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Gomes ACG, Maciel JG, Garcia AAMN, Coelho LAS, Rodrigues GM, Porto VC, Polyzois G, Klein MI, Soares S, Urban VM, Neppelenbroek KH. Anti-biofilm effectiveness of protocols for cleaning complete dentures in hospitalized patients: a randomized controlled trial. J Appl Oral Sci 2024; 32:e20230381. [PMID: 38537031 PMCID: PMC10984580 DOI: 10.1590/1678-7757-2022-0381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. OBJECTIVES To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. METHODOLOGY The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). RESULTS All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). CONCLUSIONS A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.
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Affiliation(s)
- Anna Clara Gurgel Gomes
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Janaina Gomes Maciel
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | | | - Letycia Accioly Simões Coelho
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Giulia Murcia Rodrigues
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Vinicius Carvalho Porto
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Grigorios Polyzois
- National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
| | - Marlise Inêz Klein
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Piracicaba, SP, Brasil
| | - Simone Soares
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | | | - Karin Hermana Neppelenbroek
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
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Santos Sousa TM, Rodrigues de Farias O, Dantas Batista AU, Souto de Medeiros E, Santiago BM, Cavalcanti YW. Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and meta-analysis. Int J Dent Hyg 2020; 19:62-77. [PMID: 33022878 DOI: 10.1111/idh.12477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis. METHODS This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence. RESULTS All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach. CONCLUSION Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.
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Affiliation(s)
- Taisa Mara Santos Sousa
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Ohana Rodrigues de Farias
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - André Ulisses Dantas Batista
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Department of Restorative Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Eliton Souto de Medeiros
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Materials Engineering Department, Technology Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Bianca Marques Santiago
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Clinical and Social Dentistry Department, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Yuri Wanderley Cavalcanti
- Postgraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil.,Clinical and Social Dentistry Department, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil
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Klironomos T, Katsimpali A, Polyzois G. The Effect of Microwave Disinfection on Denture Base Polymers, Liners and Teeth: A Basic Overview. Acta Stomatol Croat 2015; 49:242-53. [PMID: 27688409 PMCID: PMC4993596 DOI: 10.15644/asc49/3/7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/29/2015] [Indexed: 10/31/2022] Open
Abstract
The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties. Cross-infection control in dentistry is a significant issue in everyday clinical practice due to the recent increase in some infectious diseases such as hepatitis B, C and AIDS and therefore numerous methods of disinfection have been used. The most widespread method of disinfection used in everyday practice is chemical, however, studies have suggested that chemical disinfectants alter the physical and mechanical properties of the acrylic resins and enable the growth and proliferation of certain bacteria. Therefore, microwaves were introduced as an easy to use-and-access, low cost, chemical free alternative. The question that arose was if and in what way the microwave irradiation affected the denture related material properties. Microwaving affects the denture resin bases, liners and teeth in different ways. The results showed that microwave disinfection could be a safe alternative for the disinfection of denture bases and liners compared to the chemical one, when the procedure is carried out in dry conditions, but could possibly cause dimensional changes of clinical significance on them when the irradiation takes place in wet environment. It also seems to have no detrimental effects of clinical importance on the flexural properties, impact strength and hardness of denture resins and the bond, flexural strength, porosity and hardness of denture liners. The effects of microwave disinfection on the hardness of denture teeth and teeth/denture bond strength are still controversial and no safe conclusions can be drawn.
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Affiliation(s)
| | | | - Gregory Polyzois
- Professor, Department of Removable Prosthodontics, Dental School, University of Athens, Athens, Greece
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