard reline acrylic resins

Nanoparticle-Modified 3D-Printed Denture Base Resins: Influence of Denture Cleansers on the Color Stability and Surface Roughness In Vitro

This study aimed to evaluate the influence of denture cleansers on the color, stability, and surface roughness of three-dimensional (3D)-printed denture base resins modified with zirconium dioxide nanoparticles (nano-ZrO2). A total of 440 specimens were fabricated using one heat-polymerized resin, and two 3D-printed resins (NextDent and ASIGA). According to the nano-ZrO2 content, the specimens for each resin were divided into five groups (0%, 0.5%wt, 1%wt, 3%wt, and 5%wt). Each concentration was divided into four subgroups (n = 10) based on the immersion solution (distilled water, sodium hypochlorite, Corega, and Fittydent) and immersion duration (360 and 720 days). The color changes (∆E00) and surface roughness (Ra, µm) of each specimen were measured at different time intervals (base line, 360 days, 720 days) using a spectrophotometer and a non-contact profilometer, respectively. The results were statistically analyzed using ANOVA and a post hoc Tukey's test (α = 0.05). Sodium hypochlorite showed the highest significant color change of all the denture base resins (p < 0.001). The average value of ΔE00 for sodium hypochlorite was significantly higher than the values for the other solutions (Fittydent, Corega, and water) (p < 0.001). Color stability was significantly affected by immersion time for all types of solutions except Corega (p < 0.001). All of the tested immersion solutions (distilled water, sodium hypochlorite, Corega, and Fittydent) showed a significant increase in the surface roughness of all the denture base resins (p < 0.05). Surface roughness was substantially increased by immersion time for all types of solution except Fittydent (p < 0.001). Denture cleansers can result in substantial color change and affect the surface roughness of unmodified and nanoparticle-modified denture base resins. Therefore, the selection of denture cleanser and appropriate types of material is critical for denture longevity.

Effects of disinfectants on physical properties of denture base resins: A systematic review and meta-analysis

STATEMENT OF PROBLEM

The disinfection of removable dental prostheses and orthodontic appliances is essential to preventing transmission of pathogens. However, whether different disinfection solutions and durations affect the physical properties of denture base resins is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to statistically analyze the influence of disinfectants on the physical properties of denture base resins.

MATERIAL AND METHODS

A systematic search in Medline, Embase, PubMed, and Cochrane Library databases was conducted to evaluate the effects of chemical disinfection on the physical properties of denture base resins such as surface morphology, roughness, hardness, and flexural strength. Of 1909 studies, 44 studies were included in the systematic review and 41 in the meta-analysis. Heterogeneity was analyzed by using I2 statistics. The influence of different disinfection solutions and durations on the physical properties was further analyzed, and the risk of bias evaluated. Statistical analyses were performed by using the RevMan 5.4 software program with the standardized mean differences (SMDs) and 95% confidence intervals (CIs).

RESULTS

Of the 44 included studies, 40 studies were assessed as having a low risk of bias, and 4 had an unclear risk of bias. Meta-analysis results showed that compared with the control, disinfection could not significantly affect surface roughness and hardness within 60 minutes of immersion in disinfectant solutions or flexural strength within 30 minutes (roughness: P=.79, I2=0%; flexural strength: P=.08, I2=0%; hardness: P=.05, I2=19%). In addition, the physical properties were not significantly affected when glutaraldehyde, chlorhexidine, and peracetic acid were repeatedly used for more than 30 minutes.

CONCLUSIONS

Most of the disinfectants did not reduce the physical properties of denture base resin within 30 minutes of immersion. Glutaraldehyde, chlorhexidine, and peracetic acid are recommended if longer immersion or repeated disinfection is required.

Biofilm removal effect of diatom complex on 3D printed denture base resin

For patients who have difficulty in mechanical cleaning of dental appliances, a denture cleaner that can remove biofilm with dense extracellular polymeric substances is needed. The purpose of this study is to evaluate the efficacy of diatom complex with active micro-locomotion for removing biofilms from 3D printed dentures. The diatom complex, which is made by doping MnO2 nanosheets on diatom biosilica, is mixed with H2O2 to generate fine air bubbles continuously. Denture base resin specimens were 3D printed in a roof shape, and Pseudomonas aeruginosa (107 CFU/mL) was cultured on those for biofilm formation. Cleaning solutions of phosphate-buffered saline (negative control, NC), 3% H2O2 with peracetic acid (positive control, PC), denture cleanser tablet (DCT), 3% H2O2 with 2 mg/mL diatom complex M (Melosira, DM), 3% H2O2 with 2 mg/mL diatom complex A (Aulacoseira, DA), and DCT with 2 mg/mL DM were prepared and applied. To assess the efficacy of biofilm removal quantitatively, absorbance after cleaning was measured. To evaluate the stability of long-term use, surface roughness, ΔE, surface micro-hardness, and flexural strength of the 3D printed dentures were measured before and after cleaning. Cytotoxicity was evaluated using Cell Counting Kit-8. All statistical analyses were conducted using SPSS for Windows with one-way ANOVA, followed by Scheffe's test as a post hoc (p < 0.05). The group treated with 3% H2O2 with DA demonstrated the lowest absorbance value, followed by the groups treated with 3% H2O2 with DM, PC, DCT, DCT + DM, and finally NC. As a result of Scheffe's test to evaluate the significance of difference between the mean values of each group, statistically significant differences were shown in all groups based on the NC group. The DA and DM groups showed the largest mean difference though there was no significant difference between the two groups. Regarding the evaluation of physical and mechanical properties of the denture base resin, no statistically significant differences were observed before and after cleaning. In the cytotoxicity test, the relative cell count was over 70%, reflecting an absence of cytotoxicity. The diatom complex utilizing active micro-locomotion has effective biofilm removal ability and has a minimal effect in physical and mechanical properties of the substrate with no cytotoxicity.

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.

Effect of Different Disinfecting Agents on Surface Roughness and Color Stability of Heat-cure Acrylic Denture Material: An In Vitro Study

AIM

The current study aimed to determine the impact of three different disinfectants on the surface roughness and color stability of heat-cure acrylic denture material.

MATERIALS AND METHODS

Using a stainless-steel mold, disc-shaped wax patterns with dimensions of 10 mm in diameter and 2 mm thick (in accordance with ADA Specification No. 12) were created and prepared for a total of 75 acrylic samples. Dimensions of all 75 acrylic samples were checked with a digital Vernier caliper. About 25 samples of denture base material were immersed in three different chemical disinfectants: Group I: immersed in chlorhexidine gluconate solution, group II: immersed in sodium hypochlorite solution, and group III: immersed in glutaraldehyde solution. All samples were scrubbed daily for 1 minute with the appropriate disinfectant and submerged for 10 minutes in the same disinfectant. Between disinfection cycles, samples were kept in distilled water at 37°C. Color stability was measured using a reflection spectrophotometer. Surface roughness values were measured by a profilometer at baseline following 15 days and 30 days.

RESULTS

After 15 days, the color stability was better in chlorhexidine gluconate solution group (4.88 ± 0.24) than sodium hypochlorite solution (4.74 ± 0.18) and glutaraldehyde solution group (4.46 ± 0.16). The mean surface roughness was less in glutaraldehyde solution group (2.10 ± 0.19), followed by chlorhexidine gluconate solution group (2.48 ± 0.09) and sodium hypochlorite solution group (2.64 ± 0.03). After 30 days, the color stability was significantly better in chlorhexidine gluconate solution group (4.40 ± 0.02), followed by sodium hypochlorite solution (4.06 ± 0.16) and glutaraldehyde solution group (3.87 ± 0.17). The mean surface roughness was significantly lesser in glutaraldehyde solution group (2.41 ± 0.14), followed by chlorhexidine gluconate solution group (2.94 ± 0.08) and sodium hypochlorite solution group (3.02 ± 0.13).

CONCLUSION

In conclusion, the color stability was significantly better in chlorhexidine gluconate solution group than sodium hypochlorite solution and glutaraldehyde solution group. But the surface roughness was significantly lesser in the glutaraldehyde solution group, followed by the chlorhexidine gluconate and sodium hypochlorite solution group.

CLINICAL SIGNIFICANCE

The maintenance of the prosthesis requires the use of a denture disinfectant; therefore, it is crucial to select one that is effective but would not have a negative impact on the denture base resin's inherent characteristics over time. How to cite this article: Kannaiyan K, Rakshit P, Bhat MPS, et al. Effect of Different Disinfecting Agents on Surface Roughness and Color Stability of Heat-cure Acrylic Denture Material: An In Vitro Study. J Contemp Dent Pract 2023;24(11):891-894.

Effect of denture cleansers on color stability and surface roughness of denture bases fabricated from three different techniques: Conventional heat-polymerizing, CAD/CAM additive, and CAD/CAM subtractive manufacturing

PURPOSE

Denture base materials are commonly exposed to different denture cleansers which can affect their essential properties. This study aimed to assess the effect of denture cleansers on color stability and surface roughness of poly methyl methacrylate (PMMA) denture bases fabricated from different techniques: Conventional heat-polymerizing, CAD/CAM additive and CAD/CAM subtractive.

MATERIALS AND METHODS

In this in vitro study, 24 disc-shaped specimens were fabricated by the mentioned methods for each group. The initial color and surface roughness of specimens were recorded. The specimens were randomly divided into three subgroups (n = 8): a control subgroup (distilled water), and two experimental subgroups of bioactive oxygen tablet (Corega) and 1% sodium hypochlorite solution. Then they were immersed in the solutions simulating 180 days of clinical use. Color change (∆E) was measured by a spectrophotometer according to the CIE L*a*b* color space and the American National Bureau of Standards (NBS = 0.92 × ∆E). Final surface roughness was recorded by a profilometer and its change was calculated. The Kruskal-Wallis test followed by the Wilcoxon signed rank test were used for statistical analyses (α = .05).

RESULTS

The conventional and CAD/CAM subtractive groups showed an increase in surface roughness following immersion in hypochlorite solution (p < .05). After immersion in the solutions, the highest surface roughness was noted in the conventional group, and the lowest in the CAD/CAM additive group. The CAD/CAM additive group experienced a significant color change in hypochlorite solution (p < .05) and showed the highest color change while the CAD/CAM subtractive group showed the lowest color change in all denture cleanser solutions.

CONCLUSION

Although the CAD/CAM additive denture base resins had the lowest surface roughness after exposure to denture cleanser solutions, they showed significant color change, which should be taken into account. Using hypochlorite as a denture cleanser should be cautioned due to its negative effects on the surface roughness and color stability of denture base materials.

Influence of Contemporary Photoactivated Disinfection on the Mechanical Properties and Antimicrobial Activity of PMMA Denture Base: A Systematic Review and Meta Analysis

PURPOSE

The present study aimed to perform a systematic review and meta-analysis to investigate the effectiveness of the contemporary photoactivated disinfection methods on the mechanical features and/or antimicrobial activity of polymethyl methacrylate (PMMA) dentures bases.

METHODS

THE FOCUSED RESEARCH QUESTION WAS: : "What is the effect of contemporary photoactivated disinfection methods as compared to conventional disinfection protocols on the mechanical features and/or antimicrobial activity of PMMA dentures bases?". An electronic literature search was carried out by the author and a senior librarian specialized in health sciences on Web of Science, PubMed, and Scopus. In vitro investigations evaluating the antimicrobial and/or mechanical effects of photoactivated disinfectants as compared to conventional chemical disinfectants on the microbes formed on PMMA denture bases were included. Meta-analysis was performed for calculating the standard mean difference (SMD) with a 95% confidence interval.

RESULTS

Four out of eight studies concluded that photoactivated disinfectants, including riboflavin-mediated photodynamic therapy (PDT), hematoporphyrin-mediated PDT, poly-L-glycolic acid loaded with methylene blue, Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, erbium-doped yttrium-aluminum-garnet (Er:YAG) laser, and chitosan-mediated PDT, demonstrated a significant reduction in colony-forming unit per milliliter (CFU/mL) of exposed viable colonies of Escherichia coli (E. coli), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Candida albicans (C. albicans) comparable to the conventionally used chemical disinfectants of PMMA denture bases. Contrarily, two studies concluded that the PMMA denture base colonized with C. albicans and disinfected with conventional chemical disinfectants showed the greatest anti-fungal efficaciousness. All the included studies concluded that the application of photoactivated disinfectants does not negatively impact the mechanical features of the PMMA denture bases colonized with microbes including E. coli, S. mutans, S. aureus, and C. albicans. The meta-analysis revealed statistically significant reduction in C. albicans counts (CFU/mL [Log10]) (p < 0.00001) and improvement in the flexural strength (p = 0.0002) of PMMA-based denture base after the application of conventional disinfectants, while a statistically significant improvement in the fracture strength of PMMA-based denture base was observed after the application of photoactivated disinfectants (p = 0.03).

CONCLUSION

According to the systematic review (qualitative synthesis), photoactivated disinfectants demonstrated comparable mechanical features and antimicrobial activity of PMMA dentures bases to conventional chemical disinfectants suggesting their potential to be utilized as an alternative to conventional chemical disinfectants. However, the meta-analysis (quantitative synthesis) revealed that the application of conventional disinfectants demonstrated better outcomes related to antimicrobial activity and flexural strength of PMMA-based denture based.

Effect of nano-ceramic coating on surface property and microbial adhesion to poly(methyl methacrylate)

To improve surface properties of poly(methyl methacrylate) (PMMA) using nano-ceramic coatings and assess microbial adherence after long-term use of a chemical cleanser. Thirty-six PMMA samples were fabricated, polished and coated with a nano-thin TiO₂ or mixed TiO₂ /ZrO₂ , with uncoated samples as controls. Six samples in each group (n = 12) were soaked in Polident denture cleaner 180 times for 30 min, while six were soaked in deionized water. Surface roughness of PMMA before and after being soaked in Polident was assessed. All samples were subsequently exposed to Candida albicans for 6 h and the adherent cells were determined by viable colony count. Two-way analysis of variance was performed for statistical analysis. No significant difference in surface roughness was noted between the uncoated and coated PMMA before soaking. After soaking, surface roughness of the uncoated PMMA increased from 0.164 to 0.532 μm (p < .05). No significant change was observed for TiO₂ -coated (0.105-0.143 μm) or TiO₂ /ZrO₂ -coated PMMA (0.104-0.141 μm). Attachment of C. albicans to PMMA soaked in water showed significantly less attachment to both TiO₂ -coated (1.4 × 10³ cfu/ml) and TiO₂ /ZrO₂ -coated PMMA (1.6 × 10³ cfu/ml) than to the uncoated PMMA (2.6 × 10³ cfu/ml). After soaking in Polident, the uncoated PMMA had significantly less C. albicans attachment than coated samples. Less attachment was noted on the TiO₂ /ZrO₂ -coated PMMA then the TiO₂ -coated samples (p < .05). Nano-ceramic TiO2₂ /ZrO₂ coating of PMMA denture base material alters surface properties thus reduces oral microbial adhesion. It represents a promising alternative to the chemical disinfection for PMMA denture materials.

Effect of Denture Disinfectants on the Mechanical Performance of 3D-Printed Denture Base Materials

Denture care and maintenance are necessary for both denture longevity and underlying tissue health. However, the effects of disinfectants on the strength of 3D-printed denture base resins are unclear. Herein, distilled water (DW), effervescent tablet, and sodium hypochlorite (NaOCl) immersion solutions were used to investigate the flexural properties and hardness of two 3D-printed resins (NextDent and FormLabs) compared with a heat-polymerized resin. The flexural strength and elastic modulus were investigated using the three-point bending test and Vickers hardness test before (baseline) immersion and 180 days after immersion. The data were analyzed using ANOVA and Tukey's post hoc test (α = 0.05), and further verified by using electron microscopy and infrared spectroscopy. The flexural strength of all the materials decreased after solution immersion (p < 0.001). The effervescent tablet and NaOCl immersion reduced the flexural strength (p < 0.001), with the lowest values recorded with the NaOCl immersion. The elastic modulus did not significantly differ between the baseline and after the DW immersion (p > 0.05), but significantly decreased after the effervescent tablet and NaOCl immersion (p < 0.001). The hardness significantly decreased after immersion in all the solutions (p < 0.001). The immersion of the heat-polymerized and 3D-printed resins in the DW and disinfectant solutions decreased the flexural properties and hardness.

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.

Effects of long-term cinnamaldehyde immersion on the surface roughness and color of heat-polymerized denture base resin

STATEMENT OF PROBLEM

Cinnamaldehyde has been successfully used for the short-term disinfection of dentures; however, its long-term effects on the surface and color properties of denture base materials remain unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of simulated immersion in cinnamaldehyde for up to 5 years on the surface roughness and color parameters of a heat-polymerized denture resin.

MATERIAL AND METHODS

Eighty Ø10×5-mm disk-shaped specimens were prepared from microwave heat-polymerized polymethylmethacrylate (PMMA) and immersed in 4 solutions (n=20): TW-tap water (control), SH - 0.5% sodium hypochlorite, PX-alkaline peroxide, and CA-cinnamaldehyde (27 μg/mL). The immersion protocol simulated 104 cycles (3.5 months), 913 cycles (2.5 years), and 1825 immersion cycles (5 years) of a daily immersion cleaning protocol, with immersion times ranging from 10 to 20-minutes. Surface roughness (Sa) and the color parameters of CIELab (L∗ a∗ b∗, ΔEab), CIEDE2000 (ΔE00), and the National Bureau of Standards (NBS) were analyzed at baseline (t=0) and after the immersion cycles. The data were analyzed by 2-way analysis of variance (ANOVA) for repeated measures and the Tukey post hoc test (α=.01).

RESULTS

Sa was significantly increased in all groups after 1825 cycles compared with baseline (P<.01), regardless of the solution. Only the time factor significantly affected ΔEab, ΔE00, and NBS parameters, which were below the perceptibility and acceptability thresholds. After a simulated 5-year immersion, the surface roughness and color values of CA-treated specimens were not statistically different from those of the other groups (P>.01).

CONCLUSIONS

Cinnamaldehyde solution (27 μg/mL) produced minor effects on the surface roughness and color parameters of a heat-polymerized denture base resin similar to those of 0.5% sodium hypochlorite and alkaline peroxide after a 5-year simulated immersion.

Effect of denture cleansers on the surface properties and color stability of 3D Printed denture base materials

OBJECTIVES

To evaluate the effect of denture cleansers on surface roughness, hardness and color stability of 3D-printed resins compared to heat-polymerized resins.

METHODS

Acrylic specimens (N=160) were prepared using one heat-polymerized (HP) and three 3D-printed denture base resins. Specimens per material were randomly divided into four groups (n = 10) according to immersion solutions as follows: distilled water (DW), sodium hypochlorite (NaOCl), effervescent tablet 1 or effervescent tablet 2. Color changes (∆E) were measured using a spectrophotometer. Surface roughness (Ra, µm) and microhardness were evaluated. The results were analyzed using one- and three-way ANOVA with Tukey's post hoc test (α = 0.05).

RESULTS

After 360 days of cleaning protocols, we observed a significant increase in the surface roughness of tested materials (P<0.001). Hardness values significantly decreased in all groups (P<0.001), except HP and ND specimens, cleaned with effervescent tablet 1 (P>0.05) and AS specimens with effervescent tablet 2 (P=0.051). According to the National Bureau of Standards (NBS) score, all denture base specimens had 'perceivable' to 'extremely marked' color change after immersion in NaOCl, while immersion in effervescent tablets 1 and 2 resulted in a 'slight' to 'marked' color change.

CONCLUSION

3D-printed denture bases exhibited changes in surface roughness, hardness and color of 3D-printed dentures similar to HP denture base material. The use of denture cleansers resulted in a time-dependent increase in surface roughness and a decrease in hardness. The color change was significant with NaOCl, while effervescent denture cleansers produced a minimal color difference.

CLINICAL SIGNIFICANCE

Denture cleansers seem to influence surface properties over time. The degree of impact is mainly dependent on the type of cleanser selected, regardless of the type of denture base material.

Applications of Silver Nanoparticles in Dentistry: Advances and Technological Innovation

Silver nanoparticles (AgNPs) have been successfully applied in several areas due to their significant antimicrobial activity against several microorganisms. In dentistry, AgNP can be applied in disinfection, prophylaxis, and prevention of infections in the oral cavity. In this work, the use of silver nanoparticles in dentistry and associated technological innovations was analyzed. The scientific literature was searched using PubMed and Scopus databases with descriptors related to the use of silver nanoparticles in dentistry, resulting in 90 open-access articles. The search for patents was restricted to the A61K code (International Patent Classification), using the same descriptors, resulting in 206 patents. The results found were ordered by dental specialties and demonstrated the incorporation of AgNPs in different areas of dentistry. In this context, the search for patents reaffirmed the growth of this technology and the dominance of the USA pharmaceutical industry over AgNPs product development. It could be concluded that nanotechnology is a promising area in dentistry with several applications.

Effect of Novel Cycloaliphatic Comonomer on Surface Roughness and Surface Hardness of Heat-cure Denture Base Resin

Background:

Polymethyl methacrylate (PMMA) is a widely used resin in the field of prosthodontics for fabricating myriad orofacial prostheses. Albeit several advantages, it possesses certain lacunae concerning physicomechanical properties.

Purpose:

This in vitro research aimed to evaluate the surface roughness (SR) and hardness (SH) of heat-cured PMMA processed with a cycloaliphatic monomer, tricyclodecane dimethanol diacrylate (TCDDMDA), in methyl methacrylate at various concentrations.

Materials and Methods:

Groups have been divided into control (SRC and SHC) and experimental groups (SR10 and 20; SH10 and 20). Forty-five PMMA disc specimens were prepared. SR was assessed using a nanomechanical testing machine and the arithmetic roughness (Ra) was recorded. The same specimens were then subjected to Vicker’s microhardness testing and Vicker’s hardness number (VHN) was obtained. Data were compared using one-way analysis of variance (ANOVA) and post hoc Bonferroni tests (α=0.05).

Results:

The mean (standard deviation [SD]) of SRC, SR10, and 20 groups were 111.415 nm (0.789), 62.666 nm (0.482), and 41.004 nm (0.561), respectively. The mean (SD) VHN of SHC, SH10, and 20 groups were 21.003 (0.252), 23.975 (0.207), and 34.622 (0.079), respectively.

Conclusion:

The addition of TCDDMDA markedly decreased the SR and increased the SH of the experimental groups.

Cinnamaldehyde is a biologically active compound for the disinfection of removable denture: blinded randomized crossover clinical study

BACKGROUND

Fungal infections associated with the use of dentures, like denture stomatitis, are difficult to prevent and treat. This in situ study aimed to investigate the efficacy of cinnamaldehyde for the disinfection of complete removable dentures, and the effect on the physical and mechanical properties (Vickers microhardness, color, and surface roughness) of the acrylic resin.

METHODS

Acrylic resin disks were inserted into the dentures of a probabilistic sample of 33 complete denture users, that used cinnamaldehyde (27 μg/mL) and 0.5% sodium hypochlorite solutions in a 20 min/7-days protocol of dentures immersion in each solution, with a wash-out period of 7 days, to constitute a crossover-study. The disks were analyzed before and after the immersion, for the presence of microorganisms (CFU/mL) and by scanning electron microscope (SEM). Also, the surface roughness (Ra) and Vickers microhardness were measured, and color parameters were analyzed using the National Bureau of Standards (NBS) method. Data was analyzed by Wilcoxon and Friedman (microbiological evaluation), paired t-test (color and roughness) and independent t-test (Vickers hardness) (α = 0.05).

RESULTS

A significant reduction (P < 0.05) in the number of microorganisms was observed for each species (total microorganisms, Streptococcus mutans, and Candida spp.), with no significant differences (P > 0.05) between hypochlorite and cinnamaldehyde. There was an increase in the roughness and a decrease in the hardness of the test specimens, with no difference between the two disinfectant substances (P > 0.05). Both hypochlorite and cinnamaldehyde also caused changes in color, considered as "perceptible" by the NBS classification, but with no significant difference between disinfectant substances (P < 0.05), and under the clinically acceptable limit (ΔE ≤ 3.7).

CONCLUSION

The 27 μg/mL cinnamaldehyde solution was effective against all evaluated microorganisms and caused minor alterations in hardness, surface roughness, and color parameters, with no clinical relevance.

Silver Nanoparticles Addition in Poly(Methyl Methacrylate) Dental Matrix: Topographic and Antimycotic Studies

The widespread use of nanoparticles (NPs) in medical devices has opened a new scenario in the treatment and prevention of many diseases and infections owing to unique physico-chemical properties of NPs. In this way, silver nanoparticles (AgNPs) are known to have a strong antimicrobial activity, even at low concentrations, due to their ability to selectively destroy cellular membranes. In particular, in the field of dental medicine, the use of AgNPs in different kinds of dental prosthesis matrixes could be a fundamental tool in immunodepressed patients that suffer of different oral infections. Candida albicans (C. albicans), an opportunistic pathogenic yeast with high colonization ability, is one of the causative agents of oral cavity infection. In our work, we added monodispersed citrate-capping AgNPs with a size of 20 nm at two concentrations (3 wt% and 3.5 wt%) in poly(methyl methacrylate) (PMMA), the common resin used to develop dental prostheses. After AgNPs characterization, we evaluated the topographical modification of PMMA and PMMA with the addition of AgNPs by means of atomic force microscopy (AFM), showing the reduction of surface roughness. The C. albicans colonization on PMMA surfaces was assessed by the Miles and Misra technique as well as by scanning electron microscopy (SEM) at 24 h and 48 h with encouraging results on the reduction of yeast viability after AgNPs exposure.

Denture Liners: A Systematic Review Relative to Adhesion and Mechanical Properties

Purpose

The objective of this systematic review is to compare results concerning the properties of adhesion, roughness, and hardness of dental liners obtained in the last ten years.

Methods

Searches on the databases LILACS, PubMed/Medline, Web of Science, and Cochrane Database of Systematic Reviews were supplemented with manual searches conducted between February and April of 2018. The inclusion criteria included experimental in vitro and in vivo, clinical, and laboratory studies on resilient and/or hard liners, assessment of hardness, roughness, and/or adhesion to the denture base, and physical/mechanical changes resulting from the disinfection process and changes in liners' composition or application.

Results

A total of 406 articles were identified and, from those, 44 are discussed. Twenty-four studies examined the bond strength, 13 surface roughness, and 19 the hardness. Of these 44 studies, 12 evaluated more than one property. Different substances were used in the attempt to improve adhesion. Considering roughness and hardness, the benefits of sealants have been tested, and the changes resulting from antimicrobial agents' incorporation have been assessed.

Conclusion

Adhesion to the prosthesis base is improved with surface treatments. Rough surfaces and changes in hardness compromise the material's serviceability.

Effect of cleansers on denture base resins’ structural properties

Introduction:

We assessed the effect of different available denture cleansers on the roughness and hardness of polyetherketoneketone, thermoinjection-molded polyamide, and polymethylmethacrylate.

Materials and Methods:

A total of 150 disc-shaped specimens were fabricated (10 mm × 2 mm) from these three denture base resins, and divided into five subgroups ( n = 10) according to immersion procedures. One of these groups subjected to distilled water served as control, whereas other groups were subjected to daily cleansing with four denture cleansers (Corega, Protefix, Curaprox, and Perlodent) for 8 h a day for 140 days. The surface roughness and hardness values of specimens were recorded by measuring twice at baseline, and again after application of chemical solutions. Topography alterations after treatments were assessed with scanning electron microscopy. The data were subjected to statistical analysis and comparison among groups was done using Kruskal Wallis and Wilcoxon Signed Ranks tests. P-value <0.05 was considered significant.

Results:

The surface roughness of polyetherketoneketone, polymethylmethacrylate, and polyamide dentures was increased significantly by chemical solutions of denture cleansers. While the hardness value of polyetherketoneketone was not affected significantly after immersion in denture cleansers, those of polymethylmethacrylate and polyamide decreased significantly. Compared with Curaprox, the effervescent tablets significantly altered the surface hardness and roughness of polyamide.

Conclusion:

Denture cleansers can considerably alter the surface roughness and hardness of denture base resins and should be used carefully depending on the material.

Improving Polymethyl Methacrylate Resin Using a Novel Titanium Dioxide Coating

PURPOSE

The objective of this study was to improve the surface characteristics of poly (methyl methacrylate) (PMMA) by developing a novel, thin film coating process and to characterize the resulting coated surface.

MATERIALS AND METHODS

An atomic layer deposition (ALD) technique was developed to deposit a titanium dioxide (TiO₂ ) nano-thin film on PMMA. The surface wettability for both coated and uncoated PMMA was determined by measuring water contact angle. Wear resistance was assessed using a mechanical tooth-brushing device with a 50 g load for 6000 strokes after 5 months of water storage. A denture cleanser challenge test was performed by using sonication in 3.8% sodium perborate for 1 hour with aged specimens. X-ray photoelectron spectroscopy (XPS) was used before and after the brushing test and challenge test to analyze the PMMA surface chemical composition. The mechanical strength of coated and uncoated PMMA was measured using a three-point bending test. Surface microbial interactions were also evaluated by assessing Candida albicans biofilm attachment.

RESULTS

Nano-TiO₂ coating (30 nm thick) was successfully deposited on PMMA at 65°C. After coating, water contact angle decreased from 70° to less than 5°. After brushing test, the coating remained intact. XPS analysis revealed no loss of TiO₂ from coated specimens following brushing and denture cleanser sonication for 1 hour. There was no statistically significant difference in mechanical strength (MPa) (mean ± SD) between PMMA (139.4 ± 11.3) and TiO₂ -PMMA (160.7 ± 37.1) (p = 0.0995). C. albicans attachment decreased by 63% to 77% on the coated PMMA surface.

CONCLUSIONS

ALD is a promising technique to modify surface properties of PMMA and resulted in a stable adherent thin film. By depositing a TiO₂ coating, PMMA surface properties may lead to significantly reduced microorganism adhesion and easier pathogen removal from PMMA. For patients who wear dentures, reducing the oral microbial biofilm burden using a TiO₂ -coated PMMA surface could positively impact their oral and systemic health.

Flexural and Surface Properties of PMMA Denture Base Material Modified with Thymoquinone as an Antifungal Agent

PURPOSE

To evaluate the effect of addition of different concentrations of thymoquinone (TQ) on the flexural strength, elastic modulus, surface roughness, and hardness of PMMA denture base material.

MATERIALS AND METHODS

A total of 160 rectangular specimens were prepared from heat-polymerized acrylic resin, with dimensions of 65 × 10 × 2.5 mm³ for flexural strength testing and 10 × 20 × 3 mm³ for surface property testing. The specimens were divided into eight groups of 20 specimens: one control group without addition of TQ and seven test groups prepared by adding TQ to acrylic powder in concentrations of 0.5, 1, 1.5, 2, 2.5, 3, and 5 wt%. The polymer was added to the monomer before being mixed, packed, and processed using the conventional water bath method. A universal testing machine was used to measure flexural strength and elastic modulus. A profilometer and a Vickers hardness tester were used to measure surface roughness and hardness, respectively. One-way ANOVA and the Tukey-Kramer multiple-comparison test were used for statistical analysis, with statistical significance at p ≤ 0.05.

RESULTS

Addition of TQ to PMMA denture base material significantly decreased flexural strength and elastic modulus at high concentrations (p < 0.01), while no significant differences were observed at low concentrations (0.5%, 1% TQ) in comparison with the control group. At high TQ concentrations, surface roughness increased while hardness decreased (p < 0.0001), and no significant differences were observed at low concentrations (0.5%, 1% TQ) in comparison with the control group. The most favorable addition values were 0.5% and 1% TQ in all TQ groups.

CONCLUSIONS

Addition of TQ did not affect the flexural and surface properties of PMMA denture base material at low concentrations (0.5%, 1% TQ) and could be incorporated into PMMA denture base material as an antifungal agent.

Antimicrobial and cytotoxic effects of denture base acrylic resin impregnated with cleaning agents after long-term immersion

The coadjutant method for denture cleansing most used by denture wearers is immersion in chemical agents, which are toxic when in direct contact with cells. However, clinically, the contact between these chemical agents and prosthetic tissues does not occur directly, but rather with what remained impregnated into acrylic bases, even after rinsing the disinfected dentures. This study evaluated the antimicrobial and cytotoxic effects of a denture acrylic resin after successive cycles of daily overnight immersion in 1% sodium hypochlorite (1%NaClO) and 2% chlorhexidine digluconate (2%CHX), simulating the periods of 9 months or 1.5 year. Microbiological and cytotoxic assays were performed, respectively, by broth microdilution method (Candida albicans or Staphylococcus aureus) and MTT assay. Chemical residues of 2%CHX impregnated into the denture acrylic resin had an antimicrobial effect on both immersion periods, which was not observed with those of 1%NaClO. However, residues of 2%CHX were severely cytotoxic to human gingival fibroblasts compared to those of 1%NaClO and acrylic resin (not submitted to the denture cleansers), which were slightly cytotoxic. Even at low concentrations recommended for overnight soaking of removable dentures, the chemical residues of CHX may result in some degree of toxicity to the denture-bearing mucosa after long-term daily immersion.

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.

Antimicrobial activity of conventional and plant-extract disinfectant solutions on microbial biofilms on a maxillofacial polymer surface

STATEMENT OF PROBLEM

Dentists often note problems with infection in patients with maxillofacial prostheses. Conventional disinfection protocols are not always effective and may alter the properties of the polymer used in the prosthesis. Thus, the search for improved disinfection methods is important.

PURPOSE

The purpose of this in vitro study was to evaluate and compare the antimicrobial activity of conventional disinfectant solutions (water and neutral soap and 4% chlorhexidine) and plant extracts (Cymbopogon nardus and Hydrastis canadensis) on specimens of maxillofacial silicone contaminated with Candida albicans and Staphylococcus aureus biofilms.

MATERIAL AND METHODS

Seventy-two silicone (MDX4-4210) specimens were fabricated (5×2 mm) and sterilized. Thirty-six were contaminated with C albicans (10(6) cells/mL) and 36 with S aureus (10(8) cells/mL) to evaluate the antimicrobial activity of the cleaning protocols. After incubation (37°C/72 hours), the specimens were divided into 5 groups: not disinfected (positive control), soaking in saline solution for 10 minutes, soaking in 4% chlorhexidine for 10 minutes, soaking in C nardus for 10 minutes, soaking in H canadensis for 10 minutes, and washing by hand with water and neutral soap for 30 seconds. The viability of cells was evaluated by XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) assay and by scanning electron microscope analysis. The results were analyzed by ANOVA and the Tukey HSD test (α=.05).

RESULTS

All disinfection solutions provided a statistically significant reduction in biofilm viability compared with the control group for both microorganisms (P<.05). Washing with water and neutral soap was significantly more effective in reducing biofilm viability than immersion in the disinfection solutions, with persistence of viable microorganisms between 1.05% for C albicans and 0.62% for S aureus after this cleaning protocol. Photomicrographs revealed that 4% chlorhexidine altered the surface of the polymer.

CONCLUSIONS

Within the limitations of this in vitro study, it was concluded that the cleaning protocols with different disinfectant solutions produced a significant reduction in the viability of C albicans and S aureus biofilms on the silicone polymer. Washing with water and neutral soap was the most effective protocol against both microorganisms.

Effect of denture-coating composite on Candida albicans biofilm and surface degradation after disinfection protocol

INTRODUCTION

Denture stomatitis is the most common pathology affecting denture wearers and its main cause is colonisation of dentures with Candida albicans.

OBJECTIVE

This study investigated the effectiveness of two commercial composite surface sealants (Biscover(®) LV and Surface Coat(®)) to reduce C. albicans biofilm colonisation on denture resin, as well as their surface integrity after disinfection cycles with 1% sodium hypochlorite solution.

METHODS

Heat-cured acrylic resin specimens were manufactured (10 mm × 10 mm × 1 mm). The specimen surfaces were mechanically polished to simulate rough or smooth denture surfaces. Four surface-treatment groups were tested: smooth surfaces [0.3 μm of mean roughness (Ra)]; rough surfaces (3 μm of Ra); rough surfaces treated with Biscover(®) LV; and rough surfaces treated with Surface Coat(®). Specimens of each group were randomly divided to undergo immersion in distilled water or 1% sodium hypochlorite for 30 or 90 cycles each. Specimens of all groups in each immersion solution were tested using a crystal violet (CV) staining assay for biofilm quantification and by scanning electron microscopy for visual analyses of surface integrity and biofilm structure. CV assay data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's multiple comparison test (P < 0.05).

RESULTS

The effectiveness and surface integrity of Biscover(®) LV-treated surfaces were similar to those of smooth surfaces, whereas Surface Coat(®) -treated surfaces presented a similar performance to rough surfaces in all solutions and cycles.

CONCLUSION

These results suggest the possibility of clinical use of Biscover(®) LV for denture coating on surfaces in which mechanical polish is not indicated, such as the fitting surface.

Effects of thermal cycling on surface roughness, hardness and flexural strength of polymethylmethacrylate and polyamide denture base resins

BACKGROUND

The purpose of this study was to evaluate the effects of thermal cycling on the surface roughness, hardness and flexural strength of denture resins.

METHODS

Polyamide (PA; Deflex and Valplast) and polymethylmethacrylate (PMMA; QC-20 and Acron MC) denture materials were selected. A total of 180 specimens were fabricated and then divided into 3 groups. The first group (group 1) acted as a control and was not thermocycled. The second group (group 2) was subjected to thermocycling for 10,000 cycles in artificial saliva and 5,000 cycles in distilled water. The last group (group 3) was thermocycled for 20,000 cycles in artificial saliva and 10,000 cycles in distilled water. The surface roughness were measured with a profilometer. The hardness of the resins were measured with a Vickers Hardness Tester using a 100-gf load. The flexural strength test was performed using the universal test machine with a crosshead speed of 5 mm/min. Data were analyzed using statistical software. The results of the measurements in the 3 different tests were analyzed by Kruskal-Wallis test with Bonferroni correction. Multiple comparisons were made by Conover and Wilcoxon tests.

RESULTS AND CONCLUSIONS

There was a significant difference between the PMMA and PA groups in terms of surface roughness, hardness and transverse strength before and after thermal cycling (p&lt;0.001). Thermal cycling did not change the surface roughness, hardness and flexural strength values of either the PMMA or PA group (p&gt;0.001).

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study

BACKGROUND

Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures.

MATERIALS AND METHODS

Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically.

RESULTS

Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group.

CONCLUSION

A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Antifungal Effect of Zataria multiflora Essence on Experimentally Contaminated Acryl Resin Plates With Candida albicans

Background:

Adherence and colonization of Candida species particularly C. albicans on denture surfaces, forms a microbial biofilm, which may result denture stomatitis in complete denture users.

Objectives:

The purpose of the present study was to evaluate the antifungal effect Zataria multiflora essence in removing of Candida albicans biofilms on experimentally contaminated resin acryl plates.

Materials and Methods:

In the present experimental study, 160 resin acrylic plates (10 × 10 × 1 mm) were contaminated by immersion in 1 × 10³ C. albicans suspension for 24 hours to prepare experimental Candida biofilms. The total number of Candida cells, which adhered to 20 randomly selected acryl resin plates was determined as the Candia load before cleaning. The remaining 140 plates were divided to seven groups of 20 and immersed in five concentrations of Zataria multiflora essence from 50 to 3.125 mg/mL as test, 100000 IU nystatin as the positive and sterile physiologic serum as the negative control. The remaining Candida cells on each acryl plate were also enumerated and data were analyzed using the SPSS 16 software with Kruskal-Wallis and Wilcoxon tests.

Results:

Zataria essence at concentrations of 50 and 25 mg/mL removed 100% of attached Candida cells similar to nystatine (MFC), while weaker Zataria essence solutions cleaned 88%, 60.5% and 44.7% of attached Candida cells. Kruskal-wallis test showed a statistically significant difference between all test groups (P = 0.0001). In this study 12.5 mg/mL concentration of Zataria multiflora was considered as the minimum inhibitory concentration (MIC₉₀).

Conclusions:

Zataria essence, at concentrations of 50 and 25 mg/mL, effectively removed Candida cells that had adhered to the denture surface, similar to the level of removal observed for 100000 IU nystatin.

Comparative effect of different polymerization techniques on residual monomer and hardness properties of PMMA-based denture resins

PURPOSE

The aim of this study was to compare the residual monomer and microhardness of poly(methyl methacrylate) (PMMA)-based denture resins processed by using autoclave and conventional water bath techniques.

METHODS

To determine the amount of residual methyl methacrylate (MMA) monomer, disk-shaped specimens (n=5) were prepared from 3 different acrylic resins (Meliodent, Paladent and Qc-20). Control groups were polymerized in water bath for 30 minutes at 100°C. The study groups were prepared in an autoclave device for 60°C/30 min followed 130°C/10 min and the other group for 60°C/30 min followed by 130°C/20 min. According to standard calibration curves, ultraviolet spectrophotometry at 230 nm was used to determine the residual monomer. For the Vickers hardness measurements, disk-shaped specimens (n=5) were prepared for each test group. Hardness measurements were performed with a Vickers hardness tester under a 4.91-N press load for a 30 seconds, after immersion in distilled water at 37ºC for 48 hours. The data were analyzed by ANOVA and Tukey HSD test (p<0.05).

RESULTS

Autoclave polymerization produced a significant decrease in the amount of residual monomers for all resin groups (p<0.05). This procedure also showed a significant increase in hardness for all resin groups (p<0.05). For the 3 resin groups, no significant differences were found between autoclave polymerization for 10 minutes and for 20 minutes (p>0.05).

CONCLUSIONS

The autoclave polymerization technique exhibited significantly lower residual monomer content and greater hardness than conventional heat polymerization.

Safety and Tolerability of Essential Oil from Cinnamomum zeylanicum Blume Leaves with Action on Oral Candidosis and Its Effect on the Physical Properties of the Acrylic Resin

The anti-Candida activity of essential oil from Cinnamomum zeylanicum Blume, as well as its effect on the roughness and hardness of the acrylic resin used in dental prostheses, was assessed. The safety and tolerability of the test product were assessed through a phase I clinical trial involving users of removable dentures. Minimum inhibitory concentration (MIC) and minimum fungicidal concentrations (MFC) were determined against twelve Candida strains. Acrylic resin specimens were exposed to artificial saliva (GI), C. zeylanicum (GII), and nystatin (GIII) for 15 days. Data were submitted to ANOVA and Tukey posttest (α = 5%). For the phase I clinical trial, 15 healthy patients used solution of C. zeylanicum at MIC (15 days, 3 times a day) and were submitted to clinical and mycological examinations. C. zeylanicum showed anti-Candida activity, with MIC = 625.0 µg/mL being equivalent to MFC. Nystatin caused greater increase in roughness and decreased the hardness of the material (P < 0.0001), with no significant differences between GI and GII. As regards the clinical trial, no adverse clinical signs were observed after intervention. The substance tested had a satisfactory level of safety and tolerability, supporting new advances involving the clinical use of essential oil from C. zeylanicum.

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.

Eradication of a Mature Methicillin-Resistant Staphylococcus aureus (MRSA) Biofilm From Acrylic Surfaces

Methicillin-resistant Staphylococcus aureus (MRSA) can grow as structured biofilm in different surfaces, including oral mucosa and denture surfaces. Such biofilms can be released into the oral fluids and aspirated, causing systemic infections such as aspiration pneumonia. This study evaluated the efficacy of two disinfectant solutions and microwave irradiation in disinfecting acrylic specimens contaminated with MRSA biofilm. Thirty-six acrylic specimens were made, sterilized and contaminated with MRSA (107 cfu/mL). After incubation (37 °C/48 h), the specimens were divided into 4 groups: not disinfected (positive control); soaking in 1% sodium hypochlorite for 10 min; soaking in 2% chlorhexidine gluconate for 10 min; and irradiating by microwave for 3 min at 650 W. The viability of cells was evaluated by XTT reduction method. All specimens from the positive control group showed biofilm formation after 48 h incubation. The mean absorbance value of the control specimens was 1.58 (OD at 492 nm). No evidence of biofilm formation was observed on specimens after the disinfection methods. Disinfection by soaking in 1% sodium hypochlorite and 2% chlorhexidine gluconate and irradiating by microwaves resulted in 100% reduction of MRSA biofilm metabolism. The use of chemical solutions and microwave irradiation was shown to be effective for eradicating mature MRSA biofilms on acrylic resin specimens.

Factors affecting the bond strength of denture base and reline acrylic resins to base metal materials

OBJECTIVE

The shear bond strengths of two hard chairside reline resin materials and an auto-polymerizing denture base resin material to cast Ti and a Co-Cr alloy treated using four conditioning methods were investigated.

MATERIAL AND METHODS

Disk specimens (diameter 10 mm and thickness 2.5 mm) were cast from pure Ti and Co-Cr alloy. The specimens were wet-ground to a final surface finish of 600 grit, air-dried, and treated with the following bonding systems: 1) air-abraded with 50-70-µm grain alumina (CON); 2) 1) + conditioned with a primer, including an acidic phosphonoacetate monomer (MHPA); 3) 1) + conditioned with a primer including a diphosphate monomer (MDP); 4) treated with a tribochemical system. Three resin materials were applied to each metal specimen. Shear bond strengths were determined before and after 10,000 thermocycles.

RESULTS

The strengths decreased after thermocycling for all combinations. Among the resin materials assessed, the denture base material showed significantly (p<0.05) greater shear bond strengths than the two reline materials, except for the CON condition. After 10,000 thermocycles, the bond strengths of two reline materials decreased to less than 10 MPa for both metals. The bond strengths of the denture base material with MDP were sufficient: 34.56 MPa for cast Ti and 38.30 for Co-Cr alloy.

CONCLUSION

Bonding of reline resin materials to metals assessed was clinically insufficient, regardless of metal type, surface treatment, and resin composition. For the relining of metal denture frameworks, a denture base material should be used.

Comparative effects of denture cleansers on physical properties of polyamide and polymethyl methacrylate base polymers

The purpose of this study was to evaluate the effect of denture cleansers on the surface roughness, hardness and color stability of two polyamides (Valpast, Deflex), a butadiene styrene copolymer PMMA (Rodex), and PMMA polymer as a control group (Paladent). Each material was divided into 5 sub-groups (n=7) as two control and three test groups. Three test groups were immersed for 20 days in commercially available three denture cleansers (CO-Corega, PR-Protefix, VA-Valclean). Two-way analysis of variance and Tukey's post hoc HSD test were used to evaluate surface roughness and hardness data (α=0.05). ΔE, ΔL*, Δa*and Δb* mean values were used for ANOVA, Tamhane test was used as post hoc. Polyamides showed low hardness and high roughness before and after immersion. A significant decrease in hardness was observed for all resins except Rodex after immersion (p<0.05). The denture cleansers changed the roughness, hardness and color of some resins.

The effect of acrylamide incorporation on the thermal and physical properties of denture resins

PURPOSE

Polymethyl methacrylate (PMMA) is the most commonly used denture base material despite typically low in strength. The purpose of this study was to improve the physical properties of the PMMA based denture base resins (QC-20, Dentsply Ltd., Addlestone, UK; Stellon, AD International Ltd, Dentsply, Switzerland; Acron MC; GC Lab Technologies Inc., Alsip, Japan) by copolymerization mechanism.

MATERIALS AND METHODS

Control group specimens were prepared according to the manufacturer recommendations. In the copolymer groups; resins were prepared with 5%, 10%, 15% and 20% acrylamide (AAm) (Merck, Hohenbrunn, Germany) content according to the moleculer weight ratio, respectively. Chemical structure was characterized by a Bruker Vertex-70 Fourier transform infrared spectroscopy (FTIR) (Bruker Optics Inc., Ettlingen, Germany). Hardness was determined using an universal hardness tester (Struers Duramin, Struers A/S, Ballerup, Denmark) equipped with a Vickers diamond penetrator. The glass transition temperature (T_g) of control and copolymers were evaluated by Perkin Elmer Diamond DSC (Perkin Elmer, Massachusetts,USA). Statistical analyses were carried out using the statistical package SPSS for Windows, version 15.0 (SPSS, Chicago, IL, USA). The results were tested regarding the normality of distribution with the Shapiro Wilk test. Data were analyzed using ANOVA with post-hoc Tukey test (P<.01).

RESULTS

The copolymer synthesis was confirmed by FTIR spectroscopy. Glass transition temperature of the copolymer groups were higher than the control groups of the resins. The 10%, 15% and 20% copolymer groups of Stellon presented significantly higher than the control group in terms of hardness. 15% and 20% copolymer groups of Acron MC showed significantly higher hardness values when compared to the control group of the resin. Acrylamide addition did not affect the hardness of the QC-20 resin significantly.

CONCLUSION

Within the limitation of this study, it can be concluded that copolymerization of PMMA with AAm increased the hardness value and glass transition temperature of PMMA denture base resins.

Urban legends series: oral candidosis

Candida species (spp) are commensal yeast that can only instigate oral infection (oral candidosis - OC) when there is an underlying predisposing condition in the host. We investigated four controversial topics on OC: (i) How can a microbiological determination of OC be made as Candida spp. are commensal yeasts and not all of them form hyphae or pseudohyphae during infection? (ii) Is median rhomboid glossitis (MRG) a manifestation of candidal infection? (iii) Can candidal infection cause palate papillary hyperplasia (PPH)? (iv) What is the best therapeutic treatment for denture-associated erythematous stomatitis (DAES)? Results from extensive literature searches, including a systematic review, suggested the following: (i) the diagnosis of OC merely on the basis of the presence of yeasts is an oversimplification of a complex process. No convincing evidence of a single test or method better able to discriminate the transition from candidal saprophytism to pathogenicity has been reported in the literature; (ii-iii) conclusive evidence of a direct aetiopathogenic relationship between MRG and PPH and candidal infection has not been found; and (iv) only limited evidence is available for any DAES treatment, thus making it impossible to make strong therapeutic recommendations.

Evaluation of Vickers hardness of different types of acrylic denture base resins with and without glass fibre reinforcement

OBJECTIVE

To evaluate the Vickers hardness of different acrylic resins for denture bases with and without the addition of glass fibres.

BACKGROUND

It has been suggested that different polymerisation methods, as well as the addition of glass fibre (FV) might improve the hardness of acrylic.

MATERIALS AND METHODS

Five types of acrylic resin were tested: Vipi Wave (VW), microwave polymerisation; Vipi Flash (VF), auto-polymerisation; Lucitone (LT), QC20 (QC) and Vipi Cril (VC), conventional heat-polymerisation, all with or without glass fibre reinforcement (GFR) and distributed into 10 groups (n = 12). Specimens were then submitted to Vickers hardness testing with a 25-g load for 30 s. All data were submitted to anova and Tukey's HSD test.

RESULTS

A significant statistical difference was observed with regard to the polymerisation method and the GFR (p < 0.05). Without the GFR, the acrylic resin VC presented the highest hardness values, and VF and LT presented the lowest. In the presence of GFR, VC resin still presented the highest Vickers hardness values, and VF and QC presented the lowest.

CONCLUSIONS

The acrylic resin VC and VW presented higher hardness values than VF and QC resins. Moreover, GFR increased the Vickers hardness of resins VW, VC and LT.