Denture cleansing: a comparison of two methods. Sanitization of dentures by several denture hygiene methods. Clinical and microbiologic effects of chemical versus mechanical cleansing in professional supportive implant therapy. Comparison of two popular methods for removal and killing of bacteria from dentures. Assessment of plaque prevention on dentures using an experimental cleanser. Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures. A 3-months' study of enzymes as denture cleansers. Mechanical devices versus antimicrobial rinses in plaque and gingivitis reduction. Effect of monthly professional mechanical tooth cleaning on periodontal health in adults.
A paste brushing method (Complete) and soaking in either of two denture cleanser tablet solutions (Efferdent or Polident) were compared for denture cleansing effectiveness as measured by plaque level. The 12-week product use period with weekly evaluations allowed an assessment of plaque reaccumulation on the denture surface as well as the effect of a single cleansing event and the contribution of bleaching to the total plaque-cleansing activity. The paste/brushing method was consistently the more effective procedure for removal of denture plaque. However, the bleaching effects of the effervescent tablets could be useful in an overall denture hygiene program. Denture sanitization is an important element in the treatment of denture stomatitis and should be emphasized in instructions to patients. A two-part study was designed to compare the efficacy of eight denture-cleaning methods in removing and/or killing aerobes, anaerobes, and yeasts on dentures. Part I tested the effectiveness of the cleaners on a pure yeast culture of C. albicans. Part II tested the various denture sanitization techniques under actual clinical conditions. The following conclusions were made from the information obtained in this study: Miller's and Kleenite were the most effective sanitizing agents. Brushing the denture with soap and water and soaking the denture in the cleaner Mersene were effective to a lesser degree. Although Clorox and Calgon was effective at killing yeast under in vitro conditions, it was not effective under clinical conditions. The other denture cleaners were not found to be effective under the clinical conditions of this study for the removal and/or killing of any of the three microorganism groups cultured. In the past, the function of denture cleaners has been to remove deposits and stains from dentures. With the present knowledge of the role of microorganisms in the etiology of denture stomatitis, more emphasis should be placed on the ability of denture cleaners to sanitize dentures. The aim of the present study was to compare the cleansing properties of mechanical supportive care for dental implants with the use of an etching gel. Sixteen patients underwent a 5-month clinical trial with monthly recalls. These patients, wearing maxillary complete dentures and mandibular overdentures supported by a bar device on 4 implants, were treated in a split-mouth study design. Test and control therapy were randomly assigned to left and right sides of the mandible. At the test side, 35% phosphoric etching gel (pH 1) was applied in the peri-implant sulcus. After 1 minute, the sulcus was thoroughly rinsed with a water spray for approximately 15 seconds per implants. Control therapy consisted of supra- and subgingival debridement using carbon fiber curettes and a rubber cup. Plaque, calculus, probing pocket depth, and modified Gingival Index were determined before each treatment. Microbiologic evaluation was performed at baseline, 1 month later, and 5 months later, just before and immediately after each treatment. Per treatment and per assessment, the mean scores of all clinical parameters were calculated for each patient. The number of colony-forming units was used as the primary efficacy variable in the analysis of microbiologic data. At baseline, no differences between test and control sites were observed for any of the clinical parameters. The mean Gingival Index and the mean probing pocket depth were reduced over the 5-month period. The mean reduction in Gingival Index at the test sites proved to be significantly larger at the control sites (P = .03). Both treatment modalities resulted in an instant reduction of the number of colony-forming units, where the reduction by chemical cleaning was larger (P < .05). This short-term study employing a high recall frequency indicates that local application of 35% phosphoric acid gel can be as effective as conventional mechanical supportive therapy. A study was undertaken to compare the efficacy of a soaking solution (Efferdent Extra-Strength Denture Cleanser Tablets) to mechanical cleaning with a denture paste (Advanced Formula Dentu-Creme Denture Cleaning Paste) to remove and kill plaque bacteria from removable dentures. The study was conducted in a randomized, four-way crossover fashion with 18 subjects. At each clinic visit, subjects were randomized to one of four treatment regimens: 1) no treatment; 2) brushing with denture paste; 3) soaking in Efferdent; 4) brushing followed by soaking in Efferdent. Microbiological sampling for plaque bacteria was made before and after each treatment. Aliquot samples of 10-fold serial dilutions were plated on supplemented Schaedler Agar (for total anaerobes) and on CVE agar (for fusobacteria). Analysis of covariance was performed on the log10 transformed scores at posttreatment using the pre-treatment scores as covariates. Significant treatment effects were: F(3,41) = 81.60, p less than 0.001 for anaerobes and F(3,50) = 104.38, p less than 0.001 for fusobacteria. Pairwise comparisons using Tukey hsd post hoc tests showed that for total anaerobes, treatments 1 and 2 yielded higher scores than treatments 3 and 4. For fusobacteria, treatment 1 greater than 2 greater than 3 or 4; no difference between treatments 3 and 4. The results demonstrated the superior performance of Efferdent over Dentu-Creme. Adequate plaque control is essential for the maintenance of a healthy oral mucosa. Denture cleansers are a popular method used by denture wearers for cleaning. The clinical effectiveness of a new cleanser in tablet form has not been tested in vivo. Methods used for the in vivo assessment of denture cleanser effectiveness are often not standardized.
                The aims of this in vivo study were to develop a new method for assessing plaque levels on dentures by using digital imaging and to use this methodology, together with a validated visual scoring method, to evaluate plaque buildup on dentures.
                Thirty-five subjects were randomized to 1 of 2 treatment groups: (1) dentures soaked in a new cleanser, or (2) dentures soaked in water. The treatment period lasted 14 days. Plaque was assessed at baseline and on days 2 and 14 by using digital image analysis and a visual scoring technique. Results were analyzed with ANOVA at the 95% confidence interval.
                The new cleanser showed a statistically significant reduction in mean visual plaque of 51% at day 2 (P = 0.0002) and 42% (P = 0.0014) at day 14 compared with water. Similar results were seen with digital imaging.
                The new denture cleanser proved to be effective at preventing plaque accumulation on dentures. The analysis of digital images gave similar results as the visual scoring method. The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral-B Plaque Remover 3-D) and a manual soft toothbrush (Oral-B Squish-grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures.
                The study sample involved 40 edentulous subjects, aged 55-80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single-blinded, randomised, cross-over clinical trial, two 6-week experimental phases were separated by a 2-week wash-out period. 2 weeks prior to each experimental phase (pre-entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t-test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann-Whitney U-test. Combined data from 2 different implant systems were considered after controlling for implant type.
                Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes.
                Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri-implant bleeding and plaque indices. It was the purpose of the study to test the efficacy of dissolvent tablets containing mutanase and protease in removing denture plaque. The study group consisted of forty institutionalized geriatric denture wearers, who were assigned randomly into an enzyme group and a placebo group. Enzyme tablets and placebo for denture soaking were administered by the nurses. The dentures were immersed for 15 min once daily for three months. The amount of denture plaque, the clinical condition of the palatal mucosa, and the concentration of yeasts and bacteria in mucosal and denture smears were recorded before, during, and after the experimental period. The study was designed and carried out as a double-blind study. After denture soaking for six weeks a significant reduction of the amount of denture plaque and improvement of the clinical condition of the palatal mucosa was recorded. After denture soaking for twelve weeks the conditions had improved further when comparing the enzyme group with the placebo group. The effectiveness of mechanical oral cleaning and oral antimicrobial rinses was compared for gingivitis and bacterial plaque control in 158 subjects. Teeth were brushed ad lib throughout; four of the five groups used either an interdental cleaner, dental floss, an essential oil mouthwash or a cetypyridinium mouthwash. Gingival bleeding (EIBI), visual inflammation (VGI), and tooth plaque coverage were evaluated at zero, six and 12 weeks of product use. After six weeks, bleeding reduction was 42% greater for the interdental cleaner and 21% greater for the dental floss than for the control. All groups showed a further decrease after 12 weeks, but only the 49% reduction of the interdental cleaner was significantly greater than the control. The rinses showed no more reduction in bleeding sites than the control throughout the study. VGI scores were no different from the control for any of the groups. However, the EIBI proved much more sensitive than the visual method finding three times as many inflamed sites. Plaque was reduced by both antimicrobial rinses 27% more than the control over 12 weeks; the interdental cleaner and dental floss groups showed no significant incremental plaque reductions. The results suggest antimicrobial rinses reduce plaque on visible tooth surfaces, but do not penetrate sufficiently between teeth to affect interdental plaque and thus interdental inflammation. However, by disturbing interdental plaque, both dental floss and the interdental cleaner have little effect on visible tooth surface plaque accumulation, yet produce a significant reduction in gingival inflammation. The beneficial effects of comprehensive dental prophylaxis programs are well recognized. In order to study the factors determining the effectiveness of these programs, 28 periodontal recall patients were subjected to monthly professional mechanical tooth cleanings. Experimental and control teeth were randomly selected according to a splitmouth cross-over method. The Plaque and Gingival indices were recorded 1 month prior to the study, at the start, and at 4, 8, and 12 months. One month prior to the study calculus and bacterial plaque were thoroughly removed from all teeth. During the study period only the experimental teeth were cleaned. Efforts were made not to influence the oral hygiene of the participants by any other means. Following the initial tooth cleaning and during the preexperimental period the Plaque and Gingival indices decreased to a low level on both the experimental and control teeth (mean P1I = 0.4, mean GI = 0.3). This high standard of oral hygiene and gingival health was maintained throughout the study period, and no differences could be observed between experimental and control teeth. This indicates that factors other than the mechanical professional cleaning were responsible for the maintenance of gingival health. It is suggested that participation in the program in itself may have motivated the patients to improve their oral home care.
There is a lack of evidence about the comparative effectiveness of the different denture cleaning methods considered in this review. Few well designed RCTs were found. Future research should focus on comparisons between mechanical and chemical methods; the assessment of the association of methods, primary variables and costs should also receive future attention.