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

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.

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 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.

ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.

AbstractObjective To evaluate the effect of staining beverages (coffee, orange juice, and red wine) on the Vickers hardness and surface roughness of the base (BL) and enamel (EL) layers of improved artificial teeth (Vivodent and Trilux).Material and Methods Specimens (n=8) were stored in distilled water at 37°C for 24 h and then submitted to the tests. Afterwards, specimens were immersed in one of the staining solutions or distilled water (control) at 37°C, and the tests were also performed after 15 and 30 days of immersion. Data were analyzed using 3-way ANOVA and Tukey’s test (α=0.05).Results Vivodent teeth exhibited a continuous decrease (p<0.0005) in hardness of both layers for up to 30 days of immersion in all solutions. For Trilux teeth, similar results were found for the EL (p<0.004), and the BL showed a decrease in hardness after 15 days of immersion (p<0.01). At the end of 30 days, this reduction was not observed for coffee and water (p>0.15), but red wine and orange juice continuously reduced hardness values (p<0.0004). Red wine caused the most significant hardness changes, followed by orange juice, coffee, and water (p<0.006). No significant differences in roughness were observed for both layers of the teeth during the immersion period, despite the beverage (p>0.06).Conclusions Hardness of the two brands of acrylic teeth was reduced by all staining beverages, mainly for red wine. Roughness of both layers of the teeth was not affected by long-term immersion in the beverages.

O restabelecimento da dimensão vertical de oclusão é uma etapa importante e indispensável durante a realização de trabalhos protéticos. Sua diminuição pode ser consequência do bruxismo severo e a reabilitação dos pacientes exige a realização de tratamentos complexos, de alto custo e tempo prolongado para execução. Neste contexto, a prótese parcial removível overlay é uma alternativa viável, pela reversibilidade do tratamento e simplicidade de execução. Como tratamento provisório, não necessita de preparo dental, restabelece a dimensão vertical de oclusão e permite que o paciente se adapte a esta nova dimensão, até que seja planejado e executado o tratamento reabilitador definitivo. O presente caso clínico descreve a reabilitação provisória de um paciente bruxista, desdentado total superior, com desgaste dental excessivo na arcada inferior que procurou tratamento na Clínica de Prótese Removível da Universidade Estadual de Ponta Grossa para substituição de sua prótese total superior. Uma nova prótese total foi confeccionada e proposta a execução de uma prótese parcial removível overlay para o arco inferior, a qual devolveu estética e função ao paciente até a realização do trabalho definitivo. O paciente foi instruído e orientado sobre os fatores desencadeantes e consequências de seu hábito parafuncional e conscientizado no intuito da autopercepção para controle da frequência. Para a reabilitação final, será confeccionada uma nova prótese total superior com superfícies oclusais metálicas, coroas metalocerâmicas com oclusal em metal utilizando retenção intracanal com núcleos metálicos fundidos. Uma placa miorrelaxante será instalada sobre a arcada inferior como terapia de suporte para controle do hábito parafuncional.

The reestablishment of the vertical dimension of occlusion is an important phase during prosthodontics treatment. Its reduction can be a consequence of severe bruxism, and patient rehabilitation requires complex, expensive, and long treatments. In this context, an overlay removable partial denture is a viable alternative, as it represents a simple manufactured reversible treatment. As a temporary treatment, it does not require tooth wear, reestablishes vertical dimension of occlusion, and allows the patient to adapt to this new dimension until the definitive rehabilitation treatment can be planned and finished. This case report describes the temporary rehabilitation of a maxillary complete edentulous bruxist patient with excessive tooth wear on his lower jaw, seeking treatment at the Removable Prosthodontics Department at State University of Ponta Grossa to replace his upper complete denture. A new complete denture was made and the implementation of an overlay removable partial denture was proposed to be made to the lower arch, which provided aesthetics and function to the patient until the completion of the definitive work. The patient was instructed and guided about the causal factors and consequences of his parafunctional habit and was taught methods for self-perception to control frequency. For the final rehabilitation, a new maxillary complete denture with metal occlusal surfaces will be made as well as metaloceramic crowns with metal occlusal using intraradicular retention with cast posts. An occlusal splint will be inserted in the lower jaw as supportive therapy to control the parafunctional habit.

OBJETIVO: O objetivo deste estudo foi determinar a prevalência das desordens temporomandibulares em pacientes com prótese parcial removível, de acordo com a classificação de Kennedy. MÉTODO: A população estudada consistiu de pacientes que procuraram tratamento na Universidade Estadual de Ponta Grossa. Os pacientes selecionados eram usuários de prótese total superior e prótese parcial removível inferior, e esse uso, à época do estudo, fazia entre 1 e 5 anos. Os pacientes foram divididos em cinco grupos (n = 15): G1: usuários de prótese total superior e prótese parcial removível inferior Classe I (Kennedy); G2: usuários de prótese total superior e prótese parcial removível inferior Classe II (Kennedy); G3: usuários de prótese total superior e prótese parcial removível inferior Classe III (Kennedy); G4: usuários de prótese total superior e prótese parcial removível inferior Classe IV (Kennedy), e G5: pacientes totalmente dentados (grupo controle). O questionário de Fonseca foi aplicado para verificar o grau de DTM. O teste qui-quadrado (α = 0,05) foi usado para avaliar a associação entre as variáveis. RESULTADO: Nenhuma diferença estatística (P > 0,05) foi encontrada entre os grupos. Em todos os grupos, os pacientes apresentaram DTM leve ou moderada. CONCLUSÃO: Os resultados deste estudo clínico mostraram que a presença de DTM em pacientes usuários de prótese não pôde ser correlacionada ao uso de prótese, já que a presença de DTM para pacientes desdentados e dentados apresentou-se semelhante.

OBJECTIVE: The aim of this study was to determine the prevalence of temporomandibular disorders in patients with removable partial dentures according to Kennedy classification. METHOD: The population consisted of patients who required care at the State University of Ponta Grossa. The patients wore complete upper and lower removable partial dentures between 1 to 5 years. The patients were divided into five groups (n = 15): G1: wearer of complete maxillary denture opposed by a Class I (Kennedy) removable partial denture; G2: wearer of complete maxillary denture opposed by a Class II (Kennedy) removable partial denture; G3: wearer of complete maxillary denture opposed by a Class III (Kennedy) removable partial denture; G4: wearer of complete maxillary denture opposed by a Class IV (Kennedy) removable partial denture and G5: fully dentate patients (control group). Fonseca's questionnaire was applied to verify the level of TMD. The qui-square test (α = .05) was used to analyze association between the variables. RESULT: No statistical difference (P > 0.05) was found among groups. All groups showed mild or moderate TMD. CONCLUSION: The findings from this clinical study showed that the presence of TMD in wearers of removable partial denture could not be correlated to the classification of Kennedy, since the presence of TMD for edentulous patients and dentate patients appeared similar.

PURPOSE: This study evaluated the effect of storage in water and thermocycling on hardness and roughness of resin materials for temporary restorations. MATERIAL AND METHODS: Three acrylic resins (Dencor-De, Duralay-Du, and Vipi Cor-VC) were selected and one composite resin (Opallis-Op) was used as a parameter for comparison. The materials were prepared according to the manufacturers' instructions and were placed in stainless steel moulds (20 mm in diameter and 5 mm thick). Thirty samples of each resin were made and divided into three groups (n = 10) according to the moment of Vickers hardness (VHN) and roughness (Ra) analyses: C (control group): immediately after specimen preparation; Sw: after storage in distilled water at 37 °C for 24 hours; Tc: after thermocycling (3000 cycles; 5-55 °C, 30 seconds dwell time). Data were submitted to 2-way ANOVA followed by Tukey's test (α = 0.05). RESULTS: Op resin had higher surface hardness values (p < 0.0001; 25.4 ± 3.4) than the other ones (De = 4.5 ± 0.6; Du = 5.5 ± 0.4; VC = 6.1 ± 0.9). There was no statistical difference (p > 0.05) in roughness among materials (De = 0.31 ± 0.07; Du = 0.51 ± 0.20; VC = 0.41 ± 0.15; Op = 0.42 ± 0.18). Storage in water did not change hardness and roughness of the tested materials (p > 0.05). There was a significant increase in roughness after thermocycling (p < 0.05), except for material Du, which showed no significant change in roughness in any evaluated period (p = 0.99). CONCLUSION: Thermocycling increased the roughness in most tested materials without affecting hardness, while storage in water had no significant effect in the evaluated properties.

The effect of post-polymerization treatments (MW-microwave irradiation and WB-water-bath) on the degree of conversion (DC) of three reline resins (Ufi Gel hard-U, Kooliner-K, and Tokuso Rebase Fast-T) and one denture base resin (Lucitone 550-L), submitted to two polymerization cycles (LS-short and LL-long), was evaluated by using FT-Raman spectroscopy (n = 5). The molecular weight (Mw) of the powder of all materials and of K polymerized specimens (control; MW; and WB; n = 3) was analyzed using GPC. DC data were analyzed using Kruskal-Wallis test (a = .05). For control specimens, there were no significant differences between U (68%) and LL (77%) and among LL, K (81%), and T (84%). LS (92%) had the highest DC (P < 0.05). Only material K exhibited an increased DC after WB (P < 0.05). All powders had Mw from 4.0 x 10(5) to 6.5 x 10(5) and narrow Mw distributions (2.1 to 3.6). Polymerization and post-polymerization produced K specimens with Mw similar to that of K powder.