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Objective: To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction., Methods: A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models., Results: Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284)., Conclusion: This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults., Clinical Significance: Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Statement of Problem: Studies on the impact of denture cleansers on the physical and mechanical properties of denture bases designed and constructed by using computer software programs are lacking., Purpose: The purpose of this in vitro study was to test the effect of a peroxide denture cleanser on the hardness, fracture toughness, water sorption, and solubility of denture base materials manufactured by 3D printing and computer-aided design and computer-aided manufacturing (CAD-CAM) milling., Material and Methods: The hardness, fracture toughness, water solubility, and sorption of CAD-CAM milled and 3D printed groups (n=40) were evaluated before and after exposure to a denture cleanser. Hardness (n=10) was analyzed with a Vickers hardness testing machine, and fracture toughness (n=20) with the 3-point bend test. After the fracture of specimens, a scanning electron microscope at ×300 was used for fractographic analysis. Water sorption and solubility (n=10) were evaluated before and after immersion in denture cleanser for 6 days to simulate 180 days of immersion. Two-way repeated ANOVA and 2-way ANOVA were used to test normally distributed data, whereas the Mann Whitney U test and Wilcoxon signed ranks test were used for data that were not normally distributed (α<.05)., Results: The Vickers hardness and fracture toughness of both materials decreased after immersion in denture cleansers, with a higher decrease in values for the 3D printed group (P<.001). The denture cleanser had no effect on the water sorption and solubility of either group., Conclusions: Milled specimens had higher hardness values and fracture toughness before and after immersion in the denture cleanser. Denture cleansers resulted in the reduced hardness and fracture toughness of both groups, but the percentage change in the milled group was lower. Denture cleansers had no effect on water sorption or solubility., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Which disinfection protocol provides optimal water contact angle and microhardness for computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) materials is unclear., Purpose: The purpose of this in vitro study was to evaluate the effect of different disinfection protocols (1% sodium hypochlorite, denture cleanser gel, and effervescent tablet) on the water contact angle and microhardness of different CAD-CAM PMMA denture base materials by comparing them with a heat-polymerized PMMA., Material and Methods: Disk-shaped specimens (Ø10×2 mm) were fabricated from 3 different CAD-CAM PMMAs-AvaDent (AV), Merz M-PM (M-PM), and Polident (Poli)-and a heat-polymerized PMMA (Vynacron) (CV) (n=21). Three disinfection protocols (1% sodium hypochlorite [HC], denture cleanser gel [GEL], an effervescent tablet [TAB]) were applied to simulate 180 days of cleansing. The water contact angle and microhardness of specimens were measured before and after disinfection and compared by using a 2-way ANOVA (α=.05)., Results: For water contact angle, material (P=.010) and disinfection protocol (P=.002) had a significant effect. The material (P<.001), disinfection protocol (P=.001), and their interaction (P<.001) significantly affected the microhardness after disinfection. When the condition after disinfection was compared with that before disinfection, the water contact angle increased significantly in all material-disinfection protocol pairs (P≤.025), and microhardness increased significantly in all material-disinfection protocol pairs (P≤.040), except for GEL- (P=.689) or TAB-applied (P=.307) AV, HC-applied M-PM (P=.219), and TAB-applied Poli (P=.159)., Conclusions: The material and disinfection protocol affected the water contact angle of all tested PMMAs after disinfection, resulting in more hydrophobic surfaces for heat-polymerized or CAD-CAM PMMAs. The microhardness of heat-polymerized PMMA was less than that of all CAD-CAM PMMAs after disinfection, regardless of the protocol., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Denture stomatitis affects complete denture wearers and is frequently treated with antifungals drugs, as well as treating the denture with sodium hypochlorite. Whether the limitations of these treatments can be overcome with local hygiene protocols that do not damage the denture materials or adversely affect the patient is unclear., Purpose: The purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis., Material and Methods: For this randomized, double-blind controlled clinical trial, 108 participants were assigned to parallel groups: 0.25% sodium hypochlorite (positive control) 0.15% Triclosan, denture cleaning tablets, or denture cleaning tablets plus gingival cleaning tablets. The participants were instructed to brush the dentures and the palate and immerse the denture in the solutions. The outcomes of denture stomatitis remission, biofilm removal, decrease of microbial load (colony-forming units), and odor level of the mouth and denture were measured at baseline and after 10 days. Descriptive analyses were used for sociodemographic characterization of the participants; the Pearson chi-square test was used to compare participant frequency with different degrees of denture stomatitis. The data were not normally distributed (Shapiro-Wilks test) or homogeneous (Levene test). So, the Kruskal-Wallis and Dunn post hoc tests and Wilcoxon test were used to compare the effects of solutions and time on the variables (α=.05)., Results: The frequency of the highest to lowest denture stomatitis scores was significantly different for the 0.15% Triclosan and denture cleaning tablets groups. No significant difference was found among the groups in terms of denture stomatitis scores, biofilm, or colony-forming unit count of Candida spp. or C. albicans and S. mutans; a significant reduction was found in these parameters. The 0.25% sodium hypochlorite and 0.15% Triclosan treatments caused a significant reduction in Gram-negative microorganisms; these 2 protocols, and the denture cleaning tablets showed a significant reduction in Staphylococcus spp.; all protocols had similar effects. Only the S. mutans count of the palate decreased after 10 days. The odor level of the mouth and the denture was not significantly different (P=.778)., Conclusions: The evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Cinnamaldehyde has been successfully used for the short-term disinfection of dentures; however, its long-term effects on the surface and color properties of denture base materials remain unknown., Purpose: The purpose of this in vitro study was to evaluate the effects of simulated immersion in cinnamaldehyde for up to 5 years on the surface roughness and color parameters of a heat-polymerized denture resin., Material and Methods: Eighty Ø10×5-mm disk-shaped specimens were prepared from microwave heat-polymerized polymethylmethacrylate (PMMA) and immersed in 4 solutions (n=20): TW-tap water (control), SH - 0.5% sodium hypochlorite, PX-alkaline peroxide, and CA-cinnamaldehyde (27 μg/mL). The immersion protocol simulated 104 cycles (3.5 months), 913 cycles (2.5 years), and 1825 immersion cycles (5 years) of a daily immersion cleaning protocol, with immersion times ranging from 10 to 20-minutes. Surface roughness (Sa) and the color parameters of CIELab (L∗ a∗ b∗, ΔEab), CIEDE2000 (ΔE00), and the National Bureau of Standards (NBS) were analyzed at baseline (t=0) and after the immersion cycles. The data were analyzed by 2-way analysis of variance (ANOVA) for repeated measures and the Tukey post hoc test (α=.01)., Results: Sa was significantly increased in all groups after 1825 cycles compared with baseline (P<.01), regardless of the solution. Only the time factor significantly affected ΔEab, ΔE00, and NBS parameters, which were below the perceptibility and acceptability thresholds. After a simulated 5-year immersion, the surface roughness and color values of CA-treated specimens were not statistically different from those of the other groups (P>.01)., Conclusions: Cinnamaldehyde solution (27 μg/mL) produced minor effects on the surface roughness and color parameters of a heat-polymerized denture base resin similar to those of 0.5% sodium hypochlorite and alkaline peroxide after a 5-year simulated immersion., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Denture stomatitis is a prevalent condition in denture wearers. Economic evaluations of health care can help stakeholders, including patients, make better decisions about treatments for a given condition. Economic models to assess the costs and benefits of different options for managing denture stomatitis are lacking., Purpose: The purpose of this study was to explore the feasibility of developing a cost-effectiveness model to assess denture cleaning strategies aimed at preventing denture stomatitis from a denture-wearer perspective in the United Kingdom., Material and Methods: A model was developed to identify and estimate the costs and effects associated with 3 denture cleaning strategies. These were low care (LC)-cleaning by brushing and soaking overnight in water; medium care (MC)-brushing with toothpaste and soaking overnight in water; and optimum care (OC)-brushing and soaking overnight in water and antimicrobial denture cleanser. Costs, outcome measures (denture stomatitis-free days), and probabilities (incidence of stomatitis, unscheduled dentist visits, prescription charges, self-medication) associated with each strategy were defined. A sensitivity analysis was used to identify key drivers and test the robustness of the model., Results: The model showed that the total costs for 2015 ranged from £1.07 (LC) to £18.42 (OC). Costs associated with LC were derived from unscheduled dentist visits and use of medication and/or prescription charges. Incremental costs per denture stomatitis-free day were £0.64 (MC) and £1.81 (OC) compared with LC. A sensitivity analysis showed that varying either or both key parameters (baseline incidence of denture stomatitis and relative effectiveness of MC and OC strategies) had a substantial effect. Incremental cost-effectiveness ratios ranged from £4.11 to £7.39 (worst-case scenario) and from £0.21 to £0.61 (best-case scenario)., Conclusions: A model was developed to assess the relative cost-effectiveness of different denture cleaning strategies to help improve denture hygiene. An important finding of the study was the lack of evidence on the relative effectiveness of different cleaning strategies, meaning that several assumptions had to be incorporated into the model. The model output would therefore likely be considerably improved and more robust if these evidence gaps were filled., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the efficacy of a realistic staining/cleansing protocol for long-term prevention of discoloration of denture base resins., Materials and Methods: Sixty discs (20 × 2.5 mm) of auto- and heat-polymerizing denture acrylic resins were fabricated following manufacturer's instructions, polished on one side and stored in water (37°C) for 24 hours before they were assigned randomly into 6 groups (3 for each material, n = 10) to receive 220 cycles of three immersion protocols. Group A was immersed in the following baths: (1) filtered coffee at 45°C for 2 minutes, (2) tap water at 24°C for 20 seconds, (3) as bath 1, (4) as bath 2, (5) Corega Extradent cleansing solution at 45°C for 3 minutes, and (6) water at 24°C for 20 seconds. Group B was immersed in the four first baths of group A (without cleansing action) and group C in bath 1 for the cumulative action of 20 cycles (80 minutes in 45°C coffee) and bath 2 for 40 seconds. A noncontact optical interferometric profilometer was used for qualitative evaluation of the specimens and a contact colorimeter to estimate color change values (ΔΕ*ab) at baseline and every 20 cycles in the baths for a total of 220 cycles. Data were statistically analyzed using a 2-way-repeated measures ANOVA with Bonferoni multiple comparisons and trend analysis at α = 0.05 level of significance., Results: Data indicated changes in color from 1.7 to 14.2 ΔΕ*ab units. The highest values were related to the number of cycles and group B immersion protocol. Significant differences were found among immersion protocols (p < 0.001) and immersion cycles (p < 0.001) with a significant interaction between protocols and cycles (p < 0.001) but not between denture resins (p = 0.991)., Conclusion: The evaluated protocol A was found effective in preventing color changes in both denture resins even after a long period of action. Protocol C had a much lower staining effect on both resins than protocol B and behaved similarly to protocol A until 140 to 160 cycles. Therefore, it is probably not appropriate for use in short-term color stability experiments., (© 2018 by the American College of Prosthodontists.)

Background: Dental calculi formation on dentures can worsen the oral cavity environment by complicating oral hygiene. However, few studies have investigated the effect of how patients use and manage their dentures, denture surface roughness, and host factors such as oral cavity dryness and saliva properties on denture cleanliness and denture dental calculi formation. Accordingly, we conducted the present survey to evaluate these factors to clarify the strength of the influence of each factor., Methods: We enrolled 53 patients who had used dentures for at least 3 months and used a dental prosthesis that covered at least the six front teeth including the left and right mandibular canines. After staining the dentures, we divided the participants into a group that was positive for dental calculi (DCP group) and a group that was negative for dental calculi (DCN group). After removing all the stains, we evaluated the surface roughness of the dentures. A questionnaire was used to survey how the participants used and managed their dentures. Oral cavity dryness was evaluated, and resting saliva samples were collected to assess saliva properties. Correlations between the presence or absence of dental calculi and denture use and management were evaluated using a chi-square test. Correlations with denture surface roughness, oral cavity dryness, and saliva properties were evaluated using the Mann-Whitney U test. Correlations between the presence or absence of dental calculi and all factors were analyzed using multivariate analysis (quantification II)., Results: Surface roughness was significantly greater in the DCP group (p < 0.01), and the DCP group members wore their dentures during sleep significantly more often and used a denture cleaner when storing their dentures significantly less often (both p < 0.01). No significant differences were observed for oral cavity dryness or saliva properties. The multivariate analysis showed significant correlations of dental calculi formation with denture surface roughness and items related to denture use and management, but not for oral cavity dryness or saliva properties., Conclusions: Our findings indicate that dental calculi formation is influenced by how dentures are used and managed and by denture surface roughness, but not by oral cavity dryness and saliva properties.

Background: poor oral health is common among older people dependent on supportive care and it affects their quality of life. Cognitive impairment and functional dependency may increase the risk of compromised daily oral hygiene., Aim: to investigate the effectiveness of a tailored preventive oral health intervention among home care clients aged 75 years or over., Patients and Methods: the intervention group comprised 151 patients (84.4 ± 5.6 years) and the control group 118 patients (84.7 ± 5.2 years). An interview and a clinical examination were carried out before a tailored intervention of oral and denture hygiene. The participants in both groups were re-interviewed and re-examined after 6 months., Results: the intervention significantly reduced the number of plaque covered teeth and improved denture hygiene. In addition, functional ability and cognitive function were significantly associated with better oral hygiene., Conclusions: the intervention had a positive effect on oral hygiene, however the number of teeth with plaque remained high, even after the intervention. Multiple approaches based on individual needs are required to improve the oral health of vulnerable older adults, including integrating dental preventive care into daily care plan carried out by home care nurses., (© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com)

Aims: The aim of this study was to assess the denture hygiene knowledge and practices among patients using complete dentures attending a postgraduate dental hospital in Jabalpur city. The objective of this study was to assess the relationship between hygiene knowledge and practices to the denture wearer's gender, education, and income., Materials and Methods: A descriptive, cross-sectional survey was conducted using a self-administered questionnaire involving the complete denture patients attending the Department of Prosthodontics. The study subjects were randomly selected by recruiting old dentures wearers visiting the Department of Prosthodontics for a recall visit or for new dentures on the odd dates of the month. All subjects signed an informed consent before filling the questionnaire. The institutional review committee approved the study. Descriptive statistics included computation of frequencies and percentages. Nonparametric test, namely, chi-square test, was used for further data analysis; p-value <0.05 was considered statistically significant., Results: A total of 530 individuals were approached for participation in our survey, 30 (5.66%) subjects declined to participate. The results showed that 195 (39%) subjects were wearing the same dentures for more than 5 years. In this study, 51 (10.2%) subjects reported never having been advised by their dentists as to how to clean their dentures. Among all the subjects interviewed, 264 (52.8%) reported to clean the oral tissues daily. This study disclosed that 66 (13.2%) of the subjects usually slept with their dentures. Maximum subjects in illiterate group had experienced bad breath sometimes when compared with subjects in postgraduate group (χ 2 = 47.452, p < 0.001). There was a significant difference for method of denture cleaning according to gender (χ 2 = 101.076, p < 0.001)., Conclusion: The majority of the denture wearers have limited knowledge of denture cleansing and oral hygiene practices. Hygiene habits and practices may not always present a positive correlation with the gender, educational level, and income of the subjects., Clinical Significance: Periodic recall for evaluation of denture and mucosal surfaces along with reinforcement of denture hygiene instructions will go a long way in helping the patients reap maximum benefits out of their prostheses.

Statement of Problem: The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism., Purpose: The purpose of this randomized crossover trial was to evaluate the efficacy of denture cleansers in terms of biofilm removal, antimicrobial action, and the remission of denture stomatitis., Material and Methods: Fifty denture wearers with denture stomatitis were instructed to brush their dentures (brush and soap) and to soak them (20 minutes/14 days) in 4 solutions, as follows: C (control), 0.85% saline; SH1, 0.1% sodium hypochlorite; SH2, 0.2% sodium hypochlorite; and RC, 8% Ricinus communis. The biofilm in the intaglio surface of maxillary dentures was stained, photographed, and quantified by software (Image Tool). It was then collected (brushed with saline solution), and the obtained suspension was diluted (10 0 to 10 -3 ) and seeded (50 μL) in CHROMagar for Candida spp. After incubation, colony-forming units per milliliter values were calculated. Denture stomatitis remission was classified according to the Newton classification. Data were analyzed by Friedman (α=.05) and Wilcoxon tests and corrected by the Bonferroni test (α=.005)., Results: SH1 (mean rank [MR]=1.98) and SH2 (MR=1.64) showed lower biofilm coverage than C (MR=3.73) that was similar to RC (MR=2.92). SH1 (MR=2.43) and SH2 (MR=2.10) showed antimicrobial action for Candida spp, and RC (MR=3.36) showed similar results to C (MR=3.51) and baseline (MR=3.50). Clinical signs of denture stomatitis were reduced by SH1 (MR=2.44), while SH2 (MR=2.56) and RC (MR=2.74) showed intermediate results., Conclusions: The two sodium hypochlorite solutions were the most effective means of biofilm control. All tested solutions were effective in reducing the signs of denture stomatitis., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Oral disease can have a significant impact on the health and wellbeing of the housebound patient. The aetiology of oral conditions such as dental caries and periodontal disease have been well investigated and there is a solid evidence base in how to best prevent their progress. The Department of Health document Delivering better oral health: an evidence-based toolkit for prevention is a valuable resource that outlines the current best preventative evidence in the form of practical advice for clinicians and patients. This article aims to distil and present this advice for the benefit of community nurses. It will identify areas of particular importance for people with additional needs, particularly the elderly and infirm. Outlining how to best tailor preventative advice and treatment for this patient group.

Background: Candida albicans is one of the microorganisms which harbor the oral cavity, especially in elderly. However, the incidence of existence of this increases in patients using removable dental prosthesis. There is therefore a need to test the anticandidal efficacy of these cost-effective, easily available products to be used as routine denture cleansers., Aim and Objectives: (1) To evaluate antifungal properties of triphala churna on the heat cure denture base material. (2) To evaluate the antifungal effect of chlorhexidine gluconate on the heat cure denture base material. (3) To compare the antifungal effect of triphala churna and chlorhexidine gluconate with a control. (4) To evaluate which among triphala churna and chlorhexidine gluconate has a better antifungal property on the heat cure denture base material., Materials and Methods: Study population consisted of sixty dentures wearers from those attending the Outpatient Department of Prosthodontics of the School of Dentistry, Krishna Institute of Medical Sciences Deemed University, Karad. Swabs were collected from the dentures before and after the use of triphala and chlorhexidine. The swabs were cultured on Sabouraud dextrose agar and the total Candida counts were determined., Conclusion: Triphala as an antifungal is shown to have more efficacy than the conventional chlorhexidine mouthwash. Résumé Arrière-plan: Candida albicans est l'un des micro-organismes qui abritent la cavité buccale surtout chez les personnes âgées. Cependant, l'incidence de l'existence de cette augmentation chez les patients utilisant des prothèses dentaires amovibles. Il est donc nécessaire de tester l'efficacité anticancédique de ces produits rentables et faciles à utiliser pour être utilisés comme nettoyants de routine pour prothèses dentaires. Buts et Objectifs: (1) Évaluer les propriétés antifongiques de Triphala churna sur le matériau de base de la prothèse thermo-durcissable. (2) Évaluer l'effet antifongique du gluconate de chlorhexidine sur le matériau de base de la prothèse thermo-durcissable. (3) Comparer l'effet antifongique de Triphala churna et du gluconate de chlorhexidine avec un témoin. (4) Évaluer lequel parmi Triphala churna et le gluconate de chlorhexidine a une meilleure propriété antifongique sur le matériel de base de la prothèse de durcissement à chaud. Matériaux et Méthode: La population de l'étude était constituée de soixante porteurs de prothèses dentaires de ceux qui fréquentaient le Département de Prosthodontie de l'École des Sciences Dentaires de l'Institut Krishna des Sciences Médicales de l'Université de Karad. Des prélèvements ont été effectués sur les prothèses avant et après l'utilisation de Triphala et de chlorhexidine. On a cultivé les écouvillons sur de l'agar Sabouraud dextrose et on a déterminé le nombre total de candida., Conclusion: Triphala comme un anti fongique est démontré pour avoir plus d'efficacité que le lavage de la bouche classique chlorhexidine.

Context: Extrinsic staining of acrylic resin dentures could be a major esthetic problem for denture wearers. Tea, coffee, cola, turmeric, and tobacco often cause extrinsic staining of dentures., Aim: To evaluate the efficacy of various denture cleansing materials in the removal of tea and turmeric stains and to compare the efficacy of those denture cleansers with each other in the removal of tea and turmeric stains., Materials and Methods: Heat-cured acrylic resin specimens were stained using tea and turmeric solutions. The spectrophotometer was used to determine the reflectance values of the samples and to evaluate the efficacy of various denture cleansing materials in removal of tea and turmeric stains. Three denture cleansers, namely, sodium hypochlorite, Safe plus, and Clinsodent were used in the study. Water was used as a control., Statistical Analysis Used: ANOVA test and post hoc Tukey's test were used to determine the statistical difference between the groups., Result: A statistically significant difference was found (p ≤ 0.05) between the different denture cleansing materials used. Products containing sodium perborate along with trisodium phosphate had the highest stain removing capability., Conclusion: It was found that all the denture cleansing materials used in the study were effective in removing tea and turmeric stains. Products containing sodium perborate along with trisodium phosphate had a comparatively greater stain removal capability than products containing sodium perborate along with sodium bicarbonate followed by products containing sodium hypochlorite followed by water (control).

Purpose: To evaluate the effect of disinfection with sodium perborate or chlorhexidine (when combined with brushing) on the removal of biofilm in relined dentures., Methods: Swabs were collected 48 hours after the relining procedure and at the follow-up time intervals of 7, 15, 30, 90, and 180 days. The dentures' surface roughness was measured at the same times. 45 subjects were randomly divided into three groups of 15 subjects each. The control group brushed with coconut soap and a soft toothbrush. The sodium perborate group followed the same procedure and also disinfected with sodium perborate solution for 5 minutes per day. The chlorhexidine group followed the control group procedure and disinfected with 2% chlorhexidine digluconate solution for 5 minutes per day. The number of colony forming units and the surface roughness were evaluated statistically by 2-way repeated-measure ANOVA (α = 0.05)., Results: The control group dentures exhibited similar levels of microbial cells throughout the experiment. However, after 15 days, no microbial growth was observed on the dentures for which either disinfection agent was used. There were no statistically significant differences in superficial roughness between the groups (P = 0.298). The disinfection agents used, combined with brushing, were able to remove the relined dentures' biofilm after 15 days of disinfection. Roughness was not a predominant factor in CFU reduction.

Purpose: To assess the behaviour of the elderly with regard to hygiene procedures for and maintenance of removable dentures., Materials and Methods: 243 elderly people were interviewed using a semi-structured questionnaire, which was applied in the coverage area of Family Health Strategy in Urlandia district in the city of Santa Maria, Brazil., Results: The majority of those interviewed were 60 to 69 years old, with a prevalence of women and incomplete primary school education. In general, the dentures had been worn for more than 10 years and 43.7% of them had been made by a dental prosthetic technician. More than half the study population had not received instructions on hygiene and maintenance of the dentures., Conclusion: This population was not aware of the importance of hygiene and maintenance of the removable dentures. It is worrying that a considerable number of elderly have sought dental prosthetic care from technicians who were not trained to promote and maintain health.

The objective of this study was to investigate the influence of educational materials on the denture hygiene and utilization habits of 70 adult volunteers who had been using complete dentures for at least 5 years. On the day they received new dentures, 32 patients were provided with an illustrated leaflet and verbal instructions on oral hygiene and utilization habits, while the remaining 38 participants were advised to continue cleaning and wearing their new dentures as they had their previous dentures. After a 6- to 10-week period, 66 of 70 subjects were interviewed about socioeconomic factors, denture hygiene, and utilization habits. The percentage of patients with a proper denture care routine was low in both groups, suggesting that patients had a tendency not to change old habits. However, statistical analysis showed a positive correlation between receiving instruction and performing denture care in a way that is closer to the recommended method: brushing without toothpaste, using a specific brush; soaking in a sodium hypochlorite solution; and removing the prosthesis at night. Within the limitations of this study, it was concluded that this approach to patient education could be applied to improve the hygiene and utilization habits of denture wearers as well as encourage the correct use of complete dentures.

Aims: The aim of this study was conducting a survey of hygiene habits and use of removable partial dentures (RPDs) and correlate them with the social conditions of the interviewees., Methods: A total of 145 RPD wearers were interviewed by experienced clinical staff using a structured questionnaire. A Chi-squared test was performed to evaluate statistical significance between the variables, and the level of significance was P<0.05., Results: A total of 72 (49%) patients reported that they had not been well informed by the dentists. Brushing was the most frequent cleaning method (57.6%). 77 (53.1%) patients did not take off their dentures at night. The frequency of cleaning dentures and using cleansing tablet was significantly higher in females than in males (P<0.05). The frequency of denture cleaning, cleaned parts of denture, use of cleansing tablet, removal of dentures at night, frequency of tooth brushing, does not show any significant difference according to age, educational status or duration of denture usage (P>0.05). RPD wearers did not clean their dentures and natural teeth satisfactorily and had limited knowledge of denture cleansing and oral hygiene maintenance., Conclusions: Hygiene habits and attitudes may be affected by gender, but education level and hygiene attitudes may not always present positive correlation. Dentists should thoroughly inform patients about the harmful effects of overnight wearing and motivate to clean metal parts of RPD's and cleansing tablet use in order to minimize the abrasive effect of widely preferred cleaning method of brushing with toothpaste.

Background: Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures., Materials and Methods: Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically., Results: Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group., Conclusion: A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Statement of Problem: Candida biofilms on denture surfaces are substantially reduced after a single immersion in denture cleanser. However, whether this effect is maintained when dentures are immersed in cleanser daily is unclear., Purpose: The purpose of this study was to evaluate the effect of the daily use of enzymatic cleanser on Candida albicans biofilms on denture base materials., Material and Methods: The surfaces of polyamide and poly(methyl methacrylate) resin specimens (n=54) were standardized and divided into 12 groups (n=9 per group), according to study factors (material type, treatment type, and periods of treatment). Candida albicans biofilms were allowed to form over 72 hours, after which the specimens were treated with enzymatic cleanser once daily for 1, 4, or 7 days. Thereafter, residual biofilm was ultrasonically removed and analyzed for viable cells (colony forming units/mm(2)) and enzymatic activity (phospholipase, aspartyl-protease, and hemolysin). Factors that interfered with the response variables were analyzed by 3-way ANOVA with the Holm-Sidak multiple comparison method (α=.05)., Results: Polyamide resin presented more viable cells of Candida albicans (P<.001) for both the evaluated treatment types and periods. Although enzymatic cleansing significantly (P<.001) reduced viable cells, daily use did not maintain this reduction (P<.001). Phospholipase activity significantly increased with time (P<.001) for both materials and treatments. However, poly(methyl methacrylate) based resin (P<.001) and enzymatic cleansing treatment (P<.001) contributed to lower phospholipase activity. Aspartyl-protease and hemolysin activities were not influenced by study factors (P>.05)., Conclusions: Although daily use of an enzymatic cleanser reduced the number of viable cells and phospholipase activity, this treatment was not effective against residual biofilm over time., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: To better understand the role of the professional oral health care for elderly in improving geriatric oral health, the effects of short-term professional oral health care (once per week for 1 month) on oral microbiological parameters were assessed., Methods: Parallel, open-labelled, randomize-controlled trial was undertaken in a nursing home for elderly in Shizuoka, Japan. Thirty-four dentate elderly over 74 years were randomly assigned from ID number to the intervention (17/34) and control (17/34) groups. The outcomes were changes in oral microbiological parameters (number of bacteria in unstimulated saliva; whole bacteria, Streptococcus, Fusobacterium and Prevotella: opportunistic pathogens detection: and index of oral hygiene evaluation [Dental Plaque Index, DPI]) within the intervention period. Each parameter was evaluated at before and after intervention period. Four elderly were lost from mortality (1), bone fracture (1), refused to participate (1) and multi-antibiotics usage (1). Finally, 30 elderly were analysed (14/intervention and 16/control)., Results: At baseline, no difference was found between the control and intervention groups. After the intervention period, the percentage of Streptococcus species increased significantly in the intervention group (Intervention, 86% [12/14]; Control, 50% [8/16]: Fisher's, right-tailed, P < 0.05). Moreover, DPI significantly improved in the intervention group (Intervention, 57% [8/14]; Control, 13% [2/16]: Fisher's, two-tailed, P < 0.05). The improvement in DPI extended for 3 months after intervention. None of side effects were reported., Conclusion: The short-term professional oral health care can improve oral conditions in the elderly., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: To compare ultrasonic cleaning combined with immersion in a commercially available peroxide-based cleanser solution (Polident(®) ) with other denture cleaning methods, we examined the quantity of micro-organisms that survived on dentures before and after various cleaning methods., Subjects and Methods: One hundred complete dentures belonging to 50 nursing home residents (mean age, 84.6 years) were randomly assigned to five groups according to the cleaning method employed: (A) immersion in Polident(®) solution alone, (B) brushing with water, (C) ultrasonic cleaning with water, (D) method (A) followed by method (B) and (E) ultrasonic cleaning combined with immersion in Polident(®) solution. Before and after the dentures had been cleaned, denture biofilm was collected from the mucosal surface of each lateral half of the examined dentures. The collected micro-organisms were cultured, presumptively identified by standard methods and quantified. Comparisons between the five cleaning methods were carried out using the Kruskal-Wallis test and Dunn's multiple comparisons test., Results: The denture cleaning methods involving the use of Polident(®) solution (methods A, D and E) were significantly more effective at denture disinfection than the other methods (p < 0.05); in particular, the quantity of Candida spp. was lowest after method E (median, 0.00; significantly lower than those observed after methods A, B and C; p < 0.05)., Conclusion: It was concluded that ultrasonic cleaning combined with immersion in a peroxide-based cleanser solution effectively reduces the quantity of micro-organisms surviving on dentures and is a suitable method for elderly individuals who find brushing their dentures difficult., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Aim: This study evaluated the antibiofilm effect of an experimental solution of 2% Ricinus communis (R. communis) on a silicone-based denture liner by means of a randomized clinical trial, as well as the integrity of such liner following a cleansing regimen with such solution., Materials and Methods: About 30 complete denture wearers had their lower dentures relined with a silicone-based denture liner and randomly allocated to cleanse their dentures by means of: (A) a specific toothbrush for complete dentures and dentifrice; (B) soaking in an experimental 2% R. communis solution; and (C) association of A and B. Considered outcomes were biofilm coverage area (%), microbial counts by means of the deoxy-ribonucleic acid (DNA) checkerboard hybridization technique and physical integrity of the soft liner, assessed during a time interval of 60 days. Mean group values were compared by analysis of variance (ANOVA) and Tukey tests or generalized linear method (α = 0.05)., Results: The mechanical method presented the lowest biofilm percentage (1.45 ± 1.03) if compared to the chemical method (2.96 ± 1.98) and the associated one (2.71 ± 1.76). After 60 days (3.37 ± 2.04), biofilm accumulation was higher than at 15 days (1.28 ± 0.77) and 30 days (2.46 ± 1.54). The denture liner was less deteriorated and kept its physical integrity when the mechanical method was applied. The chemical method presented higher effectiveness against microorganisms, including some Candida species., Conclusion: The 2% R. communis solution presented stronger antimicrobial capacity than brushing on a silicone-based denture liner after immersion. However, it was not superior to the mechanical method in preserving the physical integrity of the material and in biofilm removal., Clinical Significance: Soft denture liners hygiene is a very important issue and not conclusive in the literature. The experimental solution of 2% R. communis evaluated presented promising antimicrobial potential and should be more explored to be recommended as cleanser.

Purpose: This study aimed to assess the efficacy of palatal brushing in the treatment of denture stomatitis., Materials and Methods: After screening 143 individuals with a potential diagnosis of denture stomatitis, 48 patients (mean age: 66.0 ± 11.2 years) were enrolled in a two-center phase 1 clinical trial with a one-group pretest/posttest design. The intervention of interest was manual palatal brushing after each meal and before bedtime. Clinical and microbiologic examinations were performed at baseline and 1 and 3 months after treatment. Additional data were obtained using a validated questionnaire. The primary and secondary outcomes were the remission of denture stomatitis and diminution of Candida colony-forming units (CFUs), respectively. Descriptive and nonparametric statistical tests were conducted to analyze the data., Results: At the 3-month follow-up, denture stomatitis was completely cured in 10.4% of the participants, and 70.8% of denture wearers showed improvement in the clinical signs of denture stomatitis. There was a significant reduction in the area and severity of the palatal inflammation (P < .0001). The effect size ranged from medium to large (0.34 to 0.54) depending on the classification used for the diagnosis of denture stomatitis. A significant reduction in the number of Candida CFUs isolated from the palatal mucosa and dentures (P ≤ .05) was observed., Conclusions: The results of this study suggest that palatal brushing is an effective treatment of denture stomatitis.

Preprosthetic interventions in patients with aggressive forms of inflammatory papillary hyperplasia have historically involved surgery. These procedures often involve significant postoperative discomfort and morbidity. Additionally, some patients who present with dental phobias, aversions to surgery, or underlying systemic disease may not be amenable to this type of surgical intervention. In this report, a patient with severe inflammatory papillary hyperplasia and phobias regarding the dentist and dental surgery was treated nonsurgically, following strict adherence to a clinical protocol. The methodology involved greater patient comfort during treatment, encouraged positive reinforcement to visiting the dentist for recall appointments, and effectively eliminated the underlying inflammatory papillary hyperplasia, allowing for the successful fabrication of the definitive removable prostheses., (Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to evaluate Candida colonisation in the dentures with silicone soft liner in diabetic and non-diabetic patients and to assess the antifungal efficacy of chlorhexidine gluconate on Candida colonies., Materials and Methods: Thirty patients with resorbed ridges, fifteen each in the diabetic and non-diabetic group, were selected. The mandibular denture of each patient was lined with heat-polymerised silicone resilient liner. Patients were instructed to clean the dentures with soap water and brush. Samples from the fitting surface of mandibular dentures were collected at 15, 21 and 30 days. Subsequently, samples were collected at 15, 21 and 30 days, after cleaning the dentures with a detergent solution of 4% chlorhexidine gluconate, and incubated for the evaluation of Candida growth. These data were subjected to statistical analysis by Mann-Whitney U-test., Results: Normal oral flora in diabetics and non-diabetics showed no difference (p > 0.05). The density of colonies increased after 21 and 30 days in diabetic patients (p < 0.05). Number of Candida colonies significantly reduced in both the groups after 21 and 30 days of cleaning the dentures with 4% chlorhexidine gluconate (p < 0.05)., Conclusion: Dentures with silicone resilient liner exhibit increased Candida growth in diabetic patients. Four per cent chlorhexidine gluconate solution effectively disinfects these dentures., (© 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Background: Clinical guidelines for denture care are available, but evidence for optimal nocturnal storage is scarce. The aim of the study was to compare the role of the overnight storage state on plaque growth and composition on acrylic removable dentures., Methods: In a parallel-group randomized controlled trial of 51 institutionalized participants, 3 denture overnight preservation methods were considered: (i) in water, (ii) dry or (iii) in water with added alkaline peroxide-based cleansing tablet. Biofilm samples were taken on day 7 (developing biofilm - dBF) and day 14 (maturing biofilm - mBF) from a mechanically uncleaned, standardized region, situated distally to the second lower premolars. Total and individual levels of selected perio-pathogenic and commensal species (n=20), and of Candida albicans were calculated by PCR. Differences between storage conditions (water/dry/tablet) and between the samples (dBF/mBF) were assessed by means of unpaired and paired t-tests respectively, with α=5%., Results: Overnight denture storage with cleansing tablet significantly decreased the total bacterial level of dBF and mBF up to 13.8%. Fn, Ec, Cs, Sc, Ao and Vp counts were particularly affected by tablet care. Significant lower amounts of Candida albicans for tablet storage compared to water preservation were recorded in dBF and mBF (-69.3 ± 3.8% and -75.9 ± 3.2% respectively). The mass and pathogenicity of dBF and mBF was equal, irrespective of the overnight storage intervention., Conclusions: The use of cleansing tablets for acrylic removable denture overnight storage reduces denture biofilm mass and pathogenicity compared to dry and water preservation, and may contribute to the overall systemic health., Clinical Significance: Evidence-based clinical guidelines for overnight storage of removable acrylic dentures are lacking. The findings of this study indicate that alkaline peroxide-based cleansing tablets decrease bacterial and Candida levels in denture biofilms in case of poor oral hygiene. This provides evidence for a clinical guideline to minimize microbial load of dentures, thereby reducing associated systemic health risks., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To determine the denture hygiene habits in complete denture patients according to their age and time of dentures., Methods: In this study a self administered structured was developed to know the attitude of the patients regarding denture hygiene in the department of Prosthodontics. The total study sample consisted of 230 subjects including 124 (53.9%) males and 106 (46.1%) females. Data was analyzed using SPSS version 15.0 with chi-square test at p-value <0.05., Results: Nearly half of the subjects clean their dentures daily once. Participants from the younger age group and who had been wearing dentures since 2 years maintain better frequency of cleaning. The majority of these subjects used water and brush for denture cleansing. After seeing the condition, half of the dentures were rated as good 50.3%, followed by fair and poor as 29.5 and 20.2% respectively., Clinical Significance: Poor condition of complete dentures seen in the population is mainly due to irregularly cleansing habits and also less usage of cleansing solutions. Dentists should give proper instructions regarding maintenance of denture hygiene.

Background: Regular good denture hygiene by individuals with removable partial dentures (RPDs) is an important component of oral health and in the prevention of further dental problems. These individuals should be provided with advice on the importance of denture care and be aware of this information., Aim: To establish deficiencies in patient knowledge surrounding denture hygiene by RPD wearers., Methodology: The study was undertaken as an audit. Data was collected from April 2012 to October 2012 via a questionnaire completed by 196 RPD wearers attending as patients at the University Dental Hospital Wales and the dental units at St David's Hospital and Cynon Valley Hospital. The audit criterion was patients with RPDs should have knowledge of denture hygiene, with the standard set at 100%., Results: While 91.8% of participants stated they were provided with instructions on denture hygiene when provided with their current prosthesis, 60.2% were shown to have less than an appropriate level of denture cleanliness, with 9.2% reporting that they slept wearing their prosthesis., Conclusion: The audit criterion and standard set were not achieved. A lack of knowledge surrounding denture hygiene was demonstrated among participants. As a part of the audit process the health education of RPD wearers' hygiene needs to be improved and awareness levels of the whole dental team needs to be raised. All partial dentures should receive information and regular reinforcement of key dental hygiene messages.

Background: The microwave energy is an efficient disinfection method; however, it can generate high temperatures that can result in distortion of the dentures., Objectives: To evaluate whether the addition of an enzymatic cleanser to microwave disinfection regimen would disinfect dentures with shorter irradiation time., Materials and Methods: Seven resin discs colonized with Candida albicans biofilm were placed on the palatal surface of sterile dentures to be randomly assigned to the following treatments: immersion in distilled water for 3 min with 0 (DW), 1 (DW + M1), 2 (DW + M2), or 3 min (DW + M3) of microwave irradiation; or immersion in denture cleanser for 3 min with 0 (DC), 1 (DC + M1), 2 (DC + M2) or 3 min (DC + M3) of irradiation. After the treatments, the viable cells were counted by a blinded examiner. The temperature was measured immediately after irradiation. The data were analyzed by ANOVA and Tukey post hoc tests (α = 0.05)., Results: No viable cells were found after DC + M2, DC + M3, and DW + M3 treatments, of which DC + M2 achieved the lowest temperature. No significant difference was found between the effectiveness of DW, DW + M1 and DC treatments (p > 0.05)., Conclusion: Within the limits of this study, the association of a denture cleanser and microwave energy is efficient to disinfect dentures in lower irradiation time and temperature., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

Objectives: To investigate effective denture-cleaning methods, we examined the relationships between the quantity of microorganisms adhering to dentures and the use of a denture brush and the frequency of use of a denture cleanser., Subjects and Methods: Denture plaque was collected from the mucosal surface of the examined dentures, which were 142 and 80 upper and lower complete dentures, respectively, worn by 96 outpatients (mean age: 71.9 years) of a university hospital and 41 nursing home residents (mean age: 84.8 years). The collected microorganisms were counted in terms of isolated representative colonies that were cultured and identified using standard methods. The use of a denture brush, the frequency of use, and the type and soaking time of denture cleansers as denture-cleaning methods were surveyed., Results: The quantity of microorganisms was significantly lower in dentures of denture brush users than in those of non-users in the outpatients (p < 0.01, Mann-Whitney U test). The quantity of microorganisms was significantly lower in the dentures of outpatients who used a denture cleanser daily or 3-4 times a week than in those who used one once or less per month and in the dentures of nursing home residents who used one daily than in those who used one at other frequencies (p < 0.05, Kruskal-Wallis test, followed by Dunn's Multiple Comparison test)., Conclusion: Within the limitations of this study, it was concluded that the use of a denture brush and daily use of denture cleanser should be recommended to complete dentures wearers as denture-cleaning methods that effectively reduce the quantity of microorganisms adhering to dentures., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

Objective: The aim of this study was to evaluate the correlation between patient satisfaction with removable partial dentures and denture maintenance by patients, including regular application of denture adhesives and cleansers., Background: The success of removable partial dentures depends on patient satisfaction with dentures and their regular denture maintenance., Materials and Methods: Demographic information, the Oral Impacts on Daily Performance (OIDP) indicator and details of denture maintenance (including the use of denture cleansers and adhesives) were collected from 193 (41.5% men and 58.5% women) participants by using questionnaires. A dentist performed oral examinations to evaluate denture function according to the OIDP items photographically and recorded the number of remaining teeth and Kennedy's classification., Results: Most participants were satisfied with their removable partial dentures and tended to have higher satisfaction levels than the dentist's estimation. Further, those using denture adhesives and cleansers had higher satisfaction levels than those not using such denture maintenance., Conclusions: Appropriate education regarding denture use is important because regular denture maintenance by patients affects their degree of satisfaction with dentures, as well as the dentist's skill and the patient's oral condition. Dentists could use this information to predict the potential success of dentures., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

Background: Caregivers deal with oral health care of the dependent elderly; however, this has a low priority among them, and their education in daily oral care is deficient. Therefore, studying the oral care practices as well as their oral health beliefs is important as these affect the quality of the oral care they perform., Objective: To compare formal and informal caregivers' oral care practices and oral health beliefs when taking care of severely dependent elderly., Material and Methods: A cross-sectional study was conducted on a convenience sample of 21 formal caregivers from a long-term residence and 18 informal caregivers from a local primary health care domiciliary programme. Caregivers were surveyed using a questionnaire designed to elicit oral care practices and oral health beliefs. The nursing Dental Coping Beliefs Scale questionnaire was translated and validated in Chile., Results: Significant differences were observed between formal and informal caregivers' performance of some oral health care practices. There were no significant differences between formal and informal caregivers' oral health beliefs., Conclusions: Although there are some differences in formal and informal caregivers' oral health care practices, we cannot state that one caregiver's performance is better than the other, in fact, negative oral health beliefs were found in both groups., (© 2011 The Gerodontology Society and John Wiley & Sons A/S.)

The aim of this study was to evaluate the efficacy of experimental toothpastes for removing denture biofilm by means of a randomized crossover trial. Thirty volunteers brushed their dentures using a brush and four pastes: (1) Corega refreshing mint (control), (2) 0.2% chloramine T, (3) 1.0% chloramine T, and (4) 0.01% fluorosurfactant. Each paste was used for 7 days, and participants were randomized to use them according to one of four sequences. Biofilm was disclosed (neutral red) after each period, photographed, and quantified by means of a software program. All experimental toothpastes were similar to the control in terms of posttreatment biofilm coverage.

Aim: To evaluate and compare the efficacy of two commercial and two household denture cleansers against Candida albicans adherent to acrylic denture base resin., Materials and Methods: Fifty specimens of acrylic denture base resin (10 × 10 × 2 mm) were fabricated and processed according to the manufacturer's instructions. Sterile acrylic resin specimens were inoculated by immersing in Sabouraud broth containing C albicans for 16 hours at 37°C in an incubator. Then the specimens were washed and immersed in denture cleansers (four groups) - Clinsodent (powder form), Fittydent (tablet form), vinegar (4% acetic acid), diluted vinegar (50% diluted with water), and water (control group) for 8 hours at room temperature. After 8 hours the acrylic resin specimens were washed, fixed with methanol, and stained with crystal violet. Candida cells adherent to the acrylic resin specimens were counted under microscope. The number of cells adherent to the test samples were compared with that adherent to the control., Statistical Analysis: The data were analyzed using the independent-samples 't ' tests, analysis of variance (ANOVA), and Tukey's HSD test., Results: All the denture cleansers were highly effective against C albicans. The effectiveness of commercial denture cleansers was significant better than that of household denture cleansers. Fittydent fared better than Clinsodent, but the difference between the two was not statistically significant (P=.765). Vinegar was more effective than diluted vinegar (P<.05)., Conclusion: Within the limitations of this in vitro study, denture cleansers were found to be effective in reducing C albicans cells adhering to dentures. The commercial denture cleansers (Fittydent and Clinsodent) were more effective than household denture cleansers (vinegar and diluted vinegar).

Purpose: To evaluate the effect of microwave disinfection on the color stability of a hard chairside reline resin after a 1-year service period., Methods: 40 adult patients aged between 30-75 years, who required denture reline treatment, participated in this study. Tokuyama Rebase II was used to reline complete maxillary dentures. The edentulous subjects were randomly divided into two groups (n=20) and dentures were cleansed according to two methods: CG (control group) - brushing with coconut soap and soft toothbrush; DG (disinfection group) - brushing according to previous methods and microwave disinfection once a week for 3 minutes at 650W. Color parameters in L*a*b* were recorded by spectrophotometer immediately after the reline, at 7 and 15 days, 1, 3, 6 and 9 months and 1 year post-placement. Data were analyzed by two-way repeated-measures ANOVA and Tukey tests (alpha = 0.05)., Results: Color alteration values of DG were significantly lower than those of CG (P<0.05). Color changes observed after 15 days were greater than values obtained at 7 days recall (P<0.05). All color changes observed for the CG were considered noticeable (between 1.5 and 3.0 NBS). In DG, color change was slight (between 0.5 and 1.5 NBS). There were statistically significant differences between L* values obtained initially and after 3 months, between 15 days and 3 months and between 15 days and 1 year (P<0.05). No significant differences were observed between group and time for the parameters a* and b*.

Objective: To determine the effectiveness of a denture cleanser in reducing the concentration of volatile sulphur compounds (VSC) and its antimicrobial action., Background: Micro-organisms from the denture biofilm can cause local and systemic disease and halitosis. Denture cleansers are important adjuncts in oral care, but there is limited investigation on their effect in malodour compounds., Material and Methods: Nineteen institutionalised elderly who wore at least an upper denture were selected; their VSC concentrations were measured and the denture biofilm was collected. In phase 1, the subjects wore their old denture and data were collected before (B0) and after 7(A1), 14(A2), 28(A3) days of continuous daily use of the denture cleanser. In phase 2, new dentures were inserted and measurements were made at 30(A1.1), 60(A2.2), 90(A3.3) days of treatment., Results: The VSC concentration increased from B0 to A1 (p<0.05), but no differences were found for the others intervals of times. Total micro-organism data did not show a statistical difference between times in Phase I, but in Phase II, there was a statistical difference (p<0.05) and a progressive re-colonisation was observed., Conclusion: Within the limits of this study, it was concluded that the denture cleanser had no antimicrobial effect and VSC levels were not reduced., (© 2009 The Authors. Journal compilation © 2009 The Gerodontology Society and John Wiley & Sons A/S.)

The current rates of edentulism have been estimated to be between 7% and 69% of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence-based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, American Dental Association (ADA) Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories, and representatives from GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence-based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and were published in February 2011 issue of The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force., (© 2011 by The American College of Prosthodontists.)

Purpose: To compare the effectiveness of bacterial plaque removal of six denture hygiene procedures used by patients to clean their dentures., Materials and Methods: Fifteen students randomly divided into groups G1, G2, G3, G4, G5 and G6 used maxillary intraoral appliances for 24 h without cleaning them. Afterwards, the appliances were submitted to the following procedures: P1: washing under running water for 20 s; P2 and P3: cleaning with alkaline peroxide (Corega Tabs®) for 5 and 30 min, respectively; P4: brushing with water and liquid soap for 40 s; P5: alkaline hypochlorite for 10 minutes; P6: home use chlorine solution (Q'boa® at 0.45% for 10 min), throughout a period of 6 consecutive weeks. The procedures followed a circulating scheme, so that all the appliances were submitted to all the hygiene methods studied. After the hygiene procedures, the appliances were stained, photographed and submitted to the weighing method., Results: After ANOVA and Tukey's test, differences were observed: P5 = 0.73 ± 0.3 (b), P6 = 1.27 ± 0.4(b,c), P4 = 1.92 ± 0.5 (b,c), P3 = 2.24 ± 1.0 (b,c), P2 = 7.53 ± 2.5 (c) and P1 = 26.86 ± 15. 3 (a)., Conclusion: From the results of the study, it could be concluded that the use of alkaline hypochlorite is the best way to remove bacterial plaque, followed by the home-use chlorine solution and brushing with water and liquid soap. Corega Tabs® must be used for 30 min of immersion to have a cleaning effectiveness similar to that of alkaline hypochlorite.

Objective: to evaluate the efficiency of NitrAdine (MSI Laboratories) tablets in the reduction of oral Candida levels, biofilm formation, and appliance odor in maxillary removable orthodontic appliance wearers., Method and Materials: seventy children between 11 and 15 years of age undergoing maxillary removable appliance treatment were assigned via a double-blind randomized method to the experimental or placebo arm of the study. One milliliter of unstimulated saliva was collected at the beginning of the experiment and 6 weeks later after treatment of the maxillary removable appliance with NitrAdine tablets. Samples were cultured on chromogenic Candida agar, and the number of colony-forming units per mL of saliva (CFU mL-1) was determined., Results: there was no significant difference in salivary Candida levels before or after treatment with NitrAdine tablets. There was a significant drop in plaque accumulation on the appliance and a significant amelioration in appliance odor. There was a small, nonsignificant drop in individuals exhibiting counts of 400 CFU mL-1 or more in the experimental group and a nonsignificant increase in the number of new species in the placebo group., Conclusions: NitrAdine tablets are effective in reducing plaque accumulation and appliance odor during maxillary removable appliance treatment. Further in vivo studies are required to determine the efficacy and exact protocol for NitrAdine tablets in appliance disinfection.

Objective: Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study., Material and Methods: Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically., Results: The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment., Conclusions: The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

This article reports on the long-term effect of an oral healthcare programme aimed at improving and maintaining the oral hygiene of elderly residents in a nursing home. The method was based on (i) motivation and oral-care training of the nursing staff, (ii) production of picture-based oral-care procedure cards, (iii) distribution of adequate oral-care equipment, (iv) practical implementation of new routines, and (v) assessment of results attained. The level of oral hygiene in the nursing home was assessed using the mucosal-plaque score (MPS) index. Overall evaluation was made before the start of the study, after 3 months, and eventually after 6 yr. Before implementation of the oral healthcare programme, 36% of the residents had an acceptable score. Six years later, the proportion was 70%. The evaluation showed that the introduction of such an oral healthcare programme significantly improved the oral hygiene of the residents on a long-term basis. However, 30% of the residents did not achieve an acceptable score because they were very ill or dying, aggressive or wanted to brush their teeth themselves.

Background: Measurement and assessment of denture plaque can provide valuable information regarding an individual's oral health status and assessment of new treatments or products. Current methods tend to rely on subjective indices or image analysis derived planimetric (area measurement) assessment of stained plaque on dentures. Plaque indices are most commonly used to assess plaque coverage without image capture. This is not ideal because the methods are subjective, examiner bias may occur, there is no reproducibility between studies, the methods have lower accuracy and sensitivity than image analysis, and there is no record. To the authors' knowledge, no standardised published method of denture plaque assessment is currently employed for product development and testing., Method: In this study visual and planimetric plaque assessment methods were compared using reference dentures. In addition, an in vivo study compared these methods for evaluating denture cleanser efficacy., Results and Conclusions: The results show that blinded image scoring is more representative of the true plaque area coverage than 'live' denture scoring, detecting significant decreases in plaque coverage. Planimetric analysis provides a more sensitive and less subjective technique with greater differentiation between treatments. However, analysis is very time consuming. Thus, a number of recommendations are made regarding quantification of denture plaque for the assessment of cleanser products.

Background: Soft denture lining-materials are more susceptible to microbial adhesion than hard denture base acrylic resin. Poor oral hygiene and Candida albicans infection are common among elderly denture wearers as these patients usually have difficulty in keeping them clean., Purpose: To evaluate the influence of the oral hygiene methods on the formation of a biofilm over a soft denture-lining material., Material and Methods: Twenty volunteers were randomly separated into two groups: G1 and G2. Ten volunteers performed daily hygiene of the prostheses with a soft toothbrush and toothpaste. The G2 performed a treatment identical to G1 but also immersed the prostheses in sodium hypochlorite 0.5% for 20 min, once a week. Quantification of the mean score values of biofilm formation at different times were statistically analysed using analysis of variance and Tukey's test (alpha = 0.05)., Results: G1 (0.65 +/- 0.52) showed the lowest mean score values of biofilm formation. There was statistical difference between G1 and G2. The highest mean score values were found at 6 weeks (1.3 +/- 1.08) and were statistically different from other times., Conclusion: The oral hygiene methods had a significant effect in the formation of the biofilm over a soft denture-lining material.

Purpose: The aim of this study was to compare the efficacy of two denture adhesives in edentulous patients wearing complete maxillary and mandibular dentures., Materials and Methods: Twenty-four edentulous patients were treated with complete dentures following a standardized protocol. Resistance to dislodgement of both dentures was measured in simulated functional movements by means of a gnathometer and a dynamometer. These outcome measurements were assessed first without the adhesive and then after two successive 2-week periods of using a randomly assigned denture adhesive in a crossover experimental design. The adhesives used were a standard one (Kukident Classic) and a new adhesive with a similar formulation but different physical characteristics (Kukident Pro)., Results: Twenty-four patients (mean age: 58 years) participated in this study. Gnathometer results demonstrated significant differences between the nonadhesive group and both the experimental adhesive (P = .008) and the control adhesive groups (P = .021). Differences between both adhesive groups were not significant (P = .161). Dynamometer results showed highly significant differences between the maxillary and mandibular dentures in both the nonadhesive group and the two adhesive groups (P =or< .0001). Similarly, highly significant differences were found when any of the adhesive groups were compared with the nonadhesive group (P = .0001). The patient subjective evaluation was very favorable for both adhesives., Conclusions: This study confirms the predicted and expected improvement in the stability and retention of well-fitting complete dentures with the adjunctive use of adhesives. The observed and recorded improvements with the new adhesive as compared to the traditional one were not statistically significant.

Objectives: To study the physical properties of two experimental dentifrices for complete denture hygiene, their effect on denture biofilm removal and antimicrobial properties by means of a clinical trial., Materials and Methods: The experimental dentifrices comprised two compositions. One was based on the addition of 1% chloramine T (D1) and the other on the presence of 0.01% fluorosurfactant (D2). Measurements of density, pH, consistency, rheological features and abrasiveness were conducted. Sixty complete denture wearers were randomly assigned to three groups and were instructed to brush their dentures with a specific toothbrush: (1) Water (control); (2) D1; or (3) D2. 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. Microbiological assessment was conducted to quantify Candida sp. and mutans streptococci. Data were evaluated by one-way anova and Tukey HSD, or Kruskal-Wallis (alpha = 0.05)., Results: Both dentifrices decreased biofilm coverage when compared with the control group. D1 was the most efficacious treatment to reduce mutans streptococci, whereas D2 showed an intermediate outcome (ANOVA, p < 0.040). No treatment influenced Candida albicans or non-albicans species (Kruskal-Wallis, p = 0.163 and 0.746, respectively)., Conclusion: It can be concluded that brushing complete dentures with the experimental dentifrices tested could be effective for the removal of denture biofilm.

Objective: Elderly people who are institutionalised receive qualified care. Among the services supplied, oral health care has not always been a priority. The aim of this study was to identify the characteristics of oral health care provided to the elderly residents in long-term care facilities (LTC) in Porto Alegre/RS city., Methods: Twelve private and small-size LTCs (less than 20 residents) participated in this study. All supervisors and 36 carers were interviewed. The data obtained were organised according to the offer of oral health under the following categories: responsibility for oral care, oral care routines, difficulties carrying out oral care routines., Results: The procedures used most often in order of frequency were tooth brushing, prostheses cleaning, use of mouthwashes, soaking of prostheses and cleaning of the tongue. Among the difficulties mentioned were the high cost of dental assistance, the lack of co-operation both by family members and by the elderly themselves, the oral and general health status of the elderly and the limited time available for carers to carry out the tasks. Oral care is conducted empirically, and the responsibility is left to the carers., Conclusions: Analysis of the statements given reveals that oral care does not follow any kind of protocol or standardisation. The persistence of this situation could lead to unsatisfactory oral health care in private and small LTC facilities.

The use of denture is known to increase the carriage of Candida in healthy patients, and the proliferation of Candida albicans strains can be associated with denture-induced stomatitis. The aim of this study was to evaluate the use of vinegar as an antimicrobial agent for control of Candida spp. in complete upper denture wearers. Fifty-five patients were submitted to a detailed clinical interview and oral clinical examination, and were instructed to keep their dentures immersed in a 10% vinegar solution (pH less than 3) overnight for 45 days. Before and after the experimental period, saliva samples were collected for detection of Candida, counting of cfu/mL and identification of species by phenotypical tests (germ tube formation, chlamidoconidia production, and carbohydrate fermentation and assimilation). The results were analyzed using Spearman's correlation and Student's t-test (p

Introduction: Oral yeasts are an important component of the resident microbial ecology of the oral cavity, but they are also associated with various forms of oral candidosis, such as denture stomatitis. Although Candida albicans is the predominant oral fungal pathogen, other species may also play an integral role in pathogenesis. The aim of this study was to examine the mycological ecology in patients with denture stomatitis, using an improved sampling technique, to determine whether species diversity and species quantity were related to oral pathology., Methods: Thirty-seven patients attending the Glasgow Dental Hospital were enrolled in this study following informed consent. A full clinical history was obtained, including details of their oral hygiene practices and the levels of erythema based on Newton's classification scale. Oral rinse, denture sonicate, and swab samples were taken, which were processed for quantitative and qualitative analysis of oral yeasts., Results: The proportion of patients with no inflammation or Newton's Types I, II, and III were 31, 33, 25, and 14%, respectively. Denture sonication was a superior sampling procedure, with statistically greater quantities of yeasts isolated using this methodology (P < 0.01). The predominant oral yeasts isolated were C. albicans (75%) and Candida glabrata (30%), which were isolated in higher proportions in patients with the highest grades of inflammation (100 and 80%), and in combination from 80% of these patients., Conclusions: This study has demonstrated that mixed C. albicans and C. glabrata biofilms may play an important role in the pathogenesis associated with severe inflammation in denture wearers.