Impact of Acrylic and Silicone-Based Soft-Liner Materials on Biting Force and Quality of Life of the Complete Denture Wearers: A Randomized Clinical Trial

This rerandomized clinical trial evaluated the influence of soft liners (SL) on biting force, pain perception, and the oral health-related quality of life (OHRQoL) of complete denture wearers. Twenty-eight completely edentulous patients complaining of ill-fitting lower complete dentures were selected to participate in the study from the Dental Hospital, College of Dentistry, Taibah University. All patients received new complete maxillary and mandibular dentures; then they were randomly divided into two groups (14 patients in each group): the acrylic-based SL group, in which the mandibular denture was lined with an acrylic-based soft liner, and the silicone-based SL group, in which the mandibular denture was lined with a silicone-based soft liner. OHRQoL and maximum bite force (MBF) were assessed in this study before denture relining (baseline), then at one month and three months after relining. The finding showed that both treatment modalities significantly improved the OHRQoL of included patients at one-month and three-month periods compared to baseline records (i.e., dentures before relining) with a statistically significant difference (p < 0.05). However, there is no statistical difference between groups at the baseline, one-, and three-month follow-up periods. Regarding maximum biting force, when acrylic-based SL is compared to silicone-based SL, there is no statistical difference between groups at baseline (75 ± 31 and 83 ± 32 N) and one-month follow-up periods (145 ± 53 and 156 ± 49 N); however, after three months of function, the silicone-based group recorded 166 ± 57 N statistically significant high biting force compared to the acrylic-based group that recorded 116 ± 47 N (p < 0.05). Permanent soft denture liners positively affect maximum biting force, pain perception, and OHRQoL more than conventional dentures. After three months, silicone-based SL outperformed acrylic-based soft liners in maximum biting force, which may indicate better long-term results.

Functional denture soft liner with antimicrobial and antibiofilm properties

Background/purpose

Denture soft liners, especially used for elders who have poor disinfection habits, provide a favourable environment for accumulation and colonization of microorganisms. This in vitro study is aimed to investigate the effectiveness of natural carvacrol incorporation into soft lining material on the inhibition of oral pathogens.

Materials and methods

Antimicrobial susceptibility of carvacrol was primarily determined by disc diffusion method. Soft lining material was prepared as recommended by the manufacturer and 10 μL carvacrol was added aseptically to the soft liner discs. Inhibition zones for the control discs without carvacrol (C) and carvacrol-incorporated discs (CL) were determined by disc diffusion method. The biofilm inhibition percentages of carvacrol on soft liner was determined by MTT assay and also observed by Scanning Electron Microscopy (SEM).

Results

Carvacrol displayed great antimicrobial activity for yeast, Gram-negative and Gram-positive strains. The highest inhibition zone of carvacrol (41.33 ± 1.53 mm) was measured for Bacillus subtilis strain which is followed by Candida albicans and Streptococcus sanguis (34.00 ± 1.73 mm and 32.33 ± 0.58 mm, respectively). The inhibition zones were also similar for soft liner discs with carvacrol, with the highest inhibition zones against B. subtilis, Streptococcus mutans and C. albicans (43.67 ± 0.58 mm, 40.33 ± 0.58 mm and 38.33 ± 1.15 mm, respectively). Incorporation of carvacrol into the soft liner decreased (98.03 ± 0.2%) of the biofilm formation for C. albicans.

Conclusion

Carvacrol-incorporation obviously decreased the colonization and plaque formation of oral pathogens, especially C. albicans accumulation. Carvacrol may be useful as a promising agent for antibacterial and antifungal management for denture soft lining materials.

Effect of denture soft liner on mandibular ridge resorption in complete denture wearers after 6 and 12 months of denture insertion: A prospective randomized clinical study

Purpose:

Soft liners act as a cushion between the denture base and the residual ridge. Hence, it is important to study their effect on resorption of mandibular denture bearing area. Therefore, the purpose of this study was to evaluate the influence of soft denture liner on mandibular ridge resorption after 1 year in completely denture wearers.

Materials and Methods:

Twenty-eight completely edentulous patients having age between 45 and 60 years with well-formed ridges in class I jaw relations were selected as per the inclusion and exclusion criterion. Randomization chart was used to enroll participants in experimental and control groups who were given mandibular dentures with and without soft denture liner, respectively. Vertical measurements were made on orthopantomograph and analyzed using Adobe Photoshop 7.0 software at five points, i.e., one at central incisor and two points at right and left first premolars and two in each first molar region.

Results:

On application of repeated measures analysis of variance, both groups showed a significant change in bone height after denture delivery (P < 0.05). Intergroup comparison (Wilcoxon rank sum test) of bone height in different regions at various time intervals showed statistically significant difference in bone levels (P < 0.05) from baseline to 6 months and baseline to 12months (P < 0.01), while the difference was statistically not significant during 6 and 12 months’ period.

Conclusion:

The use of soft denture liner significantly reduces the residual ridge resorption in complete denture wearers as compared to conventional denture wearers (without denture liner) over a period of 1 year.

Long-term clinical and prosthetic outcomes of soft liner and clip attachments for bar/implant overdentures: a randomised controlled clinical trial

Long-term clinical and prosthetic outcomes of soft liner attachments for bar/implant overdentures were not sufficiently investigated. The aim of this trial was to evaluate clinical and prosthetic outcomes of resilient liner and clip attachments for bar/implant-retained mandibular overdenture after 7 years. Thirty edentulous male participants received two implants in the canine areas of the mandible. Three months later, implants were splinted with a resilient bar. Mandibular overdentures were connected to the bars with either clip (CR group, n = 15) or resilient liner (RR group, n = 15) attachments. Plaque index (PI), gingival index (GI), probing depth (PD), vertical bone loss (VBL), horizontal bone loss (HBLO) and prosthetic complications (PCs) were evaluated at denture delivery (T0), 6 (T_6m ), 12 (T1), 24 (T2), 36 (T3), 48 (T4), 60 (T5), 72 (T6) and 84 (T7) months after insertion. PI and GI increased significantly with time for CR and decreased significantly for RR (P < 0·001). PD increased at T1 (CR) and T6 m (RR) and then decreased thereafter (P < 0·05). VBL increased significantly with time in both groups (P < 0·005). HBLO increased at T2 (CR) and T1 (RR) and then decreased thereafter. CR recorded significant higher PI, GI, PD, VBLO and HBLO compared to RR at all observation times (P < 0·042). The survival rates were 96·6% and 100% for CR and RR after 7 years. The most common PCs for CR and RR were clip wears and separation of the resilient liner from the denture base, respectively. Within the limitations of this study, resilient liner attachments are recommended for bar/implant-retained mandibular overdentures than clip attachments in terms of peri-implant tissue health and prosthetic complications after 7 years.

Effect of Food Simulating Agents on the Hardness and Bond Strength of a Silicone Soft Liner to a Denture Base Acrylic Resin

STATEMENT OF THE PROBLEM

Bonding failure between acrylic resin and soft liner material and also gradual loss of soft liner resiliency over time are two impending challenges frequently recognized with a denture base embraced with a resilient liner. Since patients drink various beverages, it is crucial to assess the influences of these beverages on physical characteristics of soft liners.

PURPOSE

This in vitro study envisioned to assess the influence of food simulating agents (FSA) on the hardness of a silicone soft liner by employing a Shore A durometer test and also evaluate its bond strength to a denture base resin by using tensile bond strength test.

MATERIALS AND METHODS

To test the hardness of samples, 50 rectangular samples (40 mm × 10 mm × 3 mm) were prepared from a heat-polymerized polymethyl methacrylate (Meliodent). Mollosil, a commercially available silicone resilient liner, was provided and applied on the specimens following the manufacturer's directions. In order to test tensile bond strength, 100 cylindrical specimens (30 mm × 10 mm) were fabricated. The liners were added between specimens with the thicknesses of 3 mm. The specimens were divided into 5 groups (n=10) and immersed in distilled water, heptane, citric acid, and 50% ethanol. For each test, we used 10 specimens as a baseline measurement; control group. All specimens were kept in dispersed containers at 37ºC for 12 days and all solutions were changed every day. The hardness was verified using a Shore A durometer and the tensile bond strength was examined by an Instron testing machine at a cross-head speed of 5 mm/min. The records were analyzed employing one-way ANOVA, Tukey's HSD, and LSD tests.

RESULTS

The mean tensile bond strength ± standard deviation (SD) for Mollosil was as follows for each group: 3.1 ± 0.4 (water), 1.8 ± 0.4 (citric acid), 3.0 ± 0.4 (heptane), 1.2 ± 0.3 (50% ethanol), and 3.8 ± 0.4 (control). The hardness values for each group were: 28.7 ± 2.11 (water), 33.2 ± 2.82 (citric acid), 39.2 ± 4.8 (heptane), 32.3 ± 3.56 (50% ethanol) and 22.2 ± 2.08 (control). Mean values for hardness indicated that all of the food simulating agents significantly increased hardness of the Mollosil soft liner compared to the control group (p<0.05). The results of tensile bond strength depicted that water and FSA decreased the bond strength of the soft liner -denture base resin compared to the control group and it was statistically significant (p<0.05).

CONCLUSION

The food simulating agents could influence the mechanical properties of silicone soft liners; hence, clinicians should inform their patients concerning their possible adverse effects and complications.

Finite Element Analysis of Soft-lined Mandibular Complete Denture and its Supporting Structures

Background and aims

There are many edentulous people with severely resorbed residual ridges and non-resilient lin-ing mucosa that are unable to tolerate occlusal forces during functional and parafunctional movements. Lining the tissue surface of dentures with a flexible material can theoretically distribute and absorb forces with cushioning effect. The aim of this study was to evaluate the effect of a soft liner on stress levels in mandibular complete denture and its supporting struc-tures by finite element analysis.

Materials and methods

A simplified 3-dimensional finite element model of relatively resorbed mandible, mucosa, denture and a soft liner was prepared. Then the model, with and without soft liner, underwent normal vertical and lateral occlusal forces. The stresses were analyzed using the ANSYS 12 software.

Results

Using the soft liner increased stress levels up to 18.5% and 30% in the cortical bone and mucosa, respectively, after vertical load was applied in the incisor region. Application of bilateral vertical load on the molar area increased stress in cortical bone u to 44% and in the mucosa up to 29%. Unilateral loading in the canine area increased stress level in the mucosa up to 63.5%. The highest stress was seen at denture base followed by the cortical bone.

Conclusion

Use of soft liners increased stress in denture supporting structures. Higher level of stress concentration was observed primarily in the denture base followed by the cortical bone.

Split obturator: An innovative approach

A palatal prosthesis can improve function by closing the palatal defect, preventing regurgitation, and improving swallowing and speech. Although techniques have been previously described for fabrication of palatal obturator, but there has not been any technique to devise an obturator for a patient with palatal defect with a quadhelix orthodontic appliance overlying it. One cannot wait in such patients for completion of lengthy orthodontic treatment and then think of devising prosthesis as the patient cannot carry out normal functions like swallowing and speech without the closure of defect. This article focuses on an innovative method of fabricating a palatal obturator which aims at restoring the above-mentioned functions along with improving aesthetics. It also enables us to devise the fabrication of prosthesis in two parts for easy insertion and removal and as well as to be self-cleansable. Such prosthesis would markedly improve patient psychology and confidence.

Antifungal activity of denture soft lining material modified by silver nanoparticles-a pilot study

Soft liner materials in oral cavity environments are easily colonized both by fungi and dental plaque. These factors are the cause of mucosal infections. The microorganism that most frequently colonizes soft liner materials is Candida albicans. Colonization occurs on the surface of materials and within materials. A solution to this problem might involve modification of soft liner materials with silver nanoparticles (AgNPs). In this article, we present results showing the antifungal efficacy of silicone soft lining materials modified with AgNPs. The modification process was conducted by dissolving both material components (base and catalyst) in a colloidal solution of AgNPs and evaporating the solvent. Composites with various AgNP concentrations (10, 20, 40, 80, 120 and 200 ppm) were examined. The in vitro antifungal efficacy (AFE) of composite samples was 16.3% to 52.5%.