Adding denture cleanser to microwave disinfection regimen to reduce the irradiation time and the exposure of dentures to high temperatures

Effects of Denture Cleaning Regimens on the Quantity of Candida on Dentures: A Cross-Sectional Survey on Nursing Home Residents

Oral care involving a denture cleaning regimen is important for reducing the incidence of systemic diseases. However, limited information is currently available on denture cleaning frequencies and regimens. Therefore, the present study investigated the relationship between the number of Candida spp. present on the complete dentures of nursing home residents and cleaning regimens. Residents were surveyed to assess their denture cleaning methods. Plaque was collected by applying a sterile swab to the mucosal surface of each examined complete denture worn by 77 residents, and the Candida spp. collected were cultured, identified, and quantified. The relationship between denture cleaning regimens and the quantity of Candida spp. was investigated. Correlation and multivariable analyses revealed that the strongest factor influencing the number of Candida spp. on dentures was the frequency of use of denture cleansers. The number of Candida spp. was the lowest on dentures cleaned daily with a denture cleanser. The present results demonstrated that the daily use of a denture cleanser effectively controlled the adherence of Candida spp. to dentures. Oral and other healthcare providers need to provide instructions on and assist nursing home residents with the daily care of dentures, using denture cleansers, including the environment where cleaning is performed.

Antifungal Efficacy of Sodium Perborate and Microwave Irradiation for Surface Disinfection of Polymethyl Methacrylate Polymer

Various disinfecting agents showing variable success in disinfecting polymethyl methacrylate (PMMA) are available. The aim of our study was to evaluate the antifungal efficacy of sodium perborate (denture cleaning tablet-DC), microwave irradiation, and their combination for eradicating candida albicans (C. albicans) from polymethyl methacrylate (PMMA) denture base polymer. One hundred and sixty-eight PMMA resin specimens (30 × 30 × 15 mm) were divided into four groups, including control (no disinfection), microwave disinfection in distilled water (MW-DW), sodium perborate with distilled water (DC-DW), and a combination of MW-DC-DW (n = 10). Biofilms of C. albicans were cultured on the PMMA resin denture base specimens for 96 h. The samples were exposed to three different antifungal regimes, i.e., MW, denture cleaning agent-sodium perborate (DC) and DW, and a combination of MW-DC-DW for 1 to 5 min. Scanning electron microscopy (SEM) was performed to evaluate colony formation. The colony-forming units (CFU) among the experimental groups were assessed using ANOVA, a Kruskal–Wallis test, and a Mann–Whitney test. The mean CFU values were compared with the control for each disinfecting regime at 96 h growth time. For MW-DC-DW, the CFU were significantly low at 2 and 3 min of exposure when compared with the control (DW) (p < 0.05). For the MW-DW treated group, the CFU were significantly low at 3 min of exposure when compared with the control (DW) (p < 0.05). It was also found that for DC-DW, the CFU were significantly low at 5 minutes when compared with the control specimens (DW) (p < 0.05). Microwave disinfection in combination with sodium perborate is a more effective disinfecting regime against C. albicans than that of microwave disinfection and sodium perborate alone.

Bacterial Disinfection of Polymethyl Methacrylate (PMMA) Resin Polymer Using Low Level Microwave Irradiation and Denture Cleaning Agent

The aim was to evaluate the disinfection of E. coli, S. aureus and S. mutans cultured on Polymethyl Methacrylate (PMMA) resin polymer using microwave disinfection and sodium perborate (DC). Biofilms of E. coli, S. aureus and S. mutans were cultured on the PMMA denture base for 24, 36, 48 and 96 h. Specimens were subjected to three disinfection protocols, including microwave disinfection in distilled water (MW-DW), sodium perborate (denture cleaning tablet) with distilled water (DC-DW) and a combination of MW-DC-DW for 1 to 5 min. Colony-forming units among the study groups were analyzed using Kruskal–Wallis and Mann–Whitney tests. For E. coli and S. aureus cultured on PMMA, the MW-DC-DW group displayed complete disinfection at 2 min of exposure. However, for both bacteria, the MW-DW disinfection group showed zero CFU at 3 min. DC disinfection for E. coli and S. aureus displayed zero CFU at 5 min of exposure (p ≤ 0.05). For S. mutans, MW-DC-DW and MW-DW displayed zero CFU count at 1 min and 2 min, respectively. In DC-treated samples, CFU were significantly zero at 4 min when compared with the control at each growth time. A combination of MW irradiation with DC (sodium perborate) showed higher disinfection percentage of bacterial species on PMMA polymer denture bases compared to MW and DC alone. PMMA disinfection using DC displayed a lower antimicrobial disinfection percentage than the combined use of MW and DC as well as MW alone at 1 min or 2 min disinfection for E. coli, S. aureus and S. mutans.

Does microwave and hydrogen peroxide disinfection reduce Candida albicans biofilm on polymethyl methacrylate denture surfaces?

STATEMENT OF PROBLEM

Whether the disinfection of polymethyl methacrylate (PMMA) dentures eliminates Candida albicans biofilm is unclear.

PURPOSE

The purpose of this in vitro study was to determine the antimicrobial effect of immersion in hydrogen peroxide (H₂O₂) and subsequent application of microwaves on the formation of C albicans biofilm on the surface of polished and unpolished PMMA disks.

MATERIAL AND METHODS

Polished and unpolished PMMA disks (n=40) were mounted in a Center for Disease Control (CDC) biofilm reactor by adding yeast-dextrose-peptone (YPD) broth inoculated with C albicans in a cell suspension for 24 hours. After this period, the PMMA disks (n=8) were disinfected with 5 different solutions: saline solution, 1% sodium hypochlorite (NaOCl), H₂O₂, H₂O₂ microwaved at 650 W for 3 minutes (H₂O₂/μw), and distilled water microwaved at 650 W for 3 minutes (H₂O/μw). On the polished and unpolished surface of each disk, arbitrary fluorescence units (AFU) were quantified with the live/dead bacterial viability kit (Invitrogen) by using confocal laser scanning microscopy (CLSM) to evaluate 10 different areas of each surface; these were counted as the colony-forming units (CFUs). The mean values were compared by using the Mann-Whitney U test (α=.05).

RESULTS

Polished surfaces disinfected with H₂O₂/μw obtained the lowest viable cells (9.76 AFU) and nonviable cells (12.46 AFU) compared with H₂O/μw and H₂O_2. In the unpolished surface the lowest mean values of viable cells (14.64 AFU) and nonviable cells (12.46 AFU) were obtained for the PMMA disks disinfected with H₂O/μw compared with H₂O₂/μw and H₂O₂. Both polished and unpolished disks showed significant difference (P<.05) compared with the group of PMMA disks immersed in saline solution. No CFUs were detected in the polished or unpolished PMMA disks immersed in H₂O₂/μw or in NaOCl.

CONCLUSIONS

H₂O₂ alone did not eliminate the formation of the biofilm of C albicans; however, in combination with the use of the microwave at 650 W for 3 minutes, the biofilm formation of C albicans on polished surfaces was reduced. The number of AFUs of viable-nonviable cells and CFUs depended on whether the surfaces are polished or unpolished.

Effect of a vinegar-hydrogen peroxide mixture on the surface properties of a cobalt-chromium alloy: A possible disinfectant for removable partial dentures

STATEMENT OF PROBLEM

A vinegar-hydrogen peroxide mixture has been reported to be effective in eliminating Candida albicans and Staphylococcus aureus from acrylic resin, and its action has been reported to be comparable with that of sodium hypochlorite or peracetic acid. However, the effects of this mixture on cobalt-chromium alloys remain unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the surface roughness, Knoop microhardness, surface free energy, and wettability of a cobalt-chromium alloy when exposed to a vinegar-hydrogen peroxide mixture.

MATERIAL AND METHODS

Fifty specimens of cobalt-chromium alloy were fabricated and immersed for 900 minutes, simulating 3 months of a daily 10-minute immersion in the following chemical agents (n=10): distilled water (W); 0.5% sodium hypochlorite (H); 3% hydrogen peroxide and water dilution in 1:1 ratio (HP); white-wine vinegar and water dilution in 1:1 ratio (V); and vinegar and hydrogen peroxide mixture in 1:1 ratio (VHP). Surface roughness, Knoop microhardness, surface free energy, and wettability were measured with single blinding before and after immersions. Data were statistically analyzed by using 2-way repeated measures ANOVA (α=.05).

RESULTS

The vinegar-hydrogen peroxide mixture did not affect the surface roughness or Knoop microhardness. However, 0.5% sodium hypochlorite significantly increased the roughness and decreased microhardness. Surface free energy and wettability increased after immersions, regardless of the types of solution.

CONCLUSIONS

Immersion in a vinegar-hydrogen peroxide mixture did not affect the surface characteristics of a cobalt-chromium alloy.

Color changes of polyetheretherketone (PEEK) and polyoxymethelene (POM) denture resins on single and combined staining/cleansing action by CIELab and CIEDE2000 formulas

PURPOSE

The purpose of study was to investigate the long-term effect of staining and/or cleansing solutions on the color stability of two non-metal removable partial denture materials.

METHODS

One hundred disks (25×3mm) of polyoxymethylene (POM) and polyetheretherketone (PEEK) were immersed in water, wine, coffee, cleanser and combo bath, simulating normal daily use. Color parameters in the CIELAB system was measured every 30 cycles up to 240 using a contact colorimeter and color differences estimated using ΔE_ab and ΔE₀₀ formulas. Two-way repeated measures ANOVAs and regression analyses were performed at α=0.05.

RESULTS

Regression analysis indicated a strong R² between color changes and number of cycles, for both materials. Tests of within-subjects effects for the ΔE_ab revealed significant differences among cycles and between the materials in the wine and coffee baths (p<0.001). Significant materialXcycles interactions were also recorded with all staining baths. ΔE₀₀ values were lower than ΔE_ab up to 63.6%. Tests within and between-subjects effects for the ΔE₀₀ gave similar but not the same with ΔE_ab results.

CONCLUSIONS

ΔE₀₀ found to correlate well with ΔE_ab. Long term exposure of both materials showed a progressive discoloration in all except control baths. POM discolored more than PEEK in coffee, and combo baths but not in cleanser. Discoloration was smaller in combo bath (where a cleanser was also used) indicating the effectiveness of a cleanser to prevent long term discoloration of both materials.

Long-term microwaving of denture base materials: effects on dimensional, color and translucency stability

While the combined effect of microwave irradiation with cleansing solutions on denture base materials has been investigated, the effects of only using microwave irradiation and, more importantly, in a long-term basis, was not studied yet.

The Effect of Repeated Microwaving Disinfection on the Dimensional Stability of Acrylic Dentures

OBJECTIVE

The aim of this study was to evaluate the effect of repeated microwave disinfections on the dimensional stability of acrylic dentures.

MATERIALS AND METHODS

Three groups of dentures made of a heat polymerized acrylic resin were tested. I: dentures kept in water (control group). II: dentures microwaved daily while being immersed into water (wet disinfection). III: dentures microwaved daily without being immersed into water (dry disinfection).
Measurements were taken across three reference points, on two occasions: after curing and immersion in water for 24 hours, and one week later.
Data obtained were analyzed using one-way analysis of variance (ANOVA) and Scheffe's multiple range test.

RESULTS

The results showed that the microwave disinfection provokes dimensional changes of the same pattern (shrinkage). The dentures which underwent wet disinfection exhibited the greatest shrinkage (p<0.05).

CONCLUSIONS

Disinfection using microwave energy may cause dimensional changes (shrinkage) of complete dentures.
The microwave "dry disinfection" method can be safely applied in everyday practice since the dimensional changes which occurred seem to be of no clinical significance.

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

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

Effectiveness of Chemical and Microwave Disinfection on Denture Biofilm Fungi and the Influence of Disinfection on Denture Base Adaptation

The aims of this study were to evaluate the effectiveness of six disinfection methods and the influence of these methods on the adaptation of maxillary dentures. Acrylic resin specimens contaminated with fungi were exposed to the following disinfection treatments: 1. microwave oven (900 W) at full power for 5 min (with soaking the specimen in 250 ml water), 2. microwave oven at medium power for 5 min (with soaking the specimen in 250 ml water), 3. sodium hypochlorite 5.25 % for 5 min, 4. diluted sodium hypochlorite 1:420 for 5 h, 5. Chlorhexidine gluconate for 5 h, 6. effervescent tablets for 15 min, 7. soaking in 250 ml tap water for 15 min. Colony forming units (CFUs) of remaining cells were counted and compared with t test (p ≤ 0.05). Dimensional stability was evaluated using aluminum die simulating the maxillary edentulous arch. Posterior palatal gaps were measured. Data were analyzed using one-way ANOVA test and t test (p ≤ 0.05). Microwave irradiation (at full or medium power) and sodium hypochlorite 5.25 % for 5 min were able to reduce the CFUs of fungi by more than 4 log10 whereas diluted sodium hypochlorite, chlorhexidine gluconate, and effervescent tablets did not achieve a reduction of >2.8, 2.68 and 1.66, respectively. For dimensional stability test, t test revealed significant difference between control group and the microwave at full power group (p = 0.000). Within the limits of this study, microwave oven at medium power and sodium hypochlorite (5.25 %) are effective and safe methods of disinfecting removable dentures.

Effects of cleansing methods on 3-D surface roughness, gloss and color of a polyamide denture base material

OBJECTIVE

The purpose of this study was to determine the effects of two denture cleansing methods on 3-D surface roughness, gloss and color of denture base materials.

MATERIALS AND METHODS

Thirty disks from nylon (Valplast) and 30 from heat-polymerized acrylic denture base material (Paladon 65) were made and 10 of each material were immersed in water (control), Val-Clean (peroxide cleanser) and Corega Extradent (peroxide cleanser) plus microwaving for a period simulating 30 days of daily cleansing. 3-D surface roughness, gloss and color parameters were measured before and after cleansing using an interferometric profilometer, a gloss meter and a colorimeter. The results were statistically analysed by regression, paired-t, Mann-Whitney and Kruskal-Wallis tests at α = 0.05 level of significance.

RESULTS

The results showed significant differences at baseline in L* and b* parameters between materials (p < 0.01), with a significantly lower gloss (p < 0.05) and higher roughness (p < 0.05) for Valplast. After cleansing, Δϵ* was significantly greater in Valplast than Paladon 65 (p < 0.05). Gloss of both materials decreased significantly within the Corega Extradent plus microwave solution (p < 0.05), while roughness increased significantly only for Paladon 65 (p < 0.05).

CONCLUSIONS

Valplast was found to have a significantly lower gloss and a higher roughness than Paladon 65 before cleansing. After cleansing, ΔE* increased more in Valplast than in Paladon 65, gloss of both materials decreased and roughness only of Paladon 65 increased within the Corega extradent plus microwaving method.

The effect of repeated microwave irradiation on the dimensional stability of a specific acrylic denture resin

PURPOSE

To determine the dimensional stability of a poly(methyl methacrylate) (PMMA) acrylic resin when subjected to multiple sessions of repeated microwave irradiation at power settings of 700 and 420 W.

MATERIALS AND METHODS

Twenty standardized denture bases were fabricated using a PMMA resin. Points of measurement were marked on each denture base with a standardized template, and the distances between points were recorded using a digital microscope. The denture bases were randomly placed into two experimental groups of 10 bases each. Individual denture bases were placed into a glass beaker containing 200 ml of room temperature deionized water and then exposed to either 700 or 420 W of microwave radiation for 3 minutes. The denture bases were allowed to cool to room temperature, and measurements between points were recorded. This process was carried out for two microwave periods with measurements being completed after each period. The data were then analyzed for any significant changes in distances between points using a Student's t-test.

RESULTS

All denture bases experienced 1.0 to 2.0 mm or approximately 3% linear dimensional change after each period of microwaving. Results were significant with all t-tests having values of p < 0.05.

CONCLUSION

This report showed that the denture bases deformed significantly under experimental conditions at either 700 W for 3 minutes in 200 ml of water or 420 W for 3 minutes in 200 ml of water.

Effectiveness of denture cleanser associated with microwave disinfection and brushing of complete dentures: in vivo study

Complete dentures acts as a reservoir for microbial colonization, which may lead to systemic infections. Microwave irradiation has been used as an efficient method of denture disinfection. Even though current methods eliminate denture-base microorganisms, a recurrence rate of denture stomatitis (DS) is still observed among denture-wearing patients. It was hypothesized that microwave disinfection kills microorganisms but do not remove dead bacteria from the denture surface. To test this hypothesis, the biofilm found in the dentures of 10 patients with DS was evaluated. In addition, the effects of microwave irradiation plus brushing (MW+B) on the denture biofilm and the combination of denture cleanser with microwave irradiation and brushing (MW+DC+B) for the removal of denture-accumulating microorganisms were investigated. Microbiological data were analyzed statistically by nonparametric analysis (Friedman/Wilcoxon, α=0.05). MW+B and MW+DC+B were effective in reducing the rate of microorganisms (99.2% and 99.5% respectively), but without significant difference between them (p=0.553). However, it was observed that the complete removal of microorganisms from denture surface was only possible when all regimens were combined (MW+DC+B). Microwave irradiation in combination with soaking in denture cleanser and brushing effectively disinfected the dentures and removed denture biofilm.