OBJECTIVE: This study evaluated the efficacy of NitrAdineTM-based disinfecting cleaning tablets for complete denture, in terms of denture biofilm removal and antimicrobial action. MATERIAL AND METHODS: Forty complete denture wearers (14 men and 26 women) with a mean age of 62.3±9.0 years were randomly assigned to two groups and were instructed to clean their dentures according to two methods: brushing (control) - 3 times a day with denture brush and tap water following meals; brushing and immersion (Experimental) - brushing the denture 3 times a day with denture brush and tap water following meals and immersion of the denture in NitrAdineTM-based denture tablets (Medical InterporousTM). Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface before and after the use of the product. Microbiological assessment was conducted to quantify Candida sp. RESULTS: An independent t-test revealed a significant lower biofilm percentage for the experimental group (4.7, 95% CI 2.4 to 7.9) in comparison with the control group (mean 37.5, 95% CI 28.2 to 48.1) (t38=7.996, p<0.001). A significant reduction of yeast colony forming units could be found after treatment with Medical InterporousTM denture tablets as compared to the control group (Mann-Whitney test, Z=1.90; p<0.05). CONCLUSION: The present findings suggest that NitrAdineTM-based disinfecting cleaning tablets are efficient in removal of denture biofilm. In addition, a clear antimicrobial action was demonstrated. Therefore, they should be recommended as a routine denture maintenance method for the prevention of the development of microbial biofilm induced denture stomatitis.

Este trabalho avaliou in vitro a atividade antimicrobiana de alginatos (um deles contendo agente antimicrobiano) manipulados com água ou solução de digluconato de clorexidina a 0,2% contra 12 cepas da microbiota oral. Vinte espécimes (0,5 x 1,0 cm) para cada grupo (1. Jeltrate manipulado com água, 2. Jeltrate manipulado com solução de digluconato de clorexidina a 0,2%; 3. Greengel manipulado com água; 4. Greengel manipulado com solução de digluconato de clorexidina a 0,2%) foram confeccionados sob condições estéreis e semeados em meios de cultura inoculados com as cepas indicadoras. Após incubação em aerobiose ou microaerofilia, a inibição do crescimento microbiano foi medida e os resultados foram interpretados. A curva normal de aderência revelou uma distribuição não-normal dos dados, então o teste não paramétrico de Friedman (p < 0,05) foi realizado. A atividade antimicrobiana dos grupos foi classificada na seguinte ordem crescente: 1, 3, 4 e 2. Os resultados sugerem que a manipulação de alginatos com solução de digluconato de clorexidina a 0,2% é um método efetivo para reduzir a contaminação-cruzada causada pelos moldes, mais que a incorporação do agente antimicrobiano no pó.

This study evaluated in vitro the antimicrobial activity of irreversible hydrocolloids (one containing an antimicrobial agent) prepared with water or with a 0.2% chlorhexidine digluconate solution against 12 strains of the oral microbiota. Twenty specimens (0.5 x 1.0 cm) for each group (1. Jeltrate mixed with water; 2. Jeltrate mixed with 0.2% chlorhexidine digluconate solution; 3. Greengel mixed with water; 4. Greengel mixed with 0.2% chlorhexidine digluconate solution) were prepared under sterile conditions and placed in culture media inoculated with the indicator strains. After incubation in aerobiosis or microaerophilia, inhibition of the microbial growth was measured and the results were interpreted. The normal adherence curve revealed a non-normal distribution of the data, so the non-parametric Friedman Test was performed (p < 0.05). The antimicrobial activity of the groups was classified in the following order: 1, 3, 4, and 2. The results suggest that the method of preparing irreversible hydrocolloids with a 0.2% digluconate chlorhexidine solution is more effective than the incorporation of an antimicrobial agent in the powder to reduce cross-contamination caused by impressions.

Este estudo avaliou o nível de contaminação de seis marcas comerciais de alginato (duas contendo clorexidina) e identificou a contaminação presente nesses materiais. Alíquotas de alginato (0,06 g) foram semeadas em meios de cultura seletivos e enriquecidos, em triplicata. Após incubação (37°C/7 dias), as unidades formadoras de colônia (UFC) foram contadas e foram realizadas as identificações morfotintorial (Gram) e bioquímica. Os níveis de contaminação dos materiais foram: Jeltrate - 389 UFC/g; Jeltrate Plus - 516 UFC/g; Jeltrate Chromatic - 135 UFC/g; Hydrogum - 1.455 UFC/g; Kromopan - 840 UFC/g; e Greengel - 59 UFC/g. A coloração de Gram revelou a presença de bacilos Gram-positivos e cocos Gram-positivos. As bactérias Staphylococcus epidermidis, Bacillus subtilis, Bacillus sp., Bacillus coagulans, Bacillus licheniformis, Bacillus cereus, Micrococcus luteus e Nocardia sp.; os fungos filamentosos Aspergillus niger, Aspergillus flavus, Rhizopus sp., Neurospora sp.; e a levedura Candida sp. foram isolados. A contaminação detectada nos materiais aponta a necessidade de adoção de medidas para melhorar seu controle de qualidade microbiológica. O uso de materiais contaminados na boca contradiz os princípios básicos de controle de infecção-cruzada e pode representar um risco para pacientes debilitados ou imunocomprometidos.

This study assessed the level of contamination of six commercially available irreversible hydrocolloids (two containing chlorhexidine) and identified the contamination present in the materials. Petri dishes containing selective and enriched culture media were inoculated with alginate powder (0.06 g), in triplicate. After incubation (37°C/7 days), the colony-forming units (CFU) were counted and Gram stained. Biochemical identification of the different morphotypes was also performed. The contamination levels for the materials were: Jeltrate - 389 CFU/g; Jeltrate Plus - 516 CFU/g; Jeltrate Chromatic - 135 CFU/g; Hydrogum - 1,455 CFU/g; Kromopan - 840 CFU/g; and Greengel - 59 CFU/g. Gram staining revealed the presence of Gram-positive bacillus and Gram-positive cocci. The bacteria Staphylococcus epidermidis, Bacillus subtilis, Bacillus sp., Bacillus coagulans, Bacillus licheniformis, Bacillus cereus, Micrococcus luteus, and Nocardia sp.; the filamentous fungi Aspergillus niger, Aspergillus flavus, Rhizopus sp., Neurospora sp.; and the yeast Candida sp. were isolated. The contamination detected in the impression materials points out the need for adopting measures to improve the microbiological quality of these materials. The use of contaminated materials in the oral cavity goes against the basic principles for controlling cross-contamination and may represent a risk for debilitated or immunocompromised patients.

Este trabalho avaliou a capacidade em corar, a facilidade de remoção e a ação antimicrobiana de evidenciadores de biofilme dental em prótese total. A capacidade em corar foi avaliada por método visual aplicando-se evidenciadores sobre a superfície interna da prótese total superior. Após fotografia, as próteses coradas foram escovadas (escova e dentifrício específicos para prótese total) e novamente fotografadas. Os diapositivos foram projetados em folhas de papel (aumento de 10 X); as áreas total e corada das próteses contornadas com grafite, recortadas e pesadas, para obtenção, em porcentagem, dos resultados da facilidade de remoção. A ação antimicrobiana foi avaliada pelo método de difusão em ágar e os resultados obtidos pela medida dos aros e halos de inibição formados. A melhor capacidade em corar foi apresentada pelo azul de metileno (0,05%), eritrosina (5%), fluoresceína sódica (1%), Replak e vermelho neutro (1%). Eosina (1%), fluoresceína sódica (1%) e eritrosina (5%) apresentaram a maior facilidade de remoção. Não apresentaram ação antimicrobiana eosina (1%), eritrosina (5%), fluoresceína sódica (1%), proflavina (0,3%), Replak e vermelho neutro (1%). As soluções que apresentaram maior capacidade de corar, facilidade de remoção e ausência de ação antimicrobiana, requisitos necessários para auxiliar estudos que avaliam métodos de higiene e de orientação aos pacientes, foram eosina (1%), vermelho neutro (1%) e eritrosina (5%).

This study evaluated the disclosing ability, removal facility and antimicrobial effect of biofilm disclosing agents applied on complete dentures. Disclosing ability was evaluated by means of the visual method. The solutions were applied on the internal surface of dentures. After being photographed, the dentures were brushed with denture-specific brush and dentifrice and photographed again. The obtained slides were projected on paper (10 X amplification) and the total and stained surfaces were outlined with graphite, cut off and weighed, in order to assess removal facility. The evaluation of antimicrobial effects was carried out by means of the method of diffusion in agar, and the results were obtained by measuring the length of the halos and rings. In terms of disclosing ability, the best solutions were 0.05% methylene blue, 5% erythrosin, 1% sodic fluorescein, Replak and 1% neutral red. One percent eosin, 1% sodic fluorescein and 5% erythrosin were the most easily removed solutions. One percent eosin, 5% erythrosin, 1% sodic fluorescein, 0.3% proflavine, Replak and 1% neutral red presented no antimicrobial effect. The solutions which presented the greatest disclosing ability and removal facility as well as absence of antimicrobial effect - which are essential requirements in the assessment of hygiene methods and guidance on oral health - were 1% eosin, 1% neutral red and 5% erythrosin.