Effect of microwave disinfection on the flexural strength of hard chairside reline resins

Can Nonthermal Plasma Improve the Adhesion between Acrylic Resin for Ocular Prostheses and Silicone-Based Relining Material?

PURPOSE

To investigate the influence of nonthermal plasma (NTP) treatment on the tensile bond strength between heat-polymerized acrylic resin for ocular prostheses and silicone reliner, with and without the use of an adhesive primer.

MATERIALS AND METHODS

One-hundred and sixty-four acrylic resin specimens were fabricated and randomly distributed into four groups according to the type of surface treatment: Sofreliner Primer, NTP, Sofreliner Primer + NTP, and NTP + Sofreliner Primer. Two specimens interposed with relining material (Sofreliner) formed one test sample to perform the tensile bond strength tests, before (initial) and after storage (final) in saline solution (37°C, 90 days, n = 10). Surface characterization was performed by scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The failure type was classified as cohesive, adhesive, or mixed. The data were analyzed statistically using the two-way ANOVA and Tukey test, as well as the chi-squared test (α = 0.05), Bonferroni correction (α = 0.005), and Spearman correlation coefficient (α = 0.05).

RESULTS

The SEM and EDS analyses showed the presence of a thin, homogenous organic film in the groups treated with NTP. The NTP + Sofreliner Primer group presented the largest bond strength mean values in the initial period (p < 0.05). Sofreliner Primer and NTP + Sofreliner Primer groups presented the first and second largest tensile bond strength mean values in the final period (p < 0.05), respectively. NTP + Sofreliner Primer group also had the largest number of cohesive (70%, initial) and mixed (90%, final) failures.

CONCLUSIONS

The NTP treatment performed before the primer application enhanced the bond between the acrylic resin ocular prosthesis and the Sofreliner silicone-based reliner, even after 90 days of immersion in saline solution.

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.

The Effect of Microwave Disinfection on Denture Base Polymers, Liners and Teeth: A Basic Overview

The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties. Cross-infection control in dentistry is a significant issue in everyday clinical practice due to the recent increase in some infectious diseases such as hepatitis B, C and AIDS and therefore numerous methods of disinfection have been used. The most widespread method of disinfection used in everyday practice is chemical, however, studies have suggested that chemical disinfectants alter the physical and mechanical properties of the acrylic resins and enable the growth and proliferation of certain bacteria. Therefore, microwaves were introduced as an easy to use-and-access, low cost, chemical free alternative. The question that arose was if and in what way the microwave irradiation affected the denture related material properties. Microwaving affects the denture resin bases, liners and teeth in different ways. The results showed that microwave disinfection could be a safe alternative for the disinfection of denture bases and liners compared to the chemical one, when the procedure is carried out in dry conditions, but could possibly cause dimensional changes of clinical significance on them when the irradiation takes place in wet environment. It also seems to have no detrimental effects of clinical importance on the flexural properties, impact strength and hardness of denture resins and the bond, flexural strength, porosity and hardness of denture liners. The effects of microwave disinfection on the hardness of denture teeth and teeth/denture bond strength are still controversial and no safe conclusions can be drawn.

Comparison of denture microwave disinfection and conventional antifungal therapy in the treatment of denture stomatitis: a randomized clinical study

OBJECTIVE

The aim of this study was to compare the effectiveness of denture microwave disinfection and antifungal therapy on treatment of denture stomatitis.

STUDY DESIGN

Sixty denture wearers with denture stomatitis (3 groups; n = 20 each), were treated with nystatin or denture microwave disinfection (1 or 3 times/wk) for 14 days. Mycologic samples from palates and dentures were quantified and identified with the use of Chromagar, and clinical photographs of palates were taken. Microbiologic and clinical data were analyzed with the use of a series of statistical tests (α = .05).

RESULTS

Both treatments similarly reduced clinical signs of denture stomatitis and growth on palates and dentures at days 14 and 30 (P > .05). At sequential appointments, the predominant species (P < .01) isolated was C. albicans (range 98%-53%), followed by C. glabrata (range 22%-12%) and C. tropicalis (range 25%-7%).

CONCLUSIONS

Microwave disinfection, at once per week for 2 treatments, was as effective as topical antifungal therapy for treating denture stomatitis.

Changes in roughness of denture base and reline materials by chemical disinfection or microwave irradiation: surface roughness of denture base and reline materials

OBJECTIVE

The effect of disinfection by immersion in sodium perborate solution and microwave irradiation on surface roughness of one denture base resin (Lucitone 550 -L), 3 hard chairside reline resins (Tokuyama Rebase II-TR, New Truliner-NT, Ufi Gel hard-UH) and 3 resilient reline materials (Trusoft-T; Sofreliner-S, Dentusil-D) was evaluated.

MATERIAL AND METHODS

Thirty specimens of each material were made and divided into 3 groups: Control - not disinfected; P - daily disinfection by immersing in sodium perborate solution (3.8%); MW - microwave disinfection (6 min/650 W). Roughness measurements were made after polymerization (baseline) and after 1, 3 and 28 days. Roughness differences relative to the baseline readings were analyzed by Student's t-test (P=0.05).

RESULTS

At baseline, Trusoft showed the highest (P<0.001) mean surface roughness (3.54 µm), and its surface roughness was significantly reduced after 28 days of disinfection by immersion in sodium perborate (P=0.013). Roughness measurements of material Trusoft were not performed after microwave disinfection due to the severe alterations on the surface. In the 3 groups evaluated, changes in roughness were significant for materials Ufi Gel hard (from 0.11 to 0.26 µm; P<0.041) and New Truliner (0.19 to 0.76 µm; P<0.019). The roughness of materials Lucitone 550 (0.37 µm), Tokuyama Rebase II (0.37 µm), Sofreliner (0.49 µm) and Dentusil (0.38 µm) remained unaffected (P>0.05).

CONCLUSIONS

The roughness of the hard reline materials Ufi Gel hard and New Truliner was adversely affected by microwave disinfection, immersion in water or in sodium perborate. Microwave disinfection caused severe alterations on the surface of the resilient liner Trusoft.

Microwave disinfection: cumulative effect of different power levels on physical properties of denture base resins

PURPOSE

This study evaluated the cumulative effects of different microwave power levels on the physical properties of two poly(methylmethacrylate) (PMMA) denture base resins.

MATERIALS AND METHODS

Eight sets of four PMMA specimens each (two polymerized in a water bath and two using microwave energy) were immersed in beakers containing 200 ml of distilled water. Each beaker was subjected to microwave irradiation for 3 minutes at a power level of 450,630, or 900 W. The surface roughness, surface hardness, linear stability, flexural strength, elastic modulus, impact strength, and fractographic properties were evaluated after either 6 or 36 simulated disinfection cycles. The data were statistically analyzed using ANOVA and the Tukey post hoc test (α= 0.05).

RESULTS

The polymerization method did not influence any property (p > 0.05) except linear stability. The surface roughness (p < 0.001) and hardness (p= 0.011) increased after 36 irradiation cycles at 630 or 900 W. The resin polymerized using microwave energy exhibited greater linear distortion (p= 0.012), and there was a cumulative effect on linear stability for both resins (p < 0.001). No significant change (p > 0.05) was observed in flexural strength; however, the elastic modulus decreased (p= 0.008) after 36 disinfection cycles. The impact strength and crack propagation angles displayed no significant differences (p > 0.05).

CONCLUSION

Within the limitations of this study, it can be concluded that microwave disinfection at 450 W to 630 W for 3 minutes is safe for PMMA.

Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists

The current rates of edentulism have been estimated to be between 7% and 69% of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence-based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, American Dental Association (ADA) Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories, and representatives from GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence-based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and were published in February 2011 issue of The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force.

A conventional microwave oven for denture cleaning: a critical review

INTRODUCTION

Denture cleaning should be quick and easy to perform, especially in long-term care facilities. The lack of proper oral hygiene can put older adults at higher risk from opportunistic oral infections, particularly fungal. As an alternative to regular brushing, the use of a microwave oven has been suggested for cleaning and disinfecting dentures.

OBJECTIVES

To synthesise and discuss the advantages and disadvantages of the use of a conventional microwave oven for cleaning and disinfecting complete dentures.

METHODS

A brief literature search focused on papers dealing with microwave therapy for denture cleaning through PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, Ovid MEDLINE(R) In-Process, and Scifinder Scholar.

RESULTS

One hundred and sixty-seven manuscripts published in English with full text were found, and 28 were accepted and discussed in the light of the advantages and disadvantages of the use of conventional microwave oven for cleaning and disinfecting complete dentures.

CONCLUSIONS

There was no standardisation for microwave use for denture cleaning. Manual cleaning still seemed to be the optimal method for controlling fungal infection and denture stomatitis. However, such a daily routine appeared to be underused, particularly in long-term care facilities.

Denture disinfection by microwave irradiation: a randomized clinical study

OBJECTIVE

This study evaluated the clinical effectiveness of two exposure times of microwave irradiation on the disinfection of complete dentures.

METHODS

Biofilm samples were collected from dentures of 30 patients, who were randomly divided into two experimental groups of 15 subjects each: Group 1-patients had their maxillary denture microwaved for 3 min (650W); Group 2-patients had their maxillary denture microwaved for 2 min (650W). Denture biofilm samples were taken with swabs, before (left side surfaces) and after (right side surfaces) microwave irradiation. All microbial material was plated on selective media for Candida spp., Staphylococcus spp., mutans streptococci and a non-selective media. After incubation (48 h/37 degrees C), the number of colony-forming units (cfu/mL) was counted. Microorganisms which grew on selective media were identified using biochemical methods. The data were statistically analyzed by Kruskal-Wallis test, followed by Dunn's post-test (alpha=0.05).

RESULTS

Microwave irradiation for 3 min (Group 1) resulted in sterilization of all dentures evaluated. After microwave irradiation for 2 min (Group 2), a significant decrease in Candida spp. (P=0.0062), Staphylococcus spp. (P=0.0178), mutans streptococci (P=0.0047) and non-identified species (P<0.0001) was achieved in comparison with the cfu/mL obtained before irradiation. The colonies grown after 2 min of microwave irradiation were identified as Candida albicans, non-aureus Staphylococci and Streptococcus mutans.

CONCLUSION

Microwave irradiation for 3 min may be a potential treatment to prevent cross-contamination.

Effect of different exposure times on microwave irradiation on the disinfection of a hard chairside reline resin

PURPOSE

This study evaluated the effectiveness of different exposure times of microwave irradiation on the disinfection of a hard chairside reline resin.

MATERIALS AND METHODS

Sterile specimens were individually inoculated with one of the tested microorganisms (Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans, and Bacillus subtilis) and incubated for 24 hours at 37 degrees C. For each microorganism, 10 specimens were not microwaved (control), and 50 specimens were microwaved. Control specimens were individually immersed in sterile saline, and replicate aliquots of serial dilutions were plated on selective media appropriate for each organism. Irradiated specimens were immersed in water and microwaved at 650 W for 1, 2, 3, 4, or 5 minutes before serial dilutions and platings. After 48 hours of incubation, colonies on plates were counted. Irradiated specimens were also incubated for 7 days. Some specimens were prepared for scanning electron microscopic (SEM) analysis.

RESULTS

Specimens irradiated for 3, 4, and 5 minutes showed sterilization. After 2 minutes of irradiation, specimens inoculated with C. albicans were sterilized, whereas those inoculated with bacteria were disinfected. One minute of irradiation resulted in growth of all microorganisms. SEM examination indicated alteration in cell morphology of sterilized specimens. The effectiveness of microwave irradiation was improved as the exposure time increased.

CONCLUSION

This study suggests that 3 minutes of microwave irradiation can be used for acrylic resin sterilization, thus preventing cross-contamination.

Influence of microwave disinfection on the dimensional stability of intact and relined acrylic resin denture bases

STATEMENT OF PROBLEM

Microwave irradiation has been suggested as a method to disinfect denture bases. However, the effect of microwave heating on the dimensional stability of the relined denture bases is unknown.

PURPOSE

The purpose of this study was to evaluate the dimensional stability of intact and relined acrylic resin denture bases after microwave disinfection.

MATERIAL AND METHODS

A standard brass cast simulating an edentulous maxillary arch was machined and used to fabricate 2- and 4-mm-thick denture bases (n=200), which were processed with heat-polymerized acrylic resin (Lucitone 550). The 2-mm thick-specimens (n=160) were relined with 2 mm of autopolymerizing resin (Tokuso Rebase Fast, Ufi Gel Hard, Kooliner, or New Truliner). Distances between 5 removable pins on the standard brass cast were measured with a Nikon optical comparator, and the area (mm) formed by the distance between 5 pins was calculated and served as baseline. During fabrication, the pins were transferred to the intaglio surface of the specimens. Differences between the baseline area and those subsequently determined for the specimens were used to calculate the percent dimensional changes. The intact and relined denture bases were divided into 4 groups (n=10) and evaluated after: polymerization (control group P); 1 cycle of microwave disinfection (MW); daily microwave disinfection for 7 days (control group MW7); water storage for 7 days (WS7). Microwave irradiation was performed for 6 minutes at 650 W. Data were analyzed using 2-way ANOVA followed by Tukey's test (alpha=.05).

RESULTS

Intact specimens and those relined with Kooliner and New Truliner showed increased shrinkage after 1 (P=.05, .018, and .001, respectively) and 7 (P <.001, .003, and <.001, respectively) cycles of microwave disinfection. With the exception of specimens relined with Kooliner, intact specimens showed greater shrinkage than the relined specimens after 7 cycles of microwave disinfection.

CONCLUSIONS

Microwave disinfection produced increased shrinkage of intact specimens and those relined with New Truliner and Kooliner.

Candida albicans inactivation and cell membrane integrity damage by microwave irradiation

In indicating the microwave irradiation for disinfecting dentures it is necessary to see how this procedure influences Candida albicans integrity and viability. The aim of this study was to evaluate the ability of microwaves to inactivate C. albicans and damage cell membrane integrity. Two 200-ml C. albicans (ATCC 10231) suspensions were obtained. A sterile denture was placed in a beaker containing the Experimental (ES) or the Control suspension (CS). ES was microwaved at 650 W for 6 min. Suspensions were optically counted using methylene blue dye uptake as indicative of membrane-damaged cells; spread on Agar Sabouraud dextrose (ASD) for viability assay; or spectrophotometrically measured at 550 nm. Cell-free solutions were submitted to content analyses of protein (Bradford and Pyrogallol red methods); Ca++ (Cresolftaleine complexone method); DNA (spectrophotometer measurements at 260 nm) and K+ (selective electrode technique). Data were analysed by Student's t- or Wilcoxon z-tests (alpha = 0.05). All ES cells demonstrated cell membrane damage. Viable cells were non-existent in the ES ASD plates. No significant difference in optical density between ES and CS was observed (P=0.272). ES cells released significantly high protein (P<0.001, Bradford; P=0.005, Pyrogallol red), K+ (P<0.001), Ca++ (P=0.012) and DNA (P=0.046) contents. Microwaves inactivated C. albicans and damaged cell membrane integrity.

Effect of relining, water storage and cyclic loading on the flexural strength of a denture base acrylic resin

OBJECTIVES

This study investigated the effect of relining, water storage and cyclic loading on the ultimate flexural strength (FS(U)) and on the flexural strength at the proportional limit (FS(Pl)) of a denture base acrylic resin (Lucitone 550-L).

METHODS

Rectangular bars of L were made (64 mm x 10 mm x 2 mm) and relined (1.3mm) with four relining resins (Kooliner-K, Ufi Gel Hard-UGH, Tokuso Rebase Fast-TR and New Truliner-NT). In addition, specimens relined with L and intact L specimens were made (64 mm x 10 mm x 3.3 mm). A three-point flexural test was applied on the specimens (n=10) after (1) polymerization; (2) water storage (30 days); (3) cyclic loading (10,000 cycles at 5 Hz) and (4) water storage (30 days)+cyclic loading. Data (MPa) were analyzed with three-way ANOVA and Tukey's HSD tests (alpha=0.05). To test for a possible correlation between FS(U) and FS(Pl), a linear regression coefficient "r" was calculated.

RESULTS

After water storage, L-UGH and L-TR demonstrated an increased FS(U) (41.49-50.64 MPa and 49.95-57.36 MPa, respectively) (P<0.05). Only L-TR demonstrated an increased FS(Pl) (20.58-24.21 MPa) after water storage (P<0.05). L-L had the highest FS(U) (between 78.57 and 85.09 MPa) and FS(Pl) (between 31.30 and 34.17 MPa) (P<0.05). The cyclic loading decreased the FS(U) and FS(Pl) of all materials (P<0.05). Regression analysis showed a strong linear correlation between the two variables (r=0.941).

CONCLUSIONS

Water storage improved the FS(U) of L-UGH and L-TR and the FS(Pl) of L-TR. L-L produced the highest FS(U) and FS(Pl). The FS(U) and FS(Pl) of all materials were detrimentally influenced by cyclic loading.