77
DENTURE CLEANSER & DENTURE ADHESIVE BY, R.VENKATESHWARAN

denture adheives

  • Upload
    -

  • View
    186

  • Download
    17

Embed Size (px)

DESCRIPTION

adhesives

Citation preview

Page 1: denture adheives

DENTURE CLEANSER & DENTURE ADHESIVE

BY,R.VENKATESHWARAN

Page 2: denture adheives

Contents:IntroductionRequirementsClassificationComposition Mode of actionSpecial scenarioDenture maintenanceConclusionReference

Page 3: denture adheives

Introduction:

The purpose of using denture adhesives.

Improved fitComfort Improved chewing ability and confidence.

Page 4: denture adheives

Requirements: Neutral or slightly basic pHMinimal toxicity to the oral mucosaAdhesive bond strength for 12 to 16 hoursEasier to clean off oral tissuesEasier to clean off dentureLess messyMore readily available in shopsLess expensiveBetter taste and fit

Page 5: denture adheives

Classification:Based on components: Natural gum - Karaya gum. Synthetic gum - Grantez polymer.Based on duration of action: Long acting - Poly vinyl methyl ether maleate Short acting – carboxy methyl celluloseBased on forms: Paste. Powder.

Page 6: denture adheives

Composition: Components Action

Poly vinyl methyl ether maleate,

Karaya gum, Methyl cellulose, Hydroxy methyl cellulose,Carboxy methyl cellulose

sodium.

Swell and are responsible for adhesive properties.

Sodium borate, Sodium tetra borate, Hexa chlorophene.

Antimicrobial agent

Page 7: denture adheives

Propythy-hydroxy benzoate Preservative and anti fungal

Sodium lauryl sulfate Wetting agent

Magnesium oxide Filler

Silicon-di-oxide, calcium stearate

To minimize clumping

Petrolatum, mineral oil, poly ethylene oxide

Binder

Menthol, Pepper mint oil & oil of winter green

Flavoring agent

Page 8: denture adheives

Mode of action:Swell to obliterate the space between the base of denture and the oral mucosa.

Influence:Increase the coefficient of surface tension of the fluidForms a viscous gel on contact with waterIncreases cohesiveness of the film of saliva by increasing viscosity of the film.

Page 9: denture adheives

Before applying adhesive After applying adhesive

Viscous gel

Page 10: denture adheives

Indications: Patient’s perceived retention and

stability expectations Salivary dysfunction or neurological

disorders Xerostomia due to medication side

effects Head and neck irradiation Systemic disease or disease of salivary

gland Cerebro-vascular accident (stroke)

Page 11: denture adheives

Contraindication:

For the retention of improperly fabricated denture or poorly fitting prostheses

Page 12: denture adheives

Toothpaste as denture adhesive:

Poor retention of complete denture

trial bases can interfere with jaw

relation record-making and clinical

evaluation of tooth arrangement.

Page 13: denture adheives

? Not a denture adhesive Difficult to remove from the bases

and the patient's mouth,

Potentially spread infectious material or lead to contamination of dental casts, which may result in the adhesive being incorporated into the final denture base.

Page 14: denture adheives

? To a tooth paste Toothpastes are similar in viscosity to

denture adhesive pastes Toothpaste placed in denture bases,

as if it were an adhesive, forms a seal that will provide a temporary improvement in retention

Provide the opportunity to make inter-occlussal records or evaluate phonetics and esthetics of trial tooth arrangements

Page 15: denture adheives

Advantage:

Pleasant taste and are water soluble, permits easy cleaning

Risk of adhesive contamination is reduced

Cost is not a factor

Page 16: denture adheives

Disadvantage

Mandibular dentures lined with

toothpaste are not as retentive as

maxillary dentures, so an adhesive

might still be the material of choice.

Page 17: denture adheives

Direction for use: Choice between cream and powder is

largely subjective for individual

Least amount of material that is used

should be 0.5-1.5g / denture unit (more for

larger alveolar ridge, less for small ones)

Prosthesis should be moistened and then a

thin adhesive sprayed onto denture surface

Page 18: denture adheives

Paste form: Comes in a tube and is squeezed onto the impression surface of the dentureDenture paste is probably the most preferred type of adhesive Paste also comes in a variety of flavors and strengths

Page 19: denture adheives

Method to use paste form:Two approaches to apply paste form:

Thin beadsSmall spots

Page 20: denture adheives

Thin bead technique: On maxilla: Beads of adhesive placed in

the Depth of dried denture in

incisor region and molar regions.

An anteroposterior bead along mid palate.

On mandible: Apply three small lines

into the into impression surface of denture.

Page 21: denture adheives

Spot technique:

Small spots of cream are placed at 5-mm intervals throughout the fitting surface of dried denture uniformly in both maxilla and mandible.

Page 22: denture adheives

Powder form:

Powders are sprinkled over the impression surface of denture.

The saliva in mouth, it activates the powder into sticky viscous gel holding denture in position.

Page 23: denture adheives

Inadequate or absent saliva, the denture should be slightly moistened with water before being inserted.

Easier to clean off the tissue surface after the dentures are removed.

Page 24: denture adheives

Powder form Vs Paste form

Powder formulation Paste formulation

Degree of hold is less.

Duration of action is short.

Can be used in smaller quantities.

Easy to clean of denture and tissue.

Initial hold is achieved soon.

Degree of hold is high Duration of action is

long. Requires more

material. Difficult to clean of

denture and tissue. Initial hold is achieved

comparatively late.

Page 25: denture adheives

Denture maintenance Daily removal of adhesive product from

tissue surface Prosthesis soaked in water over night, so

readily rinsed off. Running hot water over tissue surface of

denture while scrubbing with a hard toothbrush.

Adhesive on ridge is removed by rinsing with warm or hot water and then firmly wiping the area with gauze or a washcloth saturated with hot water .

Page 26: denture adheives

References:Books: Prosthodontic treatment for edentulous

patients Zarb, bolender.  Applied dental materials-John.F.McCabe  Anusavice, Phillip’s science of dental

materials – Tenth edition  Craig 12th edition – restorative dental

materials  Dental materials properties and selection –

William j.o’brein  Clinical dental materials – Michael bagby

Page 27: denture adheives

Journals: Denture adhesive: cyto-toxicity, microbial

contamination and formaldehyde content; Journal of prosthetic dentistry; vol:69 issue :3; 314-317;1983.

Effect of denture adhesive on maxillary denture stability; Journal of prosthetic dentistry; vol:72; 399-405;1994.

A method of studying the effect of adhesives on denture retention. Journal of prosthetic dentistry; vol:50; issue :3;332-337;1983.

Page 28: denture adheives

Laboratory evaluation of a new denture adhesive; Journal of Dental Materials; vol: 20; 419–424; 2004.Tooth paste used as short acting denture adhesive; Journal of prosthetic dentistry; vol:74; 119. 1995.Usage of denture adhesives; Journal of Dentistry; vol:28; 137–140;2000.g

Page 29: denture adheives

Conclusion

A useful adjunct in denture prosthesis services, with specific roles in both fabrication and post insertion phases.

They also indicated that the dual goals of maximizing the beneficial aspects of denture adhesive use while minimizing the misuse of denture adhesives be achieved.

Page 30: denture adheives

DENTURE CLEANSER

Page 31: denture adheives

Contents:

Introduction Composition Types Denture debris Advances Conclusion

Page 32: denture adheives

Introduction

Growth in the aging population has resulted in an increasing number of older persons requiring dentures. 

Proper cleansing of dentures is an essential daily routine in order to ensure the safety and satisfaction of the edentulous patient.

To maintain an esthetic, odor-free appliance.

Page 33: denture adheives

Denture debris

Every surface in the oral cavity, natural or synthetic, becomes covered within about 30 minutes with a 0.5-1.5 µ-thick precipitate of salivary glycoprotein and immunoglobulin that is termed "pellicle”.

Page 34: denture adheives

Calculus is also readily stained by tobacco, tea, coffee, certain medications (particularly iron supplements), and numerous other ingested materials.

Page 35: denture adheives

Composition

Alkaline perborate -compounds for oxidizing,

Perborate and/or carbonate -effervescing,

Edta -chelating, Silicone polymer, Detergent, Color, and fragrance agents.

Page 36: denture adheives

Types:

Mechanical method. Chemical method. Combination method. Ultrasonic cleanser.

Page 37: denture adheives

Mechanical method

use of a brush in the presence of either hot or cold water

Toothbrushes and nailbrushes are also effective in removing gross material. 

Page 38: denture adheives

Place paper towel or wash cloth in sink to prevent breakage if

droppedClean under cool water

to prevent warpingScrub all areas with

denture brush

Page 39: denture adheives

Denture Brushes

Should have pointed side

Should be discarded or sterilized following illness or infection

Replaced when frayed or dirty

Page 40: denture adheives

Boxes

Cleaned weekly Sterilized

following illness or infection or replace

Page 41: denture adheives

Disadvantage:

Microbiologic assays and scanning electron microscopic images demonstrate that use of a denture brush with water is ineffective at removing an unacceptably large proportion of adherent microorganisms.

Page 42: denture adheives

Chemical methods:

Most chemical means of disinfection is accomplished through exposure of the organisms to oxygen tension levels greater than oxygen tension levels in the mouth. 

2H2O2 2H2O + 2[O]

(nascent oxygen)

Page 43: denture adheives

Advantage:

Are potentially an effective for the control of common oral bacteria.

Significant reductions of microbial populations were achieved without the mechanical disruptive action of brushing in as little as 90 seconds.

Level of antimicrobial efficacy was comparable for a diverse range of microbes.

Page 44: denture adheives

Disadvantage

The color stability of denture base

acrylic resins was influenced.

The presence of bleach is that metallic

elements of removable partial

dentures acquire a tenacious black

stain after soaking in the bleach

solution for more than 10 minutes daily.

Page 45: denture adheives

Effervescent cleansing tablet Ingredient Function25–40% DuPont Oxone10–20% Sodiumperboratemonohydrate (SPBMH)

Primary bleaching agent, effective atroom temperature and at pH 6–10.

Secondary bleaching agent

10–20% Sodium bicarbonate

Buffer and carbonate source for effervescence

10–15% Sodium carbonate

Buffer and carbonate source for effervescence

10–15% Citric acid Acid source for CO2 effervescence

Page 46: denture adheives

1–3% Polyvinylpyrrolidone

Binder

1% Detergent Emulsifier

1% EDTA Chelant and detergency builder

1–2% Sodium benzoate

Preservative

0.5% Flavor Fragrance

0.1–0.3% Magnesium stearate

Mold release agent

0.1% Color

Sodium sulfate Filler

Page 47: denture adheives

Ultra sonic denture cleanser Sonic Denture Cleaner is an

effective and simple way to clean dentures

The Sonic Denture Cleanser effectively removes discolouration caused by coffee, tea, red wine and tobacco.

It also removes lingering food odours, such as smells of onions and garlic.

Page 48: denture adheives

Mode of action The Sonic Denture Cleaner is

integrated with UV sterilization and nano silver bacteriostasis.

It utilizes the latest electronic technology and does not require any consumables or special cleaning fluids.

The inner compartment becomes nano silver mixture holder as soon as you fill it with cold tap water.

Page 49: denture adheives

Sonic waves vibrate 8000 times per minute, removing tartar and food debris lodged between individual denture teeth and around the gum plates.

The sterilizing UV light and the bacteriostatic action of the nano-silver destroy bacteria. Stains are removed and your dentures are fresh, clean and bright again!

Page 50: denture adheives

Vinegar as an anti-microbial agent Candida albicans strains are associated

with denture-induced stomatitis. Dentures immersed in a 10% vinegar

solution (pH less than 3) overnight. A significant reduction was verified in

counts of Candida after treatment. Reduced amounts of Candida spp. in

the saliva and the presence of denture stomatitis in the patients.

Page 51: denture adheives

Nystatin anti-fungal suspension

A useful adjunct in the management of denture stomatitis. 

Banting and colleagues found that a 10% dilution of 1:100,000 suspension of nystatin was no more effective than distilled water in reducing organisms on the denture surface.

Page 52: denture adheives

Air drying Not a widespread acceptance denture

cleaning technique for two reasons. Drying an unclean denture will make the

adherent material stick ever more tightly even as it fails to remove microbial surface antigens and exotoxins. 

Dentists have historically been told that air drying an acrylic denture will distort its contours. 

Page 53: denture adheives

Danger in denture cleanser Symptoms of an allergic reaction Irritation Tissue damage, Rash, Hives, Gum tenderness, Breathing problems, and Low blood pressure.

Page 54: denture adheives

Misuse of denture cleansers

Some cleansers may list mouthwash as an ingredient, but consumers should never chew, swallow, or gargle with denture cleansers.

Dentures should be thoroughly rinsed with water before they are placed in the mouth.

Page 55: denture adheives

Advances Silicone Polymer A component of commercial denture

cleanser,silicone polymer to which oral bacteria are unable to adhere.

The component floats on the surface of the denture bath, and when the denture is removed from the solution, a thin layer (constituting 0.1-0.8 mg) of the material coats all surfaces of the prosthesis. 

Page 56: denture adheives

Microwave radiation They found the method to be

effective at significantly reducing the number of cultivable organisms on the dentures, but non-viable organisms and their by-products still present after exposure to the radiation will still able to elicit an unwanted host response. 

Page 57: denture adheives

Conclusion Dental professionals must have a

current knowledge of denture cleansing strategies in order to maximize the service offered to denture patients.

Care and cleaning of dentures is more than a strictly esthetic concern

Page 58: denture adheives

References:

Books: Anusavice-Phillip’s science of dental

materials(tenth edition) Craig 12th edition-Restorative dental

materials Michael bagby-Clinical dental materials William J. o’brein-Dental materials

properties and selection

Page 59: denture adheives

Journals: "Allergic Contact Cheilitis Due to

Effervescent Dental Cleanser: Combined Responsibilities of the Allergen Persulfate and Prosthesis Porosity," Conracr Dennariris. 41(5):268-271, November 1999.

The attitude of complete denture wearers towards denture adhesives in Istanbul; Journal of Oral Rehabilitation vol 31; 131–134 2004

Page 60: denture adheives

The Evaluation of Denture Retention and Ease of Removal from Oral Mucosa on a New Gel-Type Denture Adhesive; J Jpn Prosthodont Soc 52 : 175-182, 2008

Vinegar As An Antimicrobial Agent For Control Of Candida spp. in complete denture wearers; J Appl Oral Sci. 2008;16(6):385-90

A Clinical Study to Assess the Breath Protection Efficacy of Denture Adhesive The Journal of Contemporary Dental Practice, Volume 3, No. 4, November 15, 2002

Page 61: denture adheives

DENTUR ADHESIVE Journal References

BY,R.VENKATESHWARAN

Page 62: denture adheives

Effect of denture adhesive on the retention and stability of maxillary dentures. JPD 1994, Vol:74,Issue:4.Joseph.E.Grasso

This study to measure effectiveness of denture

adhesive.It used qualitative method to measure the

effects of a denture adhesive on retention and stability

of maxillary denture.

Improvement of retention was greatest for vertical

dimension because ridge serve as a physical

boundary, limiting movement in

anterior/posterior/lateral movements.

Page 63: denture adheives

Cont…

Maximum adhesive property was seen at 2-4hours

after application.

Use of adhesive reduced minor denture movements to

0.9-1.3mm in vertical dimension and 0.2-0.5mm in

anterior/posterior/lateral dimension for both type of

dentures.

Increase in incisal bite force from 20-35N at base line

to a maximum of 54N at 8 hours after application.

Page 64: denture adheives

Use of denture axdhesive as an aid to denture treatment.JPD 1994,Vol.62

History of denture adhesive :

Began only in age of modern dentistry, no reference

available in text till late 18th century.

Adhesive used in the beginning of 19th century.

First patent was issued in 1913.

First ADA reference came from accepted dental remedies

in 1935.

Allwrith found first non water soluble adhesive

Page 65: denture adheives

Cont..

Initially adhesive were formulated by an apothecary who mixed vegetable gums to produce a material that absorbed moisture from saliva and swelled to mucilaginous substrate that adhered to mucosa and denture

Page 66: denture adheives

Denture adhesives and uses, JADA 1996, Vol:127

In 1945 adhesive were used only to hold base plate

while “recording dental relation”.

In immediate denture construction until well fitting

denture were completed.

Page 67: denture adheives

Denture adhesive: Choosing the right powder, JADA 1991,Vol 122

Shay described that the material swells 50%-150%

by volume in presence of water filling in space

between prosthesis and tissue. As water is absorbed

by adhesive agent, the resulting anions are attracted

to cations in mucous membrane protein producing

stickiness.

Page 68: denture adheives

Cont.. The physical forces are based on a principle

derived by Stefan over a century ago, which states force required to pull two discs or plates apart is directly proportional to viscosity of liquid between them.

Saliva increases viscosity there by increasing the force required to separate prosthesis from oral mucous.

Modern adhesive have increased adhesive property by increase bio adhesive and cohesive forces.

Page 69: denture adheives

Mechanism of action Most adhesive ingredient provide bio adhesion via carboxyl

group.

As adhesive hydrates free carboxyl group from electrovalent

bond that produce stickiness.

Poly methyl vinyl ether maleic anhydride is a co polymer

synthetic compound widely used because of its high level of

carboxyl group.

As most of oral cavity is of anionic charge it readily adheres

with calcium cation formed by adhesive.

Page 70: denture adheives

Cont.. In 1970’s divalent salts of PVM-MA in addition

with carboxyl methyl cellulose (CMC). There is a quick upfront hold through CMC and

long duration through PVM-MA divalent salt. The presence of divalent salt reduced rate of

dissolution. Increased overall material by developing a highly

cross linked matrix between CMC,PVM-MA copolymer and divalent calcium ion.

Page 71: denture adheives

Relation to oral prosthesis

In 1940-Bartel’s-Adhesive did not inhibit presence

of micro organism.

In 1950-Kelly’s-Did not support bacterial growth.

In 1970-Stafford and Russell-adhesive supported

some microbial growth (candida abicans). But

were unable to demonstrate that adhesive have

inhibitory effect on oral mucosa.

Page 72: denture adheives

Cont..

Abdelmelak and Michael- Alter histology of oral mucosa during the period adhesive got adapted to adhesive. There was a marked decrease in surface keratin.

In 1980-Tarbet,Grossman-No incidence of mucosal irritation.

Shay quoted that “Misled by biased product information, misinformed by anecdotal reports or totally uninformed denture adhesive.

Page 73: denture adheives

Professional attitude towards denture adhesive, JPD,Vol:82,Issue:1. Many of dentist does not consider denture adhesive

as an useful adjunct to complete denture. Instead they considered use of denture adhesive as

a stigma in their practice and it also had some physcological effects on patients that denture is ill fitting.

It was considered that denture adhesive can have negative influence on both denture and dentist by masking underlying denture problems, avoiding necessary dental visit.

Page 74: denture adheives

Cont..

Can also contribute to occurrence of candida

albicans causing candidiasis and denture

stomatitis.

Page 75: denture adheives

JPD 1989,Vol:69,Issue:3

Microbial contamination was more pronounced

with use of natural gum raw materials.

Denture adhesive containing karaya gum may

worsen any pre-disposition to caries.

Page 76: denture adheives

IJPD 2005, Volume:14, Issue:2

Use of denture adhesive significantly increased

the BFDD (maximum bite force until denture

dislodgement)

Page 77: denture adheives

Adhesives for maxillo facial prosthesis, JPD 2002,Volume:88, Issue 5

Denture adhesive paste can also be used to retain

an extra oral facial prosthesis wax pattern for trial

placement.

Because holding pattern with hand may disrupt in

assessing the angulations and placement and

assessment of prosthetic success.

Is used for temporary retention of prosthesis.