BackgroundAppropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures.MethodsIn a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i) brushing and immersion in water without a cleansing tablet, (ii) brushing and immersion in water with a cleansing tablet, (iii) ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv) ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control) and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20), and of Candida albicans were identified using the Polymerase Chain Reaction (PCR) technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%.ResultsOvernight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01). The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores.ConclusionsThe use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing.Trial RegistrationClinicalTrials.gov NCT02454413
Background Peri‐implant soft tissues esthetics varies and depends on the restoration type such as implant‐supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). Purpose The aim of this prospective study was to assess the esthetic outcome of the peri‐implant soft tissues of (NobelBiocare™) implant‐supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. Materials and methods Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post‐insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1‐year follow‐up. Results The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant‐supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant‐supported FPD. Conclusion When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.
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