A clinical study to evaluate denture adhesive use in well-fitting dentures

Purpose: The objective of this study was the assessment of retention and stability and functional benefits of denture adhesive applied to well‐fitting and well‐made dentures. Materials and Methods: This was a randomized, crossover study to compare two marketed denture adhesives (test cream, Super Poligrip® Free, and test strip, Super Poligrip® Comfort Seal Strips) and an unmarketed cream adhesive (GlaxoSmith Kline Consumer Healthcare) with no adhesive as the negative control. Thirty‐six subjects completed the study. One hour after the application of denture adhesive, retention and stability were measured using the Kapur Index and maxillary incisal bite force. Two hours after application, functional tests were used to assess denture movement and peanut particle migration under the denture. Subjects also rated confidence, comfort, satisfaction with dentures, and denture wobble in conjunction with the functional tests. Results: Denture adhesives significantly (p < 0.05) improved retention and stability of well‐fitting dentures. Subjects experienced significantly (p < 0.05) fewer dislodgements while eating an apple after adhesive was applied to dentures. Significant (p < 0.05) increases in subjective ratings of confidence and comfort as well as decreases in denture wobble were associated with the use of adhesive. There was significant (p < 0.05) improvement in satisfaction ratings for cream adhesives. A single application of each denture adhesive was well tolerated. Conclusion: The results of this study provide evidence that use of Super Poligrip® denture adhesives can enhance aspects of performance of complete well‐fitting dentures as well as provide increased comfort, confidence, and satisfaction with dentures.     

An international multicenter study on the effectiveness of a denture adhesive in maxillary dentures using disposable gnathometers

No consensus has been achieved on whether denture adhesives are beneficial adjuncts in denture-wearers management. The purpose of this international multicenter study was to determine objectively the effect of a denture adhesive (Kukident) on the retention of complete maxillary dentures using disposable gnathometers. The disposable gnathometers have a decimal scale for measuring the incisal force before dislodgement (= maximum incisal force) of maxillary dentures. The intra-observer reliability, the inter-observer reliability, and the linearity of the gnathometer units of the disposable gnathometers were examined in three pilot studies. Participants of the international multicentre main study were 88 patients who had been selected for complete maxillary denture treatment. The maximum incisal force of their previous and new denture without and with adhesive was measured using disposable gnathometers. The intra- and inter-observer reliability of the disposable gnathometers was very good, and there was a linear relation between the gnathometer units. The effect of the denture adhesive on the maximum incisal force of complete maxillary dentures was statistically significant in previous as well as new dentures, being more pronounced in previous than in new dentures.     

Subjective Assessment by Patients of the Efficiency of Two Denture Adhesive Pastes

PURPOSE: This study evaluated the subjective responses of 30 denture wearers with regard to the effectiveness of two denture adhesive pastes. MATERIALS AND METHODS: Thirty patients responded to questions related to retention, chewing ability, taste, duration of adhesives in the mouth, and removal; comparing the use of two denture adhesives based on polymethylvinylether-maleic anhydride compounds or carboxymethyl cellulose. RESULTS: The denture adhesive paste based on polymethylvinylether-maleic anhydride (PVM-MA) compound was rated higher (73% and 87%) than carboxymethyl cellulose (CC) adhesive paste (60% and 37%) on chewing ability and duration in the mouth (p= 0.0001 and p= 0.0001, respectively) by experienced denture wearers in both maxilla and mandible. There were no statistically significant differences between the two denture adhesive pastes on the retention of maxillary dentures, taste, and removal of the adhesive (p= 0.08, p= 0.67, and p= 0.41, respectively). CONCLUSIONS: All subjects responded that the retention of their dentures was either a little better or much better when using either of the adhesive pastes.     

The Effect of a New Denture Adhesive on Bite Force Until Denture Dislodgement

PURPOSE: Denture adhesives are used to improve the denture retention and comfort of complete denture wearers. The purpose of this investigation was to establish the effect of a new denture adhesive on maximum bite force until denture dislodgement (BFDD) after adhesive application. MATERIALS AND METHODS: Fifteen denture-wearing patients (7 female, 8 male, mean age: 64 years) were involved in the study. The BFDD measurements were performed using a disposable gnathometer with a 1 to 10 scale. During one of the treatment sessions, the maximum BFDD with the pre-existing maxillary dentures using denture adhesive were measured. The measurements were also made at the baseline without adhesive and after the 1st, 2nd, 4th, and 6th hours following the application of the denture adhesive. The same procedure was applied to the new dentures about 2 weeks after the delivery of the dentures. The data were collected and statistically analyzed using ANOVA and Student's t-test. RESULTS: Consistent improvement was observed in BFDD when adhesive was used for all time intervals from the baseline (mean: 1.54 units, 3.20 units) to 6 hours (mean: 3.99 units, 4.60 units) for both pre-existing dentures (p= 0.003) and new dentures (p= 0.05), respectively. CONCLUSIONS: The results of this in vivo study suggest that the denture adhesive tested could effectively increase BFDD for up to 6 hours after application.     

Elastic modulus and flexural strength comparisons of high-impact and traditional denture base acrylic resins

Background

Fractures of acrylic resin dentures are a common occurrence in clinical dentistry. The denture may be fractured accidentally when dropped or while in service in the mouth due to flexural fatigue.

Objectives

The aim of this study was to compare the elastic modulus and the flexural strength between two heat-cured acrylic resins used in denture bases: a high-impact resin (Lucitone 199) and a traditional resin (Rodex).

Materials and methods

Rectangular strips of Lucitone 199 and Rodex (10 samples each) were fabricated and stored in artificial saliva at 37 °C for 2 weeks. The specimens were subjected to a three-point flexural test. The data were statistically analysed with Student’s t-test (p ⩽ .05).

Results

The high-impact acrylic resin had a lower elastic modulus (p = .000) and higher flexural strength (p = .001) compared to the traditional acrylic resin.

Conclusion

Within the limitations of this study, it can be concluded that the high-impact acrylic resin is a suitable denture base material for patients with clinical fracture of the acrylic denture.     

Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial

PurposeThe purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial.MethodsTwo hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed.ResultsBetween-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p < 0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p < 0.05).ConclusionsThe oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.     

Effect of silica coating and silane surface treatment on the bond strength of soft denture liner to denture base material

Objective

This study investigated the effects of different surface treatments on the tensile bond strength of an autopolymerizing silicone denture liner to a denture base material after thermocycling.

Material and Methods

Fifty rectangular heat-polymerized acrylic resin (QC-20) specimens consisting of a set of 2 acrylic blocks were used in the tensile test. Specimens were divided into 5 test groups (n=10) according to the bonding surface treatment as follows: Group A, adhesive treatment (Ufi Gel P adhesive) (control); Group S, sandblasting using 50-µm Al₂O₃; Group SCSIL, silica coating using 30-µm Al₂O₃ modified by silica and silanized with silane agent (CoJet System); Group SCA, silica coating and adhesive application; Group SCSILA, silica coating, silane and adhesive treatment. The 2 PMMA blocks were placed into molds and the soft lining materials (Ufi Gel P) were packed into the space and polymerized. All specimens were thermocycled (5,000 cycles) before the tensile test. Bond strength data were analyzed using 1-way ANOVA and Duncan tests. Fracture surfaces were observed by scanning electron microscopy. X-ray photoelectron spectrometer (XPS) and Fourier Transform Infrared spectrometer (FTIR) analysis were used for the chemical analysis and a profilometer was used for the roughness of the sample surfaces.

Results

The highest bond strength test value was observed for Group A (1.35±0.13); the lowest value was for Group S (0.28±0.07) and Group SCSIL (0.34±0.03). Mixed and cohesive type failures were seen in Group A, SCA and SCSILA. Group S and SCSIL showed the least silicone integrations and the roughest surfaces.

Conclusion

Sandblasting, silica coating and silane surface treatments of the denture base resin did not increase the bond strength of the silicone based soft liner. However, in this study, the chemical analysis and surface profilometer provided interesting insights about the bonding mechanism between the denture base resin and silicone soft liner.     

Comparison of immediate complete denture, tooth and implant-supported overdenture on vertical dimension and muscle activity

PURPOSE

To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture.

MATERIALS AND METHODS

Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables.

RESULTS

Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance.

CONCLUSION

Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis.     

Bite force and oral function in complete denture wearers

Oral function was evaluated in complete denture wearers by using a questionnaire, clinical examination and bite force measurements. Ten patients with satisifactory and ten with unsatisfactory dentures were studied and six of the latter patients were reexamined 1 year after the insertion of new dentures. The bite force values were compared with those obtained in ten dentate controls. No significant differences in bite force were found between the satisfactory and unsatisfactory denture groups. Individual values varied much in both groups. The six patients re-examined were satisfied with their new dentures and thought they had improved chewing but no significant increase of bite force was found. The maximal bite force was 5-6 times greater in the dentate subjects than in the denture wearers. Edentulous persons are very handicapped in masticatory function and even clinically satisfactory complete dentures are poor substitutes for natural teeth.     

The use of denture adhesives as an aid to denture treatment

Denture adhesives are used by more than five million denture wearers in the United States. All dentists strive to achieve stable, retentive, and comfortable dentures that do not require the use of denture adhesives. However, dentists may prescribe and use denture adhesives as a legitimate therapeutic and effective procedure in denture treatment and in denture aftercare, when indicated. Denture patients should use denture adhesive on the advice of their dentists and should be instructed in its proper use and cautioned against misuse.     

Effect of incorporation of 2-tert-butylaminoethyl methacrylate on flexural strength of a denture base acrylic resin

Polymethyl methacrylate (PMMA) resins have commonly been used as a denture base material. However, denture bases may act as a reservoir for microorganisms and contribute to oral diseases in denture wearers. It is hypothesized that the 2-tertbutylaminoethyl methacrylate (TBAEMA) incorporated to acrylic resins should have antimicrobial activity related to the presence of amino groups on acrylic resin surface.

Objectives

The objectives of this study were to evaluate the presence of amino groups on acrylic resin surface and the influence on flexural strength after incorporation of TBAEMA.

Material and Methods

Six groups were divided according to the concentration of TBAEMA incorporated to acrylic resin (Lucitone 550): 0, 0.5, 1.0, 1.5, 1.75 and 2%. Specimens surface were evaluated by electron Spectroscopy for Chemical Analysis (ESCA) to detect the presence of amino groups, represented by nitrogen ratios. Flexural strength of the specimens was tested and results were analyzed by ANOVA and Tukey''s test (α=0.05).

Results

Different nitrogen ratios were observed on specimen surfaces: 0, 0.13, 0.74, 0.66, 0.92 and 0.33% for groups 0, 0.5, 1.0, 1.5, 1.75, and 2%, respectively. Significant differences were found for flexural strength (p<0.001). The mean flexural strength values were 98.3±3.9, 93.3±3.2, 83.9±2.1, 82.8±5.2, 71.2±5.1 and 17.3±3.2 MPa for groups 0, 0.5, 1.0, 1.5, 1.75, and 2%, respectively.

Conclusion

Within the limitations of this study, the incorporation of TBAEMA results in the presence of the potentially antimicrobial amino groups on specimen surfaces, but affect the flexural strength, depending on the concentration of TBAEMA.     

The use of denture adhesive as an aid to denture treatment

Denture adhesive are used by more than five million denture wearers in the United States. All dentists strive to achieve stable, retentive, and comfortable dentures and use denture adhesives as a legitimate therapeutic and effective procedure in denture treatment and in denture aftercare, when indicated. Denture patients should use denture adhesive on the advise of their dentists and should be instructed in its proper use and cautioned against misuse.     

Efficacy of denture adhesives in maxillary dentures using gnathodynamometry: a comparative study

The purpose of this study was to investigate the effect of four commercially available denture adhesives on the incisal and premolar dislodgement forces of maxillary complete dentures by using an electronic and disposable gnathodynamometer and compare the measured incisal forces for differences. This study was conducted with 12 complete maxillary denture wearers. Four commercially available denture adhesives Super Corega^®, Corega Ultra^®, Super Corega Powder^® and Fittydent Cationic^® were investigated. Testing protocol and sequence included baseline measurements without adhesives (control) for previous and new dentures and then replications of measurements with the four adhesives. Maximum dislodgement forces were recorded in two sites between central incisors and the left 2nd premolars by using an electronic and disposable gnathodynamometer. To estimate the effect of the different adhesives on the dislodgement forces, data were analyzed by a 2- and 3-way ANOVA, while for estimating the agreement of the two devices a Bland–Altman and Mountain plots were used. ANOVAs indicated significant differences between adhesives (p < 0.05), denture types (p < 0.05) and biting sites (p < 0.05) with both devices. Bland–Altman plot and Mountain plots indicated a poor agreement of the two devices. It was concluded that denture adhesives increase the denture dislodgement forces, but with differences among them. The two devices do not highly agree with each other, but each one alone is useful in estimating dislodgement forces in clinical practice and research.     

Hydration dependent mechanical performance of denture adhesive hydrogels

Objective

Hydration in denture adhesives regulates the formation of complex morphologies and mechanical function. Multiscale experimental approaches are required to evaluate the impact of hydration on the inherent heterogeneity of denture adhesive-based hydrogels at different length scales and the impact of such phenomena on adhesion performance.

Wettability of denture relining materials under water storage over time

STATEMENT OF PROBLEM

Poor wettability of denture relining materials may lead to retention problems and patient discomfort.

PURPOSE

Purpose of this study is to compare and evaluate wettability of nine denture relining materials using contact angle measurements under air and water storage over time.

MATERIAL AND METHODS

Nine denture relining materials were investigated in this study. Two heat-curing polymethyl-methacrylate (PMMA) denture base materials: Vertex RS, Lang, one self-curing polyethyl-methacrylate (PEMA) chairside reline resin: Rebase II, six silicone relining materials: Mucopren soft, Mucosoft, Mollosil® plus, Sofreliner Touch, GC Reline™ Ultrasoft, Silagum automix comfort were used in this experiment. Contact angles were measured using high-resolution drop shape analysis system (DSA 10-MK2, KRUESS, Germany) under three conditions (in air after setting, 1 hour water storage, and 24 hours water storage). Nine materials were classified into three groups according to material composition (Group 1: PMMA, Group 2: PEMA, Group 3: Silicone). Mean values of contact angles were compared using independent samples t-test and one-way ANOVA, followed by a Scheffe''s post hoc analysis (α= 0.01).

RESULTS

Contact angles of materials tested after air and water storage increased in the following order: Group 1 (PMMA), Group 2 (PEMA), Group 3 (Silicone). Heat-cured acrylic denture base resins had more wettability than silicone relining materials. Lang had the highest wettability after 24 hours of water storage. Silicone relining materials had lower wettability due to their hydrophobicity. Wettability of all denture relining materials, except Rebase II and Mollosil® plus, increased after 24 hours of water storage.

CONCLUSIONS

Conventional heat-cured resin showed the highest wettability, therefore, it can be suggested that heat-cured acrylic resin is material of choice for denture relining materials.     

A preliminary investigation into the use of denture adhesives combined with dietary advice to improve diets in complete denture wearers

Objectives

To investigate how nutritional advice and denture adhesives may be associated with eating healthier foods.

Methods

35 edentulous subjects (13 males and 22 females, mean age 73.9 years (55–84 years)), wearing complete dentures more than one year old, completed validated questionnaires analysing saturated fat, protein, Vitamin C, the number of servings of fruit/vegetables. In addition subjects completed the NDNS and OHIP Edent questionnaires. At baseline, nutritional information and the use of denture adhesive was provided. Subjects returned after 30 consecutive days and the questionnaires were repeated. A Wilcoxon signed rank test was used to test the effect of the denture adhesive on diet and on quality of life measures.

Results

The subjects increased mean intake from 2.2 portions of fruit/vegetables a day to 3.6. Fat and saturated fats were reduced from 23.2 g to 11.3 g and Vitamin C intake increased by 34.4 mg. All were statistically significant (p < 0.0001). There was a statistically significant improvement over the 30-day treatment period in subjects’ ability as measured by using OHIP Edent scores to bite (p = 0.017) and chew a range of foods (p = 0.007).

Conclusion

Within the confines of the study, use of simple dietary advice and denture adhesives improved diet.

Clinical significance

The results of this pilot study suggest that denture fixatives may improve dietary behaviour of complete denture wearers.     

强力义齿稳固剂与Fixodent对改善义齿咀嚼效能的实验研究

目的评价强力义齿稳固剂改善总义齿咀嚼效能的能力。方法随机选择戴有总义齿的无牙颌患者和采用粘膜支持式可摘局部义齿修复的多数牙缺失患者共24例,采用同体比较法,花生米作试料,分光光度计测定咀嚼后花生米悬浊液的吸光度,测定强力义齿稳固剂使用前后吸光度值的变化。观察义齿稳固剂与咀嚼效能的关系,并与国外产品Fixodent比较。结果数据统计分析表明,强力义齿稳固剂和Fixodent使用前后吸光度值的变化均具有显著性差异（P<0.01）;而两种稳固剂使用后吸光度值的大小无显著性差异（P>0.05）。结论强力义齿稳固剂同国外产品Fixodent一样能明显提高义齿的咀嚼效能。     

The effectiveness of chemical denture cleansers and ultrasonic device in biofilm removal from complete dentures

Adequate denture hygiene can prevent and treat infection in edentulous patients. They are usually elderly and have difficulty for brushing their teeth.

Objective

This study evaluated the efficacy of complete denture biofilm removal using chemical (alkaline peroxide-effervescent tablets), mechanical (ultrasonic) and combined (association of the effervescent and ultrasonic) methods.

Material and Methods

Eighty complete denture wearers participated in the experiment for 21 days. They were distributed into 4 groups (n=20): (1) Brushing with water (Control); (2) Effervescent tablets (Corega Tabs); (3) Ultrasonic device (Ultrasonic Cleaner, model 2840 D); (4) Association of effervescent tablets and ultrasonic device. All groups brushed their dentures with a specific brush (Bitufo) and water, 3 times a day, before applying their treatments. Denture biofilm was collected at baseline and after 21 days. To quantify the biofilm, the internal surfaces of the maxillary complete dentures were stained and photographed at 45º. The photographs were processed and the areas (total internal surface stained with biofilm) quantified (Image Tool 2.02). The percentage of the biofilm was calculated by the ratio between the biofilm area multiplied by 100 and the total area of the internal surface of the maxillary complete denture.

Results

The Kruskal-Wallis test was used for comparison among groups followed by the Dunn multiple-comparison test. All tests were performed respecting a significance level of 0.05. Significant difference was found among the treatments (KW=21.18; P<0.001), the mean ranks for the treatments and results for Dunn multiple comparison test were: Control (60.9); Chemical (37.2); Mechanical (35.2) and Combined (29.1).

Conclusion

The experimental methods were equally effective regarding the ability to remove biofilm and were superior to the control method (brushing with water). Immersion in alkaline peroxide and ultrasonic vibration can be used as auxiliary agents for cleaning complete dentures.     

A Study to Evaluate the Retentive Ability of Different Denture Adhesive Materials: An In Vitro Study

Denture Adhesives are commonly used by denture wearers to enhance the retentive ability of their dentures however, little is known about the efficacy of these materials. To compare the retentive ability of three different commercially available denture adhesives. To find out the best available denture adhesive material. An in vitro investigation to evaluate the retentive ability of three commercially available denture adhesive powders and two adhesive pastes was conducted. The adhesion and cohesion that developed between the glass surface and acrylic resin samples when the various materials were interposed between them was evaluated by means of a testing apparatus. Denture adhesives increase the adhesion of resin samples to the glass surface. Fixon powder showed the highest resistance to dislodgement. The paste forms were found to be more retentive. Denture adhesives when used in combination with synthetic saliva showed the maximum value.