Effect of Different Chemical Disinfectants on Color Stability of Acrylic Denture Teeth

In vitro efficacy of synthetic lawsone derivative disinfectant solution on removing dual-species biofilms and effect on acrylic denture surface properties

Candida albicans (C. albicans) and Streptococcus mutans (S. mutans) biofilms involve in denture stomatitis. This study compared compound 1 to 2% chlorhexidine gluconate (CHX), Polident, and distilled water (DW) in biofilms reduction and effect on polymethylmethacrylate acrylic (PMMA) properties. The structure of lawsone (naphthoquinone derivative) was modified by the addition of an alkylnyloxy group to yield compound 1. Dual-species biofilms of C. albicans and S. mutans were developed on PMMA discs. The colony-forming unit count measured the number of residual biofilm cells after exposure to the test agents. PMMA discs were examined for color stability, surface roughness, hardness, and chemical structure after 28 days. At 3 min, compound 1 was less effective than CHX in reducing C. albicans (p = 0.004) and S. mutans (p = 0.034) but more effective than Polident in reducing C. albicans (p = 0.001). At 15 min, no viable cells were detectable for compound 1 and its effectiveness was comparable to CHX (p = 0.365). SEM showed fungal cell surface damages in CHX, compound 1 and Polident groups. Only color change was affected by time (p < 0.001) and type of test agent (p = 0.008), and only CHX reached a clinical perception level. Compound 1 is a promising agent for removing biofilm from the PMMA surface without substantially degrading surface properties.

Poly (Methyl Methacrylate)-Containing Silver-Phosphate Glass Exhibits Potent Antimicrobial Activity without Deteriorating the Mechanical and Biological Properties of Dental Prostheses

Poly (methyl methacrylate) (PMMA) is a commonly used denture material with poor antimicrobial effects. This study investigated the antimicrobial effects of PMMA-containing silver-phosphate glass. We fabricated a novel material comprising PMMA-containing silver-phosphate glass. Then, microhardness, flexural strength, and gloss unit were analyzed. Antimicrobial activity against Streptococcus mutans and Candida albicans was investigated. Colony-forming units were counted, and antimicrobial rates were measured. Biocompatibility tests were performed using a colorimetric MTT assay for evaluating cell metabolic activity. The microhardness, flexural strength, and gloss unit of the experimental groups (with silver-phosphate glass) were not significantly different from those of the control group (no silver-phosphate glass) (P > 0.05), which showed clinically valid values. With increasing proportions of silver-phosphate glass, the antimicrobial activity against the two microorganisms increased (P < 0.05). Furthermore, S. mutans showed more than 50% antimicrobial activity in 4%, 6%, and 8% experimental groups, C. albicans showed more than 50% antimicrobial activity in 6% and 8% groups, and a statistically significant difference in antimicrobial activity was observed compared to the control (P < 0.05). The cell viability of the experimental groups was not significantly different from that of the control group (P > 0.05). Both control and experimental groups showed approximately 100% cell viability. These results suggest that silver-phosphate glass is a promising antimicrobial material in dentistry.

The Comparison of Color Stability of Aloe Vera Gel and Chlorhexidine Solution on Acrylic Teeth

Background

There is insufficient knowledge about aloe vera color change property on acrylic teeth compared to other denture cleaners, especially chlorhexidine solution (CHX).

Objective

The present study aimed to compare the color change property of the aloe vera and chlorhexidine solution on denture acrylic teeth.

Methods

This study was experimental in vitro study design conducted in the dental laboratory of Tabriz University of Medical Sciences, Iran, 2021. The sample size in each group was 21 acrylic teeth which were randomly divided into aloe vera gel 100% and chlorhexidine solution 2% groups. Tooth colors were measured by a spectrophotometer (Spectro Shade Micro, MHT S.P.A., Milan, Italy). The immersion time in both groups was 36 hours. Data analyzed using an independent t-test was used at a 95% of confidence level.

Results

The comparison of the total color differences (ΔE) between the two groups was not statistically significant after 36 hours of immersion (P=0.440). In the chlorhexidine group, the brightness of teeth was lower than that in the aloe vera group (P=0.002).

Conclusions

Clinicians should be aware that aloe vera gel does not change the color of denture acrylic teeth after 36 hours of immersion similar to the chlorhexidine solution. For patients who cannot use chlorhexidine, aloe vera gel is a good cleaner for denture acrylic teeth without worrying about the color change of the denture. It can be considered an acceptable cleaner for denture acrylic teeth.

Optical Properties and Color Stability of Denture Teeth-A Systematic Review

PURPOSE

To systematically review past studies to determine the effect of various solutions on the color of denture teeth, thus answering the question in regards to which type of denture teeth has the best optical properties after exposure to various solutions. The method of measuring the color of artificial teeth was also evaluated as a secondary outcome.

MATERIALS AND METHODS

A search of studies that quantitatively investigated the influence of immersion solutions on the color change of denture teeth was conducted. Ovid MEDLINE, PubMed and Scopus databases were searched from 1997 to April 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used during article selection. Data regarding the effect of immersion solutions, accelerated aging and surface treatments on color change were gathered. Methodologies used to assess optical properties were also summarized and compared. The modified CONSORT checklist was used to determine the risk of bias of past studied included in this review.

RESULTS

One hundred thirty-three studies were identified after removing duplicates. Forty-one studies were selected for full-text analysis, and 35 remaining papers met the inclusion criteria and were therefore included in this systematic review. Thirty-two in vitro studies and 3 in vivo studies were included in the review. All studies reported that immersion in various solutions has a significant influence on the change in color and optical properties of denture teeth. However, the discoloration of denture teeth is still clinically acceptable in most studies. Exposure to various solutions also affected the translucency parameter of denture teeth. Most studies also investigated the surface roughness and hardness along with the optical properties, and reported that immersion cycles did not cause changes in surface roughness of denture teeth, while hardness was affected. The optical properties of PMMA denture teeth have been studied extensively, whereas that of CAD/CAM and 3D printed denture teeth is limited.

CONCLUSIONS

Color stability of CAD/CAM milled denture teeth is comparable to conventional PMMA denture teeth. There are contradictory findings in terms of color stability of 3D printed denture teeth as compared to conventional PMMA denture teeth. Staining by coffee is worst among the common beverages and solutions investigated. Denture teeth can show color changes after immersion in staining beverages as early as one week. The degree of discoloration of denture teeth after immersion is time dependent, with the larger extent in the initial phase.

The Effect of Chlorhexidine Disinfectant Gels with Anti-Discoloration Systems on Color and Mechanical Properties of PMMA Resin for Dental Applications

Chlorhexidine (CHX)-based dental hygiene products are widely used by dental patients. As these products may have long-term contact with denture poly(methyl methacrylate) (PMMA) resin, anti-discoloration systems (ADSs) were included in them to prevent discoloration of the natural teeth and dental materials. Purpose: The aim of this study was to evaluate the effect of two newly designed CHX-containing gels with ADSs and two commercial products with ADSs (Curasept 0.5% and Curasept 1%) in preventing staining and to analyze the mechanical properties of heat-curing PMMA denture base resin. Materials and methods: Twenty-five discs (five for each test group) of PMMA dental resin with a thickness of 1 mm and a diameter of 20 mm were polymerized according to the manufacturer’s instructions and stored in distillate water at a temperature of 37 °C. The surface of the specimens was covered with two commercially available gels—Curasept 1% and Curasept 0.5%, or two experimental gel formulations containing 1% CHX. PMMA specimens stored in distilled water were used as control. The initial values of color and Brinell hardness of the specimens were measured immediately after specimen preparation. The changes in color and Brinell hardness, as well as water sorption, and solubility of the specimens were measured after one year of conditioning. Statistical analysis of the obtained data was performed using one-way analysis of variance and Dunn–Bonferroni post hoc tests. Results: In the group of specimens covered with gel 1 with citric acid or Curasept 0.5%, the color change was clinically acceptable (ΔE* < 2.7). In the specimens stored in contact with gel 2 with polyvinylpyrrolidone (PVP) and Curasept 1%, the ΔE* values were 3.6 and 3.67, respectively. In the control group, the level of hardness decreased significantly from 150 to 140 during the experiment. In addition, a statistically significant decrease in hardness was observed in specimens stored with Curasept 1% and gel 2 with PVP. Specimens stored in contact with Curasept 0.5% and gel 1 with citric acid also showed a lower hardness, but the change was not statistically significant. The sorption of all the groups of PMMA specimens ranged from 22.83 to 24.47 µg/mm³, with no significant differences found between them. All the PMMA specimens stored in contact with the tested CHX gels exhibited a significantly higher solubility (6.84 ± 7.91 µg/mm³) compared to the control group (6.74 µg/mm³), with the highest solubility noted for specimens stored with Curasept 1%. Conclusions: The results showed that CHX used in the gel form with ADSs at a concentration of 0.5% and the experimental gel containing 1% CHX with citric acid caused limited changes to the color and mechanical properties of the PMMA denture base resin during the study period. These gels may be safely used by dental patients for oral hygiene regimen even for prolonged periods of time. ADSs contained in these gels seem to be effective in preventing CHX discoloration.

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.

In vitro treatment of Candida albicans biofilms on denture base material with volume dielectric barrier discharge plasma (VDBD) compared with common chemical antiseptics

OBJECTIVES

To prevent oral candidiasis, it is crucial to inactivate Candida-based biofilms on dentures. Common denture cleansing solutions cannot sufficiently inactivate Candida albicans. Therefore, we investigated the anticandidal efficacy of a physical plasma against C. albicans biofilms in vitro.

MATERIALS AND METHODS

Argon or argon plasma with 1 % oxygen admixture was applied on C. albicans biofilms grown for 2, 7, or 16 days on polymethylmethacrylate discs; 0.1 % chlorhexidine digluconate (CHX) and 0.6 % sodium hypochlorite (NaOCl) solutions served as positive treatment controls. In addition, these two solutions were applied in combination with plasma for 30 min to assess potential synergistic effects. The anticandidal efficacy was determined by the number of colony forming units (CFU) in log(10) and expressed as reduction factor (RF, the difference between control and treated specimen).

RESULTS

On 2-day-biofilms, plasma treatment alone or combined with 30 min CHX treatment led to significant differences of means of CFU (RF = 4.2 and RF = 4.3), clearly superior to CHX treatment alone (RF = 0.6). Plasma treatment of 7-day-or 16-day-old biofilms revealed no significant CFU reduction. The treatment of 7-day-old (RF = 1.7) and 16-day-old (RF = 1.3) biofilms was slightly more effective with NaOCl alone than with the combined treatment of NaOCl and plasma (RF = 1.6/RF = 1.9). The combination of CHX and plasma increased the RF immaterially.

CONCLUSION

The use of plasma alone and in combination with antiseptics is promising anticandidal regimens for daily use on dentures when biofilms are not older than 2 days.

CLINICAL RELEVANCE

Plasma could help to reduce denture-associated candidiasis.