Effect of soft denture liners on complete denture treatments: A systematic review

PURPOSE

This systematic review examined the effectiveness of soft denture relining (SDR) materials.

STUDY SELECTION

A comprehensive search of MEDLINE, Cochrane Library, and ICHUSHI was conducted up to July 26, 2020. Target outcomes were patient satisfaction, oral health-related quality of life (OHRQOL), masticatory ability (MA), denture functional duration, residual ridge resorption (RRR), and microbial contamination. An organization specializing in literature searches performed the reference searches, and two reviewers independently selected the literature sources, extracted the data, and assessed the risk of bias. The reviewers resolved any disagreements concerning the assortment of literature sources through discussion. SDR included acrylic- and silicone-based materials, which were evaluated separately.

RESULTS

Reviewers selected 7, 5, 11, 1, 4, and 6 studies to assess patient satisfaction, OHRQOL, MA, functional duration, RRR, and microbial contamination, respectively. The results confirmed that SDR improved patient satisfaction, OHRQOL, MA, and RRR. However, the functional duration of SDR material is shorter than that of hard denture relining (HDR) or acrylic resin material. Furthermore, SDR material is more susceptible to microbial contamination in the long term. The risk of bias for the included studies tended to be high because of specific issues (difficulty in blinding SDR versus HDR).

CONCLUSIONS

For patients who wear complete dentures, SDR often provides beneficial outcomes such as pain reduction and recovery from MA. However, caution should be exercised regarding their use owing to insufficient functional duration and the possibility of microbial contamination during long-term use.

Effect of Professional Denture Cleaning on Surface Roughness of Silicone or Acrylic Soft Relining Materials

The aim of this study was to investigate the effects of combining mechanical (ultrasonic) and chemical cleaning (using denture cleaners) on the surface roughness of silicone or acrylic soft relining materials. The silicone soft relining material with the lowest Shore A hardness and a acrylic soft relining material routinely used in Japan were selected. Four groups were established based on type of treatment: immersion in water (W); ultrasonic cleaning in tap water (U); ultrasonic cleaning in a hypochlorous acid denture cleanser (HU); or ultrasonic cleaning in an acidic denture cleanser (AU). Following the tests, surface roughness was determined as the arithmetic mean height of the surface (Sa) and maximum height (Sz). Data were analyzed using the Kruskal-Wallis test followed by Bonferroni correction for a multiple comparison. No significant difference was observed in the Sa or Sz of the silicone soft relining material between the 4 groups. Significant differences were observed in the Sa of the acrylic soft relining material between Groups W and HU (p=0.008) and between Groups W and AU (p=0.008), but no significant differences in the Sz among the 4 groups. Combining U with AU or U with HU yielded no increase in the surface roughness of the silicon soft relining material. The surface roughness of the acrylic soft relining material showed an increase, however, with the combination treatments used.

Comparison of adhesiveness of chewing gum to hard and soft denture base materials

PURPOSE

The purpose of this study was to compare the adhesiveness of chewing gum to hard and soft denture base materials to investigate food retention associated with the basal surface of the denture.

METHODS

Test specimens were fabricated using acrylic resin[Re], cobalt-chromium alloy[Co], zirconia[Zr], silicone soft relining material[SS], and acrylic soft relining material[AS]. Samples were set on a top-and-bottom pair lifting platform equipped with a digital force gauge. The experimenter chewed 3.0 g of chewing gum for 5 min. After surface saliva was wiped off, the chewing gum was placed on the lower test fragment and compressed until the distance between the upper and lower test fragments decreased to 1 mm. The upper test fragment was pulled at a crosshead speed of 100 mm/min. Adhesiveness was measured under dry conditions, and under wet conditions with inter-positioned artificial saliva.

RESULTS

Under dry conditions, the adhesive strength was 17.04 ± 1.99 N for Re, 12.88 ± 2.20 N for Co, 3.80 ± 1.03 N for Zr, 5.76 ± 1.41 N for SS, and 12.54 ± 2.44 N for AS. Under wet conditions, the adhesive strength was 5.26 ± 1.64 N for Re, 0.96 ± 0.21 N for Co, 3.32 ± 0.40 N for Zr, 5.20 ± 1.35 N for SS, and 6.78 ± 1.97 N for AS.

CONCLUSIONS

Among the hard denture base materials, zirconia recorded low adhesiveness and Re recorded high adhesiveness under both wet and dry conditions. The adhesiveness of Co was low under wet conditions but high under dry conditions. Among the soft denture base materials, SS under dry conditions recorded lower adhesiveness than that of AS. The adhesiveness of SS was low under both wet and dry conditions.

Effect of mechanical and chemical cleaning on surface roughness of silicone soft relining material

PURPOSE

This study aims to investigate the effect of mechanical and chemical cleaning on the surface roughness of silicone soft relining materials.

METHODS

We selected silicone soft relining materials with the highest (Soft) and lowest (Supersoft) Shore A hardness. In the abrasion test, specimens were cleaned 50,000 times using a kitchen sponge (Sponge), a soft (Soft brush) or hard (Hard brush) denture brush, or stored in water (No cleaning). In the immersion test, specimens were immersed in either water (Water), neutral peroxide denture cleanser (Neutral), alkaline peroxide denture cleanser (Alkaline), or hypochlorite denture cleanser (Hypochlorite) for 1440 h. Surface roughness of the arithmetic mean height of the surface (Sa) and maximum height (Sz) were measured before and after the tests. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests.

RESULTS

In the abrasion test, significant differences were observed for Sa and Sz with Soft relining materials, but not for No cleaning and Sponge. In the immersion test, significant differences were observed for Sa and Sz with Soft relining materials, but not between Water and Neutral or Water and Alkaline. Significant differences were observed with Supersoft, except between Water and Neutral or Water and Alkaline for Sa and between Water and Neutral for Sz.

CONCLUSIONS

Mechanical cleaning using a sponge did not increase the surface roughness of the material with a high Shore A hardness. Furthermore, neutral peroxide denture cleanser did not increase the roughness of materials with high and low Shore A hardness.

Surface morphology of silicone soft relining material after mechanical and chemical cleaning

PURPOSE

The objective was to investigate the influence of chemical and mechanical cleaning on the surface morphology of a silicone soft relining material.

METHODS

Three plate-shaped specimens were prepared for each group (Control, Hard and Soft) by laminating a 1.5-mm-thick silicone soft relining material. The Control group specimens were stored in water, and the Hard and Soft group specimens were cleaned with hard and soft bristle denture brushes, respectively. Abrasion testing with a toothbrush and immersion testing with an enzyme-containing peroxide denture cleanser were performed, simulating a period of approximately 4 months. The arithmetic mean roughness (Sa) and maximum height of the cross-section (Sz) were measured before and after abrasion and immersion testing.

RESULTS

Sa was 4.9±0.9, 22.1±4.2 and 44.2±4.0μm in the Control, Soft and Hard groups, respectively. Sz was 257.5±31.7, 392.0±23.8 and 452.2±41.9μm in the Control, Soft and Hard groups, respectively. After abrasion testing, Sa and Sz differed significantly between the Soft and Control groups and between the Hard and Control groups. Sa was 2.2±1.2μm before and after immersion, and Sz was 142.1±81.4μm before and after immersion. No significant difference was noted in either Sa or Sz in the Control specimens before or after immersion.

CONCLUSIONS

Surfaces cleaned using a soft bristle brush were less likely to roughen than those cleaned with a hard bristle brush under the conditions of this study. Additionally, chemical cleaning using the enzyme+neutral peroxide denture cleanser did not roughen the surface of the silicone soft relining material.