Tissue Conditioner Incorporating a Nano-Sized Surface Pre-Reacted Glass-Ionomer (S-PRG) Filler

We aimed to evaluate the properties of a novel tissue conditioner containing a surface pre-reacted glass-ionomer (S-PRG) nanofiller. Tissue conditioners containing 0 (control), 2.5, 5, 10, 20, or 30 wt% S-PRG nanofiller or 10 or 20 wt% S-PRG microfiller were prepared. The S-PRG nanofillers and microfillers were observed using scanning electron microscopy. The ion release, acid buffering capacity, detail reproduction, consistency, Shore A0 hardness, surface roughness, and Candida albicans adhesion of the tissue conditioners were examined. The results indicated that the nanofiller particles were smaller and more homogeneous in size than the microfiller particles. In addition, Al, B, F, and Sr ions eluted from S-PRG were generally found to decrease after 1 day. Acid neutralization was confirmed in a concentration-dependent manner. The mechanical properties of tissue conditioners containing S-PRG nanofiller were clinically acceptable according to ISO standard 10139-1:2018, although the surface roughness increased with increasing filler content. Conditioners with 5–30 wt% nanofiller had a sublethal effect on C. albicans and reduced fungal adhesion in vitro. In summary, tissue conditioner containing at least 5 wt% S-PRG nanofiller can reduce C. albicans adhesion and has potential as an alternative soft lining material.

Characterization and Physical and Biological Properties of Tissue Conditioner Incorporated with Carum copticum L.

Aim. One of the main problems in dentistry is the injury caused by the long-term application of an ill-fitting denture. The existence of multiple microorganisms along with the susceptibility of the tissue conditioners to colonize them can lead to denture stomatitis. This study is aimed at developing a tissue conditioner incorporated with Carum copticum L. (C. copticum L.) for the effective treatment of these injuries. Materials and Methods. The Carum copticum L. essential oil composition was determined by gas chromatography-mass (GC-mass) spectrometry. The antimicrobial activity of the essential oil against the standard strains of bacterial and fungal species was determined by broth microdilution methods as suggested by the Clinical and Laboratory Standards Institute (CLSI). The physical and chemical properties of the prepared tissue conditioner were investigated by viscoelasticity, FTIR assays, and the release study performed. Furthermore, the antibiofilm activity of the Carum copticum L. essential oil-loaded tissue conditioner was evaluated by using the XTT reduction assay and scanning electron microscopy (SEM). Results. The main component of the essential oil is thymol, which possesses high antimicrobial activity. The broth microdilution assay showed that the essential oil has broad activity as the minimum inhibitory concentration was in the range of 32-128 μg mL-1. The viscoelasticity test showed that the essential oil significantly diminished the viscoelastic modulus on the first day. The FTIR test showed that Carum copticum L. essential oil was preserved as an independent component in the tissue conditioner. The release study showed that the essential oil was released in 3 days following a sustained release and with an ultimate cumulative release of 81%. Finally, the Carum copticum L. essential oil exhibited significant activity in the inhibition of microbial biofilm formation in a dose-dependent manner. Indeed, the lowest and highest amounts of biofilm formation on the tissue conditioner disks are exhibited in the Streptococcus salivarius and Candida albicans by up to 22.4% and 71.4% at the 64 μg mL-1 concentration of C. copticum L. with a statistically significant difference ( P < 0.05 ). Conclusion. The obtained results showed that the Carum copticum L. essential oil-loaded tissue conditioner possessed suitable physical, biological, and release properties for use as a novel treatment for denture stomatitis.

Complete Denture Fabrication Using Digitally Fabricated Copy Dentures for a Patient with Moderate Dementia

A 91-year-old woman was referred to our hospital with a chief complaint of unsatisfactory fit and pain associated with her complete dentures. She had moderate dementia with difficulty in communication (Mini-Mental State Examination, 16; Barthel Index, 15). The closed impressions and jaw record were taken with the digitally fabricated copy dentures as follows. First, the tissue conditioner was used to correct the poor fit of the old dentures, following which minor occlusal alterations were made. Second, the copy dentures that copied the morphology of the corrected old dentures using three-dimensional (3D) scanner were fabricated with a 3D printer. The new dentures were then fabricated using conventional methods as follows. The impressions were cast and articulated, and the dentures were subsequently processed. This case report documented the following results. First, the acceptance of new dentures appeared to be easier since the new dentures copied the morphology of the familiar dentures digitally. Moreover, the 3D data of the dentures could be used for immediate denture fabrication in case of fracture or loss of the dentures. Second, only two visits were required for taking an impression and delivering the complete dentures. In addition, her old dentures were brought to our dental office by the patient’s family after the patient’s dinner; immediately after copying the dentures’ morphology, the dentures were returned to the patient’s family, thus avoiding any disturbance to the patient’s eating routine. These reduced the burden on the patient and her family.

Comparative evaluation of oral microflora adherence on modified tissue conditioners -- An in vitro study.

Aims: To evaluate the effect of silver nanoparticle, itraconazole and a combination of the two agents on the adherence of Candia albicans, Streptococcus mutans and Enterococcus faecalis on acrylic and silicone tissue conditioners. Materials and Methods: 40 pellets of Group 1 ( GC Soft Liner) and 40 of Group 2 (Sofreliner) were fabricated. The pellets were immersed in a solution of silver nanoparticles or itraconazole or a 1:1 ratio of the combination of the two medicaments. The amount of biofilm formed was assessed by the ELISA reader. Results: A decrease in adherence of Candida albicans was seen in acrylic and silicone-based tissue conditioners when compared to the untreated control samples. Silicone based tissue conditioner showed the least adherence of Candida albicans when treated with 1:1 ratio of silver nanoparticles and itraconazole. There was a statistically significant difference in microbial adhesion between acrylic and silicone tissue conditioner (p<0.001).Pellets treated with silver nanoparticles were studied for adherence of Streptococcus mutans , Candida albicans and Enterococcus faecalis. A statistically significant decrease in all three microbial adherences was observed with this group. (p<0.001) Conclusion: Silver nanoparticles and itraconazole are effective antifungal and antibacterial agents that can potentially decrease microbial colonization of Candia albicans , Streptococcus mutans and Enterococcus faecalis on tissue conditioners. Clinical implications: Silver nanoparticles and itraconazole when used will decrease biofilm formation that will not only improve the overall health of the oral cavity but also prevent denture stomatitis and diseases associated with poor oral hygiene protocols. Keywords: Silver nanoparticles, tissue conditioners, itraconazole, antimicrobial.

NEUTRAL ZONE RECORDING USING DIE PINS AND TISSUE CONDITIONER: A CASE REPORT

The primary goal of providing complete denture prosthesis is to restore function and esthetics. Arbitrary placement of teeth may cause dislodgment during function. Neutral zone is a concept which emphasize on placing the teeth in a zone where the forces between the tongue and cheeks or lips are equal. In this case report a novel dental technique is to be discussed which uses, used die pins to retain the tissue conditioning material to record the neutral zone.

An In Vitro Analysis of the Antifungal Effect of Nystatin and Fluconazole Incorporated into Tissue Conditioner with and Without Using Varnish Containing Self-cured Resin and 1,1,1-Trichloroethane

Background: Incorporating antifungal drugs into liners has been proposed to treat denture stomatitis. Varnish application on tissue conditioners can decrease the porosities and irregularities, biofilm, and pathogens adhesion. In this study, we evaluated the effect of varnish application on releasing the antifungal drugs incorporated into tissue conditioners. Methods: Pure form of nystatin and fluconazole were mixed into tissue conditioner powder separately at 5% wt/wt concentration and prepared according to manufacturer’s instruction. Then, disk-shaped specimens (5 mm in diameter and 1 mm in thickness) were prepared at 30 nystatin and 30 fluconazole specimens. Varnish (containing 50 mL of 1,1,1-trichloroethane and 3 ml of self-cured resin) was applied on the surface of 15 disks of each drug and the other specimens were used as the control group (without varnish). Next, the disks were put in agar plates cultured with standard Candida albicans and incubated for 7 days. Mean inhibition diameter for each disk was measured with digital caliper at 24 hours, 3 days, and 7 days. Each step was performed in triplicate. Data was analyzed with one-way ANOVA and Friedman, Wilcoxon, and Mann-Whitney U tests. Results: The mean inhibition diameter (MID) at days 1, 3, and 7 in fluconazole without varnish group was 12.63, 3.90, and 3.67, respectively; in fluconazole with varnish was 3.00, 2.50, and 2.50, respectively; in nystatin without varnish was 5.78, 3.90, and 3.87, respectively; in nystatin with varnish group was 2.50, 0.00, and 0.00, respectively. fluconazole without varnish group exhibited significantly higher MID and nystatin with varnish group had lower MID. Conclusions: In this experimental study, fluconazole was more effective than nystatin. In groups without varnish, antifungal effect continued up to day 7. Using varnish in tissue conditioner can decrease antifungal effect.