Brushing associated with oral irrigation in maintaining implants and overdentures hygiene – a randomized clinical trial

Odontology - Evaluate, through a randomized clinical trial, the efficacy of brushing associated with oral irrigation in maintaining implant and overdenture hygiene. Thirty-eight participants, who...     

Clinical and antimicrobial efficacy of NitrAdine ™-based disinfecting cleaning tablets in complete denture wearers

Objective

This study evaluated the efficacy of NitrAdine^TM-based disinfecting cleaning tablets for complete denture, in terms of denture biofilm removal and antimicrobial action.

Material and methods

Forty complete denture wearers (14 men and 26 women) with a mean age of 62.3±9.0 years were randomly assigned to two groups and were instructed to clean their dentures according to two methods: brushing (control) - 3 times a day with denture brush and tap water following meals; brushing and immersion (experimental) - brushing the denture 3 times a day with denture brush and tap water following meals and immersion of the denture in NitrAdine^TM-based denture tablets (Medical Interporous^TM). Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface before and after the use of the product. Microbiological assessment was conducted to quantify Candida sp.

Results

An independent t-test revealed a significant lower biofilm percentage for the experimental group (4.7, 95% CI 2.4 to 7.9) in comparison with the control group (mean 37.5, 95% CI 28.2 to 48.1) (t38=7.996, p<0.001). A significant reduction of yeast colony forming units could be found after treatment with Medical Interporous^TM denture tablets as compared to the control group (Mann-Whitney test, Z=1.90; p<0.05).

Conclusion

The present findings suggest that NitrAdine^TM-based disinfecting cleaning tablets are efficient in removal of denture biofilm. In addition, a clear antimicrobial action was demonstrated. Therefore, they should be recommended as a routine denture maintenance method for the prevention of the development of microbial biofilm-induced denture stomatitis.     

Prevalence of mutans streptococci isolated from complete dentures and their susceptibility to mouthrinses

The aims of this study were to evaluate the incidence of mutans streptococci (MS - sessile form) on complete maxillary dentures after use of a specific denture paste, and to determine the minimum inhibitory concentration (MIC) and maximum inhibitory dilution (MID) of 3 oral mouthrinses: Cepacol, Plax and Periogard. Seventy-seven complete denture wearers were randomly assigned into 2 groups, according to the product used for denture cleaning: Control group - conventional dentifrice (Kolynos-Super White); and Test group: experimental denture cleaning paste. Denture biofilm was collected at baseline and after 90 and 180 days after treatment by brushing the dentures with saline solution. After decimal serial dilution, samples were seeded onto agar sucrose bacitracin to count colonies with morphological characteristics of MS. MS identification was performed by the sugar fermentation tests. After this procedure, brain heart infusion broth (BHI) was added to oral mouthrinses (Plax, Cepacol e Periogard) and seeded on Petri dishes. The colonies were seeded using the Steers multiplier and, after the incubation, the MIC and MID of the mouthrinses were calculated. The results showed an incidence of 74.0% (n=57) of MS in the 77 complete dentures examined in the study, being 76.3% (n=29) of the Control group (conventional dentifrice) and 71.8% (28) of the Test group (experimental denture cleaning paste). In both groups, the number of positive cases for MS decreased from day 0 to day 180. In the Test group there was a slight decrease in the incidence of Streptococcus mutans 90 days after use of the experimental denture cleaning paste, which was not observed in the Control group. As regards to mouthrinses, for both groups, Periogard showed antimicrobial action with the highest dilution, followed by Cepacol and Plax. In conclusion, the incidence of MS in complete dentures was high and Periogard was the mouthrinse with the strongest antimicrobial action against MS. The experimental denture cleaning paste showed a slight action against S. mutans after 90 days of treatment.     

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.     

Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial

Statement of problem

The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism.

Bond Strength and Degree of Infiltration between Acrylic Resin Denture Liner after Immersion in Effervescent Denture Cleanser

Purpose: The purpose of this study was to investigate the effect of sodium perborate on the bond strength and degree of infiltration between acrylic resin/resilient denture liners. Materials and Methods: Three denture liners (Elite Soft, Mucopren Soft, Kooliner) were investigated. Twenty specimens (83 × 10 × 10 mm³) of each material were made by processing the denture liners against two polymerized PMMA blocks. Ten specimens for each material were stored in artificial saliva at 37°C (control group: TBS1), and the other ten specimens were stored in artificial saliva at 37°C combined with sodium perborate (experimental group: TBS2). All specimens were placed under tension until failure in a Universal Testing Machine at a crosshead speed of 5 mm/min after 7 (T7) and 60 (T60) days (n = 5). Failure strength (MPa) was recorded, and mode of failure was characterized as cohesive, adhesive, or cohesive/adhesive. For the infiltration tests, ten circular specimens (14‐mm diameter × 2‐mm thick) of each material were stored in artificial saliva and 0.5% methylene blue at 37°C (control group: I1), and ten specimens were stored in artificial saliva and 0.5% methylene blue at 37°C combined with daily immersions for 5 minutes in an effervescent solution of sodium perborate (experimental group: I2). The degree of infiltration was obtained through photographs and using Software Image Tool after 120 days. Results: For Kooliner, the statistical test did not show a significant difference in the bond strength due to the influence of the immersion period or to the use of sodium perborate. Elite Soft presented a significant increase in the average tension in T7 and in T60 in both TBS1 and TBS2. Inversely, the Mucopren suffered a significant decrease in the tension value in the same period as the TBS1 group as well as in the TBS2. The infiltration percentage was analyzed with the Kruskal–Wallis test (26.18; p < 0.05), which indicated significant differences between the compared averages for the groups. Comparing the averages of materials, the statistical test did not show significant differences between the control (I1) and experimental (I2) groups after 120 days. Conclusions: The use of sodium perborate did not promote significant alterations in the evaluated properties. Kooliner presented the best results.     

Evaluation of a Computerized Method for Denture Biofilm Quantification: Inter-Examiner Reproducibility

Purpose: The objective of this work was to evaluate the accuracy and inter-examiner reproducibility of the computerized method Image Tool 2.02 (Windows, version 2.02, University of Texas Health Science Center, San Antonio, TX) in the quantification of complete denture biofilm.
Materials and Methods: Two hundred digital photographs of the internal surface of complete upper dentures with biofilm dyed in 1% neutral red were used. The photographs were burned to a CD and sent to two researchers who received practical training and written instructions on how to use the method; then, in a 20-day period, the stained biofilm on the internal surface was measured, and ten photographs were analyzed daily. Each examiner independently quantified the percentage of stained area on each photograph. The inter-examiner reproducibility (i.e., agreement) was estimated by calculating an intra-class correlation coefficient (ICC) based on an ANOVA mixed model (SPSS software, Chicago, IL).
Results: The ICC showed excellent agreement (ICC = 0.993, p < 0.001). The difference in the percentage of the stained area recorded by the two examiners was ≤1 point for 187 (93.5%) of the 200 photographs.
Conclusions: The obtained results suggest that the computerized method aided by the Image Tool software (2.0) can be employed to quantify complete denture biofilm, seeing that it demonstrated inter-examiner reproducibility of the results.     

Abrasiveness of conventional and specific denture-cleansing dentifrices

This study analyzed the weight loss and surface roughness caused in Plexiglass specimens by conventional dentifrices (Sorriso, Colgate and Close Up) and specific dentifrices used for cleaning of dentures (Corega and Dentu Creme). Plexiglass specimens were divided into 6 groups (n=6) including: a control (distilled water - DW) and experimental groups. Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension and DW according to different brushing times (50, 100, 200 and 250 min -18,000, 36,000, 72,000 and 90,000 cycles, respectively, calculated to correspond to 1, 2, 4 and 5 years of regular brushing). The results of weight loss and surface roughness were analyzed by ANOVA and Tukey's test at 5% significance level. In all tested times, the effect of DW was insignificant. Dentifrices differed significantly from DW in the initial period. Corega dentifrice caused greater mass loss in all studied times, followed by Close Up. Dentifrices resulted in a surface roughness similar to the DW at 50 min. In the other times, Sorriso, Colgate and Corega caused more surface roughness than DW. In conclusion, specific dentifrices caused larger mass loss and lower surface roughness as conventional dentifrice.     

Trial of experimental toothpastes regarding quality for cleaning dentures

The aim of this study was to evaluate the efficacy of experimental toothpastes for removing denture biofilm by means of a randomized crossover trial. Thirty volunteers brushed their dentures using a brush and four pastes: (1) Corega refreshing mint (control), (2) 0.2% chloramine T, (3) 1.0% chloramine T, and (4) 0.01% fluorosurfactant. Each paste was used for 7 days, and participants were randomized to use them according to one of four sequences. Biofilm was disclosed (neutral red) after each period, photographed, and quantified by means of a software program. All experimental toothpastes were similar to the control in terms of posttreatment biofilm coverage.     

Effect of Three Methods for Cleaning Dentures on Biofilms Formed In Vitro on Acrylic Resin

Purpose: The aim of this study was to evaluate the effect of three denture hygiene methods against different microbial biofilms formed on acrylic resin specimens.
Materials and methods: The set (sterile stainless steel basket and specimens) was contaminated (37°C for 48 hours) by a microbial inoculum with 10⁶ colony-forming units (CFU)/ml (standard strains: Staphylococcus aureus , Streptococcus mutans , Escherichia coli, Candida albicans, Pseudomonas aeruginosa , and Enterococcus faecalis ; field strains: S. mutans , C. albicans , C. glabrata , and C. tropicalis ). After inoculation, specimens were cleansed by the following methods: (1) chemical: immersion in an alkaline peroxide solution (Bonyplus tablets) for 5 minutes; (2) mechanical: brushing with a dentifrice for removable prostheses (Dentu Creme) for 20 seconds; and (3) a combination of chemical and mechanical methods. Specimens were applied onto a Petri plate with appropriate culture medium for 10 minutes. Afterward, the specimens were removed and the plates incubated at 37°C for 48 hours.
Results: Chemical, mechanical, and combination methods showed no significant difference in the reduction of CFU for S. aureus , S. mutans (ATCC and field strain), and P. aeruginosa . Mechanical and combination methods were similar and more effective than the chemical method for E. faecalis , C. albicans (ATCC and field strain), and C. glabrata . The combination method was better than the chemical method for E. coli and C. tropicalis , and the mechanical method showed intermediate results.
Conclusion: The three denture hygiene methods showed different effects depending on the type of microbial biofilms formed on acrylic base resin specimens.