Oral hygiene habits, denture cleanliness, presence of yeasts and stomatitis in elderly people

Assessment of Hygiene Habits in Acrylic Denture Wearers: a Cross-sectional Study

Objectives:

To assess the denture hygiene habits in a population of Lebanese denture wearers.

Materials and Methods:

One hundred and thirty-two (132) patients [71 women (53.8%) and 61 men (46.2%)] wearing their acrylic dentures for more than two years were included in this study. The hygiene methods related to their dentures were evaluated and the data obtained were analyzed statistically using the IBM^® SPSS^® statistics 20.0 (USA) statistical package.

Results:

Regardless of the cleaning technique, the big majority of our participants [123 out of 132 (93.1%)] cleaned their dentures daily. The two mostly used denture cleaning techniques were rinsing with tap water (34.1%) and brushing with toothpaste (31.8%). Nearly half of our patients (45.5%) soaked their dentures during the night; most of them with cleansing tablets dissolved in water (28.8%).

Conclusions:

Within the limitations of our study, it was concluded that in a sample of Lebanese population surveyed about denture hygiene habits, the daily frequency of denture cleaning is satisfactory, but the techniques and products used were self-estimated and, consequently, not sufficient.

Antifungal and Mechanical Properties of Tissue Conditioner Containing Plant-Derived Component: An In Vitro Study

PURPOSE

To evaluate the antifungal activity and mechanical properties of a novel antifungal tissue conditioner containing Juncus powder.

MATERIALS AND METHODS

Juncus powder was mixed with GC tissue conditioner at concentrations of 2.5%, 5.0%, and 10.0% by mass. The cylindrical specimens of Juncus-mixed tissue conditioner (dimensions: 10 mm in diameter and 2 and 6 mm in height for antimicrobial and mechanical tests, respectively) were prepared. The specimens placed on the bottom of the 24-well tissue culture plate were cultured with Candida albicans CAD1 for 2 and 4 days. The proliferation of the C. albicans in the wells was determined by measuring the optical density of fungal culture, and the surface of the specimens were also observed by scanning electron microscopy (SEM). To assess the mechanical properties of the specimens, the fluidity and hardness of Juncus-mixed tissue conditioner were measured using the methods certified according to ISO 10139-1.

RESULTS

Juncus-mixed tissue conditioner significantly exhibited growth inhibitory effect in a Juncus concentration-dependent manner after both 2- and 4- day cultures. SEM observation showed that the amount of C. albicans on Juncus-mixed specimens drastically decreased, and biofilm formation was markedly inhibited. Moreover, both mechanical properties were found to be within the ranges regulated and specified by ISO.

CONCLUSION

These findings demonstrated that the tissue conditioner including Juncus powder has a significant growth inhibitory effect against C. albicans, and it is suggested that the application of Juncus-mixed tissue conditioner may prevent denture stomatitis and oral candidiasis in denture wearers.

Laboratory-Based Investigation of Denture Sonication Method in Patients with Candida-Associated Denture Stomatitis

PURPOSE

Denture stomatitis (DS) is a disease characterized by inflammation and erythema of the oral mucosa areas covered by the denture. Multifactorial etiological factors contribute to DS, but it seems that Candida plays the key role. The aim of the study was to evaluate the denture sonication method to: (i) increase the possibility of diagnosing patients with Candida-associated DS; (ii) detect and identify the mixed Candida spp., and (iii) determine the Candida colony forming units (CFU) and its possible relationship with DS severity, based on Newton's classification.

MATERIALS AND METHODS

The cross-sectional study conducted at the Clinic for Dental Prosthetics, Belgrade (Serbia) from June 2013 to December 2014 enrolled edentulous patients with dentures (n = 250). Patients without DS (n = 20) were the control group (CG). The patients' data were collected, and patients with DS (study group/SG) were selected and divided into SG Candida+ and SG Candida-. Based on severity of DS, the SG patients were classified in 3 groups (Newton's classification). Four sampling methods were applied to detect patients with Candida-associated DS: mucosa swab, denture swab, oral rinse, and denture sonication method. The sensitivity and specificity of denture sonication method were shown using the receiver operating characteristic (ROC) curve and the area under the curve (AUC).

RESULTS

In 97 (38.8%), out of 250 clinically examined patients, DS was diagnosed. In 82 (84.5%), out of 97 mycologically examined patients, Candida-associated DS was detected when denture sonication method was applied. Additionally, using the denture sonication method we observed: (i) the largest number of Candida positive patients compared to other sampling methods (p < 0.0001); (ii) the highest number of Candida CFU/ml (10⁵ ), and (iii) the possibility to detect mixed Candida cultures. The largest number of patients with Candida-associated DS showed type II (60%) DS, followed by type I (21%), and type III (19%) DS.

CONCLUSION

The denture sonication method is easy, accurate, and sensitive, and increases the possibility of diagnosing patients with Candida-associated DS. Additionally, yeast quantification, mixed Candida spp., and non-albicans Candida were detectable when cultivation on Candida CHROMagar was performed. It was not possible using conventional methods, such as swab or oral rinse.

Denture Hygiene Knowledge and Practices among Complete Denture Wearers attending a Postgraduate Dental Institute

AIMS

The aim of this study was to assess the denture hygiene knowledge and practices among patients using complete dentures attending a postgraduate dental hospital in Jabalpur city. The objective of this study was to assess the relationship between hygiene knowledge and practices to the denture wearer's gender, education, and income.

MATERIALS AND METHODS

A descriptive, cross-sectional survey was conducted using a self-administered questionnaire involving the complete denture patients attending the Department of Prosthodontics. The study subjects were randomly selected by recruiting old dentures wearers visiting the Department of Prosthodontics for a recall visit or for new dentures on the odd dates of the month. All subjects signed an informed consent before filling the questionnaire. The institutional review committee approved the study. Descriptive statistics included computation of frequencies and percentages. Nonparametric test, namely, chi-square test, was used for further data analysis; p-value <0.05 was considered statistically significant.

RESULTS

A total of 530 individuals were approached for participation in our survey, 30 (5.66%) subjects declined to participate. The results showed that 195 (39%) subjects were wearing the same dentures for more than 5 years. In this study, 51 (10.2%) subjects reported never having been advised by their dentists as to how to clean their dentures. Among all the subjects interviewed, 264 (52.8%) reported to clean the oral tissues daily. This study disclosed that 66 (13.2%) of the subjects usually slept with their dentures. Maximum subjects in illiterate group had experienced bad breath sometimes when compared with subjects in postgraduate group (χ² = 47.452, p < 0.001). There was a significant difference for method of denture cleaning according to gender (χ² = 101.076, p < 0.001).

CONCLUSION

The majority of the denture wearers have limited knowledge of denture cleansing and oral hygiene practices. Hygiene habits and practices may not always present a positive correlation with the gender, educational level, and income of the subjects.

CLINICAL SIGNIFICANCE

Periodic recall for evaluation of denture and mucosal surfaces along with reinforcement of denture hygiene instructions will go a long way in helping the patients reap maximum benefits out of their prostheses.

Inhibition of denture plaque deposition on complete dentures by 2-methacryloyloxyethyl phosphorylcholine polymer coating: A clinical study

STATEMENT OF PROBLEM

Denture plaque-associated infections are regarded as a source of serious dental and medical complications in the elderly population. Methods of managing this problem are needed.

PURPOSE

The purpose of this clinical study was to evaluate the effects of treatment with a 2-methacryloyloxyethyl phosphorylcholine polymer, PMBPAz, on plaque deposition in complete dentures.

MATERIAL AND METHODS

The study protocol was approved by the Ethics Committee of Showa University (#2013-013). Eleven individuals with maxillary complete dentures participated in this study. Their dentures were treated with PMBPAz, and the amount of denture plaque accumulation was evaluated by staining the denture surfaces with methylene blue after 2 weeks of denture usage. The same procedures were repeated to evaluate the original denture surfaces as a control. The image of the stained denture surface was captured using a digital camera, and the percentage of stained area, quantified as a pixel-based density, of the whole denture area (percentage of plaque index) was calculated for the mucosal and polished surfaces. To quantify the biofilm on the dentures, denture plaque biofilm was detached by ultrasonic vibration, resuspended in diluent, and measured with a microplate reader at an optical density of 620 nm. The effects of PMBPAz treatment on these variables were statistically analyzed with ANOVA (α=.05).

RESULTS

The mean ±SD percentage of plaque index was 40.7% ±19.9% on the mucosal surfaces and 28.0% ±16.8% on the polished surfaces of the control denture. The mean percentage of plaque index of PMBPAz-treated dentures significantly decreased to 17.4%% ±12.0% on the mucosal surfaces (P<.001) and 15.0% ±9.9% on the polished surfaces (P<.05). The quantification of plaque deposition agreed with the results of these image analyses.

CONCLUSIONS

These results demonstrated the effectiveness of the treatment with the PMBPAz to inhibit the bacterial plaque deposition on complete dentures.

Improving practice guidelines for the treatment of denture-related erythematous stomatitis: a study protocol for a randomized controlled trial

Background

Denture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy. The objective of this study is to validate these pilot results by means of a randomized controlled trial (RCT) and provide a practice guideline for clinicians.

Methods/design

A pragmatic, two-parallel-arm, multicenter RCT will be conducted in Canada, Brazil, and Chile. Fifty-two adult complete denture wearers presenting with moderate to severe DES will be allocated randomly to two groups: the Intervention arm will consist of palatal brushing and standard oral and denture hygiene measures, while the Control arm will include only standard oral and denture hygiene measures. The study outcome will be the oral Candida carriage. Participants will be assessed at baseline, and at 3 and 6 months post intervention. Descriptive, bivariate, and mixed models with repeated measures will be performed following the intention-to-treat principle.

Discussion

This pragmatic RCT will serve to provide a clinical practice guideline regarding the use of preventive measures in the treatment of biofilm-mediated oral diseases. Moreover, it will have a great impact on reducing the harm of antifungal overtreatment on patients suffering from DES.

Trial registration

ClinicalTrials.gov, NCT02686632. Registered on 15 February 2016.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-1947-y) contains supplementary material, which is available to authorized users.

Inflammatory papillary hyperplasia: A systematic review

INTRODUCTION

Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use.

OBJECTIVES

The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated.

MATERIAL AND METHODS

A search was carried out in PubMed (January 2005 to October 2015) with the key words "inflammatory papillary hyperplasia", "denture stomatitis", "granular stomatitis" and "Newton's type III" The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies.

RESULTS

Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH.

CONCLUSIONS

IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual.

Efficacy of Denture Cleansers on Impact Strength of Heat polymerized Acrylic Resins

Purpose:

The study was aimed to compare and evaluate the changes in the impact strength of heat cure denture base resins when treated using denture cleansers.

Methodology:

Study was conducted with sample size of 40 and dimesion 65 mm length, 10 mm width, and 3 mm thickness as per the ISO 1567. Distilled water has been used as control group, in which 10 samples were immersed of 40 samples. Of remaining 30 samples, 10 were treated with Clinsodent, 10 were treated with VI-Clean, and 10 were treated with Clanden denture cleansers. The impact strength of these specimens from each group was tested with the help of Charpy-type pendulum impact strength tester. The energy absorbed to fracture the specimens was recorded, and impact strength was calculated and was analyzed using Kruskal–Wallis ANOVA and Mann–Whitney test.

Results:

Impact strength of samples was significantly reduced after immersion in denture cleansers Clinsodent, VI-Clean, and Clanden solutions when compared to control group.

Conclusion:

Clinsodent, VI-Clean, and Clanden denture cleansers decrease the impact strength of heat cure denture base resin after immersion. Hence, the study concludes that denture cleansers should be used with caution and advised to follow manufacturer's instructions.

The Efficacy and Safety of Miconazole Nitrate Mucoadhesive Tablets versus Itraconazole Capsules in the Treatment of Oral Candidiasis: An Open-Label, Randomized, Multicenter Trial

Background

Oral candidiasis (OC) is a common oral fungal infection. Recently, miconazole mucoadhesive tablets have been gaining attention for OC treatment. Despite trials in patients with human immunodeficiency virus and cancer, evidence of its application in the large-scale, general population with OC is lacking. This study aimed to evaluate the efficacy and safety of miconazole nitrate mucoadhesive tablets in comparison with itraconazole capsules for OC treatment.

Methods

The study was a randomized, open-label, parallel-armed, multicenter clinical trial. Totally, 343 patients diagnosed with OC, who met the inclusion criteria, were randomly assigned to either a treatment group that received miconazole nitrate mucoadhesive tablets (10 mg) once daily or a control group that received itraconazole capsules (100 mg QD) for 2 weeks, and were followed up for 2 weeks. The clinical cure, improvement of clinical symptoms/signs, mycologic cure, and safety were evaluated.

Results

The mucoadhesive tablets (n = 171) did not show inferiority to itraconazole (n = 172) in the treatment of OC. At the end of the 14-day treatment, the clinical cure rates were 45.29% and 41.76% in the miconazole and itraconazole groups, respectively (P = 0.3472). At the end of the 14-day follow-up, the clinical cure rates were 51.18% and 41.76% in the miconazole and itraconazole groups, respectively (P = 0.0329). Adverse events occurred in 53 subjects (33 in the miconazole group and 20 in the itraconazole group). There was no statistical difference in the safety profile between miconazole and itraconazole (P = 0.0533). Thrombocytopenic purpura, although rare, occurred in one patient in the miconazole group and was considered a drug-related, severe adverse event.

Conclusion

Miconazole nitrate mucoadhesive tablets may be as effective as systemic itraconazole capsule for OC treatment. Physicians should be cautious about thrombocytopenic purpura occurring as a rare and serious adverse event of miconazole nitrate.

Trial Registration

Chinese Clinical Trial Register ChiCTR-TRC-13003935

EVALUATION OF DENTURE-RELATED FACTORS PREDISPOSING TO DENTURE STOMATITIS IN A LEBANESE POPULATION

BACKGROUND

Denture stomatitis is a common fungal oral infection of multifactorial etiology. Denture-related factors such as denture's age, hygiene, night wearing and colonization by Candida albicans are known to predispose to denture stomatitis. The aim of this study was to evaluate these factors and their relationship with the occurrence of denture stomatitis in a Lebanese population.

MATERIAL AND METHODS

Sixty patients (40 women, 20 men; age range 40-80 years) showing clinical evidence of denture-related stomatitis were selected for this study. Swab samples from the palate and the palatal surfaces of the upper dentures of these patients were collected and examined mycologically. Denture's age, hygiene, night wearing and colonization by Candida albicans were evaluated and analyzed statistically.

RESULTS

The statistical analysis showed a significant role for denture's hygiene, night wearing, and colonization by Candida albicans in the installation of the denture stomatitis. Patient's gender and age, as well as the denture's age, were not significant predictors of the disease.

CONCLUSION

In a sample of Lebanese population, poor denture hygiene, continuous denture use, and Candida denture colonization are important etiological factors that contribute to denture stomatitis.

In Vitro Effectiveness of a Terpenic Denture Cleanser on Old Biofilm Surfaces

PURPOSE

To assess the effects of terpenic denture cleanser on denture biofilm removal using scanning electron microscopy (SEM).

MATERIALS AND METHODS

The internal surface biofilm of four maxillary dentures was elucidated with Caristop-revelador Dual Tone, and 40 blue-stained specimens (0.6 cm × 0.4 cm × 2 mm) were obtained. These specimens were randomly assigned to one of the following four groups of 10 specimens each: control, Eci Clean, Fitty Dent, and terpenic denture cleanser. The period of immersion in each solution was 12 hours. Biofilm removal was evaluated using SEM, and morphologically varying areas of the SEM images were quantified with Imaris software. The data were analyzed using Kolmogorov-Smirnov, t-tests, ANOVA, and Tamhane's tests (p = 0.05).

RESULTS

Data revealed that terpenic denture cleanser removed significantly more biofilm than any other treatment examined in this study. The t-tests revealed significant differences in the clean area that resulted from the use of the terpenic cleanser compared with the clean area that resulted from the use of Eci Clean (p = 0.013). Fitty Dent was the least effective and left dirty acrylic resin. The average areas with few removed layers were 59.3%, 43.3%, and 9.5% in Fitty Dent, Eci Clean, and terpenic cleanser groups, respectively. Tamhane's tests indicated that the Eci Clean and Fitty Dent groups were significantly different from the 0.5% terpenic cleanser group (p = 0.008).

CONCLUSION

The terpenic denture cleanser was effective in removing denture biofilm.

Evaluating denture cleanliness of patients in a regional dental hospital

Aims To evaluate the quality of clinical record keeping and determine quality of denture cleanliness; record baseline denture cleanliness for 60 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping.Methods Analysis of patients' denture hygiene instruction record keeping (n = 60) was undertaken retrospectively. The Denture Cleanliness Index (DCI) was utilised to assess denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered. After one month, patients were reviewed and scored, with record keeping quality analysed.Results At baseline, 11.7% (n = 7) of patients had DCI scores of ≤2, improving to 93.8% (n = 45) after one month, demonstrating short-term improvement in denture cleanliness. Only 63% (n = 38) of patients had evidence of a record of DHI within their notes at baseline, improving to 100% at recall.Conclusions New patient information leaflet and clinical guidelines on denture hygiene have been written and implemented. The results of this study suggest that this may be a relatively straightforward method to achieve a short-term improvement in denture cleanliness. The implementation of a DCI score is helpful in allowing patients to improve denture hygiene and its wider use is supported.

Accelerating effects of cellulase in the removal of denture adhesives from acrylic denture bases

PURPOSE

Studies of effective methods for the easy removal of denture adhesives from a denture base are not well represented in the literature. We previously assessed the removability of denture adhesives by immersing within denture cleaners, showing that some cleaners have a weak effect, insufficiently effective in daily use. In this study, we prepared a cellulase, as a potential component for denture adhesive removers, and we examined whether the addition of cellulase to denture cleaners is effective in the removal of cream denture adhesives.

METHODS

We prepared the cellulase Meicelase as one component for the liquefaction of denture adhesives. We used two denture cleaners and two cream adhesives. After the immersion of plates in sample solutions, we evaluated the area of the sample plate still covered with adhesives. Biofilm removal assay was also performed using denture cleaners containing cellulase.

RESULTS

The addition of cellulase accelerated the removal of cream adhesives in immersion experiments to a rate faster than that of water and denture cleaners. However, it did not influence the removability of Candida albicans biofilms from acrylic resin specimens.

CONCLUSION

Cellulase hastened the liquefaction of cream adhesives.

Denture hygiene knowledge, attitudes, and practices toward patient education in denture care among dental practitioners of Jabalpur city, Madhya Pradesh, India

CONTEXT

Researchers have concentrated their focus on denture wearer's attitude and practice toward denture cleansing despite the fact that they should be more focused on the attitudes of the dentists' themselves towards patient education at the time of denture delivery. It is an obligation of every dentist to motivate, instruct and provide the means and methods of plaque control for their patients.

AIMS

The aim was to assess the denture hygiene knowledge, attitudes and practice towards patient education in denture care among dental practitioners (DPs) of Jabalpur city, Madhya Pradesh, India.

MATERIAL AND METHODS

A total of 168 dental practitioners completed a comprehensive questionnaire. All participants signed an informed consent before answering the questionnaire. The institutional review committee approved the study.

STATISTICAL ANALYSIS

Chi-square test for non-parametric study was employed to determine the statistical difference between the two groups. A P-value of 0.05 was considered to be statistically significant.

RESULTS

Most of the subjects were qualified with a bachelor degree 142 (85%). 25 (18%) subjects did not associate oral biofilms on complete denture with conditions like denture stomatitis and other serious systemic diseases. Approximately half of the DPs 69 (48%) and specialists 8 (31%) agreed that explaining denture hygiene instructions to old patients can be very time consuming. A recall program for their patients is of importance according to 39 (27%) of DPs and 3 (12%) specialists.

CONCLUSIONS

It may be concluded that the study subjects had limited knowledge of denture cleansing materials and denture hygiene importance. Attitudes varied among the subjects when it came to sharing information with their patients.

Role of antifungal medicaments added to tissue conditioners: A systematic review

PURPOSE

The aim of this review is to investigate the current state of knowledge on the incorporation of antifungal agents into the tissue conditioners for the treatment of denture induced stomatitis.

STUDY SELECTION

Studies reporting the incorporation of antifungal/antimicrobial agents in to tissue conditioners were included in the review. In order to search the studies on the topic "incorporation of antifungal agents in tissue conditioners for the treatment of denture induced stomatitis" ISI web of science, PubMed/MEDLINE, and Google-Scholar databases were searched from 1970 up to and including July 2015 using various keywords such as antifungal agents, tissue conditioners, Candida albicans, denture stomatitis, etc.

RESULTS

Various studies reported the efficacy and effectiveness of adding conventional organic antifungal medicines (nystatin, azole group derivatives and chlorhexidine, antimicrobials/antifungals other than organic (silver zeolite, silver nano-particles, photo-catalysts and metallic oxides) and natural and herbal antimicrobials (tea tree oil, lemongrass essential oil and origanum oil) into various tissue conditioners. The review literature reported that incorporation of antifungal agents into tissue conditioners is effective with minimal or no effects on physical and mechanical properties of tissue conditioners.

CONCLUSIONS

Incorporation of different antifungal medicaments to commercially available tissue conditioners can be recommended for the management of denture induced stomatitis.

In Vitro Analysis of Surface Roughness of Acrylic Resin Exposed to the Combined Hygiene Method of Brushing and Immersion in Ricinus communis and Sodium Hypochlorite

PURPOSE

To evaluate a solution based on Ricinus communis (Castor oil) for denture cleansing, comparing it to sodium hypochlorite (NaOCl) for the surface roughness of heat-polymerized acrylic resin.

MATERIALS AND METHODS

Forty polished and unpolished resin specimens (90 × 30 × 4 mm) were evaluated before and after their exposure to protocol hygiene: brushing the specimens with a specific denture brush and mild soap for 3 minutes, three times a day, and immersing them in hygiene solutions (0.25% NaOCl-S1 and 0.5% NaOCl-S2; 10% R. communis-S3; saline-S4: control) for 20 minutes. Surface roughness was evaluated by rugosimeter and scanning electron microscopy (SEM) before and after the protocol. For evaluation of surface roughness, polished and unpolished surfaces were used.

RESULTS

The roughness of the polished surface was not affected by time (p = 0.062), but was affected by solutions (p < 0.0001) and the interaction between factors (p = 0.005). For S1 and S4, the period did not influence the roughness. For S2, there was a change after 7 days, remaining stable after 14 days. For S3, there were changes, and stabilization occurred after 14 days. After 7 and 14 days, S2 and S3 promoted major changes, but after 21 days, there were no differences among solutions, except saline. The unpolished surface was not influenced by factors: period (p = 0.115), solution (p = 0.120), and their interaction (p = 0.382). SEM analysis showed similar results on the evaluation of surface roughness.

CONCLUSIONS

The polished surface of the prosthesis was more susceptible to changes when exposed to hygiene solutions, and although the 0.5% NaOCl solution promoted an increase in the surface roughness compared with the same solution at 0.25% and R. communis at 10%, the values are clinically acceptable.

Effect of denture cleansing solutions on different retentive attachments

STATEMENT OF PROBLEM

Various Locator abutments and attachments are available commercially for use in overdenture patients. Patients are advised to use cleansing agents to keep their overdentures clean. The effect of different cleansing agents on attachments with different retention is not known.

PURPOSE

The purpose of this in vitro study was to evaluate the retention of 3 Locator abutment attachments after they were soaked in 3 different cleansing solutions.

MATERIAL AND METHODS

An implant analog with a diameter of 4.1 mm was embedded into acrylic resin, and 1 Locator abutment was placed onto the analog. Seven specimens of clear, pink, and blue Locator attachments (n=7) were soaked in 3 different denture-cleansing solutions (NaOCl, sodium perborate, sodium perborate-sodium bicarbonate) for a time simulating 6 months of clinical use. The control group was soaked in tap water. A testing machine was used to test the attachments' retention. The retention of the attachments after they were soaked in denture cleansers was compared among the groups with repeated-measures analysis of variance followed by the Tukey HSD test (α=.05).

RESULTS

The retention of the clear attachments was significantly less after they had been soaked in sodium bicarbonate-containing denture cleanser (P=.001). The retention of the pink Locator attachments was no different after they had been soaked in the different solutions, and the retention of the blue Locator attachments decreased significantly after they had been soaked in the NaOCl and sodium bicarbonate cleansing agents (P=.002).

CONCLUSIONS

Attachments of different colors and retention were affected differently by cleansing agents.

Effect of denture-coating composite on Candida albicans biofilm and surface degradation after disinfection protocol

INTRODUCTION

Denture stomatitis is the most common pathology affecting denture wearers and its main cause is colonisation of dentures with Candida albicans.

OBJECTIVE

This study investigated the effectiveness of two commercial composite surface sealants (Biscover(®) LV and Surface Coat(®)) to reduce C. albicans biofilm colonisation on denture resin, as well as their surface integrity after disinfection cycles with 1% sodium hypochlorite solution.

METHODS

Heat-cured acrylic resin specimens were manufactured (10 mm × 10 mm × 1 mm). The specimen surfaces were mechanically polished to simulate rough or smooth denture surfaces. Four surface-treatment groups were tested: smooth surfaces [0.3 μm of mean roughness (Ra)]; rough surfaces (3 μm of Ra); rough surfaces treated with Biscover(®) LV; and rough surfaces treated with Surface Coat(®). Specimens of each group were randomly divided to undergo immersion in distilled water or 1% sodium hypochlorite for 30 or 90 cycles each. Specimens of all groups in each immersion solution were tested using a crystal violet (CV) staining assay for biofilm quantification and by scanning electron microscopy for visual analyses of surface integrity and biofilm structure. CV assay data were analysed using one-way analysis of variance (ANOVA) followed by Tukey's multiple comparison test (P < 0.05).

RESULTS

The effectiveness and surface integrity of Biscover(®) LV-treated surfaces were similar to those of smooth surfaces, whereas Surface Coat(®) -treated surfaces presented a similar performance to rough surfaces in all solutions and cycles.

CONCLUSION

These results suggest the possibility of clinical use of Biscover(®) LV for denture coating on surfaces in which mechanical polish is not indicated, such as the fitting surface.

Impact of Denture Cleaning Method and Overnight Storage Condition on Denture Biofilm Mass and Composition: A Cross-Over Randomized Clinical Trial

Background

Appropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures.

Methods

In a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%.

Results

Overnight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores.

Conclusions

The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing.

Trial Registration

ClinicalTrials.gov NCT02454413

Is Cognitive Status Related to Oral Hygiene Level and Appropriate for Determining Need for Oral Hygiene Assistance?

BACKGROUND

With declining general health, the maintenance of oral health becomes increasingly difficult. Unfortunately, health care resources are limited. An assessment tool for detecting a patient's need for oral health care assistance would promote its adequate distribution. The aim of this study is to evaluate if the Shulman clock-drawing test score is a suitable assessment tool for determining the need for oral hygiene assistance.

METHODS

Data collected from recent dental checkups of 126 inhabitants of five Austrian residential care facilities were analyzed. The Shulman clock-drawing test score was used as a measure for cognitive abilities and related to tooth and denture hygiene indices, which were assessed using the approximal space plaque index (API) and the denture plaque index (DPI).

RESULTS

Shulman score values were distributed almost evenly in the study population. The mean API was 83.6% (SD 20.2%) for the maxilla and 94.9% (SD 15.6%) for the mandible. The mean DPI was 43.9% (SD 31.4%). Cognitive impairment was not statistically related to the dental or denture hygiene index.

CONCLUSIONS

A high Shulman clock-drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients' dentures should be part of nursing personnel's daily care routine for every patient.

Denture care practice among patients attending the prosthetic clinic in a Nigerian teaching hospital

Background:

Good denture care practice by individuals using Removable Partial Denture (RPD) is an important component of oral health measures. An assessment of denture care practice of such individuals by dental care practitioners is necessary.

Objective:

To evaluate the denture care practice among prosthetics patients attending a tertiary Hospital Dental Centre in Nigeria.

Materials and Methods:

An interviewer administered questionnaire was used to obtain information from RPD wearers that were willing to participate. The questionnaire assessed among other things, patients’ bio-data, frequency, techniques and device used for cleaning their dentures. Data was analyzed using Chi-square test (P < 0.05).

Results:

One hundred and ninety eight denture wearers consisting of 100 (50.5%) males and 98 (49.5%) females participated in the study. Majority 110 (55.6%) cleaned their dentures once daily and toothbrush and pastes were used by 105 (53%) of the participants. More than 70% of the respondents removed their dentures at night. One hundred and sixty-six (83.8%) visited the dentist only when they needed treatment. There was a statistical significant relationship between frequency and technique of cleaning denture, and denture cleanliness (P < 0.05).

Conclusion:

This study shows that once daily cleaning of dentures and cleaning the denture with rest of the teeth are ineffective in prevention of plaque accumulation.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study

BACKGROUND

Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures.

MATERIALS AND METHODS

Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically.

RESULTS

Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group.

CONCLUSION

A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Toothbrush Handles Individually Adapted for Use by Elderly Patients to Reduce Biofilm on Complete Dentures: A Pilot Study

INTRODUCTION

Reduction of biofilm on dentures is important for maintaining denture wearers' health.

OBJECTIVE

The aim of this study was to assess the effectiveness of toothbrush handles individually adapted in reducing of biofilm on dentures.

MATERIALS AND METHODS

Study participants were 16 residents of the condo for the elderly, denture wearers, functionally independent and without cognitive impairment. Participants were randomly divided into two groups: Group 1 (adapted toothbrush handles) and Group 2 (conventional toothbrush). Biofilm from the inner surface of the basal area of the denture was observed using 5% erythrosine. Images obtained before starting the use of toothbrushes, after 7 and 21 days were sent for computer analysis.

RESULTS

The average amount of biofilm on the first day was considered severe in both groups. At the end of the experiment, the average biofilm coverage in Group 1 was 44.7% (13.1% reduction) and in Group 2 it was 48.6% (4.8% reduction). However, the Friedman analysis of variance test showed that the reduction was statistically significant (p< 0.05) only in Group 1, demonstrating the effectiveness of the adapted brushes.

CONCLUSION

The findings of this pilot study indicated that for the reduction of biofilm on dentures the adapted toothbrush handles were superior to the conventional type.

Assessment of Candida species colonization and denture-related stomatitis in bar- and locator-retained overdentures

The aim of this study was to assess the prevalence of denture-related stomatitis (DRS) in different attachment-retained overdenture wearers and its association with particular colonizing Candida species. Thirty-seven edentulous patients with implant-supported maxillary or mandibular overdentures were enrolled. A full clinical history was obtained, including details of patients' oral hygiene practices and the levels of erythema based on Newton's classification scale. Swabs were taken from the palate and investigated mycologically to identify the yeast colonies. Quantitative and qualitative microbiological assessments were performed, which included recording the total numbers of colonies (cfu), their color, and their morphological characteristics. Significant differences were found in cfu values between the attachment and inner surfaces of locator- and bar-retained overdentures (P < .05). Candida albicans was the most common species in both evaluations, being isolated from 81.3% of bar-retained overdentures and 38.1% of locator-retained overdentures. DRS developed in all patients using bar-retained overdentures but in only 71.4% of those using locator-retained overdentures. No statistically significant relationship was found between bar and locator attachments according to smoking habit, overnight removal, or plaque and gingival indices (P > .05).

Isolation of Candida species from the oral cavity and fingertips of complete denture wearers

BACKGROUND

Wearing a dental prosthesis is known to increase oral candidal colonization and predispose the wearer to oral candidosis. Denture wearers frequently use fingers to take the prosthesis out of their mouth. Oral Candida, if present may contaminate wearer's finger. The objective of this study was to investigate the simultaneous candidal colonization of oral cavity and fingertips of complete denture wearers.

MATERIALS AND METHODS

A total of 25 apparently healthy male subjects who had worn complete dentures for at least 1 year were selected. Information about each patient's denture age, denture hygiene, handling, and wearing habits, and hand washing habits after denture handling were be obtained. Intraoral examination of all the patients was done. For microbiological examination samples were collected from the fingertip and oral rinse of each patient. Candida species were identified with use of germ tube test and commercially available yeast identification system. Data was statistically analyzed. Significance was set at p < 0.05.

RESULTS

It was found that frequency of hand washing, denture handling and denture stomatitis with respect to fingertip candidal isolation was not statistically significant. But poor denture hygiene and denture stomatitis with respect to oral candidal colonization was statistically significant.

CONCLUSION

Denture wearers with oral Candida had a higher prevalence of Candida contamination on their fingers. Patients with removable prostheses should be informed about the importance of proper prosthesis and personal hygiene and the possibility of microbial contamination of the hands and other parts of the body.

Systemic Staphylococcus aureus infection mediated by Candida albicans hyphal invasion of mucosal tissue

Candida albicans and Staphylococcus aureus are often co-isolated in cases of biofilm-associated infections. C. albicans can cause systemic disease through morphological switch from the rounded yeast to the invasive hyphal form. Alternatively, systemic S. aureus infections arise from seeding through breaks in host epithelial layers although many patients have no documented portal of entry. We describe a novel strategy by which S. aureus is able to invade host tissue and disseminate via adherence to the invasive hyphal elements of Candida albicans. In vitro and ex vivo findings demonstrate a specific binding of the staphylococci to the candida hyphal elements. The C. albicans cell wall adhesin Als3p binds to multiple staphylococcal adhesins. Furthermore, Als3p is required for C. albicans to transport S. aureus into the tissue and cause a disseminated infection in an oral co-colonization model. These findings suggest that C. albicans can facilitate the invasion of S. aureus across mucosal barriers, leading to systemic infection in co-colonized patients.

Effect of sodium hypochlorite and peracetic acid on the surface roughness of acrylic resin polymerized by heated water for short and long cycles

OBJECTIVE

To evaluate the surface roughness of acrylic resin submitted to chemical disinfection via 1% sodium hypochlorite (NaClO) or 1% peracetic acid (C2H4O3).

MATERIALS AND METHODS

The disc-shaped resin specimens (30 mm diameter ×4 mm height) were polymerized by heated water using two cycles (short cycle: 1 h at 74°C and 30 min at 100°C; conventional long cycle: 9 h at 74°C). The release of substances by these specimens in water solution was also quantified. Specimens were fabricated, divided into four groups (n = 10) depending on the polymerization time and disinfectant. After polishing, the specimens were stored in distilled deionized water. Specimens were immersed in 1% NaClO or 1% C2H4O3 for 30 min, and then were immersed in distilled deionized water for 20 min. The release of C2H4O3 and NaClO was measured via visual colorimetric analysis. Roughness was measured before and after disinfection. Roughness data were subjected to two-way ANOVA and Tukey's test.

RESULTS

There was no interaction between polymerization time and disinfectant in influencing the average surface roughness (Ra, P = 0.957). Considering these factors independently, there were significant differences between short and conventional long cycles (P = 0.012), but no significant difference between the disinfectants hypochlorite and C2H4O3 (P = 0.366). Visual colorimetric analysis did not detect release of substances.

CONCLUSION

It was concluded that there was the difference in surface roughness between short and conventional long cycles, and disinfection at acrylic resins polymerized by heated water using a short cycle modified the properties of roughness.

Effect of daily use of an enzymatic denture cleanser on Candida albicans biofilms formed on polyamide and poly(methyl methacrylate) resins: an in vitro study

STATEMENT OF PROBLEM

Candida biofilms on denture surfaces are substantially reduced after a single immersion in denture cleanser. However, whether this effect is maintained when dentures are immersed in cleanser daily is unclear.

PURPOSE

The purpose of this study was to evaluate the effect of the daily use of enzymatic cleanser on Candida albicans biofilms on denture base materials.

MATERIAL AND METHODS

The surfaces of polyamide and poly(methyl methacrylate) resin specimens (n=54) were standardized and divided into 12 groups (n=9 per group), according to study factors (material type, treatment type, and periods of treatment). Candida albicans biofilms were allowed to form over 72 hours, after which the specimens were treated with enzymatic cleanser once daily for 1, 4, or 7 days. Thereafter, residual biofilm was ultrasonically removed and analyzed for viable cells (colony forming units/mm(2)) and enzymatic activity (phospholipase, aspartyl-protease, and hemolysin). Factors that interfered with the response variables were analyzed by 3-way ANOVA with the Holm-Sidak multiple comparison method (α=.05).

RESULTS

Polyamide resin presented more viable cells of Candida albicans (P<.001) for both the evaluated treatment types and periods. Although enzymatic cleansing significantly (P<.001) reduced viable cells, daily use did not maintain this reduction (P<.001). Phospholipase activity significantly increased with time (P<.001) for both materials and treatments. However, poly(methyl methacrylate) based resin (P<.001) and enzymatic cleansing treatment (P<.001) contributed to lower phospholipase activity. Aspartyl-protease and hemolysin activities were not influenced by study factors (P>.05).

CONCLUSIONS

Although daily use of an enzymatic cleanser reduced the number of viable cells and phospholipase activity, this treatment was not effective against residual biofilm over time.

Clinical trial of an experimental cleaning solution: antibiofilm effect and integrity of a silicone-based denture liner

AIM

This study evaluated the antibiofilm effect of an experimental solution of 2% Ricinus communis (R. communis) on a silicone-based denture liner by means of a randomized clinical trial, as well as the integrity of such liner following a cleansing regimen with such solution.

MATERIALS AND METHODS

About 30 complete denture wearers had their lower dentures relined with a silicone-based denture liner and randomly allocated to cleanse their dentures by means of: (A) a specific toothbrush for complete dentures and dentifrice; (B) soaking in an experimental 2% R. communis solution; and (C) association of A and B. Considered outcomes were biofilm coverage area (%), microbial counts by means of the deoxy-ribonucleic acid (DNA) checkerboard hybridization technique and physical integrity of the soft liner, assessed during a time interval of 60 days. Mean group values were compared by analysis of variance (ANOVA) and Tukey tests or generalized linear method (α = 0.05).

RESULTS

The mechanical method presented the lowest biofilm percentage (1.45 ± 1.03) if compared to the chemical method (2.96 ± 1.98) and the associated one (2.71 ± 1.76). After 60 days (3.37 ± 2.04), biofilm accumulation was higher than at 15 days (1.28 ± 0.77) and 30 days (2.46 ± 1.54). The denture liner was less deteriorated and kept its physical integrity when the mechanical method was applied. The chemical method presented higher effectiveness against microorganisms, including some Candida species.

CONCLUSION

The 2% R. communis solution presented stronger antimicrobial capacity than brushing on a silicone-based denture liner after immersion. However, it was not superior to the mechanical method in preserving the physical integrity of the material and in biofilm removal.

CLINICAL SIGNIFICANCE

Soft denture liners hygiene is a very important issue and not conclusive in the literature. The experimental solution of 2% R. communis evaluated presented promising antimicrobial potential and should be more explored to be recommended as cleanser.

An assessment of the effectiveness of mechanical and chemical cleaning of Essix orthodontic retainer

OBJECTIVES

To determine the effectiveness of mechanical and chemical cleaning on the removal of microorganisms from Essix orthodontic retainers.

DESIGN

In vitro laboratory study.

SETTING

Department of Orthodontics and Microbiology, Eastman Dental Institute, University College London, UK.

METHODS

Study 1: 120 Essix retainers were divided into four cleaning groups. The effectiveness of each cleaning method to remove a single species biofilm of Streptococcus mutans from the retainer was assessed. Study 2: 140 Essix retainers were divided into four study groups (brushing with fluoride toothpaste, chlorhexidine gel, immersion in chlorhexidine solution only and a control) to investigate the chemical and mechanical cleaning of the multispecies biolfilm of (Streptococcus sanguis, Actinomyces naeslundii, methicillin-resistant Staphylococcus aureus and Candida albicans).

RELEVANT RESULTS

In study 1, brushing with toothpaste resulted in 99% reduction of Streptococcus mutans. In study 2, all three cleaning methods recorded similarly statistically significant reductions in colony forming units per millilitre compared to the control. There were no statistically significant differences between any of the cleaning groups for any of the microorganisms except MRSA-16. For MRSA-16, chlorhexidine mouthwash and gel were significantly more potent in eliminating the microorganism than the fluoride toothpaste.

CONCLUSIONS

All three cleaning methods effectively removed 99% of microorganisms from the Essix retainers. Brushing with fluoride toothpaste can therefore be confirmed as an effective method for cleaning retainers in most circumstances. The use of chlorhexidine gel or mouthwash is recommended in patients where bacterial infection has to be avoided due to immunosuppression or other reasons.

Multiple logistic regression analysis of risk factors associated with denture plaque and staining in Chinese removable denture wearers over 40 years old in Xi'an--a cross-sectional study

Background

Removable dentures are subject to plaque and/or staining problems. Denture hygiene habits and risk factors differ among countries and regions. The aims of this study were to assess hygiene habits and denture plaque and staining risk factors in Chinese removable denture wearers aged >40 years in Xi’an through multiple logistic regression analysis (MLRA).

Methods

Questionnaires were administered to 222 patients whose removable dentures were examined clinically to assess wear status and levels of plaque and staining. Univariate analyses were performed to identify potential risk factors for denture plaque/staining. MLRA was performed to identify significant risk factors.

Results

Brushing (77.93%) was the most prevalent cleaning method in the present study. Only 16.4% of patients regularly used commercial cleansers. Most (81.08%) patients removed their dentures overnight. MLRA indicated that potential risk factors for denture plaque were the duration of denture use (reference, ≤0.5 years; 2.1–5 years: OR = 4.155, P = 0.001; >5 years: OR = 7.238, P<0.001) and cleaning method (reference, chemical cleanser; running water: OR = 7.081, P = 0.010; brushing: OR = 3.567, P = 0.005). Potential risk factors for denture staining were female gender (OR = 0.377, P = 0.013), smoking (OR = 5.471, P = 0.031), tea consumption (OR = 3.957, P = 0.002), denture scratching (OR = 4.557, P = 0.036), duration of denture use (reference, ≤0.5 years; 2.1–5 years: OR = 7.899, P = 0.001; >5 years: OR = 27.226, P<0.001), and cleaning method (reference, chemical cleanser; running water: OR = 29.184, P<0.001; brushing: OR = 4.236, P = 0.007).

Conclusion

Denture hygiene habits need further improvement. An understanding of the risk factors for denture plaque and staining may provide the basis for preventive efforts.

Evaluation of the durability and antiadhesive action of 2-methacryloyloxyethyl phosphorylcholine grafting on an acrylic resin denture base material

STATEMENT OF PROBLEM

The polymer 2-methacryloyloxyethyl phosphorylcholine is currently used on medical devices to prevent infection. Denture plaque-associated infection is regarded as a source of serious dental and medical complications in the elderly population, and denture hygiene, therefore, is an issue of considerable importance for denture wearers. Furthermore, because denture bases are exposed to mechanical stresses, for example, denture brushing, the durability of the coating is important for retaining the antiadhesive function of 2-methacryloyloxyethyl phosphorylcholine.

PURPOSE

The purpose of this study is to investigate the durability and antiadhesive activity of two 2-methacryloyloxyethyl phosphorylcholine polymer coating techniques: poly-2-methacryloyloxyethyl phosphorylcholine grafting and poly-2-methacryloyloxyethyl phosphorylcholine-co-n-butyl methacrylate coating. It was revealed that 2-methacryloyloxyethyl phosphorylcholine polymer coating of the denture base resin polymethyl methacrylate decreases bacterial biofilm formation.

MATERIAL AND METHODS

Durability was examined by rhodamine staining and elemental surface analysis and by determining the wetting properties of the 2-methacryloyloxyethyl phosphorylcholine polymer-modified polymethyl methacrylate after a friction test that comprised 500 brushing cycles. Antiadhesive activity was examined by using a Streptococcus mutans biofilm formation assay.

RESULTS

Poly-2-methacryloyloxyethyl phosphorylcholine-grafted polymethyl methacrylate retained 2-methacryloyloxyethyl phosphorylcholine units and antiadhesive activity even after repetitive mechanical stress, whereas co-n-butyl methacrylate-coated polymethyl methacrylate did not.

CONCLUSION

These results demonstrated that graft polymerization of 2-methacryloyloxyethyl phosphorylcholine on denture surfaces may contribute to the durability of the coating and prevent microbial retention.

Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials

OBJECTIVES

The aim of this meta-analysis was to compare the efficacy of antifungal therapy with any other alternative methods used for the treatment of denture stomatitis.

DATA SOURCES

MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews were searched, complemented by hand searching, until the first week of January 2013.

STUDY SELECTION

Included studies consisted of randomized clinical trials published in English or French, which compared antifungals with any other alternative or placebo, used for the treatment of denture stomatitis. The remission of clinical signs of denture stomatitis, and the reduction in Candida colony counts were considered as the clinical and microbiological outcomes, respectively. Random effects models were used to conduct the statistical analyses.

RESULTS

From 233 identified articles, a total of 15 manuscripts on 14 randomized controlled trials were included in systematic review and 8 in the meta-analysis. No statistically significant difference between antifungal treatment and disinfection methods was found for both clinical (OR=0.7; 95% CI: 0.32-1.36; Z=-1.14; p=0.256) and microbiological (OR=0.8; 95% CI: 0.26-2.5; Z=-0.35; p=0.724) outcomes. The meta-analysis showed a statistically significant difference between an antifungal and a placebo for the microbiological outcome (OR=0.32; 95% CI: 0.12-0.89; Z=-2.2; p=0.028), favouring the antifungals. However, there was no statistically significant difference between antifungal and placebo for the clinical outcome (OR=0.2; 95% CI: 0.04-1.04; Z=-1.9; p=0.056).

CONCLUSIONS

Disinfection agents, antiseptic mouthwashes, natural substances with antimicrobial properties, microwave disinfection and photodynamic therapy could be suggested as an adjunct or alternative to antifungal medications in the treatment of denture stomatitis.

Cutaneous fungal infections in the elderly

This article summarizes the common, superficial, cutaneous, fungal infections that are found in older adults. The epidemiology, classic appearance, and current treatments of these fungal infections are discussed. These common skin pathogens occur in many older adults.

Comparative effects of denture cleansers on physical properties of polyamide and polymethyl methacrylate base polymers

The purpose of this study was to evaluate the effect of denture cleansers on the surface roughness, hardness and color stability of two polyamides (Valpast, Deflex), a butadiene styrene copolymer PMMA (Rodex), and PMMA polymer as a control group (Paladent). Each material was divided into 5 sub-groups (n=7) as two control and three test groups. Three test groups were immersed for 20 days in commercially available three denture cleansers (CO-Corega, PR-Protefix, VA-Valclean). Two-way analysis of variance and Tukey's post hoc HSD test were used to evaluate surface roughness and hardness data (α=0.05). ΔE, ΔL*, Δa*and Δb* mean values were used for ANOVA, Tamhane test was used as post hoc. Polyamides showed low hardness and high roughness before and after immersion. A significant decrease in hardness was observed for all resins except Rodex after immersion (p<0.05). The denture cleansers changed the roughness, hardness and color of some resins.

Occurrence of Candida species colonization in a population of denture-wearing immigrants

Infection of the oral cavity and dentures by Candida species are frequent in denture wearers. C. albicans is the most common pathogen; however, other emerging Candida species are also responsible for this condition. Few data are available about the occurrence of Candida species in the oral cavities of denture-wearing immigrants to Italy. In this study, we compare the Candida species found in the oral mucosa and on dentures from a population of denture wearing immigrants to Italy to a matched Italian group. Oral swabs were collected from dentures and the underlying mucosa of patients enrolled in the study and were then cultured to test for the presence of Candida species in each sample. Out of 168 patients enrolled (73 Italians and 95 immigrants), 51 Italians (69.8 percent) and 75 immigrants (78.9 percent) tested positive for the presence of Candida. Candida albicans was the most frequently observed species overall; however, we found a higher occurrence of C. glabrata among immigrants than among Italians. In addition, immigrants displayed a higher incidence of Candida – associated stomatitis and a lower mean age than Candida-positive individuals from the Italian group. Immigrants are more prone to longer colonization of the oral mucosa and dentures by Candida. In these patients, dentures must be checked periodically to prevent the presence of Candida.

Does the presence of anterior mandibular teeth increase the incidence of denture stomatitis?

PURPOSE

To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs.

MATERIALS AND METHODS

Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded.

RESULTS

The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03).

CONCLUSION

In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.