RESUMEN

BACKGROUND: Denture-related erythematous stomatitis (DES) is a chronic biofilm-mediated disease, affecting one in every three complete denture wearers. Antifungals are the treatment most commonly prescribed by oral health professionals, based on the belief that colonization by Candida spp. is the main cause of DES. However, high recurrence rates and adverse effects are commonly observed, prompting the need for practice guidelines regarding treatment. Results from our pilot study demonstrate that palatal brushing can reduce the palatal inflammation and potentially associated Candida carriage without any need for antifungal therapy. The objective of this study is to validate these pilot results by means of a randomized controlled trial (RCT) and provide a practice guideline for clinicians. METHODS/DESIGN: A pragmatic, two-parallel-arm, multicenter RCT will be conducted in Canada, Brazil, and Chile. Fifty-two adult complete denture wearers presenting with moderate to severe DES will be allocated randomly to two groups: the Intervention arm will consist of palatal brushing and standard oral and denture hygiene measures, while the Control arm will include only standard oral and denture hygiene measures. The study outcome will be the oral Candida carriage. Participants will be assessed at baseline, and at 3 and 6 months post intervention. Descriptive, bivariate, and mixed models with repeated measures will be performed following the intention-to-treat principle. DISCUSSION: This pragmatic RCT will serve to provide a clinical practice guideline regarding the use of preventive measures in the treatment of biofilm-mediated oral diseases. Moreover, it will have a great impact on reducing the harm of antifungal overtreatment on patients suffering from DES. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02686632 . Registered on 15 February 2016.

Asunto(s)

Antifúngicos/uso terapéutico , Biopelículas/efectos de los fármacos , Candidiasis Bucal/tratamiento farmacológico , Dentadura Completa/efectos adversos , Estomatitis Subprotética/tratamiento farmacológico , Biopelículas/crecimiento & desarrollo , Brasil , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/microbiología , Chile , Protocolos Clínicos , Dentadura Completa/microbiología , Adhesión a Directriz , Humanos , Análisis de Intención de Tratar , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Quebec , Recurrencia , Proyectos de Investigación , Método Simple Ciego , Estomatitis Subprotética/diagnóstico , Estomatitis Subprotética/microbiología , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

This study evaluated the influence of methacrylic acid (MA) incorporation on hardness, roughness, and flexural strength of a denture base acrylic resin. Thirty-two circular and 40 rectangular specimens were divided into four groups, according to the concentration of MA substituted into the monomer component of a heat-polymerized acrylic resin, as follows: 0% (Control), 10%, 20% and 50% (v/v). The following properties were assessed: Vickers hardness, surface roughness, and flexural strength. Variables were analyzed by ANOVA/Tukey’s test (α=.05). For the four incorporated MA concentrations (0%, 10%, 20% and 50%), the following results were obtained for hardness (19.0±1.4A, 19.6±1.3A, 19.6±0.9A, 14.2±0.6B VHN), surface roughness (0.26±0.05A, 0.17±0.01AB, 0.18±0.03AB, 0.13±0.03B μm) and flexural strengh (96.3±8.3A, 98.8±6.2A, 102.4±8.6A, 106.3±13.7A MPa). The incorporation of MA may cause slight changes in the structure of the tested material, as evidenced by the hardness test. However, the values for surface roughness reduced as MA concentration increased, suggesting that MA addition may improve the acrylic resin texture.

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Este estudo avaliou a influência da incorporação do ácido metacrílico (AM) sobre a dureza, rugosidade e resistência flexural de uma resina acrílica para base de próteses removíveis. Trinta e dois espécimes circulares e 40 retangulares foram divididos em quatro grupos, conforme a concentração de AM substituído no componente monomérico de uma resina acrílica termopolimerizável: 0% (Controle), 10%, 20% e 50% (v/v). As seguintes propriedades foram avaliadas: dureza Vickers, rugosidade superficial e resistência flexural. As variáveis foram analisadas por meio de ANOVA seguida pelo teste de Tukey (α=0,05). Para as concentrações de AM incorporadas (0%, 10%, 20% e 50%), os seguintes resultados foram obtidos para a dureza (19,0±1,4A, 19,6±1,3A, 19,6±0,9A, 14,2±0,6B VHN), rugosidade superficial (0,26±0,05A, 0,17±0,01AB, 0,18±0,03AB, 0,13±0,03B μm) e resistência flexural (96,3±8,3A, 98,8±6,2A, 102,4±8,6A, 106,3±13,7A MPa). A incorporação do AM pode causar mudanças discretas nas propriedades estruturais do material testado, como evidenciado pelo teste de dureza. No entanto, os valores de rugosidade diminuíram em proporção ao acréscimo de AM, sugerindo que essa incorporação pode melhorar a textura da resina acrílica para base protética.