Comparative Evaluation of Hardness and Energy Absorption of Some Commercially Available Chairside Silicone-Based Soft Denture Liners and a Heat-Cured Soft Denture Liner

Aim

To investigate the hardness and energy absorption of four commercially available chairside types of silicone materials and compare their properties with heat-cured silicone material.

Materials

The chairside materials investigated were GC reline soft, mucopren soft, sofreliner soft and elite soft relining. The heat-cured polymer silicone material was Molloplast B. All soft lining materials were processed according to manufacturers' instructions. Two properties were investigated. Ten specimens for each test were prepared for each soft liner except for the water absorption and solubility test, for which only five specimens were prepared. The specimens of energy absorption (10 × 10 × 3 mm) were tested using a Lloyd instruments testing machine. Hardness specimens (38 × 38 × 3) were tested using a shore A durometer and were divided into two subgroups; dry and wet storage.

Results

The specimens of energy absorption (10 × 10 × 3 mm) were tested using a Lloyd instruments testing machine. Sofreliner soft was significantly softer than Molloplast B. GC reline soft was significantly harder than molloplast B. At high loads, sofreliner soft and elite soft relining was significantly more resilient than molloplast B. Mucopren soft was significantly stiffer than Molloplast B. At low loads, all materials showed similarities in stiffness and resilience; the difference between them was insignificant. After one month of immersion, GC reline and mucopren significantly increased hardness values.

Conclusion

In all conditions and at all four-time points, the hardness values for GC Reline soft were the greatest, and hardness values for Sofreliner Soft were the least. Some chairside soft denture lining materials could have similar significant properties to molloplast-B, such as sofreliner soft and elite.

Tensile Bond Strength between Different Denture Base Materials and Soft Denture Liners

(1) Background: Various materials are available for CAD-CAM denture base fabrication, for both additive and subtractive manufacturing. However, little has been reported on bond strength to soft denture liners. Therefore, the aim of this study was to investigate tensile bond strength, comparing between different denture base materials and soft denture liners. (2) Methods: Seven different materials were used for denture base fabrication: one heat-polymerized polymethyl methacrylate, three materials for subtractive manufacturing, two materials for additive manufacturing and one polyamide. Two materials were used for soft denture lining: one silicone-based and one acrylate-based. The study was conducted according to the specification ISO No. 10139-2:2016, and the type of failure was determined. The Kruskal-Wallis test with Dunn's post hoc test was used to analyse the values of tensile bond strength, and Fisher's exact test was used to analyse the type of failure. p Values < 0.05 were considered statistically significant. (3) Results: The tensile bond strength values were not statistically significantly different combining all the materials used for denture base fabrication with the acrylate-based soft denture liner (p > 0.05), and the average values ranged between 0.19 and 0.25 Mpa. The tensile bond strength values of the different denture base materials and silicone-based denture liner were statistically significantly different (p < 0.05), and the average values ranged between 1.49 and 3.07 Mpa. The type of failure was predominantly adhesive between polyamide and both additive-manufactured denture base materials in combination with the acrylate-based soft liner (p < 0.05). (4) Conclusions: The use of digital technologies in denture base fabrication can have an influence on different tensile bond strength values for soft denture liners, with different types of failure when compared with heat-cured PMMA. Similar tensile bond strength values were found between the acrylate-based soft denture liner and denture base materials. Significant differences in tensile bond strength values were found between the silicone-based soft denture liner and denture base materials, where the additive-manufactured and polyamide denture base materials showed lower values than heat-cured PMMA and subtractive-manufactured denture base materials.

Effects of Litsea cubeba Essential Oil Incorporated into Denture Soft Lining Materials

The antimicrobial properties, cell cytotoxicity and surface hardness of soft lining materials (GC soft liner, Viscogel and Coe comfort) incorporated with various concentrations of Litsea cubeba essential oil (LCEO) were evaluated. The minimum inhibitory concentrations of LCEO against Candida albicans and Streptococcus mutans were 1.25% v/v and 10% v/v, respectively. However, when LCEO was incorporated into the three soft lining materials (GC soft liner, Viscogel and Coe comfort), 10% v/v and 30% v/v of LCEO could inhibit the growth of C. albicans and S. mutans, respectively. The extracts of soft lining materials with 10% and 30% v/v LCEO, 2% chlorhexidine, 30% v/v nystatin and no additive were used for cytotoxicity tests on a human gingival fibroblast cell line. There was no significant difference in cell viability in all groups with additives compared to the no additive group (p > 0.05). Surface hardness increased significantly between 2 h and 7 day incubation times in all groups, including the controls (p < 0.05). A higher LCEO concentration had a dose-dependent effect on the surface hardness of all soft lining materials (p < 0.05). However, the surface hardness of materials with additive remained in accordance with ISO 10139-1. LCEO could be used as a natural product against oral pathogens, without having a negative impact on soft lining materials.

Effect of denture liners surface modification with Equisetum giganteum and Punica granatum on Candida albicans biofilm inhibition

Aim: This study investigated the effect of denture liners surface modification with Equisetum giganteum (EG) and Punica granatum (PG) on Candida albicans biofilm inhibition supposing its usage as a sustained-release therapeutical delivery system for Candida-associated denture stomatitis. Materials & methods: C. albicans biofilm (SC5314 or ATCC 90028) was formed on soft liners superficially modified by a primer mixed to drugs at minimum inhibitory concentrations (0.100 g for EG and PG or 0.016 g for nystatin per ml of primer). After 24 h, 7 or 14 days, antibiofilm activity was evaluated by colony-forming unit counts. Results: Not all groups were equi-efficient to nystatin after 24 h and 7 days. After 14 days, EG and PG efficacies were not different from nystatin (almost 100% inhibition). Conclusion: The proposed protocol presents a promising option to allopathic drugs for Candida-associated denture stomatitis treatment.

Is there an optimal method to detach Candida albicans biofilm from dental materials?

Introduction. Candida albicans can produce a complex, dynamic and resistant biofilm on the surface of dental materials, especially denture base acrylic resins and temporary soft liners. This biofilm is the main aetiological factor for denture stomatitis, an oral inflammatory condition characterized by chronic and diffuse erythema and oedema of the denture bearing mucosa.Gap Statement. There is no consensus in the literature regarding the best method to detach biofilms from dental materials. In order to assess the antifungal efficacy of new materials and treatments, the biofilm needs to be properly detached and quantified.Aim. This study compared different methods of detaching C. albicans biofilm from denture base acrylic resin (Vipi Cril) and temporary soft liner (Softone) specimens.Methodology. Specimens of each material were immersed in an inoculum of C. albicans SC5314 and remained for 90 min in orbital agitation at 75 r.p.m. and 37 °C. After the removal of non-adherent cells, the specimens were immersed in RPMI-1640 medium for 48 h. Biofilm formation was evaluated with confocal laser scanning microscopy (n=5). Then, other specimens (n=7) were fabricated, contaminated and immersed in 3 ml of sterile phosphate-buffered saline (PBS) and vortexed or sonicated for 1, 2, 5, or 10 min to detach the biofilm. The quantification of detached biofilm was performed by colony-forming unit (c.f.u.) ml^-1 count. Results were submitted to one-way analysis of variance (ANOVA)/Tukey HSD test (α=0.05).Results. A mature and viable biofilm was observed on the surfaces of both materials. For both materials, there was no significant difference (P>0.05) among detachment methods.Conclusion. Any of the tested methods could be used to detach C. albicans biofilm from hard and soft acrylic materials.

Effect of Incorporation of Silver Nanoparticles on the Tensile Bond Strength of a Long term Soft Denture Liner

OBJECTIVES

 This study aimed at assessing the effect of the addition of silver nanoparticles (SNPs) to a silicone soft liner on its tensile bond strength to denture base resin.

MATERIALS AND METHODS

 SNPs were added to Mucopren cold cure soft liner in 0 (control), 0.5, 1, 2, and 3 wt% concentrations and bonded in 120 stainless steel molds with processed heat cure acrylic resin blocks. Liner/resin combination samples were divided into two groups. The first half was stored for 2 days in distilled water at 37°C and then subjected to tensile bond strength, while the other half were thermocycled 3000 times before testing. Mean bond strength, expressed in mega pascals (MPa), was determined in the tensile test with the use of a universal testing machine at a crosshead speed of 5 mm/min.

STATISTICAL ANALYSIS

 Data were analyzed using SPSS via one-way analysis of variance test, t-test, and Tukey's posthoc, at a 95% confidence level (p < 0.05).

RESULTS

 Addition of SNPs and thermocycling both caused a significant reduction in the tensile bond strength of Mucopren to acrylic resin; however, in the thermocycled group, the bond strength increased with the increase in the concentration of SNPs (p < 0.001).

CONCLUSION

 Addition of SNPs to Mucopren soft silicone liner reduces its tensile bond strength to denture acrylic resin.

Intraoral Device for Optimal Antifungal Delivery in a Rat Model

BACKGROUND

Antifungal agents incorporated into temporary denture resilient liners as drug carriers and delivery have been suggested as an alternative treatment for denture stomatitis. However, to test the in vivo biocompatibility of this protocol, standardization of an intraoral device for optimal drug delivery is required.

OBJECTIVE

Standardized criteria were produced to adjust an acrylic intraoral device (IOD) for rats feasible for denture stomatitis treatment by sustained drug-delivery based on minimal inhibitory drug concentrations (MICs) of antifungals for Candida albicans biofilm.

METHOD

Adjustments methodological involved diet, impression technique, type of retention device to the palate and histopathological analysis. 115 Wistar rats were tested without IOD, with devices without relining or relined with temporary resilient material (Trusoft) modified or not by drugs at MICs (nystatin-0.032g/mL; chlorhexidine diacetate-0.064g/mL; ketoconazole-0.128g/mL). The animals were sacrificed after 7 or 14 days from the IOD installation.

RESULTS

Paste diet enabled the best animal survival conditions. The IODs that most satisfactorily remained in position were those designed only to the posterior palatal mucosa and cement-retained in molars, being all obtained from impressions highly detained and individual. In both periods, Trusoft without/with drugs showed good performance. Only histological samples from hard/soft tissues were considered appropriate for region of interest-RI determination (n=12), which corresponded to the area restricted to the first molars between the palatal neurovascular bundles. Final samples of all groups allowed a standardized descriptive histopathological analysis in both periods.

CONCLUSION

The methodological standardization of this rat model resulted in IODs for optimal antifungal delivery for denture stomatitis treatment.

In Vitro Evaluation of Resilient Liner after Brushing with Conventional and Experimental Ricinus communis-Based Dentifrices

PURPOSE

To evaluate the effect of experimental (Ricinus communis) and commercial dentifrices used for denture cleaning on abrasiveness (gravimetric method; roughness), hardness, and color stability of a resilient relining material.

MATERIALS AND METHODS

Sixty circular (15 × 3 mm) specimens were distributed into four groups: C (control; brushing with water); CO (brushing with Colgate - for natural teeth); CB (brushing with Corega Brite - for complete dentures); RC (brushing with experimental dentifrice). Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension for 50 minutes, calculated to correspond to 1 year of regular brushing. Variables were measured initially and after the trial period. For the gravimetric method, the difference in mass was considered. The surface roughness was measured by a rugosimeter, and the hardness test was performed by a Shore A durometer. Color changes (ΔE; CIE L*a*b* and NBS systems) were measured by a portable spectrophotometer. Results were analyzed by ANOVA/Tukey's test (α = 0.05).

RESULTS

The largest mass variation (μg; p < 0.0001) occurred in C (-6.21 ± 3.18). Concerning roughness, CB (0.26 ± 0.04) showed the lowest value, followed by RC (0.29 ± 0.08) and CO (0.34 ± 0.24) (p < 0.0001). Group C produced the greatest surface roughness (0.72 ± 0.25). Hardness values decreased after brushing with water (p = 0.014). No significant differences were found among RC (50.31 ± 1.03), CO (49.11 ± 1.31), CB (49.17 ± 1.23), and C (48.02 ± 1.26). Color stability was similar in all groups (p = 0.135; C: 2.3 ± 0.77; CO: 2.6 ± 0.54; CB: 2.2 ± 0.44; RC: 2.9 ± 1.56).

CONCLUSIONS

The use of experimental dentifrice could be indicated, as it showed similar results to the specific dentifrice, keeping the resilient material properties within acceptable values.

Effect of Incorporation of Antifungal Agents on the Ultimate Tensile Strength of Temporary Soft Denture Liners

PURPOSE

To investigate the ultimate tensile strength of temporary soft denture liners modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm (SC5314) determined in previous microbiological research.

MATERIALS AND METHODS

Dumbbell-shaped specimens (n = 7) with a central cross-sectional area of 6 × 3 × 33 mm were produced by Softone and Trusoft, without (control) or with incorporation of drugs in powder form at MICs for C. albicans biofilm (per g of material powder): nystatin (0.032 g), chlorhexidine diacetate (0.064 g), ketoconazole (0.128 g), miconazole (0.256 g), and itraconazole (0.256 g). After plasticization, specimens were immersed in distilled water at 37°C for 24 hours, 7 or 14 days, and then tested in tension in a universal testing machine at 40 mm/min. Data of tensile strength (MPa) and elongation percentage (%) were submitted to 3-way ANOVA and Tukey's test (α = 0.05).

RESULTS

At the end of 14 days, the tensile strength for both materials was significantly lower in the groups modified by miconazole and itraconazole compared to the other groups (p < 0.0001), which showed no significant difference between them (p > 0.05). After 7 and 14 days in water, miconazole and itraconazole added into both materials resulted in significantly lower elongation percentages compared to the other antifungal agents and control (p < 0.0001), which were similar to each other (p > 0.05).

CONCLUSIONS

The addition of the nystatin, chlorhexidine, and ketoconazole at MICs for C. albicans biofilm resulted in no harmful effects on the tensile strength and elongation percentage of the temporary soft denture liner materials up to 14 days.

Effect of the addition of antimicrobial agents on Shore A hardness and roughness of soft lining materials

PURPOSE

While the incorporation of antimicrobial agents into soft denture liners has been suggested as a reliable alternative treatment for denture stomatitis, it may affect the liner's properties. The effect of addition of antimicrobial agents for the treatment of denture stomatitis on the surface roughness and Shore A hardness of soft lining materials was evaluated.

MATERIALS AND METHODS

The test groups comprised specimens (36 × 7 × 6 mm(3) ) of soft materials (Softone and Trusoft) without (control) or with incorporation of drugs (nystatin, miconazole, ketoconazole, chlorhexidine diacetate, and itraconazole). Hardness (Shore A) and roughness (Ra) were evaluated after immersion of specimens (n = 10) in distilled water at 37°C for 24 hours, 7 and 14 days. Data were analyzed by 3-way ANOVA/Tukey's test (α = 0.05).

RESULTS

After 14 days, an increase (p < 0.05) was observed in the hardness of soft materials with time for the modified specimens, except for itraconazole. Addition of drugs increased the Softone roughness only for the addition of miconazole and chlorhexidine (p < 0.05), and did not increase the roughness of Trusoft with time. Only chlorhexidine and itraconazole altered the roughness compared to the control for each material (p < 0.05).

CONCLUSIONS

The smallest changes of hardness and roughness with time in the modified groups compared to controls were observed for itraconazole groups for both materials.

Effect of antimicrobial agents incorporated into resilient denture relines on the Candida albicans biofilm

OBJECTIVE

The antimicrobial action of five drugs incorporated in temporary denture relines on the fungal biofilm was evaluated.

MATERIALS AND METHODS

A Candida albicans biofilm (SC5314) was formed on specimens (10 × 1 mm) of materials (Trusoft and Softone) modified or not (control) by the drugs (nystatin, miconazole, ketoconazole, itraconazole, and chlorhexidine diacetate). Cell viability was determined spectrophotometrically by the tetrazolium salt reduction assay (XTT) after 24 h, 48 h, and 7 and 14 days of incubation. The minimum inhibitory concentrations (MICs) were those which inhibited 90% or more of fungal growth. Fungal susceptibility was confirmed by confocal laser scanning microscopy analysis.

RESULTS

The MICs of drugs incorporated in the materials were 0.032, 0.256, 0.128, 0.256, and 0.064 g ml(-1) for nystatin, miconazole, ketoconazole, itraconazole, and chlorhexidine, respectively. Images from nystatin, chlorhexidine, and ketoconazole demonstrated no viable cells.

CONCLUSIONS

The antimicrobials incorporated in the resilient materials inhibited fungal growth during 14 days, with lower MICs for nystatin and chlorhexidine.

Analysis of stress on mucosa and basal bone underlying complete dentures with different reliner material thicknesses: a three-dimensional finite element study

The aim of this study was to determine the optimal thickness of reliner material that provides the least amount of stress on thin mucosa and supporting bone in patients with complete removable dentures using a three-dimensional finite element analyses. The model was obtained from two CT scans of edentulous mandibles with dentures supported by the alveolar ridge. After virtual reconstruction, the three-dimensional models were exported to the solidworks cad software and divided into six groups based on the thickness of the reliner material as follows: (i) without material, (ii) 0·5 mm, (iii) 1 mm, (iv) 1·5 mm, (v) 2 mm and (vi) 2·5 mm. The applied load was 60 N and perpendicular to the long axis of the alveolar ridge of all the prosthetic teeth, and the mucosal thickness used was 1 mm. The analyses were based on the maximum principal stress in the fibromucosa and the minimum principal stress in the basal bone. Stress concentration was observed in the anterior zone of the mandible in the mucosa and in the bone. The maximum and minimum principal stress in the mucosa and bone, respectively, decreased, whereas the thickness of the reliner material increased until 2 mm, which transmitted the lowest stress, compared with the control. Reliner materials with a thickness of 2·5 mm showed higher stress values than those with a thickness of 2 mm. In conclusion, reliner material with a thickness of 2 mm transmitted the lowest amount of stress to the mucosa and bone in 1 mm of mucosa thickness.

Effect of silica coating and silane surface treatment on the bond strength of soft denture liner to denture base material

OBJECTIVE

This study investigated the effects of different surface treatments on the tensile bond strength of an autopolymerizing silicone denture liner to a denture base material after thermocycling.

MATERIAL AND METHODS

Fifty rectangular heat-polymerized acrylic resin (QC-20) specimens consisting of a set of 2 acrylic blocks were used in the tensile test. Specimens were divided into 5 test groups (n=10) according to the bonding surface treatment as follows: Group A, adhesive treatment (Ufi Gel P adhesive) (control); Group S, sandblasting using 50-µm Al2O3; Group SCSIL, silica coating using 30-µm Al2O3 modified by silica and silanized with silane agent (CoJet System); Group SCA, silica coating and adhesive application; Group SCSILA, silica coating, silane and adhesive treatment. The 2 PMMA blocks were placed into molds and the soft lining materials (Ufi Gel P) were packed into the space and polymerized. All specimens were thermocycled (5,000 cycles) before the tensile test. Bond strength data were analyzed using 1-way ANOVA and Duncan tests. Fracture surfaces were observed by scanning electron microscopy. X-ray photoelectron spectrometer (XPS) and Fourier Transform Infrared spectrometer (FTIR) analysis were used for the chemical analysis and a profilometer was used for the roughness of the sample surfaces.

RESULTS

The highest bond strength test value was observed for Group A (1.35±0.13); the lowest value was for Group S (0.28±0.07) and Group SCSIL (0.34±0.03). Mixed and cohesive type failures were seen in Group A, SCA and SCSILA. Group S and SCSIL showed the least silicone integrations and the roughest surfaces.

CONCLUSION

Sandblasting, silica coating and silane surface treatments of the denture base resin did not increase the bond strength of the silicone based soft liner. However, in this study, the chemical analysis and surface profilometer provided interesting insights about the bonding mechanism between the denture base resin and silicone soft liner.

Bond strength of hard chairside reline resins to a rapid polymerizing denture base resin before and after thermal cycling

PURPOSE

This study assessed the shear bond strength of 4 hard chairside reline resins (Kooliner, Tokuso Rebase Fast, Duraliner II, Ufi Gel Hard) to a rapid polymerizing denture base resin (QC-20) processed using 2 polymerization cycles (A or B), before and after thermal cycling.

MATERIALS AND METHODS

Cylinders (3.5 mm x 5.0 mm) of the reline resins were bonded to cylinders of QC-20 polymerized using cycle A (boiling water-20 minutes) or B (boiling water; remove heat-20 minutes; boiling water-20 minutes). For each reline resin/polymerization cycle combination, 10 specimens (groups CAt e CBt) were thermally cycled (5 and 55 degrees C; dwell time 30 seconds; 2,000 cycles); the other 10 were tested without thermal cycling (groups CAwt ad CBwt). Shear bond tests (0.5 mm/min) were performed on the specimens and the failure mode was assessed. Data were analyzed by 3-way ANOVA and Newman-Keuls post-hoc test (alpha=.05).

RESULTS

QC-20 resin demonstrated the lowest bond strengths among the reline materials (P<.05) and mainly failed cohesively. Overall, the bond strength of the hard chairside reline resins were similar (10.09+/-1.40 to 15.17+/-1.73 MPa) and most of the failures were adhesive/cohesive (mixed mode). However, Ufi Gel Hard bonded to QC-20 polymerized using cycle A and not thermally cycled showed the highest bond strength (P<.001). When Tokuso Rebase Fast and Duraliner II were bonded to QC-20 resin polymerized using cycle A, the bond strength was increased (P=.043) after thermal cycling.

CONCLUSIONS

QC-20 displayed the lowest bond strength values in all groups. In general, the bond strengths of the hard chairside reline resins were comparable and not affected by polymerization cycle of QC-20 resin and thermal cycling.