Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients. pathogens pneumonia h admission straightforward affordable disease antibiofilm anti patients (MCDs 34 1 n=20 n20 n 20 (n=20) water toothpaste controls (controls) (1 peroxide 012 0 12 0.12 2 digluconate, digluconate , digluconate) 650 (65 methods % (% CFU/mL. CFUmL CFU/mL . CFU mL (CFU/mL) KruskalWallis Kruskal Wallis α=0.05. α005 α α=0.05 05 (α=0.05) P<0.05. P005 P P<0.05 (P<0.05) rapid lowcost, lowcost low cost, cost low-cost n=2 n2 (n=20 (controls ( 01 0.1 65 (6 (CFU/mL α00 α=0.0 (α=0.05 P00 P<0.0 (P<0.05 n= (n=2 0. 6 α0 α=0. (α=0.0 P0 P<0. (P<0.0 (n= α=0 (α=0. P<0 (P<0. (n α= (α=0 P< (P<0 (α= (P< (α (P

RESUMO Vários patógenos, incluindo SARS-CoV-2, são capazes de permanecer viáveis em superfícies durante dias, o que favorece a contaminação cruzada. Medidas preventivas são essenciais para prevenir infecções e controlar a propagação da COVID- 19. A régua de Fox é um dispositivo essencial no planejamento clínico de próteses totais e é inevitável o contato com os fluidos orais do paciente, durante seu manejo. Apesar de sua importância, a régua de Fox convencional de policarbonato é facilmente danificada com o processo de esterilização. Portanto, o objetivo deste artigo é propor a utilização de uma régua Fox descartável. A confecção é feita de forma simples com palitos de madeira unidos por cola de cianoacrilato, seguindo o mesmo formato do convencional, mas com a vantagem adicional de ser produzida em tamanho individualizado de acordo com o rebordo superior. A régua Fox descartável proposta permite obter o paralelismo do rolete de cera superior com a linha bipupilar e com o plano de Camper. Portanto, o dispositivo descartável descrito neste artigo foi capaz de desempenhar as mesmas funções do convencional, de forma prática, sem riscos de contaminação cruzada e com baixo custo.

ABSTRACT Numerous pathogens, including SARS-CoV-2, can remain viable on surfaces over days, which favors cross-contamination. Preventive measures are essential to prevent infections and control the spread of COVID-19. Fox ruler is an essential device in the clinical planning of complete dentures and the contact with the patient’s oral fluids during handling is unavoidable. Despite its importance, the conventional polycarbonate Fox ruler is easily damaged in the sterilization process. Therefore, the purpose of this article is to propose the use of a disposable Fox ruler. The confection is carried out in a simple way with wooden toothpicks joined by cyanoacrylate glue, following the same shape as the conventional one, but with the additional advantage of being made in an individual size according to the upper edge. The proposed disposable Fox ruler makes it possible to obtain the parallelism of the upper wax roller with the bipupillary line and with the Camper plane. Therefore, the disposable device described in this article was able to perform the same functions as the conventional one, in a practical way, without risks of cross contamination and with low cost.

Abstract This was a retrospective cohort study to investigate the impact of COVID-19 pandemic on the gender gap in articles submitted to three international dental journals based in Brazil. All submissions performed to Brazilian Dental Journal, Brazilian Oral Research, and Journal of Applied Oral Science before (2019) and during the pandemic (2020) were assessed. Gender of the first, last, and corresponding authors were collected. Other variables collected were journal, continent studied by authors and stage of their careers (classified according to authors’ highest degree), and final decision reached in the article. Absolute and relative frequencies with 95% confidence intervals, Pearson’s Chi-square tests, and Fisher’s Exact test were used (α = 0.05). In total, 4,726 unique submissions were analyzed. A higher proportion of early-career authors was observed during the pandemic (44.8% to 49.3%, p = 0.021). Most articles were rejected but without association with gender. Increased proportion of male first authors from before to during the pandemic was observed (39% to 42.1%, p = 0.034). Drop in the proportion of articles with women as first authors was observed for researchers in their early- (65.9% to 58.8%, p = 0.02) and mid-career stages (63% to 55.8%, p = 0.014). Reduction in women as first authors was observed during the pandemic in South and Central Americas (66.7% to 61.5%, p = 0.010), and when the last author was a female, or the corresponding author was a male. In conclusion, a disproportionate impact on female dental researchers in submitting articles in the period from before to during the pandemic was observed when considering first authorship, suggesting that the COVID-19 may have increased the gender inequality in dental science.

Abstract To assess facial changes after oral rehabilitation with complete dentures (CDs) by 3D technology allows understanding the results of a treatment that changes facial proportions. Precise outcome parameters can improve decision making. Objective This descriptive observational research aimed to assess facial changes in completely edentulous patients after oral rehabilitation with a CD by a 3D stereophotogrammetry system. Methodology 30 edentulous patients (7 men and 23 women), aged 50 to 75, were analyzed with stereophotogrammetry at 28 previously determined anthropometric landmarks, at 2 different times: T1, before treatment, and T2, after inserting the CDs. Images were analyzed with a specific software for linear and angular measurements. The paired t-test was used to compare timestamps (α=0.05). Results Major changes were observed in 7 of the 13 linear measures and 7 of the 9 angular measures. The following linear measurements had an increase: Sn-Gn (lower third of the face), Ls-Li (height of the vermilion lip), and ChL-ChR (mouth width). Sn-Ls (nasal philtrum height) decreased. For angular measurements, Sn-St-Pg (lower facial convexity) angles increased, and the Prn-Sn-Ls (nasolabial angle) and GoR-Pg-GoL (mandible convexity) angles decreased. Conclusions Major facial changes in newly rehabilitated edentulous patients with CDs included an increase of the lower third of the face, of the vermilion lip, of mouth width, and of the lower facial convexity, and a decrease of the nasolabial angle and mandible convexity.

Abstract Denture stomatitis is the most frequent oral lesion in removable prosthesis wearers, with high recurrence rates and a complex treatment. Objective This study describes a protocol to obtain and to contaminate a palatal device with Candida albicans biofilm that could be used for an animal model of denture stomatitis. Methodology Acrylic resin devices (N=41) were obtained from impressions of the palates of Wistar rats with individual trays and polyether. The efficacy of microwave irradiation (MW), ultraviolet light (UV), or ultrasonic bath (US) was assessed by colony viability and spectrophotometric analyses (n=5) in order to select the most appropriate method for sterilizing the devices. Then, different devices (n=5) were contaminated with C. albicans and evaluated by CFU/mL determination, scanning electron microscopy, and laser confocal microscopy. Device stabilization was assessed with either autopolymerizing acrylic resins or a self-adhesive resin cement (n=2). The spectrophotometric data were analyzed by one-way ANOVA followed by the Tukey’s HSD post-hoc test (α=0.05). Results MW was the only method capable of sterilizing the devices, and the contamination protocol developed a mature and viable C. albicans biofilm (~1.2 x 106 CFU/mL). The self-adhesive resin cement was the best stabilization material. Conclusions This acrylic resin palatal device was designed to be similar to the clinical situation of contaminated prostheses, with easy manufacturing and handling, effective stabilization, and satisfactory contamination. Thus, the acrylic device can be a valuable tool in the development of denture stomatitis in rats.

Abstract Objective To evaluate the surface morphology and in vitro leachability of temporary soft linings modified by the incorporation of antifungals in minimum inhibitory concentrations (MIC) for Candida albicans biofilm. Methodology Specimens of soft lining materials Softone and Trusoft were made without (control) or with the addition of nystatin (Ny), miconazole (Mc), ketoconazole (Ke), chlorhexidine diacetate (Chx), or itraconazole (It) at their MIC for C. albicans biofilm. The surface analyses were performed using Confocal laser scanning microscopy after 24 h, 7 days, or 14 days of immersion in distilled water at 37ºC. In vitro leachability of Chx or Ny from the modified materials was also measured using Ultraviolet visible spectroscopy for up to 14 days of immersion in distilled water at 37ºC. Data (μg/mL) were submitted to ANOVA 1-factor/Bonferroni (α=0.05). Results Softone had a more irregular surface than Trusoft. Morphological changes were noted in both materials with increasing immersion time, particularly, in those containing drugs. Groups containing Chx and It presented extremely porous and irregular surfaces. Both materials had biexponential release kinetics. Softone leached a higher concentration of the antifungals than Trusoft (p=0.004), and chlorhexidine was released at a higher concentration than nystatin (p<0.001). Conclusions The surface of the soft lining materials changed more significantly with the addition of Chx or It. Softone released a higher concentration of drugs than Trusoft did, guiding the future treatment of denture stomatitis.

Resumo O objetivo deste estudo foi verificar se as modificações feitas com o adesivo etil cianoacrilato, ECA (Super Bonder ®, Loctite, Itapevi, SP, Brasil) sobre as resinas acrílicas para reembasamento, poderiam inibir ou reduzir a formação de biofilmes de C.albicans sobre sua superfície quando comparado com um selante de superfície comercial (BisCover®, Bisco, Schaumburg, EUA). Amostras de resina acrílica para reembasamento foram fabricadas e divididas aleatoriamente em 6 grupos (n=8): CG (grupo controle), sem tratamento superficial; ECA1, revestimento de ECA na superfície antes da esterilização; ECA2, revestimento de ECA após esterilização; ECA3, ECA incorporado no volume da resina; DPE1, revestimento de BisCover® antes da esterilização; DPE2, revestimento de BisCover® após esterilização. Os espécimes foram inoculados com C. albicans SC5314 (1x107 células/mL) e incubados durante 24 h. Seguidamente, o biofilme foi corado com LIVE/DEAD® BaclightTM L7007 Kit e analisado no microscópio confocal de varredura a laser. As imagens foram avaliadas pelo software bioImageL® v.2.0, no qual foram calculados o biovolume total (μm3), as células viáveis (%) e a área coberta (%). Os dados foram analisados estatisticamente pelos testes de Kruskal-Wallis e Dunn (p<0,05). Os resultados mostraram que os grupos revestidos com ECA apresentaram os melhores resultados, reduzindo a formação do biofilme de C. albicans. As imagens adquiridas revelaram que esses grupos (ECA1 e ECA2) apresentaram um número reduzido de células, principalmente na forma de levedura (menos patogênico), enquanto os outros grupos apresentaram um maior número de células, principalmente na forma de hifas (mais patogênicas). Com base nessas descobertas, encontra-se um efeito benéfico na aplicação do adesivo ECA sobre as superfícies das resinas acrílicas para reembasamento, sugerindo assim uma nova alternativa de prevenir a formação de biofilme fúngico em próteses dentárias.

Abstract The aim of this study was to verify whether modifications made in a hard chairside reline resin by an ethyl-cyanoacrylate adhesive, ECA (Super Bonder®, Loctite, Itapevi, SP, Brazil) would be able to inhibit or reduce Candida albicans biofilm formation on its surface, comparing to a commercial surface sealant (BisCover®, Bisco, Schaumburg, USA). Reline resin specimens were fabricated and randomly divided into 6 groups (n=8): CG (control group), no surface treatment; ECA1, ECA coating on the surface before sterilization; ECA2, ECA coating after sterilization; ECA3, ECA incorporated in the resin bulk; DPE1, BisCover® coating before sterilization; DPE2, BisCover® coating after sterilization. Specimens were inoculated with C. albicans SC5314 (1x107 cells/mL) and incubated for 24 h. Then, the biofilm were stained with LIVE/DEAD® BaclightTM L7007 Kit and analyzed by Confocal Laser Scanning Microscopy. The images were evaluated by bioImageL® v.2.0 software and total biovolume (µm3), viable cells (%), and covered area (%) were calculated. Data were statistically analyzed by Kruskal-Wallis and Dunn tests (p<0.05). Results showed that ECA-coated groups presented better results, reducing C. albicans biofilm formation. Acquired images revealed that these groups (ECA1 and ECA2) presented a reduced number of cells, mostly in yeast form (less pathogenic), while the other groups presented higher number of cells, mostly in hyphae form (more pathogenic). Based on these findings, a beneficial effect of Super Bonder® coating reline resins surface could be demonstrated, suggesting a promising way to prevent fungal biofilm formation on dentures.

Resumo A fissura de lábio, alvéolo e palato é uma malformação congênita causada pela falta de fusão dos processos embrionários labial e palatino, que podem comprometer as principais funções do sistema estomatognático. Utilizando o Nordic Orofacial Test - Screening (NOT-S), este estudo transversal observacional, objetivou avaliar a presença da disfunção orofacial nos indivíduos com fissura de lábio, alvéolo e palato em relação a indivíduos sem fissura ou anomalia craniofacial. Cento e vinte indivíduos entre 32 e 65 anos de idade foram selecionados e divididos em dois grupos: pacientes sem fissura labiopalatina (N-CLAP) e pacientes com fissura de lábio, alvéolo e palato (CLAP). Os dois grupos foram combinados por gênero. Cada indivíduo foi entrevistado e submetido a uma avaliação clínica durante a qual o NOT-S foi utilizado para avaliar a disfunção orofacial. O teste de Mann-Whitney comparou desempenho no NOT-S entre os grupos. O teste Qui-Square comparou os domínios NOT-S entre os grupos. A concordância intra-examinador foi K=0,75. Uma comparação dos escores de NOT-S entre os grupos revelou diferenças estatisticamente significativas no gênero (p<0,001), mas não foram encontradas diferenças estatisticamente significativas na comparação de gênero intragrupo. A avaliação dos domínios de NOT-S entre os grupos N-CLAP e CLAP apresentou diferenças estatisticamente significativas nos domínios II (p=0,021), IV (p<0,001) e VI (p=0,002) da entrevista e diferenças significativas em todos os domínios do exame clínico (p<0,001). Indivíduos com CLAP apresentaram maior presença de disfunção orofacial do que os indivíduos sem fissura labioapalatina, conforme avaliado pelo NOT-S.

Abstract Cleft lip, alveolus and palate is a congenital malformation caused by the lack of fusion of the lip and palate embryonic processes, which may disrupt the main functions of the stomatognathic system. Aim: This study aimed to assess the orofacial dysfunction in individuals with cleft lip, alveolus, and palate compared to non-cleft patients. One hundred and twenty individuals between 32 and 65 years of age were selected in the Craniofacial Center and in the School of Dentistry and divided into two groups: non-cleft patients (N-CLAP) and cleft lip, alveolus, and palate patients (CLAP). The two groups were matched by gender. Each individual was interviewed and submitted to a clinical evaluation during which the NOT-S was used to assess orofacial dysfunction. To verify the intra-examiner agreement, the values were compared using the Kappa test. The Mann-Whitney test compared performance on the NOT-S between the groups. The Chi-Square test compared the NOT-S domains between the groups. A comparison of the NOT-S scores between the groups revealed statistically significant differences in gender (p<0.001), but no statistically significant differences in the intragroup gender comparison were found. The assessment of the NOT-S domains between the N-CLAP and CLAP groups exhibited statistically significant differences in domains: breathing (p=0.021), chewing and swallowing (p<0.001), and dryness of the mouth (p=0.002) of the interview and significant differences in all domains of the clinical examination (p<0.001). Individuals with CLAP showed more orofacial dysfunction than non-cleft patients, without gender differences, after being assessed through the NOT-S.

Abstract The proper selection of polymerization cycle is important to prevent overheating of the monomer that could cause degradation, porosity and, consequently, deleterious effects on the denture base properties. Objective This study evaluated the porosity, water sorption and solubility of acrylic resins (Vipi Cril-VC and Vipi Wave-VW) after conventional or microwave polymerization cycles. Material and Methods Specimens (n = 10) were made and cured: 1-WB = 65°C during 90 min + boiling during 90 min (VC cycle - control group); 2-M25 = 10 min at 270 W + 5 min at 0 W + 10 min at 360 W (VW cycle); 3-M3 = 3 min at 550 W; and 4-M5 = 5 min at 650 W. Afterward, they were polished and dried in a dessicator until a constant mass was reached. Specimens were then immersed in distilled water at 37°C and weighed regularly until a constant mass was achieved. For porosity, an additional weight was made with the specimen immediately immersed in distilled water. For water sorption and solubility, the specimens were dried again until equilibrium was reached. Data were submitted to 2 way-ANOVA and Tukey HSD (α=0.05). Results Porosity mean values below 1.52% with no significant difference among groups for both materials were observed. Resins showed water sorption and solubility values without a significant difference. However, there was a significant difference among groups for these both properties (P<0.013). The highest sorption (2.43%) and solubility (0.13%) values were obtained for WB and M3, respectively. Conclusions The conventional acrylic resin could be polymerized in a microwave since both the materials showed similar performance in the evaluated properties. Shorter microwave cycles could be used for both the materials without any detectable increase in volume porosity.

Resumo Introdução Os dentes acrílicos artificiais devem apresentar característica de resistência aos ácidos, a fim de assegurar a manutenção de suas propriedades, ao longo de sua vida útil. Entretanto, não há estudos disponíveis na literatura pertinente sobre as propriedades superficiais de dureza e rugosidade das diferentes camadas de resina acrílica que compõem os dentes artificiais submetidos a ensaios de erosão simulada. Objetivo Avaliar a dureza e rugosidade superficiais das camadas externa e interna de dentes artificiais acrílicos reforçados submetidos a desafio ácido. Metodologia Molares (SR Postaris e Trilux) seccionados transversalmente foram avaliados inicialmente quanto à dureza Vickers e rugosidade. Esses ensaios foram repetidos após metade das amostras de cada tipo de dente (n=10) ser imersa em água destilada (controle) e outra metade em vinagre durante 15 min/dia por 28 dias. Os resultados foram analisados por ANOVA 2-critérios e teste de Tukey (α=0,05). Resultado A dureza inicial da camada externa dos dois diferentes tipos de dente não sofreu alteração significativa pelo desafio ácido (p>0,05) e a imersão em vinagre não causou efeito deletério à dureza inicial da camada interna dos dois tipos de dentes avaliados (p>0,05). Após 28 dias, a rugosidade inicial de ambos os tipos de dentes estudados, para as duas camadas, não foi alterada com água ou vinagre (p>0,05). Conclusão Os dentes acrílicos reforçados foram resistentes ao desafio ácido uma vez que suas camadas interna e externa não apresentaram alteração significativa de dureza e rugosidade superficiais.

Abstract Introduction Artificial acrylic teeth must be resistant to acids for ensure the maintenance of their properties throughout their useful life. However, there are no studies available in the literature about the surface properties of hardness and roughness of the different layers of acrylic resin that make up the artificial teeth submitted to simulated erosion tests. Objective To evaluate the surface hardness and roughness of external and internal layers of artificial cross-linked acrylic teeth submitted to acid challenge. Methodology First molars (SR Postaris and Trilux) transversely sectioned had its Vickers hardness and roughness initially evaluated. These tests were repeated after half of the tooth samples (n=10) be immersed into distilled water (control) and half in vinegar during 15 min/day for 28 days. Data were analyzed using 2-way ANOVA and Tukey's test (α=0.05). Result The initial external layers hardness of both was not significantly altered by acid challenge (p> 0.05) and the immersion in vinegar caused no deleterious effect on the initial internal layers hardness of the two tested teeth (p>0.05). After 28 days, the initial roughness of both teeth evaluated for the two layers was not affected by water or vinegar (p>0.05). Conclusion The reinforced acrylic teeth were resistant to acid challenge since its internal and external layers showed no significant change in hardness and surface roughness.

Resumo Avaliar a adição de antifúngicos nas mínimas concentrações inibitórias (MCIs) para o biofilme de Candida albicans sobre a dureza e rugosidade da reembasadores resilientes temporários. Foram confeccionados corpos de prova (n=8; 36×7×6 mm) a partir de um condicionador de tecido (Softone) e um reembasador resiliente (Trusoft), sem (controle) ou com a incorporação de fármacos nas MCIs: nistatina (0,032 g/mL), diacetato de clorexidina (0,064 g/mL), cetoconazol (0,128 g/mL), miconazol (0,256 g/mL) e itraconazol (0,256 g/mL). Os corpos de prova foram armazenados em água destilada a 37 °C durante 24 h, 7 dias e 14 dias antes das mensurações de dureza e rugosidade. Os dados foram analisados por ANOVA 3-fatores e teste de Tukey HSD (α=0,05). A adição dos antifúngicos em ambos os materiais não demonstrou nenhuma alteração evidente na dureza ou diminuiu esta propriedade em comparação com o controle, exceto para o miconazol no Softone que aumentou a dureza após 14 dias (p=0,003). A adição de nistatina aos dois materiais, clorexidina no Trusoft e cetoconazol no Softone não resultou em alterações significativas de rugosidade em comparação com o controle após 7 e 14 dias (p>0,05). Nestes períodos, o itraconazol aumentou a rugosidade de ambos os materiais (p<0,001). A adição de todos os antifúngicos, exceto para o miconazol no Softone, não resultou em efeitos deletérios sobre a dureza dos materiais ao longo do tempo de avaliação. As MCIs de nistatina em ambos os materiais reembasadores resilientes temporários, cetoconazol no Softone e clorexidina no Trusoft não produziram efeitos deletérios para a rugosidade em até 14 dias.

Abstract Evaluating the addition of minimum inhibitory concentrations (MICs) of antifungals for Candida albicans biofilm on the hardness and roughness of temporary denture soft liners. Specimens (n=8; 36×7×6 mm) of tissue conditioner (Softone) and resilient liner (Trusoft) were produced either without (control) or with incorporation of drugs at MICs: nystatin (0.032 g/mL), chlorhexidine diacetate (0.064 g/mL), ketoconazole (0.128 g/mL), miconazole (0.256 g/mL) and itraconazole (0.256 g/mL). Specimens were stored in distilled water at 37 °C for 24 h, 7 days and 14 days prior to the hardness/roughness measurements. Data were analyzed by 3-way ANOVA and Tukey HSD test (α=0.05). The addition of the antifungals into both materials demonstrated no evident hardness change or decrease of this property compared with the control, except for miconazole in Softone, which increased the hardness after 14 days (p=0.003). The addition of nystatin into both materials, chlorhexidine in Trusoft and ketoconazole in Softone resulted in no significant changes of roughness compared with the control, after 7 days and 14 days (p>0.05). In these periods, itraconazole increased the roughness of both materials (p<0.001). The addition of all antifungals, except for the miconazole in Softone, resulted in no deleterious effects on the materials’ hardness over the evaluation time. The MICs of nystatin in both temporary soft lining materials, ketoconazole in Softone and chlorhexidine in Trusoft resulted in no deleterious effects for roughness up to 14 days.