Evaluation of Hardness and Colour Change of Soft Liners after Accelerated Ageing

The Influence of Decontamination Procedures on the Surface of Two Polymeric Liners Used in Prosthodontics

Polymeric liners are materials commonly used in prosthodontics to reshape denture surfaces contacting the soft tissues of the oral cavity. The aim of the study was to determine the impact of different cleaning methods on two polymeric materials used in prosthodontics as non-adhesive permanent liners. The material for the research consisted of samples made from Mollosil Plus (Detax, Ettlingen, Germany)-direct polysiloxan liner; and Plastitanium (Pressing Dental, San Marino, Republic of San Marino)-an injection-molded liner. A total of 198 samples were made, 99 of each assessed material. They were exposed to different cleaning methods-a toothbrush, a toothbrush and soap, a toothbrush and toothpaste (BlendaMed, Procter&Gamble, Cincinnati, OH, USA), a toothpaste and denture cleaning paste (Protefix Hygiene Denture Paste, Queisser Pharma, Germany), denture cleansing tablets (Protefix Hygiene Cleaning Tablets, Queisse Pharma, Germany), and a disinfecting spray (Aftermat, Port Jefferson Station, New York City, NY, USA)-for 1 min, 5 min, 10 min, and 15 min. The image acquisition was performed with scanning electron microscopy and samples were analyzed for the homogeneity of their surfaces-the presence of holes, grooves, precipitate, and small and large separating pieces of the material marking departures from this homogeneity. For each type of damage, one point was given. Continuous data from two groups were compared with Mann-Whitney U testing. Due to a small sample size and distribution of variables other than normal, to compare more than two groups, Kruskal-Wallis testing with post hoc analysis (Dunn test with Bonferroni correction) was used. Categorical data were compared with the chi-square test and the Fisher's exact test. The Mollosil Plus material should be decontaminated with the use of a toothbrush or toothbrush with soap, while Plastitanium material should be disinfected. Plastitanium samples are more susceptible to damage during the decontamination procedures than Mollosil Plus.

Synthesis and characterization of a silver nanoparticle-containing polymer composite with antimicrobial abilities for application in prosthetic and orthotic devices

Background

The presence of skin problems in patients using external lower limb prosthesis is recurrent. This has generated the need to develop interfaces for prosthesis with the ability to control microbial growth. Silver nanoparticles (AgNPs) have been implemented in the development of biomaterials because of their high antimicrobial activity. This article discusses the development of an AgNP-containing polymer composite with antimicrobial activity for developing prosthetic liners.

Methods

AgNPs were synthesized using a photochemical method and certain physicochemical properties were characterized. Furthermore, the antimicrobial activity of AgNPs against Staphylococcus aureus ATCC 25923 and methicillin-resistant Staphylococcus aureus (MRSA), was assessed on the basis of their minimum inhibitory concentrations (MICs). AgNPs were incorporated into a silicon elastomer to assess certain physicomechanical properties, antimicrobial activity and cytotoxic effect of the material.

Results

The maximum antimicrobial activity of the material against Staphylococcus aureus ATCC 25923 and MRSA was 41.58% ±2.97% at AgNP concentration of 32.98 μg/mL and 14.85% ±5.94% at AgNP concentration of 16.49 μg/mL, respectively. Additionally, the material exhibited tensile yield strength, rupture tensile strength, and tensile modulus of elasticity of 0.70 - 1.10 MPa, 0.71–1.06 MPa, and 0.20 - 0.30 MPa, respectively. The mechanical characteristics of the material were within the acceptable range for use in external lower limb prosthetic and orthotic interfaces.

Conclusions

It was possible to incorporate the AgNPs in a silicone elastomer, finding that the composite developed presented antimicrobial activity against Staphylococcus aureus ATCC 25923 and MRSA when compared to non-AgNP material samples.

Peel bond strength and antifungal activity of two soft denture lining materials incorporated with 1% chlorhexidine diacetate

Two soft denture lining materials (SC-Soft Confort and TS-Trusoft) were investigated with and without the addition of 1.0% of chlorhexidine diacetate (1.0% CHX). To assess peel bond strength, specimens (75×10×6 mm) were submitted to a peel test at 10 mm/min immediately and after 24 h. To evaluate Candida albicans growth inhibition, disc of specimens (10×3 mm) were immersed in a solution with 3×10⁶ CFU/mL of C. albicans, and spectral measurements were made following immersion in MTT solution for 2, 4, and 6 days. The agar diffusion test was performed by investigating the diameters of inhibition zones around the disc of specimens (10×3 mm)after 48 h. Data were submitted to statistical analysis (α=0.05) and the failure modes were visually classified. The incorporation of 1.0% CHX significantly decreased the peel bond strength for TS (p=0.001) and SC (p=0.005) for immediate test and for TS after 24 h (p=0.010), but not for SC. C. albicans growth was decreased for both materials over time (p<0.05). SC presented inhibition zones approximately 2.0 times larger than TS. The incorporation of 1.0% CHX inhibited fungal growth without impairment to the peel bond strength for SC after 24 h.

Effect of different types of disinfection solution and aging on the hardness and colour stability of maxillofacial silicone elastomers

INTRODUCTION

Understanding the effect of aging and different disinfecting agents on the physical properties of pigmented maxillofacial silicones may help eliminate the current uncertainty as to the best follow-up suggestions for the patients treated with silicone prostheses.

METHODS

One hundred fifty specimens (14 × 2 mm) were evaluated for colour and 75 specimens (30 × 10 mm) for hardness (total, 225 specimens). Five specimens were used for hardness testing in each disinfecting solution while 10 silicone specimens were used for colour evaluation. The samples were separated into 5 groups and the initial hardness and colour evaluations were performed and placed in disinfectant solution (neutral soap, effervescent tablet, 0.2% chlorhexidine, 4% chlorhexidine, sodium hypochlorite). A second set of colour and hardness measurements was taken after 48 hours of disinfection and 1,008 hours of artificial aging in a QUV-accelerated weathering tester. Two-way and 1-way analysis of variance with Tukey tests and paired t-test were used for statistical analysis (α = 0.05).

RESULTS

Before artificial aging, the hardness value of the red pigment group was found to be significantly lower than that of the brown pigment group. After aging, the lowest Shore A value was seen in the neutral soap group, while the highest was seen in the effervescent tablet.

CONCLUSIONS

Based on the results of this study, chlorohexidine 0.2% was found to be most suitable agent for disinfection of the prostheses. Washing with neutral soap caused loss of pigment from the surface of the silicones. Sodium hypochlorite was found to have a colour-fading effect on silicone specimens.

Surface Properties of Temporary Soft Liners Modified by Minimum Inhibitory Concentrations of Antifungals

Abstract Evaluating the addition of minimum inhibitory concentrations (MICs) of antifungals for Candida albicans biofilm on the hardness and roughness of temporary denture soft liners. Specimens (n=8; 36×7×6 mm) of tissue conditioner (Softone) and resilient liner (Trusoft) were produced either without (control) or with incorporation of drugs at MICs: nystatin (0.032 g/mL), chlorhexidine diacetate (0.064 g/mL), ketoconazole (0.128 g/mL), miconazole (0.256 g/mL) and itraconazole (0.256 g/mL). Specimens were stored in distilled water at 37 °C for 24 h, 7 days and 14 days prior to the hardness/roughness measurements. Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). The addition of the antifungals into both materials demonstrated no evident hardness change or decrease of this property compared with the control, except for miconazole in Softone, which increased the hardness after 14 days (p=0.003). The addition of nystatin into both materials, chlorhexidine in Trusoft and ketoconazole in Softone resulted in no significant changes of roughness compared with the control, after 7 days and 14 days (p>0.05). In these periods, itraconazole increased the roughness of both materials (p<0.001). The addition of all antifungals, except for the miconazole in Softone, resulted in no deleterious effects on the materials’ hardness over the evaluation time. The MICs of nystatin in both temporary soft lining materials, ketoconazole in Softone and chlorhexidine in Trusoft resulted in no deleterious effects for roughness up to 14 days.

Effect of different disinfecting procedures on the hardness and color stability of two maxillofacial elastomers over time

OBJECTIVE

Disinfection procedures often cause deterioration in a maxillofacial prosthesis. Color and hardness alterations could lead to a replacement of the prosthesis.

MATERIAL AND METHODS

An experimental chlorinated polyethylene (CPE) and a commercial polydimethyl siloxane (PDMS) sample were treated with four different disinfection procedures for a period which simulates 1 year of clinical service. The applied disinfection procedures included microwave exposure and immersion in three solutions, sodium hypochlorite, neutral soap and a commercial disinfecting soap. Shore A hardness (∆H) and color differences (∆E) were determined before and after each procedure. All data were analyzed by Two Way Analysis of Variance (ANOVA) and Tukey's post hoc tests at a level of α=0.05.

RESULTS

The samples presented significant alterations in color and hardness after the different disinfection treatments. The color differences (∆E) were at least eye detectable in all cases and clinically unacceptable in most of the cases, with values ranging from 1.51 to 4.15 and from 1.54 to 5.92 for the PDMS and CPE material, respectively. Hardness was decreased after all the disinfection procedures in the PDMS, while for the CPE, a decrement was observed after disinfection with sodium hypochlorite and neutral soap and an increment after microwave exposure and the disinfection with a commercial antimicrobial agent. The PDMS samples presented greater alterations in color and hardness after disinfection with sodium hypochlorite solution, while the microwave exposure caused negligible effects. The CPE samples were affected most after disinfection when treated with neutral soap, and more slightly when disinfected with sodium hypochlorite solution.

CONCLUSIONS

The disinfection procedures caused alterations in color and hardness of the examined materials. The most suitable disinfection procedure for the PDMS material is microwave exposure, while disinfection with sodium hypochlorite solution is not recommended. The CPE material is suggested to be disinfected with sodium hypochlorite solution and the use of neutral soap is not recommended. Comparing the two materials, the PDMS material is most color stable, while the CPE material presented fewer changes in hardness.

Color changes of autopolymerized silicone or acrylic soft denture reliners: the effect of accelerated aging

The aim of this in vitro study was to investigate the effect of accelerated aging on the color stability of six autopolymerized silicone and acrylic soft reliners. Ten specimens for each material were fabricated. Initial color was measured with a tri-stimulus colorimeter. One set of five specimens was placed in distilled water at 37 °C under dark for 15 days, while the remaining were subjected to photoaging initially for 1 and then for 6 days. Color changes (ΔE) then calculated. Data were analysed by ANOVA, Tukey and t tests at a = 0.05. All the reliners after storage in water showed ΔE ranged from 2.8 (Mucopren Soft) to 7.9 (Vertex Soft). After accelerated aging for 1 day, ΔE ranged from 4.6 (Vertex Soft) to 12.4 (Eversoft) whereas after 6 days from 1.7 (Ufigel SC) to 11.8 (Eversoft). All the reliners showed perceptible ΔE except Ufigel SC in 6 days aging and clinically unacceptable ΔE except Sofreliner S and Vertex Soft after aging for 1 day. Eversoft showed the highest discoloration after aging.

Effect of ageing and immersion in different beverages on properties of denture lining materials

OBJECTIVES

To evaluate the color stability and hardness of two denture liners obtained by direct and indirect techniques, after thermal cycling and immersion in beverages that can cause staining of teeth.

MATERIAL AND METHODS

Seventy disc-shaped specimens (18 x 3 mm) processed by direct (DT) and indirect techniques (IT) were made from Elite soft (n=35) and Kooliner (n=35) denture liners. For each material and technique, 10 specimens were subjected to thermal cycling (3,000 cycles) and 25 specimens were stored in water, coffee, tea, soda and red wine for 36 days. The values of color change, Shore A hardness (Elite soft) and Knoop hardness (Kooliner) were obtained. The data were subjected to ANOVA, Tukey's multiple-comparison test, and Kruskal-Wallis test (P<0.05).

RESULTS

The thermal cycling promoted a decrease on hardness of Kooliner regardless of the technique used (Initial: 9.09± 1.61; Thermal cycling: 7.77± 1.47) and promoted an increase in the hardness in the DT for Elite Soft (Initial: 40.63± 1.07; Thermal cycling: 43.53± 1.03); hardness of Kooliner (DT: 8.76± 0.95; IT: 7.70± 1.62) and Elite Soft (DT: 42.75± 1.54; IT=39.30± 2.31) from the DT suffered an increase after the immersion in the beverages. The thermal cycling promoted color change only for Kooliner in the IT. Immersion in the beverages did not promote color change for Elite in both techniques. The control group of the DT of Kooliner showed a significant color change. Wine and coffee produced the greatest color change in the DT only for Elite Soft when compared to the other beverages.

CONCLUSION

The three variation factors promoted alteration on hardness and color of the tested denture lining materials.