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Gomes ACG, Maciel JG, Garcia AAMN, Coelho LAS, Rodrigues GM, Porto VC, Polyzois G, Klein MI, Soares S, Urban VM, Neppelenbroek KH. Anti-biofilm effectiveness of protocols for cleaning complete dentures in hospitalized patients: a randomized controlled trial. J Appl Oral Sci 2024; 32:e20230381. [PMID: 38537031 PMCID: PMC10984580 DOI: 10.1590/1678-7757-2022-0381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. OBJECTIVES To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. METHODOLOGY The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). RESULTS All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). CONCLUSIONS A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.
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Affiliation(s)
- Anna Clara Gurgel Gomes
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Janaina Gomes Maciel
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | | | - Letycia Accioly Simões Coelho
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Giulia Murcia Rodrigues
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Vinicius Carvalho Porto
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | - Grigorios Polyzois
- National and Kapodistrian University of Athens, School of Dentistry, Athens, Greece
| | - Marlise Inêz Klein
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Piracicaba, SP, Brasil
| | - Simone Soares
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
| | | | - Karin Hermana Neppelenbroek
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, SP, Brasil
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Çakmak G, Asadolahi NW, Schimmel M, Molinero-Mourelle P, Akay C, Donmez MB, Yilmaz B. Effect of coffee thermal cycling on the surface properties and stainability of additively manufactured denture base resins in different layer thicknesses. J Prosthodont 2023. [PMID: 37968565 DOI: 10.1111/jopr.13803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE To compare the effect of coffee thermal cycling on surface roughness (Ra), Vickers microhardness (MH), and stainability of denture base resins additively manufactured in different layer thicknesses with those of subtractively manufactured denture base materials. MATERIALS AND METHODS Eighty disk-shaped specimens (Ø10×2 mm) were fabricated from two subtractively (Merz M-PM [SM-M] and G-CAM [SM-G]) and three additively (NextDent 3D+ [50 µm, AM-N-50; 100 µm, AM-N-100], FREEPRINT Denture [50 µm, AM-F-50; 100 µm, AM-F-100], and Denturetec [50 µm, AM-S-50; 100 µm, AM-S-100]) manufactured denture base materials (n = 10). Ra measurements were performed before and after polishing by using a non-contact optical profilometer, while MH values and color coordinates were measured after polishing. Specimens were then subjected to 5000 cycles of coffee thermal cycling, all measurements were repeated, and color differences (ΔE00) were calculated. A linear mixed effect model was used to analyze Ra and MH data, while one-way analysis of variance was used to analyze ΔE00 data (α = 0.05). Ra values were further evaluated according to a clinically acceptable threshold of 0.2 µm, while ΔE00 values were evaluated according to perceptibility (1.72 units) and acceptability (4.08 units) thresholds. The interaction between the material type and the time interval affected both Ra and MH (p ≤ 0.001). Tested materials had their highest Ra before polishing (p ≤ 0.029). Before polishing, AM-F-100 had the highest, and SM-M and SM-G had the lowest Ra (p < 0.001). After polishing and after coffee thermal cycling, SM-G mostly had lower Ra than those of other materials (p ≤ 0.036). SM-G mostly had higher MH than that of other materials before and after coffee thermal cycling (p ≤ 0.025). Coffee thermal cycling reduced the MH of SM-M and increased that of AM-S-100 (p ≤ 0.024). AM-N-100 had higher ΔE00 than AM-F, AM-S-100, and SM-G (p ≤ 0.009), while AM-F and SM-G had lower ΔE00 than AM-S-50 and AM-N-50 (p ≤ 0.024). CONCLUSIONS Polishing reduced the surface roughness of all materials, whereas the effect of coffee thermal cycling was nonsignificant. Most of the tested materials had acceptable surface roughness after polishing and after coffee thermal cycling according to the reported threshold. Layer thickness only affected the microhardness of tested additively manufactured resins, which was material-dependent. Subtractively manufactured specimens mostly had high microhardness and that of nonreinforced subtractively manufactured resin decreased after coffee thermal cycling. When reported color thresholds are considered, all materials had acceptable color stability.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nura Watson Asadolahi
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Osmangazi University, Eskisehir, Turkey
- Translational Medicine Research and Clinical Center, Osmangazi University, Eskisehir, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA
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