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Denture adhesives and cleansers/ oral surgery courses  

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Denture adhesives and cleansers/ oral surgery courses  

  1. 1. Denture Adhesives and Cleansers INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.com
  2. 2. Denture Adhesives ♦ Commercially available, non-toxic, soluble material (powder, cream, or liquid) that is applied to the tissue surface of the denture in order to enhance denture retention, stability, and performance www.indiandentalacademy.com
  3. 3. • Successful denturetherapy isinfluenced by thebiomechanical phenomenaof support,stability,and retention. • Retention,or theresistanceto movement of thedentureaway from thesupporting tissues,iscritical. • Physical forcesinfluencing dentureretention includeadhesion, cohesion, capillary attraction, surfacetension,fluid viscosity, atmospheric pressure, external forcesoriginating from theoral- facial musculature. • Theinterfacial surfacetension developed asaresult of thesaliva layer between thedenturebaseand thesupporting soft tissuesis quiteimportant. • Retention isrealized asthesalivalayer maximizescontact with approximating prosthetic and mucosal surfaces. • Dentureadhesivesaugment thesameretentivemechanisms already operating when adentureisworn. Introduction www.indiandentalacademy.com
  4. 4. Indications and contraindications ♦ Dentureadhesivesareindicated when well madecomplete denturesdo not satisfy apatient'sperceived retention and stability expectations.  ♦ Patientswho suffer from xerostomiadueto medication side effects, ahistory of head and neck irradiation, systemic disease or diseaseof thesalivary glands, havegreat difficulty managing completedenturesdueto impaired retention and an increased tendency for ulceration of thebearing tissues ♦ Useof dentureadhesivecan compensatefor theretention that is lacking in theabsenceof healthy saliva, and can mitigatethe onset of oral ulcerationsthat result from frequent dislodgments.  ♦ prove psychologically beneficial when the patient requires supplemental retention and stability, www.indiandentalacademy.com
  5. 5. ♦ Several neurological diseasescan complicatetheuseof completedentures - CEREBROVASCULARACCIDENT(STROKE) may render part of theoral cavity insensitiveto tactilesensation, or partially /wholly paralyzeoral musculature.  Adhesivesassist in helping thesepatientsaccommodateto new denturesor thosefabricated prior to thestrokewhich thepatient isnow unableto manage dueto lost sensory feedback and neuromuscular control. - OROFACIAL DYSKINESIAisaprominent sideeffect of phenothiazine-classtranquilizers(e.g., fluphenazine, trifluoperazine, thioridazineor thiothixine), other neuroleptics (e.g., haloperidol), and even gastrointestinal medications(e.g., prochlorperazine, metoclopramide).  Thismovement disorder, is often alate-onset sideeffect of dopamine-blocking drugs characterized by exaggerated, uncontrollablemuscular actionsof thetongue, cheeks, lipsand mandible. Heredentureretention, stability, and function isavirtual impossibility without adjunctiveretention, such asdentureadhesive. www.indiandentalacademy.com
  6. 6. ♦ Patientswho haveundergoneresectivesurgery for removal of oral neoplasia, or thosewho havelost intraoral structuresand integrity dueto trauma, may havesignificant difficulty in functioning with atissue- borneprosthesisunlessdentureadhesiveisemployed, even if rotational undercutshavebeen surgically created to resist displacement of theprosthesis. ♦ Dentureadhesiveis notindicatedforthe retentionof improperlyfabricatedorpoorly fittingprostheses. www.indiandentalacademy.com
  7. 7. Mechanism(s) of Action ♦ Dentureadhesivesaugmentthesameretentivemechanisms already operating when adentureisworn. ♦ Enhanceretention through optimizing interfacial forcesby:  - Increasing the adhesive and co hesive pro perties and visco sity o f the medium lying between the denture and its basalseat - Eliminating vo ids between the denture base and its basalseat.  ♦ Adhesives( hydrated material that isformed when an adhesive comesinto contact with salivaor water) areagentsthat stick readily to both thetissuesurfaceof thedentureand to the mucosal surfaceof thebasal seat.  ♦ Hydrated adhesivesaremo re co hesive than saliva, physical forcesintrinsic to theinterposed adhesivemedium resist thepull moresuccessfully than would similar forceswithin saliva.  www.indiandentalacademy.com
  8. 8. ♦ Thematerial increases theviscosityof thesalivawith which it mixes, and thehydrated material swells inthe presenceof saliva/waterandflows underpressure.  ♦ Aswater isabsorbed by theby theadhesiveagentsthe resulting anionsareattracted to thecat ionsin themucous membraneproteinsand producethestickiness. ♦ Thepropertiesof current adhesivesdependson a combination of both physical and chemical forces. ♦ Saliva increases the viscosity of theadhesivethereby increasing theforcerequired to separatetheprosthesisfrom oral surface. ♦ Voidsbetween thedenturebaseand bearing tissuesare thereforeobliterated. www.indiandentalacademy.com
  9. 9. Components ♦ Prior to theearly 1960's,werebased on vegetablegums--such askaraya, tragacanth, xanthan, and acacia--that display modest, non-ionic adhesion to both dentureand mucosa, and possessed very littlecohesivestrength.  ♦ Gum-based adhesives(still commercially available) are highly water so luble, particularly in hot liquidssuch ascoffee, tea, and soups, and wash out readily from beneath dentures. ♦ Allergic reactionshavebeen reported to karaya(and to the paraben preservativethat thevegetablederivativesrequire), and formulationswith karayaimpart amarked odor reminiscent of acetic acid.  Overall, theadhesiveperformanceof thevegetable gum-based materialsissho rt-lived and relatively unsatisfacto ry www.indiandentalacademy.com
  10. 10. ♦ Thecomposition of most modern dentureadhesivesincludes constituentsthat promotebioadhesionviacarboxyl groupsonce theadhesiveishydrated. ♦ Two commonly employed active ingredients in denture adhesives are poly [vinyl methyl ether maleate ]and carboxymethylcellulose. ♦ Mixturesof thesaltsof short-acting (carboxymethylcelluloseor "CMC") and long-acting (poly[vinyl methyl ether maleate], or "Gantrez") polymers.  ♦ In thepresenceof water, CMC hydratesand displaysquick- onset ionic adherenceto both denturesand mucousepithelium.  ♦ Theoriginal fluid increasesitsviscosity and CMC increasesin volume, thereby eliminating voidsbetween prosthesisand basal seat.  www.indiandentalacademy.com
  11. 11. ♦ Thesetwo actionsmarkedly enhancetheinterfacial forcesacting on thedenture ♦ Polyvinylpyrrolidone("Po vido ne") isanother, less-commonly used agent that behaveslikeCMC.  Over amoreprotracted time coursethan necessary for theonset of hydration of CMC, gantrez saltshydrateand increaseadherenceand viscosity. ♦ The"long-acting" (i.e, lesssoluble) gantrez saltsalso display molecular cross-linking, resulting in ameasurableincreasein cohesivebehavior.  ♦ Thiseffect issignificantly morepronounced and longer lived in calcium-zinc gantrez formulationsthan in calcium-sodium gantrez.  ♦ Eventually all thepolymersbecomefully solubilized and washed out by saliva; thiselimination ishastened by the presenceof hot liquid. www.indiandentalacademy.com
  12. 12. ♦ Other componentsof dentureadhesiveproductsimpart particular physical attributesto theformulations.  Petrolatum, mineraloil, and polyethyleneoxideareincluded in creamsto bind the materialsand to maketheir placement easier ♦ Siliconedioxideand CalciumStearateareused in powdersto minimizeclumping.  ♦ Mentholand PeppermintOils areused for flavoring, reddyefor color, and sodiumborateand methyl- orpoly-parabenas preservatives. Gantrez® MS-955 33% Carboxy methylcellulose 27 % WhitePetrolatum 20% Light Mineral Oil 20% www.indiandentalacademy.com
  13. 13. Uses /advantages ♦ Contributesto reduceddenturemovementand improves chewing function ♦ Improvement in oral hygienefor denturepatientsby reducing or preventing dentureplaque. ♦ Theuseof dentureadhesivein conjunction with routinedenture cleaning inhibits stain accumulation. ♦ Increasedmaximumbitingforce, retention, stabilityand stabilizesmasticatory rhythm of completedenturewearerswith both good and poor denturebearing tissues. ♦ Reducemucosal irritation, reducefood impaction beneath the denturebase, ♦ Increasebiteforce,improvefunctional load distribution across thedenture-bearing tissues, ♦ Facilitatethepsychological well-being of thepatient.www.indiandentalacademy.com
  14. 14. ♦ Patientswith xerostomia,theuseof awell- hydrated dentureadhesiveprovides - A cushioning or lubricating effect,reducing frictional irritation of thesupporting soft tissues, preventing further tissuedehydration. www.indiandentalacademy.com
  15. 15. Application of Denture Adhesive♦ Cream /Powder ♦ Powder formulationsdo not confer thesamedegreeof "hold", nor do their effectslast aslong, in comparison to comparable cream formulations.  However powderscan beused in smaller quantities, are easier to clean out of denturesand off tissues, and arenot perceived as"messy" by patients. ♦ Theinitial "hold" for powdersisachieved sooner than it iswith cream formulations. ♦ Theleast amount of material that iseffectiveshould beused. approximately 0.5to1.5gperdentureunit(morefor larger alveolar ridges, lessfor smaller ones). The use of small amounts of hydrated paste adhesives works well due to favorable adhesive,cohesive,and viscosity ♦ For powders, theclean prosthesisshould be moistenedand then athin, even coating of theadhesivesprayed onto thetissue surfaceof thedenture. www.indiandentalacademy.com
  16. 16. ♦ Theexcessisshaken off, and theprosthesisinserted and seated firmly.  ♦ If thepatient suffersfrom inadequateor absent saliva, the sprayed dentureshould bemoistened lightly with water before being inserted.  Prepareyour denturesby washing thoroughly with warm water. Be surethat thedenturesarestill wet beforeapplying adhesivepowder Gently squeezethebottle,cover theentiresurfacethat touches themucosawith thin even layer of powder and shakeoff the excess www.indiandentalacademy.com
  17. 17. Application of paste • A small amount of thepasteshould bedispensed onto theclean and dry intaglio surfaceof thedenture • Theuseof excessiveadhesivewill likely interferewith proper placement of thedentureon thebearing tissues. • For themaxillary denture,adhesiveshould bedispensed in the midpalatal region whilefor themandibular denturevery small amountscan beplaced in two o r three lo catio ns alo ng the ridge crest even layer of adhesive.www.indiandentalacademy.com
  18. 18. Evenly disperse the paste overthe entire intaglio surface of the prosthesis with a clean,dry fingerThis will result in a thin, even layerof adhesive. The denture is submersed in a containerof cool waterto maximally hydrate the adhesive The denture should remain submersed in waterfor approximately 20 to 30 seconds. The denture is placed in the mouth and firmly seated with fingerpressure forapproximately 10 seconds .Maintenance of seating pressure will cause the adhesive to flow throughout the interfacial space between the denture base and denture bearing softwww.indiandentalacademy.com
  19. 19. Technique for Adhesive removal ♦ Patientsmust beinstructed that daily removal of adhesive product from thetissuesurfacesof thedentureisan essential requirement for theuseof thematerial.  ♦ DentureAdhesiveabsorbsexcesswater, thehold will loosen. Several techniquesmay help you break theseal between theadhesiveand thegum tissue: - For denturesof any type, swish mouth with warm water or amouthwash . - For theLowerdenture, pull gently whileapplying a rocking motion. - For theUpperdenture, removal may bemoredifficult due to moresurfacearea. Placethumb against thefront teeth, www.indiandentalacademy.com
  20. 20. •Removal isfacilitated by letting theprosthesissoak in water or soaking solution overnight, during which theproduct will be fully solubilized and can then bereadily rinsed off.  •If soaking isnot possiblebeforenew adhesivematerial needs to beplaced, removal isfacilitated by running hot water over thetissuesurfaceof thedenturewhilescrubbing with a suitable, hard-bristledenturebrush.  •Adhesivethat isadherent to thealveolar ridgesand palateis best removed by rinsing with warm or hot water, and then firmly wiping theareawith gauzeor awashcloth saturated with hot water. Initial scrubbing will loosen residual adhesive material,facilitating subsequent removal. www.indiandentalacademy.com
  21. 21. Denture is then held submerged in a containerof warm water and simultaneously scrubbed using the electric toothbrush . Firm pressure should be applied to the brush in orderto eliminate adhesive from the denture surface. Particles orclumps of adhesive material will be seen rising to the surface of the waterThis procedure is continued until the entire denture surface is free of residual adhesive To removeadhesiveresiduefrom mouth, gums, tongue, and palate, brush theroof of mouth and gumswith asoft- bristled toothbrush, toothpaste, and comfortably hot water. www.indiandentalacademy.com
  22. 22. Patient education ♦ It ismandatory that dentistseducatedenturepatientsabout dentureadhesives--their use, abuse, advantages, disadvantages, and availablechoices.  ♦ Themajor information resourcefor apatient should bethe dentist ♦ Patientsneed to beeducated about thelimitationsof denture adhesive.  ♦ Discomfort will not beresolved by placing a"cushioning layer" of adhesiveunder thedenture.  ♦ Pain /sorenesssignalsaneed for professional management. ♦ Gradual increasein thequantity of adhesiverequired for acceptablefit of thedentureisalso aclear signal to seek professional care.  ♦ In all cases, denturepatientsneed to berecalled annually for oral mucosal evaluation and prosthesisassessment. www.indiandentalacademy.com
  23. 23. Clinical considerations ♦ Dentureadhesiveproductsimprovepatient acceptanceof comfort and function with dentures ♦ Dentureadhesivesare notcapableo f exerting fo rces that wo uld accelerate ridge reso rptio n ♦ They reducetheamount of lateralmovements of the dentures, even ill fitting dentures. ♦ Contributesto reduced denturemovement and improves chewing function ♦ Improvement in oral hygienefor denturepatientsby reducing or preventing dentureplaque. ♦ Theuseof dentureadhesivein conjunction with routine denturecleaning inhibitsstain accumulation. www.indiandentalacademy.com
  24. 24. ♦ Increased maximum biting force, retention, stability and stabilizesmasticatory rhythm of completedenturewearers with both good and poor denturebearing tissues. ♦ Reducemucosal irritation, reducefood impaction beneath thedenturebase, ♦ increasebiteforce,improvefunctional load distribution acrossthedenture-bearing tissues, ♦ Facilitatethepsychological well-being of thepatient ♦ patientswith xerostomia,theuseof awell-hydrated denture adhesiveprovidesacushioning or lubricating effect,reducing frictional irritation of thesupporting soft tissues, preventing further tissuedehydration. www.indiandentalacademy.com
  25. 25. Summary ♦ Anatomic,physiologic,and mechanical factorsassociated with thestability and retention of completedenturesare important for achieving optimal therapeutic results. ♦ Theproper useof dentureadhesiveto supplement sound completedenturetherapy should becarefully presented to patientsprior to delivery of theprostheses. ♦ Dentureadhesivescan effectively augment denture stability and retention to improveoverall denture performance,and patient comfort and satisfaction. www.indiandentalacademy.com
  26. 26. Denture cleansers ♦ An essential component of completedentureservice ispatienteducationaboutdenturehygiene. ♦ Careof denturesand themucosal tissuesof the edentulousmouth isimportant for overall health,especially in older persons. ♦ Maintenanceof adequatedenturehygienethrough mechanical or chemical methodsor both isessential to minimizeand preferably eliminateadversetissue reactions. ♦ It must bean integralcomponentof postinsertion patientcare. www.indiandentalacademy.com
  27. 27. ♦ Every surfacein theoral cavity,natural or synthetic becomes covered within about 30 minuteswith a0.5-1.5 µ-thick precipitateof salivary glycoprotein and immunoglobulin that is termed “ Pellicle.” ♦ Thepelliclein turn providesasubstrateto which oral debris (such asmucin,food particlesand desqua-mated epithelial cells)and microorganisms(bacteriaand fungi)readily adhere. ♦ The adherent bacteriaand fungi convert materialssuch as sucroseand glucosein theoral environment into aprotective plaquecovering under which they can thriveand proliferate further. ♦ Thisprocessisfavored when salivary flow isimpaired by diseaseor,morecommonly,asasideeffect of medications. ♦ In theabsenceof an adequateamount of saliva,lessantimicrobial action will beavailableto counter theactivity and proliferation of microorganisms. www.indiandentalacademy.com
  28. 28. ♦ Presenceof depositsand accumulation isdirectly related to - protein rich saliva - micro porousnatureof polymeric basethat facilitatesplaque /calculusdeposition ♦ Surfaceirregularitiesprovidean increasein surfaceareaand an expansion in thenumber of nichesnot readily cleansed by actionsof thetongueor other orofacial musculature. ♦ Thisisaparticular concern in thecaseof oral appliances fabricated out of methacrylateresin. ♦ Despitean outwardly smooth appearance,theseapplianceshave apockmarked surfacewhen viewed under microscopic magnification. ♦ Thisisdueto bubbleformation from unpolymerized monomer in thecourseof dentureprocessing www.indiandentalacademy.com
  29. 29. ♦ Increased tendency for undesirabledepositsissimilarly observed when achemically polymerized and rather porous chair siderelinematerial hasbeen applied to adenturesurface. ♦ Multipleinnocuousand pathogenic bacterial varietieshavebeen identified in dentureplaque,- S. aureus,P. aeruginosa, E.coli, K.pneumoniae, alphastrep., beta-strep., GroupD strep.,and assortedgram(-)rods. ♦ Speciesof Fusobacteria,which excretevolatilesulfur compoundsassociated with halitosis,havebeen identified as populousin dentureplaque. ♦ Thefungal organismsmost commonly associated with denture plaqueareof thegenusCandida ♦ Theyeastsarepresent in thesalivaof amajority of denture wearersand display an affinity for adherenceto methacrylate resin. ♦ Effectiveat populating the“craters”formed by an intersection of amonomer bubblewith thepolished surfaceof theacrylic resin from which they aredifficult to eradicate.www.indiandentalacademy.com
  30. 30. Chronic Atrophic Candiasis associated with denture wearing in the maxilla Chronic pseudomembranous candidiasis Denture induced hyperplasia due to fungal overgrowth. www.indiandentalacademy.com
  31. 31. Theoral depositsand microorganismsthat adhereto adental appliancebring about several undesirableeffects. ♦ Unaesthetic in appearanceand unpleasant odor/taste ♦ Impairment in tasteand smell perception of external stimuli under circumstancesof poor denturehygiene. ♦ Dentureplaqueservesassourceof infectiousoral material availablefor aspiration,particularly in personswith limited salivary flow. ♦ Metabolic by-productsand exotoxinsin thedepositscan be irritating to oral tissues. ♦ Plaque, can also becomecalcified if not removed thoroughly and regularly. ♦ Thesurfaceof themineralized calculusprovidesa hospitable surfacefor further plaqueaccretion ♦ Calculusisalso readily stained by tobacco, tea,coffee,certain medications(particularly iron supplements) www.indiandentalacademy.com
  32. 32. Cleaning techniques ♦ Mechanical brushing ♦ Chemical cleansers Common denture cleaning materials 1. Oxygenating cleansers 2. Alkalinehypochloritesolutions 3. Dilutemineral acids 4. Abrasivepowdersand pastes 5. Enzymecoating materials(Proteases) www.indiandentalacademy.com
  33. 33. Requirements of an ideal cleanser 1. Nontoxic 2. Easy to remove 3. Harmlessto patient if accidentally spilled/splashed 4. Harmlessto denturebasematerials,dentureteeth and soft liners 5. Ableto dissolveall thedenturedepositssuch ascalculus 6. Bactericidal and fungicidal 7. Long shelf lifeand cheap MECHANICAL TECHNIQUES • Light brushing with soft denturebrush or multifluted soft nylon brush with round endsand soap& water. • Removesthedebriswithout abrading denturebaseand teeth • Cannot disinfect • Pasteswith gentleabrasives–sodium bicarbonate/acrylic resin- maybeused www.indiandentalacademy.com
  34. 34. Dentures and partial dentures should be rinsed thoroughly aftereach meal to remove food particles. Dentures should be removed from the mouth before bedtime and brushed thoroughly. Brush the denture overa sink filled with waterto prevent breakage if the denture is accidentally dropped. A toothbrush will remove plaque and food particles effectively from dentures, natural teeth and the soft lining of the mouth. The gums underthe denture should be massaged daily with a soft toothbrush.www.indiandentalacademy.com
  35. 35. ♦ A lesscommon but incomparably moreeffectivemechanical approach to denturecleaning isthrough theuseof atable-top ultrasonic cleaner. ♦ Thesecleanersaremin bathtub-likedevicesthat contain a cleaning solution. Thedentureisimmersed in thetub and then sound wavescreateawavemotion that dislodgestheundesirable deposits. ♦ Useof an ultrasonic cleaner, however, doesnot replacea thorough daily brushing. In between brushings, rinsedenture after every meal. Disadvantages • Abrasion /scratchesdueto hard bristles,forceful brushing or abrasivedentrifices • Irregular surfacespromotedeposits/staining www.indiandentalacademy.com
  36. 36. Chemical denture cleansers Most commonly useimmersion techniques. Advantages- accessibility to all areasof dentures. - minimum damagedueto mishandling - minimum abrasion of denturebases - simple technique OXYGENATING CLEANSERS ♦ Alkalineperoxides- powder & tablets ♦ Contents– alkalinecompounds - detergents - sodium perborate - flavouring agents ♦ Mixed with water-sodium perboratedecomposes releasing peroxideswhich decomposesreleasing oxygenwww.indiandentalacademy.com
  37. 37. ♦ Cleaning isresult of oxidizingabilityof peroxide decomposition and effervescentactionof theoxygen ♦ Effectively breaksdown, dissolves, floatsaway organic depositsand killsmicroorganisms ♦ Not effective in removing heavy calculus deposits ♦ Somenot compatiblewith soft liners ♦ techniqueisthat thepowder (or tablet) isdissolved in water and thedenturessoaked overnight. They arebrushed and rinsed well beforeuse, hence: ♦ Overnight immersion in alkalineperoxidesolution issafe, effectivemethod of cleaning and sterilization esp. geriatric/disabled patients .www.indiandentalacademy.com
  38. 38. HYPOCHLORITESOLUTIONS ♦ Diluted household bleaches(sodium hypochlorite) commonly used ♦ removeplaque,light stains,kill adherent organisms Technique-immersion of denturesin 5 % sod.hypochlorite in 3 partswater(1:3) followed by light brushing ♦ Or ,solution of 1tsp hypochlorite(Clorox) and 2 tsp glassy phosphate(Calgon) in !/2 glasswater-controlscalculus& stains ♦ Not recommended for denturefabricated from cast base metal alloys ♦ Corrosion and darkening of themetal ♦ Conc. Solution should not beused-causealter colour of denturebaseresin ♦ discolour soft linersesp.silicones www.indiandentalacademy.com
  39. 39. DILUTEACIDS ♦ Citric acid, isopropyl alcohol, HCl, plain vinegar ♦ Swabbed with abrush onto denturesurface ♦ Material attacksinorganic phosphateportion of denture deposits, reducing thecalculus ♦ Vinegar lesseffectivethan bleaching solutions ♦ Denturerinsed thoroughly to avoid contact with mucosa ♦ Corrosion of alloys Enzyme containing materials ♦ Mutaneseand protease ♦ Reduceplaquesignificantly after 15 min. soak,esp.when combined with mechanical brushing ♦ Their efficacy against Candidawasinferior to theaction of alkalineperoxidecompounds. www.indiandentalacademy.com
  40. 40. Others materials ♦ Siliconepolymers - Provideprotectivecoating that interfereswith bacterial adherenceuntil next application - Floatson thesurfaceof thedenturebath,and when dentureis removed from thesolution,athin layer constituting 0.1-0.8 mg of thematerial coatssurfacesof theprosthesis.Thematerial will not rinseor rub off but isslowly lost over theday. ♦ Microwave radiation– - To disinfect and clean resin bases. - Significantly reducesthenumber of cultivableorganismson thedentures,but non-viableorganismsand their by-productsstill present after exposureto theradiation will still ableto elicit an unwanted host response. - Theuseof amicrowaveshould bepreceded by somemethod of debridement such asultrasonication or thorough brushing. www.indiandentalacademy.com
  41. 41. ♦ Overnight airdrying – - effectively kill yeastsand many bacterial species, through exposureof theorganismsto oxygen tension levelsgreater than oxygen tension levelsin themouth - Air-drying doesnot havewidespread acceptanceasa denturecleaning techniquefor two reasons. ♦ First, merely drying an unclean denturewill makethe adherent material stick ever moretightly even asit fails to removemicrobial surfaceantigensand exotoxins.Therefore,must bepreceded by mechanical debridement of thedenturesurface. ♦ Second,dentistshavehistorically been told that air drying an acrylic denturewill distort itscontours. www.indiandentalacademy.com
  42. 42. Disadvantages of various cleansers cleanser constituent Dis-adv Oxygenating cleanser Alkaline perborate Ineffective for heavy calculus deposits; harmful to soft liners Hypochlorite dilute NA.hypochlorite Bleach resin bases ; Discolour soft liners; Corrosion of base alloys Unpleasant odor Dilute acids HCl;citric acid; Corrosion; Bad odor Cleansing powder/paste Abrasive agents Abrasion of denture base ;teeth www.indiandentalacademy.com
  43. 43. Precautions ♦ Denturecleansersarenot intended for internal use, ♦ Somedenturecleanserscontain ingredientsassociated with allergic reactions, including anaphylaxis. Other ingredients may irritatemucosaand may betoxic if ingested. ♦ Carefully monitor patientsuseof denturecleansers, especially thosepatientswho may havedifficulty reading or understanding label warningsand cautions, aswell aspatients who areconfused or haveAlzheimer'sDisease. ♦ Warn them never to chew,swallow, orgargle with denture cleansers. ♦ Remind them to thoroughly rinsedenturesand other dental appliancesbeforeplacing them into themouth. ♦ Remind patientsthat improper useof denturecleanersmay causeseriousconsequences. www.indiandentalacademy.com
  44. 44. Summary ♦ Unclean denturesrepresent both an esthetic and ahealth concern for theperson using them. ♦ Dental professionalsneed to haveaworking knowledgeof therangeof techniquesand materialsthat areavailablefor cleaning denturesand keeping them in ahygienic stateso that they areableto instruct patientsappropriately. ♦ Brushing alone,with or without adentifrice,isan inadequate approach for controlling dentureplaque. ♦ Lessthan onehour soaking in adilutebleach solution or oneof thecommercial effervescent productsareboth effectivemeansfor cleaning dentures. www.indiandentalacademy.com
  45. 45. ♦ Ultrasonication iseffectivebut not broadly used.Microwavetreatment and air drying effectively kill organismsbut may not eradicate antigenic irritants. ♦ Interferencewith bacterial adherencethrough daily application of asiliconepolymer to the surfaceof thedentureisapromising recent development in denturecleansing technology. www.indiandentalacademy.com
  46. 46. references ♦ Zarb-Bolender:Prsthodontic treatment foredentulous patients 12th edition,Elsevier,2003 ♦ Joseph J.Massad,William J.Davis,Richard June,William A.Joseph Thornton,David R:Rationale forAdhesives in Complete Denture Therapy ,P&G Dental Resource net. ♦ Use of dental adhesives:P&G Dental resource Net ♦ Fujimori takuto,Hirano:Effect of denture adhesive of masticatory functions of complete denture wearers.JMed Dent Sci.2000;49:151-156 • Grasso J, Gay T, Rendell J, BakerR,:Effect of denture adhesive on retention of the mandibularand maxillary dentures during function. JClin Dent. 2000;11(4):98-103. • Hasegawa, Sekita, Hayakawa :Effect of denture adhesive on stability of complete dentures and the masticatory function. JMed Dent Sci.2003;50:239-247. • A. Kneipp, X. Zhou:Inhibition of Denture Stain with Denture Adhesive Use:P&G www.indiandentalacademy.com
  47. 47. • J. Rajaiah, N. Ramji, J.E. Barnes, A.M. Kneipp,In vitro Inhibition of Streptococcus mutans by Denture Adhesives :P&G • Rendell JK, Gay T. The effect of denture adhesive on mandibularmovement during chewing. JAm Dent Assoc. 2000 Jul;131(7):981-6. • Sabita Mram.Denture Adhesives:Theirpalce in clinical practice.JOFIndian Prosthodontic society.2002,Vol2,No.3:26-28 • www.ispcorp.com/products/oralcare/content/brochure/oral/ app • Kenneth Shay:Dental hygiene ;review and update.Journa of conteporary dental practice 2000,vol1,No2 • Skinnerand philips:dental material science,11th edition, 1998 • Kazazo_lu E1 ., Kulak Y 1 . and KadirT2 .An effect of mouth spray on denture microorganisms; An in vitro and www.indiandentalacademy.com
  48. 48. • NikawaH, Yamamoto T. Commercial denture cleansers--cleansing efficacy against Candidaalbicans biofilm and compatibility wit soft denture-lining materials. Int JProsthodont. 1995 Sep-Oct;8(5):434- 44. • NikawaH, HamadaT, A review of in vitro and in vivo methodsto evaluatetheefficacy of denture cleansers.Int JProsthodont. 1999 Mar-Apr;12(2):153- 9. • MooreTC, Smith DE, Kenny GE. Sanitization of denturesby several denturehygienemethods. J Prosthet Dent. 1984 Aug;52(2):158-63. www.indiandentalacademy.com