by: Dr.

Sarvesh s Patel

Denture cleansers:
A variety of products designed to safely remove stains, debris, and deposits from the surfaces of dental prostheses, by means of immersion or brushing with a denture brush and paste,

toothpaste, or powder.
.

Mosby's Dental Dictionary,.[internate]. 2nd ed.:Elsevie;2008;available from http://medical-dictionary.thefreedictionary.com/denture+cleanser

 Oral hygiene remains important Role of denture cleansers

Role of dentist

Requirement of ideal denture cleanser

Nontoxic and non irritant. Easy to remove and harmless . Able to dissolve all the denture deposits such as calculus. Exhibits a bactericidal and fungicidal effect. Long shelf life and inexpensive.

TYPES OF DENTURE CLEANSER

Mechanical
Brush Pastes and Powder Sonic

Chemical
Alkaline peroxide Alkaline hydrochloride Disinfecting agents

Miscellaneous
Use of silicone polymers. Overnight airdrying and microwave

Enzymes
Diluted acids

radiation
Reactive oxygen species

BRUSH
The most common method Technique is effective when used meticulously in removing

artificial discolorations and plaque. Wear on dentures:

Increases Increasing diameter of the bristles

Decreases

Increasing length of the bristles

Budtz-Jorgensen-Materials and methods for cleaning dentures. J Prosthet Dent 1979;42;6;619

No measurable differences between the hand brush and the electric tooth brush with respect to staining removal from the acrylic resin.

Aseel Mohammed, The effect of denture cleansers on the color stability, water sorption and water solubility of stained light cured acrylic denture base material, MDJ ,Vol.:4 No.:2 2007

PASTE AND POWDERS

Composition of the paste

Abrasive 10-40%,

Humectant 20-70%,
Water 5-30%, Binder 1-2%, Detergent 1-3%, Flavor 1-2%,

Preservative 0.05-0.5%
Therapeutic agent 0.1-0.5%.

 Increases the amount of wear on dentures.

Abrasive

Zirconium ---> superior Polymethylmethacrylate --->little Soluble sodium bicarbonate ---> less Insoluble calcium carbonate --->high

Budtz-jorgensen-materials and methods for cleaning dentures. J prosthet dent 1979;42;6;619

OTHER ROUTINLY AVAILABLE MATERIAL USED AS DENTURE CLEANSEAR

Dettol soap, Whitening tooth paste, Sodium bicarbonate powder, Ethanol hand sanitizer gel Siwak powder Salvadore Persica Tooth paste, siwak powder and sodium bicarbonate powder had a high stain removal effect consequently after ethanol.
Aseel Mohammed, The effect of denture cleansers on the color stability, water sorption and water solubility of stained light cured acrylic denture base material, MDJ ,Vol.:4 No.:2 2007

Ultrasonic units
Mechanism
Provides vibration that can be used to clean denatures.

It does not cause a significant reduction of the number of microorganisms that can be cultured from dentures.

 Use of disinfectant solutions in ultrasonic unit increases the disinfectants effectiveness .

Disadvantage: It may not adequately remove plaque on the denture surface. Use: In institutions, nursing homes and hospitals.

Chemical denture cleanser

Alkaline peroxide Alkaline hypochlorite Disinfecting agents Enzymes Diluted acids

ALKALINE PEROXIDE
Most commonly used denture cleanser. Available in powder or tablets form.

Chemical reaction:
Tablet or powder + water hydrogen peroxide + alkali

Mode of action:
Alkali (chemical reagents) decrease surface tension 2H2O2 (hydrogen peroxide) 2H2O + 2(O)(nascent oxygen) Nascent oxygen released has a mechanical effect on cleansing.

Budtz-jorgensen-materials and methods for cleaning dentures. J prosthet dent 1979;42;6;619

Chittaranjan B ,et al.Material and Methods for cleaning the Dentures.IJDA,, January-March;20113(1):423-6

Advantages:
Most effective on new plaque or stains. (If only denture is soaked in it for several hours or overnight)

Disadvantages:
Prolonged immersion and routine use of may cause bleaching of acrylic resin. Soft or resilient denture liners are very susceptible to the harmful effect of peroxide cleanser.

USE: Every alternate days over night immersion.

Mechanism:
Directly on the organic matirx of palque Disolution of polymer srtucture

Hypocloride

Hypochlorite does not dissolve calculus, but it may inhibit calculus formation on dentures by dissolving the plaque organic matrix.
Budtz-jorgensen-materials and methods for cleaning dentures. J prosthet dent 1979;42;6;619

Advantages :
Useful in remove stains and plaque. Dissolve mucin and other organic substances.

Bactericidal and fungicidal properties.

Disadvantage :
Tarnishing and corroding of metal denture components.
Hypochlorite solutions also bleach acrylic resins.

Use: once a week

Disinfecting agents
Chlorhexidine: Mechanism:

Budtz-jorgensen-materials and methods for cleaning dentures. J prosthet dent 1979;42;6;619

Advantages : Significant reduction in the amount of denture plaque Improvement in the denture-bearing mucosa in patients with denture stomatitis

Disadvantages: Severe staining. Brushing dentures with a 1% chlorhexidine gel

caused less severe staining.

Salicylate solution :
A 0.05% salicylate solution slightly less effective than a 0.2% solution of chlorhexidine gluconate in the treatment of denture stomatitis. Advantage: Solution does not stain the dentures.

Ethanol, isopropyl alcohol, formalin

Disinfection of dentures and to Use avoid contamination from the operatory to the dental laboratory and vice versa .

Disadvantages: Bad odor and taste and their bleaching and crazing effects

Enzyme (mutanese,protease,dextranase)
Available in water soluble tablets

Mechanism of action:
Enzymes
breakdown

Macromolecules of Glycoprotein, Mucoprotein & Mucopolysaccharides of plaque. A combination of proteinase and mutanase caused a significant reduction in the amount of denture plaque and reduce the formation of new plaque

Use :
Patients instructed to immerse the denture in freshly prepared solution 8h/day Most effective particularly when combined with mechanical brushing of the denture

Also effective in improving denture stomatitis.

Study on : Effectiveness of the enzymes dextranase, mutanase, and

proteinase on denture plaque deposits was studied.

The enzymes used in form of water-soluble tablets, both alone and in

various combinations. A combination of proteinase and mutanase caused a significant reduction in the amount of denture plaque and reduced the formation of new plaque. Palatal tissues in patients with denture stomatitis improved significantly No unwanted or harmful side effects reported
The effectiveness of an enzyme-containing denture cleanser, Quintessence lnt 1992; 23: 87-190

Diluted Acids
Contain: Citric acid, Isopropyl alcohol, Hydrochloric acid, or plain house hold vinegar

Diluted acids attack the inorganic phosphate portion of denture deposits, thus reducing calculus accumulation. Vinegar can also kill microorganism but less affective than bleaching solution.

Disadvantage:
Corrosion of metal components in dentures. Unpleasant test order. Care must be taken : damaging to fabrics and harmful to eyes and skin.

Miscellaneous
Use of silicone polymers.
Provide a protective coating , which interferes with bacterial adherence to the denture surface until their next application .

Overnight air-drying and microwave radiation Used to disinfect

and clean resin base , mostly in conjunction with mechanical brushing.

Reactive oxygen species : are chemically reactive molecules containing oxygen. Examples oxygen irons and peroxide. It is natural byproduct of the normal metabolism of oxygen.

Study on : Evaluation of denture base resin after disinfection method using reactive oxygen species (ROS). Material: polymethyl methacrylate denture base resin. Chemicals: 5% sodium hypochlorite, 70% alcohol, and ROS. The surface roughness and flexural strength were analyzed and the attachment of Candida albicans to the resin surface was investigated. Sodium hypochlorite : significantly increased the surface roughness and decreased flexural strength. ROS : did not significantly differ from those of the control specimens + specimens exhibited diminished Candida attachment. ROS disinfection method preserves acceptable material stability levels in polymethyl methacrylate resins.
Odagiri K ,et al. on:Evaluation of denture base resin after disinfection method using reactive oxygen species (ROS). Dent Mater J. 2012;31(3):443-8. Epub 2012 May 14.

SURFACE ROUGHNESS
EFFECT OF DIFFERENT DENTURE CLEANSERS ON SURFACE ROUGHNESS OF DENTURE BASE MATERIALS , by ar Ural, et all,in 2011
CHEMICAL Immersion Time 7 days (5 hours of soaking per day) Polident 0.003 m DENURE BASES Acrylic resin Chrome cobalt 0.002m

Corega Tabs
Fittydent

0.001 m
0.004 m

0.006m
0.002m

Efferdent Sodium hypocloride

0.001 m 0.012m

0.003 m 0.026 m

ar ural ,et al .effect of different denture cleansers on surface roughness of denture base materials,clinical dentistry and research 2011; 35(2): 14-20

Tensile strengh /Surface roughness /Hardness

Effect of a denture cleanser on hardness, roughness and tensile bond strength of denture liners. Material used : A self-curing reline acrylic resin (Kooliner) elastomeric liner (Elite Soft)

Chemical : sodium perborate

Tensile strengh Surface roughness in roughness of material both materials, no significant difference, no significant changes, denture cleanser solution did not affect the materials bond strength. but ComparingElite Soft presented a significantly lower roughness means than Kooliner.

Immersion Time 5min Hardness significant increase in the hardness & stiffness it is noticed throughout the 60-day period in both groups for both materials

Antnio de Luna,et al.Effect of a denture cleanser on hardness, roughness and tensile bond strength of denture liners ,Braz J Oral Sci. 7(26):1596-1601

Reason of surface roughness

The effervescent hygiene agents have a chemical and a mechanical cleaning action, resulting in the production of bubbles created by oxygen release during the reaction, which could increase the materials surface roughness.

A rough denture surface can lead to biofilm accumulation and colonization by candida albican which leads to denture induced

stomatitis

Name of article And Author .

Author & source of article

Material use :

Effect of denture
cleansers on chemical and mechanical behavior of selected soft lining materials.

Rafa Brozek, Soft denture linears et al. Acrylics :Vertex Soft and Villacryl Soft. dental materials 2 7 ( 2 silicone : Molloplast B and Mollosil, 0 1 1 ) 281290 Chemicals:
2% aqueous chlorhexidine gluconate, 2% aqueous sodium hypochlorite, Corega Tabs cleansing tablets

3% aqueous hydrogen peroxide;

to artificial saliva.

Time period : Immersion for 16h a day and dry at room temperature for the next 8h each day.

Conclusion :
Practical denture cleansing agents affect the properties of soft lining materials. It reducing their elastomeric character, acrylics being more adversely affected than the silicones. These changes are associated with the loss of various chemicals, including plasticizers and monomers, from the

soft lining materials.

Kazanji M N,et al. in 2004 conducted study on Evaluation of the effect of some denture cleansers on the colour of acrylic resin denture base materials. Time period: 7 days
chemicals 0.5% sodium hypochlorite 3% hydrogen peroxide Heat cure acrylic resin visual significant changes (long tearm use ) visual significant changes (long tearm use ) Self cure acrylic resin visual significant changes visual significant changes

6% vinegar 5% hydrochloric acid

0.2% chlorhexidine gluconate 0.05% glutaraldehyde 0.5% povidone iodine tap water

No visual significant changes No visual significant changes

No visual significant changes No visual significant changes No visual significant changes No visual significant changes

visual significant changes visual significant changes

visual significant changes visual significant changes visual significant changes visual significant changes

Kazanji M N,et al. Evaluation of the effect of some denture cleansers on the colour of acrylic resin denture base materials. AlRafidain Dent J Vol. 4, No. 2, 2004

Reason of loss of color changes :

Strong oxidizing property of Hydrogen peroxide solution and Sodium hypochlorite

Liberated oxygen caused oxidation of the tertiary amine accelerator or the unreacted double bonds that are

presented in the resin matrix .

Conclusions and recommendations:

Mechanical cleaning is an effective means of improving denture cleanliness and maintaining a healthy mucosa beneath removable

dentures.
There is no experimental evidence that brushing with a tooth paste is more efficient than using soap.

To avoid excessive wear, a paste with a low abrasiveness

(polymethyl methacrylate or sodium bicarbonate) and a relatively soft denture brush or tooth brush should be recommended.

 Efficient chemical denture cleanser might be important alternative to

mechanical cleansing especially among geriatric or handicapped

denture wearers.

Alkaline peroxide solution :Every alternate days overnight

immersion Hypochlorite cleansers are effective with overnight immersion: once a week. Dilute acids such as acetic acid : only at weekly or biweekly

intervals because they are corrosive.

 In the case of denture stomatitis :

0.2% Chlorhexidine gluconate , 1% chlorhexidine gel,

0.1% solution of sodium salicylate (without causing staining),

Enzymes.

THANK YOU