Abstract The formation of biofilm on denture bases is a recurrent clinical problem that favors the development of denture stomatitis. The effectiveness of a hygiene protocol in a 3D-printed denture base resin is still uncertain. Objective To evaluate of the effectiveness of immersion, associated or not with brushing in a soap solution, on the biofilm control of a 3D-printed denture base resin. Methodology Specimens of denture base resins [Cosmos Denture (COS) and Classico (CLA/control)] were contaminated in vitro with Candida albicans and immersed in sodium hypochlorite 0.25% (SH, alkaline peroxide) AP, chlorhexidine digluconate 2% (CD or PBS-Control), associated or not with brushing with 0.78% Lifebuoy soap. Roughness was evaluated before and after brushing and immersion. The effectiveness of the protocols was assessed by CFU/mL, cellular metabolism (XTT), scanning electron microscopy (SEM), and confocal scanning laser microscopy. Data were analyzed by T student, ANOVA/Welch, and Tukey/Gomes–Howell pos-hoc tests (α = 0.05). Results CLA showed greater roughness than COS. CFU/mL and XTT were higher in COS resin with a higher hyphae formation. Immersion in SH and CD eliminated CFU/mL and reduced XTT for both resins, associated or not with brushing. AP reduced CFU/mL only when associated with brushing. Conclusions The biofilm on the 3D-printed resin was thicker and presumably more pathogenic, regardless of its smoother surface. Immersions in SH 0.25% and CD 2% are effective hygiene protocols for both resins, associated or not with brushing. AP should be recommended when associated with brushing with a Lifebuoy 0.78% solution.

Abstract The period of functional adaptation to a new conventional complete denture embraces many transitory issues, and this period is directly related to the rehabilitation success. Objective This clinical trial evaluated the influence of the height of mandibular ridge on the masticatory function of complete denture (CD) wearers during the adaptation period. Methodology A total of 28 individuals wearing new CDs (NR, n=14, normal mandibular ridges, 64±12.5 years, 9 female; RR, n=14, resorbed mandibular ridges, 69±6.8 years, 9 female) were assessed at 24 hours, 30 days, three months and six months after the insertion of the CDs for masticatory performance (MP, sieves method), satisfaction with CDs (questionnaire) and maximum occlusal bite force (MOBF) (gnatodynamometer). The classification of the mandibular ridges followed the Kapur index. Data of MP and MOBF were analyzed by two-way ANOVA and satisfaction with CDs was analyzed by Generalized Estimating Equations (GEE), α=.05. Results Participants with NR presented better masticatory performance (p=.000 - NR 30.25±9.93%, RR 12.41±7.17%), general satisfaction (p=.047), retention of mandibular denture (p=.001), chewing ability (p=.037), and comfort of wearing a mandibular denture (p=.000). Regardless of the mandibular ridge, MP (p=.000) was higher at three (21.26±12.07%) and six months (24.25±12.26%) in comparison to 24 hours (18.09±10.89%), the MOBF (p=.000) was higher at three months (78.50±6.49 N) compared to 24 hours (57.34±5.55 N) and 30 days (62.72±5.97 N), and the comfort of wearing a mandibular denture (p=.002) at three months (1.61 ± 0.07) was greater than 24 hours (1.29±0.10) and 30 days (1.36±10). Conclusions The study suggests that the participants with NR have higher MP and satisfaction with their CD, regardless of the follow-up period after the insertion of the new CD. After subjects received the CD, a period of 3 months was necessary for achieving better achievement MOBF, MP, and self-perceived comfort with the mandibular denture, regardless of the height of the mandibular ridge.

Resumo Vários sistemas de encaixe para sobredentaduras mandibulares implantossuportadas estão atualmente disponíveis e estudos são necessários para entender as suas propriedades mecânicas. O objetivo deste estudo foi avaliar a força de retenção e as características de desgaste de três sistemas de encaixe por meio de uma simulação de deslocamento cíclico de sobredentaduras implantossuportadas. Trinta amostras foram fabricadas e divididas em 3 grupos: 1-O-ring; 2-Mini Ball; e 3-Equador. Um teste de fadiga mecânica foi aplicado aos espécimes utilizando uma máquina de teste universal servo-hidráulica com 5500 ciclos de inserção/remoção (f = 0,8 Hz), imersos em saliva artificial. Os valores da força de retenção foram obtidos antes e após 1500, 3000 e 5500 ciclos utilizando uma velocidade de 1 mm/min e uma célula de carga de 1 kN. Um espécime de cada grupo foi selecionado aleatoriamente e analisado por microscopia eletrônica de varredura. O teste de Análise de Variância a dois fatores para medidas repetidas e o teste de comparações múltiplas de Bonferroni foram utilizados para análises estatísticas (α = 0,05). O sistema de O-ring permaneceu estável durante todos os períodos testados e apresentou valores de força de retenção significativamente menores do que os sistemas Mini Ball e Equator. O sistema Mini Ball apresentou um aumento significativo na força de retenção após o teste mecânico (controle = 21,04 ± 3,29N; 5500 ciclos = 24,01 ± 3,30N). O sistema Equator apresentou uma diminuição significativa na força de retenção após cada período testado, mas os valores eram maiores do que os outros sistemas. O tipo de sistema de encaixe influenciou na força de retenção de diferentes maneiras após testes mecânicos. O sistema do Equador exibiu os maiores valores de força de retenção. As matrizes dos sistemas Mini Ball e Equator produziram deformação e desgaste nas superfícies sem ruptura dos anéis de poliamida.

Abstract Several attachment systems for mandibular implant-supported overdentures are currently available and studies are required to understand their mechanical properties. The objective of this study was to evaluate the retention force and wear characteristics of three attachment systems in a simulation of the cyclic dislodging of implant-supported overdentures. Thirty samples were fabricated and divided into 3 groups: 1-O-ring; 2-Mini Ball; and 3-Equator. A mechanical fatigue test was applied to the specimens using a servo-hydraulic universal testing machine performing 5500 insertion/removal cycles (f=0.8 Hz), immersed in artificial saliva. Retention force values were obtained before and after 1500, 3000, and 5500 cycles using a speed of 1 mm/min and a load cell of 1 kN. One specimen from each group was randomly selected and analyzed by scanning electron microscopy. Two-way repeated measures ANOVA and the Bonferroni post hoc test were used for statistical analyses (α=0.05). The O-ring system remained stable during all periods tested and exhibited significantly lower retention force values than the Mini Ball and Equator systems. The Mini Ball system exhibited a significant increase in retention force after the mechanical test (baseline=21.04±3.29N; 5500 cycles=24.01±3.30N).The Equator system exhibited a significant decrease in retention force after each period tested, but the values were higher than the other systems. The type of attachment was found to influence retention force in different ways after mechanical tests. The Equator system exhibited the highest retention force values. The Mini Ball and Equator matrices produced deformation and wear on the surfaces without breakage of the polyamide rings.

Resumo Introdução As disfunções temporomandibulares (DTM) podem comprometer a capacidade mastigatória devido à presença de dor, disfunção muscular e limitação dos movimentos mandibulares. Melhorias substanciais da dor relacionada à DTM podem ser alcançadas através de abordagens terapêuticas incluindo a educação e os autocuidados. Objetivo O objetivo do presente estudo foi investigar o impacto dessas modalidades de tratamento no desempenho mastigatório de mulheres com DTM dolorosa. Material e método Cinquenta e duas mulheres foram divididas aleatoriamente em três grupos: Grupo Controle (CG); Grupo Educação (receberam instruções sobre DTM) (EG); Grupo de Autocuidado e Educação (receberam instruções sobre DTM e instruções sobre terapias de autocuidado) (SEG). As instruções de educação sobre DTM e terapias de autocuidado foram transmitidas através de vídeo e material ilustrativo impresso. O desempenho mastigatório foi avaliado através do método dos tamises com alimentos testes naturais nos períodos de avaliação: atendimento inicial, 30 dias após e ao fim de 60 dias de acompanhamento. Os dados obtidos, em porcentagem, foram analisados e foi utilizado o teste paramétrico ANOVA one-way para comparação das médias dos grupos CG, EG e SEG (α= 0,05). Resultado O desempenho mastigatório dos participantes foi semelhante, independentemente dos tratamentos, no atendimento inicial (p=0,604), após 30 dias (p=0,450) e após 60 dias (p=0,669). Conclusão Os resultados indicam que o tratamento com terapias educativas e de autocuidado durante um período de 60 dias não teve impacto no desempenho mastigatório das mulheres com DTM dolorosa.

Abstract Introduction Temporomandibular disorders (TMD) can compromise masticatory performance due to the presence of pain, muscular dysfunction and limitation of mandibular movements. Substantial improvements in TMD pain can be achieved through therapeutic approaches including education and self-care. Objective The aim of the present study was to investigate the impact of these treatment modalities in the masticatory performance of women with painful TMD. Material and method Fifty-two women were randomly divided into three groups: Control Group (CG); Education Group (received education about TMD) (EG); Self-Care and Education Group (received education about TMD and instructions self-care therapies) (SEG). The education instructions about TMD and self-care therapies were transmitted through a video and printed illustrative material. The masticatory performance was evaluated through the sieves method with natural tested foods in the evaluation periods: baseline evaluation, 30 days after and 60 days of follow-up. Data were analyzed and used with a one-way ANOVA parametric test for mean comparison of CG, EG and SEG groups (α = 0.05). Result The masticatory performance of the participants was similar, irrespective of the proposed treatments, at baseline (p=.604), 30 days (p=.450) and 60 days (p=.669). Conclusions The results indicated that treatment with educational and self-care therapies over a period of 60 days had no impact on the masticatory performance of women with painful TMD.

Abstract There is a lack of clinical evidence on mandibular overdentures (MOD) supported by a single implant. Objective: To compare patient satisfaction and masticatory performance in MOD supported by one versus two implants in a two-group parallel randomized clinical trial. Material and Methods: Twenty-one patients wearing new maxillary and mandibular complete dentures (CDs) were randomly divided to receive one (GI, n = 11) or two (GII, n = 10) implants in the mandibular arch. Four months after implant placement, o-ring abutments were installed in the implants, and matrix attachments were placed in the lower complete dentures. Patient satisfaction with their dentures and masticatory performance were compared at baseline, 3, 6, and 12 months after the procedure. Data on patient satisfaction were analyzed using the Friedman test and the Mann-Whitney U test. Data on masticatory performance were analyzed using one-way repeated measures analysis of variance (ANOVA) and Student's t test (α=0.05). Results: Both groups exhibited a significant increase in overall patient satisfaction in all periods evaluated (p<0.05), except for GI after 12 months, which had values similar to baseline (p=0.74). Satisfaction levels of GI and GII were similar at baseline, 3 and 6 months, but GII showed higher satisfaction levels (p=0.01) than GI at 12 months. GI and GII exhibited a significant increase (p<0.05) in masticatory performance for all periods relative to baseline. However, GII had higher masticatory performance with dentures than GI, regardless of the period (p<0.05). Conclusion: MOD supported by two implants demonstrated better patient satisfaction in the follow-up at 12 months and better masticatory performance than MOD supported by one implant.

Resumo Introdução O manchamento dos dentes artificiais pode estar relacionado à abrasão da resina acrílica provocada pela escovação, resultando na maior deposição de corantes provenientes de bebidas, e consequentemente maior prejuízo estético. Objetivo O objetivo do presente estudo foi avaliar métodos de remoção de manchas extrínsecas por meio de analise com espectofotômetro. Material e método Dentes artificiais foram divididos em 12 grupos (n=10), de acordo com o tipo de tratamento (repolimento – Re ou imersão em perborato de sódio, Corega Tabs – Sp), tipo de solução de manchamento, café (Cf) ou Coca-Cola® (Cc) ou água (W) e com/sem escovação (B). Os métodos de remoção de manchas propostos (Re e Sp) foram realizados de acordo com protocolos pré-estabelecidos. Os espécimes Sp foram submetidos a 7 ciclos de imersão (5 minutos cada). O repolimento foi realizado com pastas de pedra pomes e branco de espanha, utilizando escovas de cerdas macias e rodas de feltro. As leituras de estabilidade de cor (ΔE) foram realizadas por meio de um espectrofotômetro: T0 (baseline), T1 (após escovação/imersão em bebidas), e T2 (após Re ou Sp). Resultado Alterações de cor entre T1 e T2 (teste T pareado; α=0,05) foram observadas para o grupo CfSp (p=.032); e para os grupos BWRe (p=.000), BCfRe (p=.049) e CcRe (p=.042). Os dentes artificiais submetidos à escovação mostraram maior alteração de cor (ANOVA 2 fatores; p<0,001). Conclusão Conclui-se que a imersão em perborato de sódio (Corega Tabs) pode ser utilizada para remoção de manchas de café e o repolimento para remoção de manchas de Coca-Cola®. Ainda, a escovação produziu as maiores alterações de cor nos dentes artificiais, independentemente da solução de imersão.

Abstract Introduction The staining of artificial teeth can be related to the acrylic resin abrasion caused by brushing, resulting in higher deposition of dyes from the beverage, and consequently higher aesthetic damage. Objective The aim of this in vitro study was to evaluate methods for removal of stains from acrylic denture teeth using spectrophotometric analysis. Material and method Artificial teeth were divided into twelve groups (n=10) according to the type of treatment (re-polishing - Re or immersion in Corega Tabs - Sp), staining solutions, coffee (Cf) and Coca-Cola® (Cc) or water (W) and with/without toothbrushing (B). The Sp specimens were submitted to seven immersion cycles (5 min each). The Re specimens were polished with pumice stone followed by Spain white paste. Color differences (ΔE) were captured by a spectrophotometer: T0 (baseline), T1 (after brushing/immersion in solutions) and T2 (after Re or Sp). Result Statistically significant color change between T1 and T2 (paired T-test; α =.05) was observed for the group CfSp (p=.032); and for the groups BWRe (p=.000), BCfRe (p=.049) and CcRe (p=.042). Higher color changes were observed for the specimens submitted to toothbrushing (ANOVA two way; p<.001). Conclusion It could be concluded that the immersion in sodium perborate (Corega Tabs) can be used for removal of coffee stains from denture teeth, and re-polishing for removal of Coca-Cola® stains. Still, toothbrushing produced greater color changes on denture teeth, regardless of the immersion solution.

O objetivo deste estudo foi avaliar o efeito da utilização de um adesivo para prótese na satisfação e nos parâmetros cinesiográficos em usuários de próteses totais por meio de um estudo "cross-over". Cinquenta pacientes desdentados receberam novas próteses totais bimaxilares. Após um período de adaptação, os participantes incluídos no estudo receberam uma sequência de tratamento: Protocolo 1- utilização do adesivo para prótese durante os primeiros 15 dias, seguida por não utilização do adesivo os próximos 15 dias; Protocolo 2- não utilização do adesivo durante os primeiros 15 dias; seguida por utilização do adesivo nos próximos 15 dias. Os resultados foram avaliados após 15 dias de cada sequência de tratamento. Um questionário para avaliar a satisfação dos pacientes e um cinesiógrafo para registrar os movimentos mandibulares e o padrão de movimento da prótese total maxilar durante mastigação foram utilizados. O teste de "Wilcoxon" (α=0,05) e o "t-test" de Student para amostras pareadas (α=0,05) foram utilizados para comparar o grau de satisfação dos pacientes e os dados cinesiográficos, respectivamente. O adesivo para prótese melhorou significativamente a satisfação geral dos participantes (p<0,001). Os registros cinesiográficos mostraram um aumento significativo (1,7 mm) no movimento mandibular vertical (p<0,001) e uma menor intrusão (0,3 mm) da prótese total superior (p=0,002) durante a mastigação após o uso de adesivo. O uso de adesivo para prótese melhorou a satisfação dos usuários de próteses totais e gerou um aumento no movimento mandibular vertical e uma menor intrusão da prótese total maxilar durante a mastigação.

The aim of the present study was to assess the effect of a denture adhesive (DA) on patient satisfaction and kinesiographic parameters of complete denture wearers by a cross-over study. Fifty edentulous patients received a set of new complete dentures. After an adaptation period, the participants were enrolled in the trial and randomized to receive a sequence of treatment protocols: Protocol 1- DA use during the first 15 days, followed by no DA for the next 15 days; Protocol 2- no DA during the first 15 days, followed by use of DA for the next 15 days. Outcomes were assessed after 15 days of each sequence of treatment. A questionnaire was used to assess the patients´ satisfaction. A kinesiograph was used to record mandible movements and patterns of maxillary complete denture movement during chewing. The Wilcoxon test (α=0.05) and a paired sample t-test (α=0.05) were used to compare satisfaction levels and kinesiographic data, respectively. Use of DA improved the overall level of patient satisfaction (p<0.001). The kinesiographic recordings revealed a significant increase (1.7 mm) in vertical mandible movements (p<0.001) during chewing and a lower (0.3 mm) vertical intrusion of the maxillary complete dentures (p=0.002) during chewing after using the DA. Use of DA in complete denture wearers improved the patients´ satisfaction and altered mandible movements, with increases in vertical movements during chewing and less intrusion of maxillary complete dentures.

INTRODUÇÃO: A ocorrência de estomatite protética é relativamente comum uma vez que as superfícies das próteses bucais representam um ambiente propício para adesão de microrganismos orais e formação de biofilme. OBJETIVO: Avaliar as propriedades de superfície (molhabilidade/rugosidade) e estabilidade de cor de uma resina acrílica combinada com o polímero antimicrobiano poli (2-tert-butilaminoetil) metacrilato (PTBAEMA). MATERIAL E MÉTODO: Trinta espécimes em formato de disco de uma resina acrílica (Lucitone 550) foram divididos em três grupos: 0% (controle), 5% e 10% PTBAEMA. Os valores de rugosidade (Ra) foram medidos utilizando um rugosímetro, e a molhabilidade foi determinada através de medições de ângulo de contato utilizando um goniômetro e água deionizada como líquido teste. Dados de cores foram medidos com um espectrofotômetro. Os testes de Kruskal-Wallis e Dunn foram utilizados para comparar os valores de rugosidade. Os dados de molhabilidade foram analisados utilizando-se ANOVA e teste de Tukey. Os dados de cor foram comparados com o teste t de Student e valores ΔE foram classificados de acordo com o National Bureau of Standards (NBS). Todas as análises estatísticas foram realizadas considerando α = 0,05. RESULTADO: Diferenças significativas (p<0,05) foram detectadas entre os grupos para rugosidade, molhabilidade, e estabilidade de cor. De acordo com o NBS, as alterações de cor obtidas nos grupos 5% e 10% PTBAEMA foram "marcante" e "extremamente marcante", respectivamente. CONCLUSÃO: Pode-se concluir que a incorporação de PTBAEMA em uma resina acrílica aumentou a rugosidade e molhabilidade das superfícies e produziu alterações de cor com relevância clínica.

INTRODUCTION: The occurrence of stomatitis is common since the surface characteristics of the dentures may act as reservoirs for microorganisms and have the potential to support biofilm formation. PURPOSE: To assess the surface properties (wettability/roughness) and color stability of an acrylic resin combined with the antimicrobial polymer poly (2-tert-butylaminoethyl) methacrylate (PTBAEMA). MATERIAL AND METHOD: Thirty disc-shaped specimens of an acrylic resin (Lucitone 550) were divided into three groups: 0% (control); 5% and 10% PTBAEMA. Surface roughness values (Ra) were measured using a profilometer and wettability was determined through contact angle measurements using a goniometer and deionized water as a test liquid. Color data were measured with a spectrophotometer. Kruskal-Wallis and Dunn's test were used to compare roughness values. Wettability data were analyzed using ANOVA and Tukey's test. Color data were compared using the Student's t-test and ∆E values were classified according to the National Bureau of Standards (NBS). All statistical analyses were performed considering α=.05. RESULT: Significant differences (p<.05) were detected among the groups for roughness, wettability and color stability. According to the NBS, the color changes obtained in the 5% and 10% PTBAEMA groups were "appreciable" and "much appreciable", respectively. CONCLUSION: It could be concluded that PTBAEMA incorporation in an acrylic resin increased the roughness and wettability of surfaces and produced color changes with clinical relevance.

OBJECTIVES: The purpose of this study was to evaluate the antimicrobial activity of an acrylic resin combined with an antimicrobial polymer poly (2-tert-butylaminoethyl) methacrylate (PTBAEMA) to inhibit Staphylococcus aureus, Streptococcus mutans and Candida albicans biofilm formation. MATERIAL AND METHODS: Discs of a heat-polymerized acrylic resin were produced and divided according to PTBAEMA concentration: 0 (control), 10 and 25%. The specimens were inoculated (10(7) CFU/mL) and incubated at 37ºC for 48 h. After incubation, the wells were washed and each specimen was sonicated for 20 min. Replicate aliquots of resultant suspensions were plated at dilutions at 37ºC for 48 h. The number of colony-forming units (CFU) was counted and expressed as log (CFU+1)/mL and analyzed statistically with α=.05. RESULTS: The results showed that 25% PTBAEMA completely inhibited S. aureus and S. mutans biofilm formation. A significant reduction of log (CFU+1)/mL in count of S. aureus (control: 7.9±0.8A; 10%: 3.8±3.3B) and S. mutans (control: 7.5±0.7A; 10%: 5.1±2.7B) was observed for the group containing 10% PTBAEMA (Mann-Whitney, p<0.05). For C. albicans, differences were not significant among the groups (control: 6.6±0.2A; 10%: 6.6±0.4A; 25%: 6.4±0.1A), (Kruskal-Wallis, p>0.05, P=0.079). CONCLUSIONS: Acrylic resin combined with 10 and 25% of PTBAEMA showed significant antimicrobial activity against S. aureus and S. mutans biofilm, but it was inactive against the C. albicans biofilm.

Polymethyl methacrylate (PMMA) resins have commonly been used as a denture base material. However, denture bases may act as a reservoir for microorganisms and contribute to oral diseases in denture wearers. It is hypothesized that the 2-tert-butylaminoethyl methacrylate (TBAEMA) incorporated to acrylic resins should have antimicrobial activity related to the presence of amino groups on acrylic resin surface. OBJECTIVES: The objectives of this study were to evaluate the presence of amino groups on acrylic resin surface and the influence on flexural strength after incorporation of TBAEMA. MATERIAL AND METHODS: Six groups were divided according to the concentration of TBAEMA incorporated to acrylic resin (Lucitone 550): 0, 0.5, 1.0, 1.5, 1.75 and 2%. Specimens surface were evaluated by Electron Spectroscopy for Chemical Analysis (ESCA) to detect the presence of amino groups, represented by nitrogen ratios. Flexural strength of the specimens was tested and results were analyzed by ANOVA and Tukey's test (α=0.05). RESULTS: Different nitrogen ratios were observed on specimen surfaces: 0, 0.13, 0.74, 0.66, 0.92 and 0.33% for groups 0, 0.5, 1.0, 1.5, 1.75, and 2%, respectively. Significant differences were found for flexural strength (p<0.001). The mean flexural strength values were 98.3±3.9, 93.3±3.2, 83.9±2.1, 82.8±5.2, 71.2±5.1 and 17.3±3.2 MPa for groups 0, 0.5, 1.0, 1.5, 1.75, and 2%, respectively. CONCLUSION: Within the limitations of this study, the incorporation of TBAEMA results in the presence of the potentially antimicrobial amino groups on specimen surfaces, but affect the flexural strength, depending on the concentration of TBAEMA.

Despite the large number of studies addressing the effect of microwave polymerization on the properties of acrylic resin, this method has received limited clinical acceptance. This study evaluated the influence of microwave polymerization on the flexural strength of a denture base resin. A conventional heat-polymerized (Clássico), a microwave-polymerized (Onda-Cryl) and a autopolymerizing acrylic (Jet) resins were used. Five groups were established, according to polymerization cycles: A, B and C (Onda-Cryl, short cycle - 500W/3 min, long - 90W/13 min + 500W/90 sec, and manufacturing microwave cycle - 320W/3 min + 0W/3 min + 720W/3 min); T (Clássico, water bath cycle - 74ºC/9h) and Q (Jet, press chamber cycle - 50ºC/15 min at 2 bar). Ten specimens (65 x 10 x 3.3mm) were prepared for each cycle. The flexural strength of the five groups was measured using a three-point bending test at a cross-head speed of 5 mm/min. Flexural strength values were analyzed by one-way ANOVA and the Tukey's test was performed to identify the groups that were significantly different at 5% level. The microwave-polymerized groups showed the highest means (p<0.05) for flexural strength (MPa) (A = 106.97 ± 5.31; B = 107.57 ± 3.99; C = 109.63 ± 5.19), and there were no significant differences among them. The heat-polymerized group (T) showed the lowest flexural strength means (84.40 ± 1.68), and differ significantly from all groups. The specimens of a microwavable denture base resin could be polymerized by different microwave cycles without risk of decreasing the flexural strength.