Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser

Abstract

The development of opportunistic infections due to poor denture hygiene conditions justified the search for effective hygiene protocols for controlling denture biofilm. Objective This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction.Material and Methods It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire.Results S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient’s satisfaction.Conclusions 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

Evaluation of biofilm removal and adverse effects on acrylic resin by diluted concentrations of sodium hypochlorite and Ricinus communis solutions

“…The 1% solution was effective; however, this concentration may result in adverse effects on acrylic resin in short and long periods of immersion. The 0.5% solution was also effective in periods of 20 minutes and 8 hours . Therefore, recent clinical trials have been conducted to verify the effectiveness of the diluted concentrations of sodium hypochlorite on biofilm control.…”

“…Therefore, recent clinical trials have been conducted to verify the effectiveness of the diluted concentrations of sodium hypochlorite on biofilm control. Badaró et al used 0.25% and 0.5% solutions, on participants with and without denture stomatitis, which indicated the lowest percentage of biofilm compared to a 10% R. communis solution. Concentrations of 0.1% and 0.2% were also effective on biofilm removal and antimicrobial action, when used in participants with denture stomatitis.…”

“…Despite being experimental, the R. communis solution has demonstrated intermediate results not only for biofilm removal, but also for the antimicrobial action in a 10% concentration . An 8% R. communis solution also indicated intermediate efficacy on biofilm removal and it is important to emphasise that this solution was compared to sodium hypochlorite, which is widely recognised in the literature for its efficacy on the control of denture biofilm . Additionally, when compared to an alkaline peroxide (Polident) a 2% solution demonstrated a similar ability to reduce the biofilm in a clinical trial evaluation .…”

“…Literature has shown that sodium hypochlorite should be used in diluted concentrations and short time of immersions because such solutions may cause adverse effects depending on the concentration, time and period of immersion employed, which are directly related to the durability and success of the rehabilitation. Concentrations of 1% and 0.5% were effective in controlling denture biofilm and commonly used as a denture cleanser; however, these solutions showed alterations on the properties of the acrylic resin when evaluated, for short and long immersions, simulating a period of 6 months, 18 months, 5 years …”

“…1,2 Combination of mechanical and chemical methods is the most significant method for denture hygiene owing to the ability to remove biofilm (mechanical method) and show antimicrobial action (chemical solution). [3][4][5][6][7][8] Literature has shown that sodium hypochlorite should be used in diluted concentrations and short time of immersions [5][6][7]9,10 because such solutions may cause adverse effects depending on the concentration, time and period of immersion employed, 11,12 which are directly related to the durability and success of the rehabilitation.…”