Effects of immersion disinfection of agar-alginate combined impressions on the surface properties of stone casts

Study on the effect of chlorogenic acid on the antimicrobial effect, physical properties and model accuracy of alginate impression materials

Background

Dental impressions are essential for accurately capturing the detailed anatomy of teeth and surrounding oral structures. However, these impressions often become contaminated with saliva and blood, making proper disinfection necessary. The application of chemical disinfectants has been associated with negative side effects, leading to suboptimal disinfection practices in clinical settings.

Objective

The purpose of this study was to evaluate the effectiveness of chlorogenic acid (CA) as a disinfectant for alginate impression materials, the impact of CA disinfection on the physical properties and dimensional accuracy of alginate impressions was also investigated.

Methods

The physical properties of alginate impression materials, such as elastic recovery, strain-in-compression, initial setting time, and fluidity, were assessed after mixing the alginate impression materials with three different concentrations of CA solution (10 mg/mL, 15 mg/mL, 20 mg/mL). To evaluate the antimicrobial effect of CA, alginate impressions mixed with a 10 mg/mL CA solution and impressions mixed with distilled water (control group) were contaminated with four types of microorganism: Escherichia coli, Staphylococcus aureus, Candida albicans, and Streptococcus pneumoniae. Following a five-minute incubation period, a CA solution at a concentration of either 50 mg/mL, 55 mg/mL, or 60 mg/mL was sprayed on the samples for disinfection. Samples were collected at different time intervals (10 min, 20 min, 30 min) and cultured to determine the number of colony-forming units (CFU/mL), providing insight into the antimicrobial efficacy of these CA solutions. The dimensional accuracy of alginate impressions was assessed in three groups: one with alginate impressions mixed with distilled water, another with alginate impressions sterilized with available chlorine (2,000 mg/L) mixed with distilled water, and the last group consisting of alginate impressions mixed with 10 mg/mL CA solution and sprayed with 60 mg/mL CA solution. Both the standard model and the plaster model underwent 3D scanning, and the data were processed and compared by software. The root mean square (RMS) was used as a parameter to evaluate the deviation between models.

Results

All alginate impression materials mixed with either 10 mg/mL, 15 mg/mL, or 20 mg/mL concentrations of CA solution met the ISO 21563 standard for elastic recovery, strain-in-compression, and fluidity. However, only the material mixed with a concentration of 10 mg/mL CA had an initial setting time within the range specified by the T-6505 Japanese industrial standard. The application of CA solution by mixing or spraying showed significant antimicrobial effects on Staphylococcus aureus, Escherichia coli, Candida albicans, and Streptococcus pneumoniae. There was no significant difference in the dimensional accuracy of the alginate impressions between the group of the CA solution applied, the blank group, or the chlorine intervention group.

Effects of Polishing and Artificial Aging on Mechanical Properties of Dental LT Clear® Resin

Three-dimensional printing has become incorporated into various aspects of everyday life, including dentistry. Novel materials are being introduced rapidly. One such material is Dental LT Clear by Formlabs, a resin used for manufacturing occlusal splints, aligners, and orthodontic retainers. In this study, a total of 240 specimens, comprising two shapes (dumbbell and rectangular), were evaluated through compression and tensile tests. The compression tests revealed that the specimens were neither polished nor aged. However, after polishing, the compression modulus values decreased significantly. Specifically, the unpolished and nonaged specimens measured 0.87 ± 0.02, whereas the polished group measured 0.086 ± 0.03. The results were significantly affected by artificial aging. The polished group measured 0.73 ± 0.05, while the unpolished group measured 0.73 ± 0.03. In contrast, the tensile test proved that the specimens showed the highest resistance when the polishing was applied. The artificial aging influenced the tensile test and reduced the force needed to damage the specimens. The tensile modulus had the highest value when polishing was applied (3.00 ± 0.11). The conclusions drawn from these findings are as follows: 1. Polishing does not change the properties of the examined resin. 2. Artificial aging reduces resistance in both compression and tensile tests. 3. Polishing reduces the damage to the specimens in the aging process.

Antimicrobial effect and the mechanical and surface properties of a self-disinfecting and a chlorhexidine-incorporated Type IV dental stone

STATEMENT OF PROBLEM

Stone casts are subject to contamination, but whether disinfectants incorporated into the stone are effective is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the antimicrobial activity and the mechanical and surface properties of self-disinfecting gypsum (SDG) and gypsum mixed with 2% chlorhexidine (GCHX).

MATERIAL AND METHODS

Antimicrobial action was evaluated using the diffusion-disk technique on Streptococcus aureus and Candida albicans 1 hour and 24 hours after pouring the gypsum. The groups were SDG, GCHX, a positive control (PC) of gypsum mixed with distilled water, and a negative control (NC) of filter paper disk soaked with 2% chlorhexidine; n=8. Inhibition halos were measured using the ImageJ software program and statistically analyzed using the repeated measures mixed ANOVA with time×group interaction. Compressive strength (CS) in MPa and surface roughness (SR) in μm (parameters: Ra - roughness average; and Sa - 3-dimensional (3D) arithmetic mean of the surface profile) tests were performed to characterize the specimens (evaluated groups: SDG, GCHX, and PC; n=10). CS data were analyzed by a 2-way ANOVA with time×group interaction, and SR data by a 1-way ANOVA (α=.05).

RESULTS

For S aureus, there were differences between GCHX and SDG at 1 hour and 24 hours (P<.05), but no significant differences were found for C albicans (P>.05). GCHX was better than PC, except for C albicans, and showed a reduction in CS when compared with PC and SDG (P<.05) at all time intervals. The SR of GCHX increased (Ra:1.76, Sa:2.08) when compared with PC (Ra:0.89, Sa:1.12) and SDG (Ra:1.03, Sa:1.35) (Ra: P<.004 and Sa: P<.001).

CONCLUSIONS

The antimicrobial activity of GCHX against S aureus was better than that of SDG, but neither had an effect against C albicans. As for CS and SR, GCHX presented a decrease in properties when compared with PC and SDG but was within the American Dental Association #25 specification values.

Dimensional changes of commercial and novel polyvinyl siloxane impression materials following sodium hypochlorite disinfection

BACKGROUND

Dental impressions are used to record anatomy of teeth and surrounding oral structures. Impression materials become contaminated with saliva and blood requiring disinfection, which may have negative impact on dimensional stability of materials.

OBJECTIVE

Comparatively evaluate linear dimensional changes of synthesized Tetra-functional (dimethylsilyl) orthosilicate (TFDMOS) containing Polyvinylsiloxane (PVS) impressions following sodium hypochlorite disinfection.

METHODS

Percentage dimensional changes of three commercial PVS (Elite HD Monophase, Extrude and Aquasil Ultra Monophase) and five experimental PVS impression materials were measured. Experimental material contained novel cross-linking agent (TFDMOS) and a non-ionic surfactant (Rhodasurf CET-2) that is Exp-A (without TFDMOS), Exp-B (with TFDMOS), Exp-C (TFDMOS+ 2% Rhodasurf CET-2), Exp-D (TFDMOS+ 2.5% Rhodasurf CET-2) Exp-E (TFDMOS+ 3% Rhodasurf CET-2). Samples were made using rectangular stainless-steel molds (40 × 10 × 3 mm3) and linear dimensional changes were measured using a calibrated travelling microscope at 10× magnification after immersion in distilled water (D.W) and 1% Sodium Hypochlorite solution at two different time intervals i.e., 30 min and 24 h.

RESULTS

Samples immersed in 1% NaOCl showed significant (p < 0.05) dimensional changes after 30 min of immersion. Exp-E showed significantly greater dimensional changes than their control (Exp-A and Exp-B). In distilled water, there were no significant difference among the tested materials. Aquasil exhibited highest expansion (0.06%) in both solutions. At 24 h, among the commercial materials, Extrude had the greatest expansion followed by Aquasil and Elite in DW while Aquasil showed the greatest expansion followed by Extrude and Elite in NaOCl.

CONCLUSION

Experimental PVS had linear dimensional changes within the ISO 4823; 2015 recommended range. However, extended immersion can negatively affect the linear dimensions.

Evaluation of Antimicrobial Effects on Dental Impression Materials and Biofilm Removal by Sodium Dichloroisocyanurate

Dental materials are inevitably contaminated with oral microorganisms. To prevent transmission of infectious diseases, impressions need to be disinfected. In the present study, we examined the disinfection effects on impression materials and biofilm removal by sodium dichloroisocyanurate (SDIC). Exponentially growing Streptococcus mutans, Escherichia coli, Staphylococcus aureus and Candida albicans, and dental plaque bacteria were suspended in phosphate buffered saline (PBS) and exposed for 1, 5 and 10 min to 1 mL of the 10 ppm, 100 ppm, 1,000 ppm, and 10,000 ppm SDIC solutions. The bactericidal effect was evaluated by colony forming units of each microorganisms. Moreover, the effect of SDIC solution on S. mutans biofilm was examined. Bactericidal effects of SDIC solutions on oral bacteria on dental impression surfaces were assessed and the surface quality of dental casts after immersion in SDIC solution for 30 min was observed under a scanning electron microscope. The number of all bacterial strains, including plaque bacteria, were significantly decreased by SDIC solution treatment in a dose-dependent manner. Significant S. mutans biofilm removing activity of SDIC was observed in 1,000 and 10,000 ppm solution. The number of oral bacteria adhering to the surfaces of impressions markedly decreased following 10-min immersion in the 1,000 ppm SDIC solution. The 30-min immersion of dental impression in the 1,000 ppm SDIC solution did not adversely affect the surface roughness of dental casts. The results indicate that SDIC Solution is useful to deactivate oral bacteria on dental impression.

Evaluating the stability of extended-pour alginate impression materials by using an optical scanning and digital method

STATEMENT OF PROBLEM

The dimensional stability of alginate dental impressions is a key factor for the reliability of delayed gypsum pouring and digital scanning. However, studies of the dimensional stability of alginates with conventional methods that consider the dimensional variations of large impressions are lacking.

PURPOSE

The purpose of this in vitro study was to investigate and compare 2 digital methods for the analysis of dimensional stability of large impressions made with 5 different extended-pour alginates and to assess dimensional stability up to 5 days.

MATERIAL AND METHODS

Impressions of a simplified master maxillary model were made with Alginoplast, Blueprint, Hydrogum 5, Orthoprint, and Phase Plus and then analyzed at different time points. Digital scans of the alginate impression surfaces were obtained with a desktop scanner and analyzed by evaluating the linear measurements between reference points and by using a novel method that consists of the analysis of the entire scanned surface to evaluate the expansion and contraction of the impressions.

RESULTS

The first method revealed that the dimensional changes did not exceed 0.5%, with the exception of Phase Plus at day 3 (-0.6 ±0.7%), and the average dimensional variation was always lower than or equal to 0.2 mm. Blueprint was the most stable material (-0.2 ±0.6%). The second method revealed dimensional variations always lower than 0.03 mm and confirmed Blueprint as the best performing material (0.001 ±0.006 mm) and Phase Plus the worst (-0.019 ±0.006 mm).

CONCLUSIONS

Both the methods used to evaluate alginate stability showed that the analyzed materials remain stable over time; the dimensional variations showed a similar trend, with differences in the absolute values depending on the applied method. Linear measurements are affected by the operator and choice of reference points; however, by evaluating the average variations of the entire structure surfaces, local variations should be minimized. The evaluation of the average variations with the second method offers the advantage of a rapid visual representation of these variations.

Innovation by Computer-Aided Design/Computer-Aided Manufacturing Technology: A Look at Infection Prevention in Dental Settings

Recent data indicates limited awareness and compliance on infection prevention procedures by dental offices and by dental laboratories. Guidelines for infection prevention in dentistry have been published by Centres for Disease Control and Prevention since 2003; the section “IX-Special consideration” includes a subsection concerning the prevention in dental laboratories, but it has not been modernised in later versions to fit the needs of traditional and computer-aided technology. Traditional techniques required disinfecting items (impression, chewing waxes, and appliances) with well-suited products, which are also chosen for limiting impression changes or appliance deterioration. Effective procedures are available with difficulties. Some of these contain irritant or non-eco-friendly disinfectants. The transport of impression, to dental laboratories, is often delayed with limited precautions for limiting cross-infection. Gypsum casts are frequently contaminated mainly by bacteria and their antibiotic-resistant strains and even stored for long periods during dental implant supported restoration and orthodontic therapy, becoming a hidden source of infection. Nowadays, computer-aided design/computer-aided manufacturing technology seems to be an interesting way to promote both business and safety, being more comfortable for patients and more accurate than traditional technology. A further advantage is easier infection prevention since, for the most part, mainly digital impression and casts are not a source of cross-infection and the transport of contaminated items is reduced and limited to try-in stages. Nevertheless, a peculiar feature is that a digital electronic file is of course unalterable, but may be ruined by a computer virus. Additionally, the reconditioning of scanner tips is determinant for the optical characteristics and long term use of the scanner, but information for its reconditioning from producers is often limited. This study focuses on some critical points including (a) insufficient guidelines, (b) choice of proper procedure for scanner reconditioning, and (c) data protection in relation to patient privacy.

Alginate Materials and Dental Impression Technique: A Current State of the Art and Application to Dental Practice

Hydrocolloids were the first elastic materials to be used in the dental field. Elastic impression materials include reversible (agar-agar), irreversible (alginate) hydrocolloids and synthetic elastomers (polysulfides, polyethers, silicones). They reproduce an imprint faithfully, providing details of a high definition despite the presence of undercuts. With the removal of the impression, being particularly rich in water, the imprints can deform but later adapt to the original shape due to the elastic properties they possess. The advantages of using alginate include the low cost, a better tolerability on the part of the patient, the ease of manipulation, the short time needed for execution, the instrumentation and the very simple execution technique and possibility of detecting a detailed impression (even in the presence of undercuts) in a single step. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted a search of articles in written in English published from 2008 to 2018. All the relevant studies were included in the search with respect to the characteristics and evolution of new marine derived materials. Much progress has been made in the search for new marine derived materials. Conventional impression materials are different, and especially with the advent of digital technology, they have been suffering from a decline in research attention over the last few years. However, this type of impression material, alginates (derived from marine algae), have the advantage of being among the most used in the dental medical field.