Effect of Food-Simulating Liquids on the Leachability of Plasticizers from Dental Tissue Conditioners

OBJECTIVE

 Tissue conditioners are composed of poly(ethyl methacrylate) (PEMA) powder and plasticizer/ethanol mix liquid. Butyl phthalyl butyl glycolate (BPBG) plasticizer is commonly used in tissue conditioners, but the main concern with phthalate plasticizer is its leachability and biocompatibility, especially the estrogenic activity and cytotoxicity of phthalate. Therefore, acetyl tributyl citrate (ATBC) plasticizer has been introduced and formulated as plasticizer in tissue conditioner; however its leachability characteristics are still unknown. Furthermore, the effect of foodsimulating liquids toward leachability of BPBG and ATBC plasticizers has not been documented. The objective of this study was to compare the effect of food-simulating liquids on the leachability of plasticizers and hardness of two experimental tissue conditioners containing BPBG and ATBC plasticizers.

MATERIALS AND METHODS

 Ten experimental materials were prepared using PEMA polymer powder with 95% plasticizer (BPBG and ATBC) and 5% ethanol by volume, using powder to liquid ratio of 1.67:1, and the thickness was controlled at 3 mm. Shore A hardness value was measured after immersion in distilled water, artificial saliva, 25% ethanol/water mix, 3% citric acid, and coconut oil at 37°C. Measurements were taken at 2 hours and 1, 2, 3, 4, 7, 10, 14, 21, 28, 42, 56, and 84 days. Six readings were taken for each sample and hardness change was calculated and statistically analyzed using Wilcoxon signed-rank test.

RESULTS

 Increase in hardness value was noted for both plasticizers over time with the highest increase was when immersed in coconut oil. Shore A hardness value was significantly higher in ATBC after 84 days of immersion in all food-simulating liquids. The increase in hardness is due to plasticizer/ethanol leaching; however, as ethanol content was the same (5%), the hardness change is attributed to the leaching of plasticizers.

CONCLUSION

 Leaching of both plasticizers was highest in coconut oil indicating that tissue conditioners may have a shorter intraoral lifetime in patients eating high-fat diet.

Milled Crown on Post Crack Tooth Syndrome as the Denture Abutment Tooth: A Case Report

This clinical case describes using a milled crown on a cracked tooth as the abutment for a removable partial denture. A 63-year-old male patient diagnosed with lipoma undergoing chemotherapy and radiotherapy presented with symptomatic crack tooth syndrome on tooth 36 and partial edentulism. Conservative treatment using a molar band to extracoronally splint the tooth was conducted to determine the prognosis of the crack line. A lower partial cobalt-chromium denture was constructed by incorporating the milled crown of tooth 36 as the abutment. After six months of follow-up, there were no crack tooth symptoms, and regular review was adopted to monitor the tooth. The construction of a milled crown of a cracked tooth presented good and promising clinical outcomes in preserving tooth vitality and preventing crack propagation in partially dentate dentition for the long term.

A Rare Case of Contact Allergy towards Impression Compound Material

Impression compound has been introduced for more than 100 years. Since then, it has been widely used to obtain a preliminary impression of the edentulous arch. Although the use of impression compound has declined markedly over recent years as newer materials have become available, the cost-effectiveness and desirable physical and mechanical properties make this material indispensable in developing countries and teaching institutions. Its high viscosity characterizes impression compound as a mucocompressive impression material, which enables the full depth of the sulcus to be recorded for the retention of complete dentures. Literature reviews revealed that most contact allergies to impression materials are towards polyether, very few are towards alginate and polysulfide, and no reported cases have been found toward impression compound. This case report demonstrates a recent rare case of contact allergy towards impression compound during a routine impression taking for a fully edentulous arch in a 61-year-old woman. The patient developed symptoms of an allergic reaction, and the management of the condition was described.

Oral Health-Related Quality of Life of Adult Orang Asli in Jelebu, Malaysia: A Cross-Sectional Study

Aims:

This study aimed at exploring the self-perception of Orang Asli (OA) from the Temuan tribe in Jelebu by using the Global Self-rated Oral Health (GSROH) and General Oral Health Assessment Index (GOHAI).

Materials and Methods:

It was a cross-sectional study involving a two-stage sampling to select the district and villages. A total of 325 participants were selected based on convenience sampling.

Results:

Almost half of the participants rated their oral health as poor or average. The mean GOHAI score was 52.96 (±7.749), ranging from 29 to 60. The GOHAI score was statistically significantly lower for female gender (P = 0.025), lower education level (P = 0.001), and elderly (P = 0.001). The GSROH score was also statistically significant with GOHAI score (P = 0.001).

Conclusions:

A limited number of studies were conducted in this area, particularly in the vulnerable population of OA. Our study found that half of the OA living in the fringe had a poor GOHAI score. It is, therefore, suggested that potential study and intervention programs concentrate on the low GOHAI score group; the male, lower educational context, and the elderly.

An Evaluation on Full Coverage Crown Preparation: An Institutional Analysis

Introduction: Undergraduate (UG) dental students are trained for fixed prosthodontics course clinically in teaching institutions during the clinical years. However, there is a lack of objective data on the quality of fixed prostheses preparations done by UG students on their patients for academic and clinical staff. Aim: To evaluate the full-coverage crown preparations performed by UG dental students in the university clinical teaching programme. Materials and Methods: This study was a clinical audit done in the Faculty of Dentistry, Universiti Sains Islam, Malaysia (USIM) from April to July 2018. The demographic and clinical data were collected from the patients’ notes and included relevant information of patients such as age, gender and others. Full-coverage crowns were analysed and crown preparation assessments were done using specific criteria and standards. The descriptive data were measured in frequency and percentage for categorical variables and mean and standard deviation for continuous data. Results: A total of 31 patients fitted with 45 units of full-coverage crowns were analysed. The mean age of patients treated by fifth year dental students was 40.5 (±14.16) years. A 51% Porcelain Fused to Metal (PFM) crown provided to the patients. On the whole, UG undergoing the dentistry programme in the institution scored the lowest (51%) on proximal reduction and the highest (97.7%) on producing smooth and continuous preparation. Conclusion: Majority of the crowns prepared by students have acceptable preparation except in proximal reduction and cervical margin preparation that can be improved upon and emphasised further during the teaching and learning sessions.

The Knowledge And Practice Of Copy Denture Technique Among Dentist And Dental Technologist

Introduction: Copy denture technique is a classic technique for construction of a new denture based on the favourable aspects of the original denture using a replica. This technique helps in adaptation of new denture in elderly population. The aim of this paper was to assess the knowledge and practice of copy denture technique among dentists and dental technologists. Materials and Methods: A pre-tested questionnaire was sent to all participants who attended the Copy Denture Workshop organized by USIM on 13th April 2017. Two sets of the same questionnaire were distributed to the participant before and after the seminar. Results: Out of 100 participants, only 77% (n=77) have given valid feedbacks. The results showed, even though 54.5% (n=42) participants had more than 5 years of clinical experience, 42.9% (n=33) of the participants have poor knowledge in this technique before the seminar begin. However 55.9% presented with positive attitude towards copy denture. Most of the participants did not know about copy denture technique (43.1%) and the advantages of the technique (32.9%). 74.1% (n=57) participants were uncertain to perform the technique and did not have the skills to perform the copy denture technique. However, after attending the workshop, their attitude towards copy denture increased (+15.6%) and the mean score value was statistically significance with p-value 0.049. Conclusion(s): Awareness and workshop on copy denture technique should be encouraged to improve knowledge and practice, so that the patient who requested for replacement denture will benefit from this technique.

Salvodara Persica As An Oral Aids For Edentulous Patients

Introduction: Salvadora percisa (popularly known as miswak) has been widely used as an aid for oral hygiene in dentate patient. There is no side effect of using miswak stick. A new approach introduced the role of miswak stick in edentulous patient. It may prevent the incidence of denture stomatitis among denture wearer. This study assessed the effectiveness of the miswak stick as an oral aid in edentulous patients as an alternative treatment for denture stomatitis. Materials and Methods: A clinical case control study included patients affected by denture stomatitis. The Miswak stick was introduced to the subjects to use as the oral device to clean the denture and oral mucosal area everyday. Pre- and postoperative assessment (clinical and photographic) were evaluated within 8 to 12 weeks and analysed by comparing the mapping of denture stomatitis inflammation. Results:  A total of 11 subjects with denture stomatitis comprised as type 1; n=5 (46%), type 2; n=4 (36%) and type 3; n=2 (18%). 54.5% of subjects showed more than 50% reduction in the mapping of denture stomatitis inflammation (p<0.05) after the use of miswak stick. This study also showed that the use of miswak stick for more than 3 weeks to Type I and II denture stomatitis (54.6%) has successfully reduce the inflammation for more than 50%. 54.5% of the subjects with good denture hygiene has 50% more reduction of denture stomatitis. Conclusion(s):  The miswak stick was significantly effective to reduce the denture stomatitis with a regular use and maintenance of good denture hygiene.