The microbiologic cross-contamination of dental prostheses

Development of Autopolymerizing Resin Material with Antimicrobial Properties Using Montmorillonite and Nanoporous Silica

Although autopolymerizing resin offers numerous applications in orthodontic treatment, plaque tends to accumulate between the appliance and the mucosa, which increases the number of microorganisms present. In this study, we added cetylpyridinium chloride (CPC) loaded montmorillonite (Mont) and nanoporous silica (NPS) to autopolymerizing resin (resin-Mont, resin-NPS) and evaluated their drug release capacity, antimicrobial capacity, drug reuptake capacity, mechanical strength, and color tone for the devolvement of autopolymerizing resin with antimicrobial properties. As observed, resin-Mont and resin-NPS were capable of the sustained release of CPC for 14 d, and a higher amount of CPC was released compared to that of resin-CPC. Additionally, resin-Mont and resin-NPS could reuptake CPC. Moreover, the antimicrobial studies demonstrated that resin-Mont and resin-NPS could release effective amounts of CPC against Streptococcus mutans for 14 d and 7 d after reuptake, respectively. Compared to resin-CPC, resin-Mont exhibited a higher sustained release of CPC in all periods, both in the initial sustained release and after reuptake. However, the mechanical strength decreased with the addition of Mont and NPS, with a 36% reduction observed in flexural strength for resin-Mont and 25% for resin-NPS. The application of these results to the resin portion of the orthodontic appliances can prevent bacterial growth on the surface, as well as on the interior, of the appliances and mitigate the inflammation of the mucosa.

Evaluation of Effective Chloramine-T Concentration to Be Incorporated in Dental Stone for Antimicrobial Activity

Objective The objective of this study was to determine the antimicrobial activity of type III gypsum at three different chloramine-T concentrations and to ascertain the most effective concentration to be added for optimum inhibitory activity against Candida albicans. Method Ten discs of type III gypsum were fabricated for each group. Standard type III gypsum without any disinfectant was used for the control group. For the experimental group, an admixture of chloramine-T and standard dental stone was employed in varying w/w concentrations (0.1%, 0.25%, and 0.5%). Discs were placed in a petri dish containing Sabouraud dextrose agar lawned with Candida albicans culture and incubated for 24 hours. The zone of inhibition created around the discs was measured and evaluated. Result The mean zone of inhibition (mean ± standard deviation) in the control group was 0 mm; 0.70±1.05 mm in group 1 (0.1% w/w concentration), 2.70 ± 2.35 mm in group 2 (0.25% w/w concentration), and 20.80 ± 1.68 mm in group 3 (0.5% w/w concentration). A one-way ANOVA test showed that there was a significant difference in the inhibition zone created around all groups (p < 0.05), with the discs of group 3 yielding the most positive results. Conclusion The addition of 0.5% chloramine-T to type III gypsum showed the most promising result, out of the concentrations tested, as a self-disinfecting dental stone and could be used for further investigations.

Quantitative Analysis of Selected Microorganisms Present at Various Sites in a Prosthetics Clinic and Dental Laboratory during Complete Denture Fabrication

Background: Contamination with oral commensals and pathogenic microorganisms, and cross contamination between clinic and laboratory can occur. The amount of contamination has not been determined. Methods: Samples from different clinical and laboratory stages before and after disinfection (17 sites, 10 samples per stage) were collected. Laboratory surfaces and equipment were swabbed for 10 days (11 sites). Swabs were cultured for total mixed flora, Streptococci, Lactobacilli, Staphylococcus aureus, aerobic Gram-negative bacteria (AGNB) and Candida. Knowledge of infection control among staff and students was assessed. Results: Clinic: In total, 30–40% of the samples overall were contaminated with mixed flora and Streptococci of >100 cfu/swab; >100 cfu of AGNB and Candida were present on 6% and 1% of samples; 2% contained <100 cfu of S. aureus. Laboratory: In total, 17–48% of the samples overall were contaminated with mixed flora and Streptococci of >100 cfu/swab; >100 cfu of AGNB were present on 11% of samples; none contained >100 cfu of Candida. Disinfection significantly reduced the level of all organisms. Knowledge of infection control was sufficient, but compliance was poor. Conclusion: Although the count of mixed flora was high, potential pathogens such as S. aureus and Candida were low. In immunocompromised patients, this can become a problem.

Comparison of the disinfectant effects of Nanosil D2 and Korsolex extra solutions on thermoset acrylic resin contaminated with Streptococcus mutans and Bacillus subtilis

This study was conducted to compare the disinfectant effects of Nanosil D2 and Korsolex extra on thermoset acrylic resin contaminated with Streptococcus mutans and Bacillus subtilis. In this experimental study, 90 acrylic samples were made and sterilized. Two samples were cultured as a sterilization control in brain-heart infusion (BHI) and the rest of samples were divided into two groups. Samples of one group were placed in a bacterial suspension of S. mutans and the samples of another group were placed in a suspension containing B. subtilis. Each group was divided into two subgroups for immersion in Nanosil or Korsolex extra solutions. Seven samples were selected from each group at each of 30 min, 1 h, and 2 h and transferred to the BHI test tube, and their turbidity was evaluated after 24 h. SPSS 17 software was used to analyze the data, and the significance level of test was considered P < 0.05. At 1 h, Bacillus level of Nanosil D2 was significantly lower than that of Korsolex extra, and at all ½, 1, and 2 h, the level of Streptococcus in Nanosil D2 solution was significantly lower than that of Korsolex extra (P < 0.05). Bacillus and Streptococcus levels showed significant reduction in both solutions over time. The disinfecting power of Nanosil D2 is more than that of Korsolex extra.

Effect of comonomer of methacrylic acid on flexural strength and adhesion of Staphylococcus aureus to heat polymerized poly (methyl methacrylate) resin: An in vitro study

Aims and Objective:

The purpose of the present study was to evaluate and compare flexural strength and Staphylococcus aureus adhesion of heat-activated poly (methyl methacrylate [MMA]) resin modified with a comonomer of methacrylic acid (MAA) and MMA monomer.

Materials and Methods:

Comonomer preparation was done with the addition of varying concentration of MAA (0, 15, 20, and 25 wt %) to the MMA of conventional heat-activated denture base resin to prepare the specimens. Prepared specimens were stored in distilled water at 37°C for 1 day and 1 week before the evaluation of flexural strength and microbial adhesion. Flexural strength was measured using a universal testing machine at a crosshead speed for 2 mm/min (n = 10). Microbial adhesion (colony-forming unit [CFU]) was evaluated against S. aureus using a quadrant streaking method (n = 5). Data were subjected to one-way ANOVA, and the significant differences among the results were subjected to Tukey's HSD test. P < 0.05 was considered statistically significant.

Results:

Addition of MAA to the MMA monomer was found to significantly reduce the adhesion of S. aureus for all the groups. Reduction of CFU of S. aureus was found be more significant for Group 3 as compared to control, both at 1-day (P < 0.001) and 1-week (P < 0.002) storage in distilled water. However, no statistically significant changes in the flexural strength were observed with the addition of MAA at 1-day (P = 0.52) and 1-week (P = 0.88) time interval.

Conclusion:

Addition of MAA to conventional denture base resin reduced the microbial adhesion without significantly affecting the flexural strength.

Infection control knowledge and practice: A cross-sectional survey on dental laboratories in dental institutes of North India

Aim and Objectives

The aim of the study was to assess the knowledge of dental laboratory technicians regarding infection control and modes of infection control employed by them.

Settings and Design

A self-assessment questionnaire-based survey was carried out among dental technicians to assess the knowledge and practice of infection control in dental laboratories.

Materials and Methods

Survey instrument containing 16 questions were randomly distributed to 70 dental colleges of North India regarding knowledge of infection control methods and infection control practised in laboratories. Data were collected and analyzed.

Results

The response showed that 30.76% of dental technicians receive 30-50 or more than 50 impressions in a week. About 96.15% of the technicians used a plastic bag to carry impressions. Twenty-five percent of the dental technicians were aware of infection control protocol. Fifty-five percent of the technicians received impressions while wearing gloves and 61.53% of the institutes had a separate receiving area. Nearly 71.15% of the technicians communicate with the doctor regarding the disinfection of impression received in the laboratory. Almost 30.76% of the dental technicians disinfect all the impressions and 67.30% technicians use immersion for disinfection of impressions. Only 38.46% responded that they immerse impressions for 10 min for disinfection. About 73.07% use gloves, 90.38% use mouth masks, 57.69% wear eye shields, and 88.46% wear aprons while working. Nearly 78.84% of the technicians received vaccination against hepatitis B virus. Almost 69.23% of the technicians change pumice slurry after regular intervals, and 75% do not add any disinfectant. Nearly 59.61% of technicians disinfect the prostheses before sending it to the clinic, and 42.30% disinfect them by immersion technique. About disposal of waste, 80.76% said that they dispose the waste properly.

Conclusion

To summarize, most of the technicians were not aware of basic infection control protocols.

The Effect of Repeated Microwaving Disinfection on the Dimensional Stability of Acrylic Dentures

OBJECTIVE

The aim of this study was to evaluate the effect of repeated microwave disinfections on the dimensional stability of acrylic dentures.

MATERIALS AND METHODS

Three groups of dentures made of a heat polymerized acrylic resin were tested. I: dentures kept in water (control group). II: dentures microwaved daily while being immersed into water (wet disinfection). III: dentures microwaved daily without being immersed into water (dry disinfection).
Measurements were taken across three reference points, on two occasions: after curing and immersion in water for 24 hours, and one week later.
Data obtained were analyzed using one-way analysis of variance (ANOVA) and Scheffe's multiple range test.

RESULTS

The results showed that the microwave disinfection provokes dimensional changes of the same pattern (shrinkage). The dentures which underwent wet disinfection exhibited the greatest shrinkage (p<0.05).

CONCLUSIONS

Disinfection using microwave energy may cause dimensional changes (shrinkage) of complete dentures.
The microwave "dry disinfection" method can be safely applied in everyday practice since the dimensional changes which occurred seem to be of no clinical significance.

Evaluation of the efficacy of chemical disinfectants for disinfection of heat-polymerised acrylic resin

OBJECTIVE

This study evaluated the efficacy of disinfectants on the internal aspect of heat-polymerised acrylic resin contaminated with microbial strains.

BACKGROUND

Dentures absorb oral fluids and become contaminated by different microorganisms.

METHODS

Two hundred and fifty rectangular specimens were made of heat-polymerised acrylic resin, and then divided into five groups corresponding to the microbial strains (Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, S. mutans and Enterococcus faecalis). After contamination, the specimens were immersed in 1 and 2% sodium hypochlorite and 2% glutaraldehyde for periods of 5, 10 and 15 min. The specimens were placed into tubes containing different broths and incubated at 35°C and then visually analysed. Turbidity in the medium indicated microbial growth. The Fisher's exact test was used in the analysis of the results.

RESULTS

The strain E. faecalis was the most resistant to the disinfectant solutions, and among them, glutaraldehyde was more effective than 2 and 1% hypochlorite for disinfection for 5 min; in the 10-min period there were no differences between the disinfectants. In 15 min of immersion, 1% hypochlorite and glutaraldehyde were more effective than 2% hypochlorite.

CONCLUSIONS

Disinfection for 10 min with 1% hypochlorite and glutaraldehyde is effective in disinfecting the internal aspect of heat-polymerised acrylic resin.

Effect of microwave treatment on the shear bond strength of different types of commercial teeth to acrylic resin

OBJECTIVE

The purpose of this study was to verify the effect of microwave treatment on the shear bond strength of commercial types of teeth to acrylic resin, when the glossy ridge laps were unmodified (groups 1 and 5), bur abraded (groups 2 and 6), bur grooved (groups 3 and 7) or etched by monomer (groups 4 and 8).

BACKGROUND

Controversial findings have shown that mechanical or chemical changes in ridge-lap surface of the tooth increase or decrease the bond strength between tooth and acrylic resin, and the microwave disinfection may cause different changes on this bond strength.

MATERIALS AND METHODS

Eighty specimens (n = 10) were made with the acrylic resin bonded to tooth glossy ridge lap, polymerised in water at 74 degrees C for 9 h, and deflasked after flask cooling. Specimens of the groups 5, 6, 7 and 8 were individually immersed in 150 ml of water and submitted to microwave treatment in an oven at 650 W for 3 min. Control specimens (groups 1, 2, 3 and 4) were not microwave treated. Shear bond strength test was performed in an Instron machine with a cross-speed of 1 mm/min. Collected data were submitted to anova and Tukey's test (alpha = 0.05).

RESULTS

Microwave treatment decreased the shear bond strength values of the tooth/resin bond. In the microwaved and non-microwaved procedures, mechanical retention improved the shear bond strength when compared with the control and monomer treatments.

CONCLUSION

Shear bond strength of the tooth/resin bond was influenced by the microwave treatment and different commercial teeth association, and was lower for the Biotone tooth.

Effect of repeated disinfections by microwave energy on the physical and mechanical properties of denture base acrylic resins

The present study evaluated the effect of repeated simulated microwave disinfection on physical and mechanical properties of Clássico, Onda-Cryl and QC-20 denture base acrylic resins. Aluminum patterns were included in metallic or plastic flasks with dental stone following the traditional packing method. The powder/liquid mixing ratio was established according to the manufacturer's instructions. After water-bath polymerization at 74 degrees C for 9 h, boiling water for 20 min or microwave energy at 900 W for 10 min, the specimens were deflasked after flask cooling and finished. Each specimen was immersed in 150 mL of distilled water and underwent 5 disinfection cycles in a microwave oven set at 650 W for 3 min. Non-disinfected and disinfected specimens were subjected to the following tets: Knoop hardness test was performed with 25 g load for 10 s, impact strength test was done using the Charpy system with 40 kpcm, and 3-point bending test (flexural strength) was performed at a crosshead speed of 0.5 mm/min until fracture. Data were analyzed statistically by ANOVA and Tukey's test (alpha= 0.05%). Repeated simulated microwave disinfections decreased the Knoop hardness of Clássico and Onda-Cryl resins and had no effect on the impact strength of QC-20. The flexural strength was similar for all tested resins.

Effect of repeated simulated disinfections by microwave energy on the complete denture base adaptation

This study evaluated the effect of repeated microwave disinfections on the adaptation of the maxillar denture base using 2 different flask closure methods. Twenty stone cast-wax base sets were prepared for flasking by traditional cramp or RS system methods. Five bases for each method were submitted to 5 repeated simulated disinfections in a microwave oven with 650W for 3 minutes. Control bases were not disinfected. Three transverse cuts were made through each stone cast-resin base set, corresponding to canine, first molar, and posterior region. Measurements were made using an optical micrometer at 5 points for each cut to determine base adaptation: left and right marginal limits of the flanges, left and right ridge crests, and midline. Results for base adaptation performed by the flask closure methods were: traditional cramp (non-disinfected = 0.21 ± 0.05mm and disinfected = 0.22 ± 0.05mm), and RS system (non-disinfected = 0.16 ± 0.05 and disinfected = 0.17 ± 0.04mm). Collected data were submitted to ANOVA and Tukey test (α=.05). Repeated simulated disinfections by microwave energy did not cause deleterious effect on the base adaptation, when the traditional cramp and RS system flask closure methods were compared.

Effect of the simulated disinfection by microwave energy on the impact strength of the tooth/acrylic resin adhesion

The objective of this study was to determine the effect of simulated microwave disinfection on the tooth/acrylic resin impact strength. Acrylic molar teeth with a wax stick attached to the ridge lap were included in brass flasks. Specimens were made with Classico thermopolymerized acrylic resin, according to the groups: 1 and 5 - tooth with no treatment (control); 2 and 6 - tooth bur abrasion; 3 and 7 - tooth bur retention; and 4 and 8 - tooth monomer etch. Eighty specimens (n=10) were polymerized in bath cycle at 74( masculine)C for 9 hours and deflasked after flask cooling. Specimen from groups 2, 4, 6 and 8 was submitted to simulated microwave disinfection in a microwave oven at 650W for 3 minutes. Impact strength test was performed with an Otto Wolpert-Werke machine (Charpy system) with an impact load of 40 kpcm. Fracture load value was transformed into impact strength as a function of the bond area (kfg/cm(2)). Collected data were submitted to ANOVA and Tukey's test (alpha=.05) and results indicate that the simulated microwave disinfection decreased the impact strength in all treatments.

Effect of microwave disinfection on physical and mechanical properties of acrylic resins

This study evaluated the effect of microwave energy on the hardness, impact strength and flexural strength of the Clássico, Onda-Cryl and QC-20 acrylic resins. Aluminum die were embedded in metallic or plastic flasks with type III dental stone, in accordance with the traditional packing technique. A mixing powder/liquid ratio was used according to the manufacturer's instructions. After polymerization in water batch at 74ºC for 9 h, boiling water for 20 min or microwave energy at 900 W for 10 min, the specimens were deflasked after flask cooling at room temperature, and submitted to finishing. Specimens non-disinfected and disinfected by microwave irradiation were submitted to hardness, impact and flexural strength tests. Each specimen was immersed in distilled water and disinfected in a microwave oven calibrated to 650 W for 3 min. Knoop hardness test was performed with 25 g load for 10 s, impact test was carried out using the Charpy system with 40 kpcm, and 3-point bending test with a crosshead speed of 0.5 mm/min until fracture. Data were submitted to statistical analysis by ANOVA and Tukey's test (?=0.05). Disinfection by microwave energy decreased the hardness of Clássico and Onda-Cryl acrylic resins, but no effect was observed on the impact and flexural strength of all tested resins.

Influence of simulated microwave disinfection on complete denture base adaptation using different flask closure methods

STATEMENT OF PROBLEM

Denture microwave disinfection may result in dimensional changes that may distort the acrylic resin base, causing discomfort to the patient.

PURPOSE

The purpose of this study was to determine the effect of simulated microwave disinfection on maxillary denture base adaptation using 2 different flask closure methods.

MATERIAL AND METHODS

Forty stone cast-wax base sets were prepared for flasking by the traditional flask closure (TFC) and Restriction System flask closure (RSFC) methods (n=20). The RSFC consists of 2 iron plates to hold the flask during definitive flask closure, maintaining the flask in a closed position after release of pressure. Acrylic resin (Classico) was prepared according to the manufacturer's instructions. After polymerization in water at 74 degrees C for 9 hours, the bases were removed following flask cooling and submitted to conventional finishing with abrasive stones and pumice slurry. Ten bases for each TFC or RSFC method (n=10) were submitted to simulated disinfection (SD) in 150 mL distilled water in a microwave oven at 650 W for 3 minutes; control bases for each TFC or RSFC method (n=10) were not disinfected (ND). Three transverse cuts were made through each stone cast-resin base set, corresponding to the distal of canines, mesial of first molars, and posterior palatal region. Measurements were made in the bases using an optical micrometer at 5 points for each cut to determine adaptation: left and right marginal limits of the flanges, left and right ridge crests, and midline. Collected data were submitted to 3-way ANOVA followed by the Tukey HSD test (alpha=.05).

RESULTS

Dimension gap values (mm) for ND denture bases prepared by the RSFC method were significantly lower (0.16 +/- 0.05) when compared to the TFC method (0.21 +/- 0.05) (P<.027). Simulated disinfection statistically improved the base adaptation in bases prepared by the TFC method (0.17 +/- 0.03), compared to the ND bases (0.21 +/- 0.05) (P<.027). Simulated disinfection statistically significantly improved base adaptation (P<.0001) only in the distal of canines (ND=0.13 +/- 0.01; SD=0.11 +/- 0.03) and the posterior palatal region (ND=0.25 +/- 0.04; SD=0.21 +/- 0.01) when bases were prepared by the TFC method.

CONCLUSION

Simulated disinfection by microwave energy improved denture base adaptation when the TFC method was used, but did not statistically alter base adaptation for the RSFC method.

Effect of Disinfection Treatments on the Hardness of Soft Denture Liner Materials

PURPOSE

To evaluate the effects of disinfection treatments with chemical solutions (2% glutaraldehyde, 5% sodium hypochlorite, and 5% chlorhexidine) and microwave energy on the hardness of four long-term soft denture liners.

MATERIALS AND METHODS

Forty rectangular specimens of four soft lining materials (Molloplast-B, Ufi Gel P, Eversoft, and Mucopren soft) were made for each material. Ten samples of each material were immersed in different disinfectant solutions for 10 minutes or placed in a microwave oven for 3 minutes at 500 W. The hardness values were obtained with a Shore A durometer, before the first disinfection cycle (control), and also after two cycles of disinfection. Data were submitted to analysis of variance and Tukey's test (p < 0.01).

RESULTS

The highest value of hardness was obtained for Molloplast-B, independent of the disinfection technique. Mucopren soft demonstrated intermediate values and Ufi Gel P and Eversoft the lowest values of Shore A hardness. For Molloplast-B, the disinfection using glutaraldehyde demonstrated the highest value of hardness. The number of disinfections had no effect on the hardness values for all the materials studied and disinfection techniques.

CONCLUSIONS

The application of two disinfection cycles did not change the Shore A hardness values for all the materials. The glutaraldehyde solution demonstrated the highest values of Shore A hardness for the Molloplast-B, Mucopren soft, and Ufi Gel P materials, while Eversoft did not present any differences in hardness when submitted to different disinfection treatments.

Effect of Disinfectants on the Hardness and Roughness of Reline Acrylic Resins

PURPOSE

Potential effects on hardness and roughness of a necessary and effective disinfecting regimen (1% sodium hypocholorite and 4% chlorhexidine) were investigated for two hard chairside reline resins versus a heat-polymerizing denture base acrylic resin.

MATERIALS AND METHODS

Two standard hard chairside reliners (Kooliner and Duraliner II), one heat-treated chairside reliner (Duraliner II +10 minutes in water at 55 degrees C), and one standard denture base material (Lucitone 550) were exposed to two disinfecting solutions (1% sodium hypochlorite; 4% chlorhexidine gluconate), and tested for two surface properties [Vickers hardness number (VHN, kg/mm(2)); Roughness (Ra, microm)] for different times and conditions (1 hour after production, after 48 hours at 37 +/- 2 degrees C in water, after two disinfection cycles, after 7 days in disinfection solutions, after 7 days in water only). For each experimental condition, eight specimens were made from each material. Data were analyzed by analysis of variance followed by Tukey's test, and Student's t-test (p= 0.05).

RESULTS

For Kooliner (from 6.2 +/- 0.3 to 6.5 +/- 0.5 VHN) and Lucitone 550 (from 16.5 +/- 0.4 to 18.4 +/- 1.7 VHN), no significant changes in hardness were observed either after the disinfection or after 7 days of immersion, regardless of the disinfectant solution used. For Duraliner II (from 4.0 +/- 0.1 to 4.2 +/- 0.1 VHN), with and without heat treatment, a small but significant increase in hardness was observed for the specimens immersed in the disinfectant solutions for 7 days (from 4.3 +/- 0.2 to 4.8 +/- 0.5 VHN). All materials showed no significant change in roughness (Kooliner: from 0.13 +/- 0.05 to 0.48 +/- 0.24 microm; Duraliner II, with and without heat treatment: from 0.15 +/- 0.04 to 0.29 +/- 0.07 microm; Lucitone 550: from 0.44 +/- 0.19 to 0.49 +/- 0.15 microm) after disinfection and after storage in water for 7 days.

CONCLUSIONS

The disinfectant solutions, 1% sodium hypochlorite and 4% chlorhexidine gluconate, caused no apparent damage on hardness and roughness of the materials evaluated.

Effect of microwave sterilization and water storage on the Vickers hardness of acrylic resin denture teeth

STATEMENT OF PROBLEM

Acrylic resin denture teeth soften upon immersion in water, and the heating generated during microwave sterilization may enhance this process.

PURPOSE

Six brands of acrylic resin denture teeth were investigated with respect to the effect of microwave sterilization and water immersion on Vickers hardness (VHN).

MATERIAL AND METHODS

The acrylic resin denture teeth (Dentron [D], Vipi Dent Plus [V], Postaris [P], Biolux [B], Trilux [T], and Artiplus [A]) were embedded in heat-polymerized acrylic resin within polyvinylchloride tubes. For each brand, the occlusal surfaces of 32 identical acrylic resin denture posterior teeth were ground flat with 1500-grit silicon carbide paper and polished on a wet polishing wheel with a slurry of tin oxide. Hardness tests were performed after polishing (control group, C), after polishing followed by 2 cycles of microwave sterilization at 650 W for 6 minutes (MwS group), after polishing followed by 90-day immersion in water (90-day Wim group), and after polishing followed by 90-day storage in water and 2 cycles of microwave sterilization (90-day Wim + MwS group). For each specimen, 8 hardness measurements were made and the mean was calculated. Data were analyzed with a 2-way analysis of variance followed by the Bonferroni procedure to determine any significance between pairs of mean values (alpha=.01).

RESULTS

Microwave sterilization of specimens significantly decreased (P <.001) the hardness of the acrylic resin denture tooth specimens P (17.8 to 16.6 VHN), V (18.3 to 15.8 VHN), T (17.4 to 15.3 VHN), B (16.8 to 15.7 VHN), and A (17.3 to 15.7 VHN). For all acrylic resin denture teeth, no significant differences in hardness were found between the groups MwS, 90-day Wim, and 90-day Wim + MwS, with the exception of the 90-day Wim + MwS tooth A specimens (14.4 VHN), which demonstrated significant lower mean values (P <.001) than the 90-day Wim (15.8 VHN) and MwS (15.7 VHN) specimens.

CONCLUSIONS

For specimens immersed in water for 90 days, 2 cycles of microwave sterilization had no effect on the hardness of most of the acrylic resin denture teeth.

Hardness of heat-polymerized acrylic resins after disinfection and long-term water immersion

STATEMENT OF THE PROBLEM

In selecting a disinfectant for dental prostheses, compatibility between the disinfectant and the type of denture base material must be considered to avoid adverse effects on the hardness of the acrylic resin.

PURPOSE

This study investigated the hardness of 2 denture base resins after disinfection and long-term water immersion.

MATERIAL AND METHODS

Thirty-two disk-shaped specimens (13 mm in diameter and 8 mm thick) were fabricated from each resin (Lucitone 550 and QC-20), polished, stored in water at 37 degrees C for 48 hours, and submitted to hardness tests (Vickers hardness number [VHN]) before disinfection. Disinfection methods included scrubbing with 4% chlorhexidine gluconate for 1 minute, immersion for 10 minutes in 1 of the tested disinfectant solutions (n=8) (3.78% sodium perborate, 4% chlorhexidine gluconate, or 1% sodium hypochorite), and immersion in water for 3 minutes. The disinfection procedures were repeated 4 times, and 12 hardness measurements were made on each specimen. Control specimens (not disinfected) were stored in water for 56 minutes. Hardness tests (VHN) were also performed after 15, 30, 60, 90, and 120 days of storage in water. Statistical analyses of data were conducted with a repeated measures 3-way analysis of variance (ANOVA) and Tukey post-hoc test (alpha=.05).

RESULTS

Mean values +/- SD for Lucitone 550 (16.52 +/- 0.94 VHN) and QC-20 (9.61 +/- 0.62 VHN) demonstrated a significant (P <.05) decrease in hardness after disinfection, regardless of material and disinfectant solutions used (Lucitone 550: 15.25 +/- 0.74; QC-20: 8.09 +/- 0.39). However, this effect was reversed after 15 days of storage in water. Both materials exhibited a continuous increase (P <.05) in hardness values for up to 60 days of water storage, after which no significant change was observed.

CONCLUSION

Within the limitations of this in vitro study, QC-20 and Lucitone 550 specimens exhibited significantly lower hardness values after disinfection regardless of the disinfectant solution used.

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Polishing of dental prostheses can cause a dangerous cycle of cross-contamination involving dentists, laboratory technicians, patients and auxiliary personnel. The aim of this study was to show the microbial contamination in the dental laboratory during the polishing procedure of complete dentures. For this purpose, 4 experiments were conducted. Experiment I - Determination of the total colony-forming units (CFU) counts contaminating complete maxillary dentures. During the polishing procedure, determination of the CFU counts transferred to the operator (Experiment II) and of the total CFU counts transferred to previously sterilized complete dentures (Experiment III). Experiment IV - The total counts of remaining CFU in the lathe spindle after Experiments II and III. Complete dentures were highly contaminated (mean = 1.4 x 10(7) CFU/mL). There was a elevated level of contamination by splatter and aerosols. There was high microbial transfer from the contaminated lathe spindle to the sterile prostheses (mean = 1.7 x 10(7) CFU/mL). The spindles were highly contaminated after polishing procedures (mean = 3.5 x 10(8) CFU/mL). The polishing of dental prostheses is a possible source of transmission of communicable diseases in the laboratory and requires improved techniques for infection control.

The effect of disinfectant solutions on the hardness of acrylic resin denture teeth

This investigation studied the effects of disinfectant solutions on the hardness of acrylic resin denture teeth. The occlusal surfaces of 64 resin denture teeth were ground flat with abrasives up to 400-grit silicon carbide paper. Measurements were made after polishing and after the specimens were stored in water at 37 degrees C for 48 h. The specimens were then divided into four groups and immersed in chemical disinfectants (4% chlorhexidine; 1% sodium hypochlorite and sodium perborate) for 10 min. The disinfection methods were performed twice to simulate clinical conditions and hardness measurements were made. Specimens tested as controls were immersed in water during the same disinfection time. Eight specimens were produced for each group. After desinfection procedures, testing of hardness was also performed after the samples were stored at 37 degrees C for 7, 30, 60, 90 and 120 days. Data were analysed using two-way analysis of variance (anova) and Tukey's test at 95% confidence level. According to the results, no significant differences were found between materials and immersion solutions (P > 0.05). However, a continuous decrease in hardness was noticed after ageing (P < 0.05). It was conclude that the surfaces of both acrylic resin denture teeth softened upon immersion in water regardless the disinfecting solution.

An infection control protocol: effectiveness of immersion solutions to reduce the microbial growth on dental prostheses

This investigation evaluated the effectiveness of an infection control protocol for cleansing and disinfecting removable dental prostheses. Sixty-four dentures were rubbed with sterile cotton swab immediately after they had been taken from patients' mouths. Samples were individually placed in the culture medium and immediately incubated at 37 +/- 2 degrees C. The dentures were scrubbed for 1 min with 4% chlorhexidine, rinsed for 1 min in sterile water and placed for 10 min in one of the following immersion solutions: 4% chlorhexidine gluconate, 1% sodium hypochlorite, Biocide (iodophors) and Amosan (alkaline peroxide). After the disinfection procedures, the dentures were immersed in sterile water for 3 min, reswabbed and the samples were incubated. All samples obtained in the initial culture were contaminated with micro-organisms. All the lower dentures immersed in Biocide showed positive growth, and the upper dentures were positive for growth in six of eight dentures. The 4% chlorhexidine gluconate, 1% sodium hypochlorite and Amosan solutions have been proved effective to reduce the growth of the micro-organisms in the 10 min immersion period. The protocol evaluated in this study seems to be a viable method to prevent cross-contamination between dental personnel and patients.

Microbiological study of selected risk areas in dental technology laboratories

OBJECTIVES

To investigate the microbiological status of certain risk areas in the dental technology laboratory, namely pumice slurry, impression agar and curing water baths.

METHODS

Samples were inoculated onto selective and non-selective media. Resultant fungal and bacterial colonies were counted and identified to genus or species level.

RESULTS

Pumice slurry freshly made up using disinfectant was free from contamination, but colony counts approached 10(9) g-1 after 3 days' use. Impression agar was free from contamination, probably because of its method of preparation and maintenance, which appears to achieve sterility. Staphylococci were most commonly isolated from curing water baths (and from the air). Candida spp. and other yeasts were common in pumice slurry.

CONCLUSIONS

Personnel and managers should be aware of the potential cross-contamination hazards posed by the presence of a range of opportunist pathogens in dental technology laboratories.

Control of microbial contamination with commercially available cleaning solutions

The elimination of cross-contamination from operatory to laboratory is required for effective infection control. This study determined whether microbial cross-contamination occurs during cleaning of dental prostheses with an ultrasonicator and examined ways to reduce or eliminate the contamination that might occur. The antimicrobial activities of a temporary cement remover and tartar and stain remover were compared with deionized water and a known strong antimicrobial agent. All solutions were assessed without and with ultrasonication. The microbicidal strains were cultured in brain-heart infusion broth, with and without acrylic resin slabs, and the organisms were killed either without or with sonication and without or with acrylic resin slabs. Further testing with natural plaque-contaminated denture materials is warranted.

Bacterial contamination in reversible hydrocolloid conditioning units

Four hydrocolloid conditioning units were randomly tested for bacterial contamination. All were contaminated beyond the United States Army's acceptable limit of potability. The predominant bacteria were identified. A discussion of clinical significance and proposals for aseptic technique are presented.

The effectiveness of two disinfectants on denture base acrylic resin with an organic load

This study compared the biocidal effectiveness of chlorine dioxide and 5.25% sodium hypochlorite (diluted 1:10) on acrylic resin strips inoculated with Staphylococcus aureus, Candida albicans, or Escherichia coli in the presence of an organic load. Sterile acrylic resin strips were immersed in a solution containing 10% horse serum and 10(5) to 10(7) organisms/ml for each type of organism, then disinfected in chlorine dioxide, sodium hypochlorite, or 0.9 sterile saline for 30 seconds or 1, 2, or 4 minutes. After disinfection, the strips were neutralized and incubated for 72 hours. The results showed a difference between the ability of chlorine dioxide and sodium hypochlorite to kill the test organisms on acrylic resin strips when organic matter is present. Chlorine dioxide achieved complete disinfection of all three organisms within 2 minutes. Sodium hypochlorite achieved complete disinfection of all three organisms within 4 minutes.

Evaluation of the barrier system, an infection control system for the dental laboratory

An experimental system of laboratory infection control was tested, using 76 dentures from 40 volunteer patients. The dentures were cleansed on entering and again on leaving the laboratory. To evaluate the effectiveness of disinfection, the dentures were cultured as they were received from the patient, after the first cleansing, after polishing, and after the second cleansing. The disinfection of the prostheses involved scrubbing them with Hibiclens skin cleanser, rinsing, disinfection in one of three disinfectants (1:16 Sporicidin solution, full-strength Sporicidin solution, and 5.25% sodium hypochlorite [undiluted Clorox]), and finally rinsing. Full-strength Sporicidin solution was significantly more effective than diluted Sporicidin solution, but no statistically significant difference was found between full-strength Sporicidin solution and sodium hypochlorite, or between sodium hypochlorite and 1:16 Sporicidin solution. All three solutions were effective in reducing or eliminating culturable aerobic bacteria.

The isolation of fungi from laboratory dental pumice

Samples of used dental laboratory pumice from the two dental laboratories were cultured for the isolation of fungi. The resulting supernatant fluid from sedimentation of each pumice sample after suspension in sterile saline was serially diluted and plated onto Sabouraud agar. After incubation, fungal colonies observed were enumerated, isolated, and identified. The mean number of fungal colonies recovered from 10 pumice samples in laboratories I and II was 51.0 X 10(2) and 22.6 X 10(2), respectively. In both laboratories the predominant fungi recovered were Aspergillus niger and Fusarium sp. Other fungi recovered included Cephalosporium and Penicillium species and A. flavus. Many of these organisms have been involved in human disease. It is suggested that the presence of fungi in used dental laboratory pumice presents an unhygienic condition in the dental laboratory and may place dental laboratory technicians and denture patients at increased risk of fungal sensitization and disease.

Acinetobacter contamination of laboratory dental pumice

Micro-organisms of the genus Acinetobacter, implicated as opportunistic pathogens, have been recovered from dentures after laboratory repair. A study was undertaken to determine if Acinetobacter could be isolated from used dental pumice. Cultural studies demonstrated that Acinetobacter calcoaceticus variety lwoffi was present in high numbers in used pumice and was a major gram-negative microbial contaminant.